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To investigate the accuracy and reliability of 3‐dimensional (3D) transvaginal sonography in classifying submucous fibroids using the International Federation of Gynecology and Obstetrics PALM‐COEIN (polyp, adenomyosis, leiomyoma, malignancy and hyperplasia, coagulopathy, ovulatory dysfunction, endometrial, iatrogenic, and not yet classified) classification and protrusion (percent) compared to 2‐dimensional (2D) transvaginal sonography, 2D saline infusion sonography, and 3D saline infusion sonography, using hysteroscopy as a reference test. A prospective cohort pilot study was performed among 14 consecutive patients undergoing hysteroscopic surgery, preceded by routine sonography (2D transvaginal sonography, 2D saline infusion sonography, 3D transvaginal sonography, and 3D saline infusion sonography). The intraclass correlation coefficient (ICC) for 2D transvaginal sonography versus hysteroscopy was 0.69 (95% confidence interval [CI], 0.06, 0.90) compared to 0.94 (95% CI, 0.83, 0.98) for 2D saline infusion sonography. The ICCs for 3D transvaginal sonography versus hysteroscopy were 0.69 (95% CI, 0.03, 0.90 [investigator A]) and 0.55 (95% CI, –0.48, 0.86 [investigator B]). The ICCs for 3D saline infusion sonography versus hysteroscopy were 0.94 (95% CI, 0.81, 0.98 [investigator A]) and 0.87 (95% CI, 0.60, 0.96 [investigator B]). Interobserver agreement of 3D transvaginal sonography was 0.81 (95% CI, 0.43, 0.94) compared to 0.86 (95% CI, 0.56, 0.96) for 3D saline infusion sonography. In these preliminary data, 3D transvaginal sonography was not as accurate as 2D or 3D saline infusion sonography and was not more accurate than 2D transvaginal sonography. There was moderate interobserver agreement for 3D transvaginal sonography. There might be room for improvement, as 3D transvaginal sonography is more accurate when endometrial thickness increases. Further study is warranted to evaluate in which patients saline infusion sonography eventually can be obviated.

Pancreatic neuroendocrine tumors (pNETs) are highly prevalent in patients with multiple endocrine neoplasia type 1 (MEN1), and metastatic disease is an important cause of MEN1-related mortality. Especially small nonfunctional (NF) pNETs pose a challenge to the treating physician and more information is needed regarding their natural course. We assessed long-term natural history of small NF-pNETs and its modifiers in the Dutch MEN1 population.

ABSTRACTObjectives:The aims of this study were (1) to quantify and compare the load of a professional football team's training days and matches and (2) to compare training of nonstarters the day after the match with regular training of starters and nonstarters.Methods:On-field training load during in-season training days (categorized as days before match day, i.e., MD minus) and 3 friendly matches were recorded using alocal positioning measurement system.Results:Mixed linear models showed lower load when training approached match day. Relative to match values (100%), training values for running (52 -20%; MD-4 -MD-1) and high-speed running (38 -15%) were lower than for total distance (67 -35%), and all considerably lower than match values. On average, medium and high accelerations and decelerations during training were more similar to match values (90 -39%). Load during nonstarters training was lower than during regular training for almost all variables on MD-4 and several high-intensity variables on MD-3 and MD-2.Conclusions:The results highlight that acceleration and deceleration measures complement more commonly used external load variables based on distance and speed. Furthermore, nonstarters are potentially under-loaded compared to starters, especially in terms of (high-speed) running.

Artificial double inversion-recovery and phase-sensitive inversion-recovery MRI scans were generated from multicenter input data, with high between-center and between-reader reliability for detection of cortical and juxtacortical multiple sclerosis lesions.

