Assessment of diet quality, nutrient intake, and dietary behaviours in obese children compared to healthy children

Wprowadzenie: Otyłość została uznana przez Światową Organizację Zdrowia za najczęstszą przewlekłą chorobę na świecie. W Polsce obserwuje się wzrost rozpowszechnienia otyłości wśród dzieci. Cel pracy: Porównanie jakości diety, spożycia składników odżywczych oraz zachowań żywieniowych w grupie otyłych dzieci w porównaniu z dziećmi o prawidłowej masie ciała. Materiał i metody: Badaniami objęto 105 dzieci w wieku 7-15 lat. Grupę badaną stanowiło 52 otyłych pacjentów z Poradni Dietetycznej Uniwersyteckiego Szpitala Dziecięcego w Krakowie bez towarzyszących chorób przewlekłych oraz 53 pacjentów z prawidłową masą ciała. Zachowania żywieniowe dzieci i ich dietę oceniono za pomocą kwestionariusza (FFQ) oraz 24-godzinnego wywiadu żywieniowego. Do oceny jakości diety wykorzystano wskaźnik Healthy Diet Indicator (HDI). Wyniki: Dieta badanych otyłych dzieci była bogata w wysoko przetworzone i wysokotłuszczowe produkty oraz uboga w warzywa, owoce i produkty pełnoziarniste. Otyłe dzieci spożywały średnio 73,42 ±19,60 kcal/kg m.c. vs 49,89 ±12,20 kcal/kg m.c. (p < 0,01) dzieci o prawidłowej masie ciała oraz więcej energii z tłuszczów niż z węglowodanów. Zaobserwowano niskie spożycie witaminy A, D, kwasu foliowego, wapnia, jodu i żelaza w obu grupach. Za pomocą HDI wykazano niską jakość diety u prawie 40% otyłych dzieci. Wnioski: Leczenie dietetyczne otyłych dzieci powinno koncentrować się nie tylko na zmniejszeniu kalorii pochodzących z produktów spożywczych, lecz także na wyborze produktów o dużej gęstości odżywczej oraz nauce zdrowych nawyków żywieniowych.Introduction: Obesity has been recognised by the World Health Organisation as the most common chronic disease in the world. An increase in the prevalence of childhood obesity has been seen in Poland. Purpose: The aim of this study was to compare the dietary behaviours, quality of diet, and nutrient intake in a group of obese children compared to children with normal body weight. Material and methods: A total of 105 children aged between seven and 15 years were surveyed. The test group consisted of 52 obese patients from a Dietary Clinic in the Children’s University Hospital in Cracow, without accompanying chronic diseases, and 53 normal weight patients. Children’s nutritional behaviours and diet were assessed with a questionnaire (FFQ) and a 24-hour recall. To assess diet quality the Healthy Eating Indicator (HDI) was used. Results: The diet of the studied obese children was rich in highly processed and high-fat products, and poor in vegetables, fruits, and wholegrain products. Obese children consumed on average 73.42 ±19.60 kcal per body weight whereas normal-weight children consumed 49.89 ±12.20 (p < 0.01) and obtained more energy from fat than from carbohydrates. A low intake of vitamins A and D, folic acid, calcium, iodine, and iron in both groups was observed. The HDI showed a low-quality diet in nearly 40% of obese children. Conclusions: Dietary treatment of obese children should concentrate not only on reduction of calories from food products but also on choices of high-nutrient-density products and on developing healthy eating habits

Body composition and a school day hydration state among Polish children : a cross-sectional study

Background: Little is known on the relationship between obesity and hydration level in children. To explore the possible association between children’s hydration status and body composition, we conducted this cross-sectional study. Methods: The survey was carried out in 2018 in Preliminary and High Schools from the Malopolska Province, Poland. The study group consisted of 264 children aged 7-15 years. The level of hydration was assessed based on urine osmolality during a school day. The examined had anthropometric tests and body composition assessment (FM, BF%, FFM, TBW, TBW%). Odds ratio (OR) and 95% confidence interval (CI) were calculated using a logistic regression analysis. Results: In the study group, 9.5% of the examined were overweight, 7.2% obese, and it referred more to the country than towns (p < 0.05). Improper hydration was found in 53% of children, and 16.3% of them were severely dehydrated during a school day (urine osmolality > 1000 mOsm/kgH2O). The level of dehydration was higher in children with excessive body fat (BF%) than in children with normal BF% [903.00 vs. 775 mOsm/kgH2O]. Older age (>10 y) showed inverse association with dehydration [OR 0.52 (95% CI; 0.28–0.99)] and excessed BF% showed 2.3-fold increase in odds of dehydration during a school day [OR 2.39 (95% CI; 1.15–4.94)]. Improper hydration was a risk factor of difficulties with concentration declared by students during a school day OR 2.85 (95% CI; 1.16–6.99). Conclusions: Attention should be paid to appropriate hydration especially in children with excessive body fat content who feature a higher risk of dehydration and fluid demand

A comparison of the impact of two methods of nutrition-behavioral intervention on selected auxological and biochemical parameters in obese prepubertal children : crossover preliminary study

