Nutritional assessment of asylum seekers children in The Netherlands

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1 Nutritional assessment of asylum seekers children in The Netherlands Annette Agnes Maria Stellinga-Boelen

2 ISBN printed version: ISBN digital version: Studies described in this thesis were performed together with the Community health Services for Asylum Seekers (Medische Opvang Asielzoekers Noord Nederland), Pediatric Gastroenterology, University Medical Centre Groningen, University of Groningen department of Clinical Chemistry, KCL, Medical Centre Leeuwarden, and the department of Health Science, University Medical Centre Groningenn, University of Groningen. Paranimfen: Muriël Antoinette Yvonne Schreuder Daniël Pieter Stellinga Cover illustration: The Potatoeaters: Vincent van Gogh, Nuenen 1885 Amsterdam, Van Gogh Museum (Vincent van Gogh Stichting) Cover Design: Ton Lindhout Printing : Poosen & Looien b.v. Wageningen

3 We zijn vijf maanden bij mijn oma in huis geweest. Er waren veel granaataanvallen en luchtalarmen. Heel veel gebouwen zijn afgebrand en elk huis is door minstens een granaat geraakt. Mak en ik sliepen op de grond, mijn moeder en vader op een bank. We hadden bijna niets te eten. Een beetje rijst, spaghetti en soms bonen.andere groente was er niet, alleen een tomaat die we in stukjes sneden voor Mak, Deni en mij... We zijn allemaal magerder geworden, behalve Asja. Zij Krijgt geen voedselhulp, maar ze eet met ons mee. Arm dier, ze wordt nooit uitgelaten. Toch heeft ze meer Geluk dan andere honden die hun baasje hebben Verloren. - Lana, 8 jaar, uit Sarajevo Overgenomen uit: Ik droom over vrede Tekeningen en teksten door kinderen uit het voormalige Joegoslavie. Unicef 1994

4 2007 by Annette A. M. Stellinga-Boelen. All rights reserved. No part of this book may be reproduces or transmitted in any form or by any means without written permission of the author and the publisher holding the copyrights of the published articles. Publication of this thesis was kindly sponsored by the Community health Service Drenthe and the Community health Service for Asylum seekers North Netherlands.

5 RIJKSUNIVERSITEIT GRONINGEN Nutritional assessment of asylum seekers children in the Netherlands Proefschrift ter verkrijging van het doctoraat in de Medische Wetenschappen aan de rijksuniversiteit Groningen op gezag van de Rector Magnificus, dr. F. Zwarts, in het openbaar te verdedigen op woensdag 28 november 2007 om uur door Annette Agnes Maria Stellinga-Boelen geboren op 14 juni 1964 te Beverwijk

6 Promotor: Prof. Dr. H.J. Verkade Copromotor: Dr. C.M.A. Bijleveld Beoordelingscommissie : Prof. Dr. A.F. Bos Prof. Dr. H.S. Heymans Prof. Dr. M.J.H. Slooff

7 Voor Amina, Abdella, Gina, Ajla, Badmah,Mazen, Sadiq, Satenik, Aliaa, Faduma, Shirkhan, Erfan, Mucharbiek, Jasin, Tazi, Ali, Mohammed, Omid, Lena, Mariana, Tamerlan, Orchan, Dimitri, Baschar, Zhora, Ramin, Bellal, Dunya, Francisca, Senahid, Harutyun, Selsela, Liliana, Walodja, Narine, Faris, Aram, Nadiesda, Jamilla, Veysu, Yusuf, Elbeson, Wannis, Edgar, Miguel, Francesco, Andrea, Meryem, Ketura, Melton, Meggie, Mustafa...,...,...,..., alle kinderen die al jaren in asielzoekerscentra wonen 7

8 8

9 Contents: Chapter 1: General introduction and outline of the thesis. 11 Chapter 2: Dietary intake in asylum seeker children in 33 The Netherlands, strongly related to age and origin. A.A.M. Stellinga-Boelen, P.A.Wiegersma, C.M.A.Bijleveld Eur J Clin Nutr. Jan;61(1): Chapter 3: Obesity in asylum seekers children in The Netherlands 49 the use of national reference charts. A.A.M. Stellinga-Boelen, P.A.Wiegersma, C.M.A.Bijleveld, H.J.Verkade Eur J of Public Health. Mar ; [Epub ahead of print] Chapter 4: Iron deficiency among children of asylum seekers 63 in The Netherlands. A.A.M. Stellinga-Boelen, H.Storm, P.A.Wiegersma, C.M.A.Bijleveld, H.J.Verkade J of Pediatric Gastroenterology and nutrition 2007 (in press) Chapter 5: Vitamin D levels in children of asylum seekers in 75 The Netherlands in relation to season and dietary intake. A.A.M. Stellinga-Boelen, P.A.Wiegersma, H.Storm, C.M.A.Bijleveld, H.J.Verkade Eur J of Pediatrics. Mar;166(3): Chapter 6: Bone mineral density of asylum seekers children 87 in The Netherlands A.A.M. Stellinga-Boelen, H.Storm, H.J.Verkade Submitted Chapter 7: General Discussion 93 Summary 105 Samenvatting 109 Abbreviations 113 Dankwoord 115 Curriculum vitae 117 9

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