BackgroundThe mental health burden among refugees in high-income countries (HICs) is high, whereas access to mental healthcare can be limited.ObjectiveTo examine the effectiveness of a peer-provided psychological intervention (Problem Management Plus; PM+) in reducing symptoms of common mental disorders (CMDs) among Syrian refugees in the Netherlands.MethodsWe conducted a single-blind, randomised controlled trial among adult Syrian refugees recruited in March 2019–December 2021 (No. NTR7552). Individuals with psychological distress (Kessler Psychological Distress Scale (K10) >15) and functional impairment (WHO Disability Assessment Schedule (WHODAS 2.0) >16) were allocated to PM+ in addition to care as usual (PM+/CAU) or CAU only. Participants were reassessed at 1-week and 3-month follow-up. Primary outcome was depression/anxiety combined (Hopkins Symptom Checklist; HSCL-25) at 3-month follow-up. Secondary outcomes included depression (HSCL-25), anxiety (HSCL-25), post-traumatic stress disorder (PTSD) symptoms (PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition; PCL-5), impairment (WHODAS 2.0) and self-identified problems (PSYCHLOPS; Psychological Outcomes Profiles). Primary analysis was intention-to-treat.FindingsParticipants (n=206; mean age=37 years, 62% men) were randomised into PM+/CAU (n=103) or CAU (n=103). At 3-month follow-up, PM+/CAU had greater reductions on depression/anxiety relative to CAU (mean difference −0.25; 95% CI −0.385 to −0.122; p=0.0001, Cohen’s d=0.41). PM+/CAU also showed greater reductions on depression (p=0.0002, Cohen’s d=0.42), anxiety (p=0.001, Cohen’s d=0.27), PTSD symptoms (p=0.0005, Cohen’s d=0.39) and self-identified problems (p=0.03, Cohen’s d=0.26), but not on impairment (p=0.084, Cohen’s d=0.21).ConclusionsPM+ effectively reduces symptoms of CMDs among Syrian refugees. A strength was high retention at follow-up. Generalisability is limited by predominantly including refugees with a resident permit.Clinical implicationsPeer-provided psychological interventions should be considered for scale-up in HICs.

The first aim of the present study was to determine the change in speech recognition in noise over a period of 5 years in participants ages 18 to 70 years at baseline. The second aim was to investigate whether age, gender, educational level, the level of initial speech recognition in noise, and reported chronic conditions were associated with a change in speech recognition in noise.

The objectives of this systematic review are to examine how researchers report missing data in questionnaires and to provide an overview of current methods for dealing with missing data.

OBJECTIVE To describe the prospective relationship between physical activity and academic performance. DATA SOURCES Prospective studies were identified from searches in PubMed, PsycINFO, Cochrane Central, and Sportdiscus from 1990 through 2010. STUDY SELECTION We screened the titles and abstracts for eligibility, rated the methodological quality of the studies, and extracted data. MAIN EXPOSURE Studies had to report at least 1 physical activity or physical fitness measurement during childhood or adolescence. MAIN OUTCOME MEASURES Studies had to report at least 1 academic performance or cognition measure during childhood or adolescence. RESULTS We identified 10 observational and 4 intervention studies. The quality score of the studies ranged from 22% to 75%. Two studies were scored as high quality. Methodological quality scores were particularly low for the reliability and validity of the measurement instruments. Based on the results of the best-evidence synthesis, we found evidence of a significant longitudinal positive relationship between physical activity and academic performance. CONCLUSIONS Participation in physical activity is positively related to academic performance in children. Because we found only 2 high-quality studies, future high-quality studies are needed to confirm our findings. These studies should thoroughly examine the dose-response relationship between physical activity and academic performance as well as explanatory mechanisms for this relationship.

This study is part of the Amsterdam Growth and Health Longitudinal Study, which was undertaken to assess the long‐term interrelationships between cumulative frequency of geographic relocation (CFGR) and the development of personality characteristics (i.e., Inadequacy, Rigidity, Social Inadequacy, Dominance, Self‐sufficiency, Self‐esteem, and Hostility). We found that participants who had more mobility experiences had lower consistency in their personality characteristics (the exception being Rigidity). Residential mobility from different life stages was positively associated with the continuity and change of Inadequacy and Dominance. In addition, young adults with higher Rigidity personality experienced fewer geographic moves during the transition from young adulthood to mid‐life. Our study provides evidence that CFGR in different life stages may be associated with the development of personality characteristics from young adulthood to mid‐life in different ways. Increased awareness of the potential interrelationships between frequent geographic relocation and personality development may have positive consequences for adult psychological health.

The gastrointestinal inflammatory response may play a role in the susceptibility of preterm infants for infections. We previously reported a trend toward lower endogenous infection morbidity after enteral supplementation of neutral and acidic oligosaccharides (SCGOS/LCFOS/AOS). We hypothesize that enteral supplementation of prebiotics may decrease infectious morbidity by reducing intestinal inflammation. Therefore, we aimed to determine the effect of enteral supplementation of prebiotics on intestinal inflammation, as measured by fecal IL-8 (f-IL-8) and calprotectin (f-calprotectin), in preterm infants. In a randomized controlled trial, infants with a GA <32 wk and/or birth weight <1,500 g received enteral supplementation of prebiotics or placebo (maltodextrin) between d 3 and 30 of life. F-IL-8 and f-calprotectin was assessed at baseline, d 7, 14, and 30 of life. In total, 113 infants were included. Baseline patient and nutritional characteristics were not different in the SCGOS/LCFOS/AOS (n = 55) and the placebo group (n = 58). Enteral supplementation of prebiotics had no effect on f-IL-8 and f-calprotectin. F-IL-8 and f-calprotectin were strongly correlated at all time points (p < 0.001). In conclusion, enteral supplementation of prebiotics (SCGOS/LCFOS/AOS) does not affect f-IL-8 and f-calprotectin levels in preterm infants.

The gastrointestinal inflammatory response may play a role in the susceptibility of preterm infants for infections. We previously reported a trend toward lower endogenous infection morbidity after enteral supplementation of neutral and acidic oligosaccharides (SCGOS/LCFOS/AOS). We hypothesize that enteral supplementation of prebiotics may decrease infectious morbidity by reducing intestinal inflammation. Therefore, we aimed to determine the effect of enteral supplementation of prebiotics on intestinal inflammation, as measured by fecal IL-8 (f-IL-8) and calprotectin (f-calprotectin), in preterm infants. In a randomized controlled trial, infants with a GA <32 wk and/or birth weight <1,500 g received enteral supplementation of prebiotics or placebo (maltodextrin) between d 3 and 30 of life. F-IL-8 and f-calprotectin was assessed at baseline, d 7, 14, and 30 of life. In total, 113 infants were included. Baseline patient and nutritional characteristics were not different in the SCGOS/LCFOS/AOS (n55) and the placebo group (n58). Enteral supplementation of prebiotics had no effect on f-IL-8 and f-calprotectin. F-IL-8 and f-calprotectin were strongly correlated at all time points (p< 0.001). In conclusion, enteral supplementation of prebiotics (SCGOS/LCFOS/AOS) does not affect f-IL-8 and f-calprotectin levels in preterm infants.

ObjectiveTo determine the effect of patient exercise adherence within the prescribed physical therapy treatment period and after physical therapy discharge on patient outcomes of pain, physical function, and patient selfperceived effect in individuals with osteoarthritis OA of the hip andor knee.MethodsWe performed a prospective observational followup study in which 150 patients with OA of the hip andor knee receiving exercise therapy were followed for 60 months. Data were obtained from a randomized controlled trial, with assessments at baseline and 3, 15, and 60 months of followup. The association between exercise adherence and patient outcomes of pain, physical function, and selfperceived effect was examined using generalized estimating equations analyses.ResultsAdherence to recommended home exercises and being more physically active were significantly associated with better treatment outcomes of pain, selfreported physical function, physical performance, and selfperceived effect. The association between adherence and outcome was consistent over time. Adherence to home activities was only associated with better selfperceived effect.ConclusionBetter adherence to recommended home exercises as well as being more physically active improves the longterm effectiveness of exercise therapy in patients with OA of the hip andor knee. Both within and after the treatment period, better adherence is associated with better patient outcomes of pain, physical function, and selfperceived effect. Since exercise adherence declines over time, future research should focus on how exercise behavior can be stimulated and maintained in the long term.

ObjectiveTo identify subgroups of workers absent from work due to low back pain who are more or less likely to return to work earlier as a result of a graded activity intervention, and to investigate whether this intervention is effective in reducing painrelated fears and if so, whether these reductions in painrelated fears mediate return to work.MethodsA subgroup analysis was conducted on data from a previous randomized controlled trial of 134 Dutch airline workers, which found that a behaviorallyoriented graded activity intervention was more effective than usual care in stimulating return to work. The subgroup analyses added interaction terms to a Cox regression model that described the relationship between treatment allocation and return to work over 12 months of followup. Furthermore, we studied the effects of graded activity on painrelated fears and added variables indicating a reduction in painrelated fears to the model in order to investigate their influence on return to work.ResultsStatistically significant interactions were found for disability, fearavoidance beliefs about physical activity, and fearavoidance beliefs about work. No indication was found that the reduction in painrelated fears in the graded activity group mediated more favorable returntowork results in this group.ConclusionWorkers who perceive their disability to be moderate and workers with moderate scores for fearavoidance beliefs return to work more rapidly as a result of the graded activity intervention than workers with higher scores. The return to work of workers receiving the graded activity intervention is possibly independent from the reductions in painrelated fears caused by this intervention.

The objective of this study was to investigate the development and tracking of nutritional status, body composition and physical fitness, and the longitudinal relationship of changes in nutritional status, and body composition with changes in physical fitness over a 1‐year period of follow‐up. Studied were 380 boys and 322 girls aged 7–14 years from the Ellisras Longitudinal Study. Boys and girls were divided into two groups of pre‐adolescence (<11 years) and adolescence (>10 years). High tracking coefficients (>8) were found for nutritional status, body mass index, and fat‐free mass, while low tracking coefficients (<4) were found for the sum of skinfolds, fat mass, arm muscle area, and central fat distribution. Moderate and low tracking coefficients were found for the physical fitness items. Longitudinal regression analyses showed that physical fitness performances that require a high energy flux over a short period of time are affected by muscle wasting, whereas having a low body weight appears to be important for a good performance on other fitness items in these malnourished rural South African children. Am. J. Hum. Biol. 19:551–558, 2007. ©2007 Wiley‐Liss, Inc.

This study examined specific and general psychological distress 8.5 years following the 1992 cargo aircraft crash in Amsterdam. Participants included 334 occupationally exposed fire fighters and 834 occupationally exposed police officers compared with reference groups of 194 fire fighters and 634 police officers who were exposed to duty-related stressors other than the disaster. On the standardized instruments of psychological distress, exposed fire fighters reported more somatic complaints and fatigue, while exposed police officers reported higher psychological distress on all aspects. The degree and type of exposure at the disaster site and other background factors were associated with several outcomes of psychological distress levels of exposed rescue workers. The disasters’ aftermath of rumors about potential health consequences due to toxic exposure likely contributed to the long-lasting psychological distress of some of the rescue workers as well.

Glutamine depletion has negative effects on the functional integrity of the gut and leads to immunosuppression. Very low birth weight (VLBW) infants are susceptible to glutamine depletion, as enteral nutrition is limited in the first weeks of life. Enteral glutamine supplementation may have a positive effect on feeding tolerance, infectious morbidity and short-term outcome. The aim of the study was to determine the effect of enteral glutamine supplementation on plasma amino acid concentrations, reflecting one aspect of safety of enteral glutamine supplementation in VLBW infants.

Glutamine depletion has negative effects on the functional integrity of the gut and leads to immunosuppression. Very low birth weight (VLBW) infants are susceptible to glutamine depletion, as enteral nutrition is limited in the first weeks of life. Enteral glutamine supplementation may have a positive effect on feeding tolerance, infectious morbidity and short‐term outcome. The aim of the study was to determine the effect of enteral glutamine supplementation on plasma amino acid concentrations, reflecting one aspect of safety of enteral glutamine supplementation in VLBW infants. In a double‐blind placebo‐controlled randomized controlled trial, VLBW infants (gestational age <32 weeks or birth weight <1500 g) received enteral glutamine supplementation (0.3 g/kg per day) or isonitrogenous placebo supplementation (alanine) between day 3 and day 30 of life. Supplementation was added to breast milk or to preterm formula. Plasma amino acid concentrations were measured at four time points: before the start of the study and at days 7, 14 and 30 of life. Baseline patient and nutritional characteristics were not different in glutamine (n = 52) and control (n = 50) groups. Plasma concentrations of most essential and non‐essential amino acids increased throughout the study period. There was no effect of enteral glutamine supplementation. In particular, the increase of plasma glutamine and glutamate concentrations was not different between the treatment groups (P= 0.49 and P= 0.34 respectively, day 30). Enteral glutamine supplementation in VLBW infants does not alter plasma concentrations of glutamine, glutamate or other amino acids. Enteral supplementation in a dose of 0.3 g/kg per day seems safe in VLBW infants.

No abstract.

VAN MECHELEN, W., J. W. R. TWISK, G. B. POST, J. SNEL, and H. C. G. KEMPER. Physical activity of young people The Amsterdam longitudinal growth and health study. Med. Sci. Sports Exerc.,Vol. 32, No. 9, pp. 1610–1616, 2000.

TWISK, J. W. R., H. C. G. KEMPER, and W. van MECHELEN. Tracking of activity and fitness and the relationship with cardiovascular disease risk factors. Med. Sci. Sports Exerc.,Vol. 32, No. 8, pp. 1455–1461, 2000.

The purpose of this study was to describe the longitudinal development of running economy [defined as the oxygen uptake ( V?O 2) at a submaximal running speed] in males and females from teenage to young adult age using data from the Amsterdam Growth and Health Study. Submaximal V?O 2 (in ml · kg -1· min -1) was measured in 84 males and 98 females while they ran on a treadmill at a constant speed of 8 km · h -1 for 6 min at three different treadmill slopes (0%, 2.5% and 5%). This test was carried out six times, on the same subjects at the ages of 13, 14, 15, 16, 21, and 27 years. The longitudinal development of running economy in males and females was analysed using a two-way analysis of variance for repeated measurements. At all three slopes, a significant decrease in V?O 2 with increasing age was found for both males and females, implying a significant increase in running economy for both sexes. Males showed significantly higher V?O 2 values than females at all ages measured and for all three slopes, suggesting that females have a significantly higher running economy than males. In order to make a better comparison of the V?O 2 of individuals of different sizes, allometric models were used; power function ratios were constructed in which body mass was expressed to an exponential power. Following this analysis the difference in submaximal V?O 2 and running economy between males and females appeared even larger.

ObjectiveTo investigate the clinical effectiveness and safety of stand alone and blended internet based vestibular rehabilitation (VR) in the management of chronic vestibular syndromes in general practice.DesignPragmatic, three armed, parallel group, individually randomised controlled trial.Setting59 general practices in the Netherlands.Participants322 adults aged 50 and older with a chronic vestibular syndrome.InterventionsStand alone VR comprising a six week, internet based intervention with weekly online sessions and daily exercises (10-20 minutes a day). In the blended VR group, the same internet based intervention was supplemented by face-to-face physiotherapy support (home visits in weeks 1 and 3). Participants in the usual care group received standard care from a general practitioner, without any restrictions.Main outcome measuresThe primary outcome was vestibular symptoms after six months as measured by the vertigo symptom scale-short form (VSS-SF range 0-60, clinically relevant difference ≥3 points). Secondary outcomes were dizziness related impairment, anxiety, depressive symptoms, subjective improvement of vestibular symptoms after three and six months, and adverse events.ResultsIn the intention-to-treat analysis, participants in the stand alone and blended VR groups had lower VSS-SF scores at six months than participants in the usual care group (adjusted mean difference −4.1 points, 95% confidence interval −5.8 to −2.5; and −3.5 points, −5.1 to −1.9, respectively). Similar differences in VSS-SF scores were seen at three months follow-up. Participants in the stand alone and blended VR groups also experienced less dizziness related impairment, less anxiety, and more subjective improvement of vestibular symptoms at three and six months. No serious adverse events related to online VR occurred during the trial.ConclusionStand alone and blended internet based VR are clinically effective and safe interventions to treat adults aged 50 and older with a chronic vestibular syndrome. Online VR is an easily accessible form of treatment, with the potential to improve care for an undertreated group of patients in general practice.Trial registrationNetherlands Trial Register NTR5712.

Study questionIs stepped care compared with usual care effective in preventing the onset of major depressive, dysthymic, and anxiety disorders in older people with visual impairment (caused mainly by age related eye disease) and subthreshold depression and/or anxiety?Methods265 people aged ≥50 were randomly assigned to a stepped care programme plus usual care (n=131) or usual care only (n=134). Supervised occupational therapists, social workers, and psychologists from low vision rehabilitation organisations delivered the stepped care programme, which comprised watchful waiting, guided self help based on cognitive behavioural therapy, problem solving treatment, and referral to a general practitioner. The primary outcome was the 24 month cumulative incidence (seven measurements) of major depressive dysthymic and/or anxiety disorders (panic disorder, agoraphobia, social phobia, and generalised anxiety disorder). Secondary outcomes were change in symptoms of depression and anxiety, vision related quality of life, health related quality of life, and adaptation to vision loss over time up to 24 months’ follow-up.Study answer and limitations 62 participants (46%) in the usual care group and 38 participants (29%) from the stepped care group developed a disorder. The intervention was associated with a significantly reduced incidence (relative risk 0.63, 95% confidence interval 0.45 to 0.87; P=0.01), even if time to the event was taken into account (adjusted hazard ratio 0.57, 0.35 to 0.93; P=0.02). The number needed to treat was 5.8 (3.5 to 17.3). The dropout rate was fairly high (34.3%), but rates were not significantly different for the two groups, indicating that the intervention was as acceptable as usual care. Participants who volunteered and were selected for this study might not be representative of visually impaired older adults in general (responders were significantly younger than non-responders), thereby reducing the generalisability of the outcomes.What this study adds Stepped care seems to be a promising way to deal with depression and anxiety in visually impaired older adults. This approach could lead to standardised strategies for the screening, monitoring, treatment, and referral of visually impaired older adults with depression and anxiety.Funding, competing interests, data sharingFunded by ZonMw InZicht, the Dutch Organisation for Health Research and Development-InSight Society. There are no competing interests. Full dataset and statistical code are available from the corresponding author.Study registrationwww.trialregister.nlNTR3296.

OBJECTIVE: To compare the effects of a minimal intervention strategy aimed at assessment and modification of psychosocial prognostic factors and usual care for treatment of (sub)acute low back pain in general practice. Design Cluster randomised clinical trial. Setting 60 general practitioners in 41 general practices. Participants 314 patients with non-specific low back pain of less than 12 weeks' duration, recruited by their general practitioner. Interventions In the minimal intervention strategy group the general practitioner explored the presence of psychosocial prognostic factors, discussed these factors, set specific goals for reactivation, and provided an educational booklet. The consultation took about 20 minutes. Usual care was not standardised. MAIN OUTCOME MEASURES: Functional disability (Roland-Morris disability questionnaire), perceived recovery, and sick leave because of low back pain assessed at baseline and after 6, 13, 26, and 52 weeks. RESULTS: The dropout rate was 8% in the minimal intervention strategy group and 9% in the usual care group. Multilevel analyses showed no significant differences between the groups on any outcome measure during 12 months of follow-up in the whole group or in relevant subgroups (patients with high scores on psychosocial measures at baseline or a history of frequent or prolonged low back pain). CONCLUSION: This study provides no evidence that (Dutch) general practitioners should adopt our new treatment strategy aimed at psychosocial prognostic factors in patients with (sub)acute low back pain. Further research should examine why our new strategy was not more effective than usual care.

van Lenthe F J (Institute for Research in Extramural Medicine, Faculty of Medicine, Vrije Universiteit Amsterdam, v.d. Boechorststraat 7–9, 1081 BT Amsterdam, The Netherlands), Kemper H C G, van Mechelen W and Twisk J W R. Development and tracking of central patterns of subcutaneous fat in adolescence and adulthood: The Amsterdam Growth and Health Study. International Journal of Epidemilogy 1996; 25: 1162–1171. Background A central pattern of body fat Is recognized as a risk indicator of cardiovascular diseases in adulthood. The development of this body fat pattern from childhood into adulthood however, remains to be explored. Methods The development of two trunk skinfolds (subscapular, supra-iliac), two extremity skinfolds (biceps; triceps), and three trunk-extremity skinfold ratios for males (n = 71) and females (n = 84), were described over a period of 17 years from 13 to 29 years of age. In addition, tracking of the skinfolds and the skinfold ratios was investigated over this period. Data for this study came from the Amsterdam Growth and Health Study, an ongoing longitudinal study in the Netherlands that started in 1977. Results In adolescence, a decrease was seen in extremity skinfolds for men but not for women. For both sexes, the trunk skinfolds increased over the entire period of study. An increase was found in trunk-extremity skinfold ratios in males, but not in females. Tracking coefficients, calculated as Pearson correlation coefficients between the initial measurement and subsequent measurements, were about 0.4 for the single skinfolds between 13 and 29 years of age for both men and women. For the skinfold ratios, these correlation coefficients were about 0.55. Longitudinal tracking coefficients, measuring the association between the initial measurement and all follow-up data simultaneously, were about 0.65 for both men and women. Conclusions A central pattern of body fat, mainly seen in males, seems to start in adolescence. From a preventive point of view, tracking coefficients were too low to be of predictive value. In order to conclude that the roots of a central pattern of body fat are in adolescence, careful search for determinants of change of this body fat pattern is needed.