Obese children are exposed to short and long-term health consequences, such as dyslipidemia, hypertension and diabetes mellitus. For these reasons, the prevention and treatment of obesity in the pediatric population is a challenge for health care professionals. The aim of this study was to evaluate whether an intensive intervention based on diet and physical activity has a better impact on the auxological and biochemical parameters than standard care (intervention). The study included 20 children (six boys, 14 girls), of the mean age 8.9 (SD 1.4) before puberty. The participants were randomly assigned to two groups: Group I (starting treatment with intensive intervention), and II (starting treatment with standard intervention). After three months, the groups were switched. The comparison of the two interventions in the study group indicates a better effectiveness of intensive intervention in the improvement of anthropometric parameters and majority of biochemical ones (except for insulin concentration, HOMA IR index and LDL cholesterol). As the result of intensive intervention, the mean % of weight-to-height excess and hip circumference decreased significantly (p < 0.005). Our results confirm that complex intervention based on systematic control visits, including personalized dietitian counselling and physician care, during the weight reduction process is more effective than a one-off standard visit

Wpływ postaw rodzicielskich na sposób żywienia dzieci w wieku przedszkolnym w Krakowie na tle uwarunkowań socjo-demograficznych

Preschool period is a stage of intensive development of the food preferences and the pro-health attitudes associated with normal eating behaviors and consequently eating habits in adulthood. The aim of the study was to assess eating behaviors of children attending kindergartens in relation to selected socio-economic factors in their families.The study was conducted in a group of 325 children, whose average age was 5.23 ±1.30 years, attending nine kindergartens in Krakow. The questionnaire was filled in by 51.4% (N = 167) of parents of boys and 48.6% (N = 158) of girls. To conduct qualitative assessment of nutrition habits the Food Frequency Questionnaire (FFQ) was used with addition of questions regarding the socio-economic situation of the surveyed families. Differences in selected dietary behaviors of children were evaluated by gender, family income and parents’ educational level. The study indicates the existence of the relationship between food-related behaviour of preschool children and parents’ education level and family income.The resulting image of dietary behaviours of children in the study group has identified numerous anomalies that require an active and ongoing nutrition education for children and their parents

Provision of special diets to children in public nurseries and kindergartens in Kraków (Poland)

BackgroundA specialized diet could be due to an allergy or other medical needs and also religious or cultural reasons. This study aimed to assess the availability and provision of special diets in kindergartens and nurseries financed by the Municipality of Kraków.MethodsThis observational cross-sectional study was based on a diagnostic survey carried out using the Computer-Assisted Web Interview method and addressed to the managers of nurseries (n = 21) and kindergartens (n = 71) and, separately, to the parents of children attending these facilities (n = 1,096). Non-parametric tests were applied for an unadjusted comparison between children at nurseries and those at kindergartens.ResultsChildren with particular dietary requirements received special diet meals in 95.2% of nurseries and 60.5% of kindergartens. The availability of special diets was associated with the type of facility (p = 0.001), the number of children who ate in the facility (p = 0.032), and the daily cost of meals served to children (p = 0.009). The cost of meals was higher in kindergartens that offered special diets vs. those that did not offer such diets (p &lt; 0.001). According to parents, 96.4% of the total number of children ate meals served in the facilities. In nurseries, 16.1% of children were on a special diet (as per the doctor’s recommendations in 11.7% of cases and according to parents’ own choice in 4.4%). In kindergartens, a special diet was served to 12.7% of children (doctor’s recommendations, 8.5%; parents’ own choice, 4.2%). The most common reason for using a special diet was food allergy (8.2% of children in nurseries and 5.8% of children in kindergartens). It was reported more often by the parents of children attending nurseries than by the parents of children attending kindergartens (8.0% vs. 4.2%, p = 0.007). The requirement for a special diet was found to be associated with the age of children (p &lt; 0.033) and the use of oral treatment for chronic disease (p &lt; 0.001).ConclusionProviding special diets for children is better in nurseries than in kindergartens. Legal regulations are urgently needed to ensure equal access to adequate nutrition for all children with special dietary needs in childcare facilities

Zachowania informacyjne Polaków dotyczące zdrowego odżywiania się. Wyniki badania EATWELL

Information behaviour of Poles in area of healthy eating. Results of EATWELL surveyThe rate of obesity in Poland increases rapidly, especially fast among children and adolescents. An important and also fully accepted by the society ways of fighting this phenomenon are social marketing and educational interventions. To make these activities effective they have to keep pace with changes in information behavior of target groups. But the importance of raising information competency of consumers is not fully understood by those who design and implement health programs and health Information behavior and literacy rarely are the subject of research. The goal of this study is to find where and how Polish citizens look for diet related information, what barriers they encounter, and whether they behave differently in comparison with citizens of other European countries. Method: A survey administered through computer-assisted on-line web-interviewing to a probabilistic, stratified by age and gender, sample of respondents in Poland (n = 600). Comparison sample – same number of respondents in Belgium, Denmark, Italy and UK. Results: 49% of surveyed Poles do not know where to look for healthy diet related information and have bigger problems with this task then the respondents in other surveyed countries. In comparison with Danish, a probability that a Pole knows where to look for such information decreases twice. Individual and environmental determinants strongly affect information knowledge and behavior. Men, educated, poorer and sicker persons have bigger problems with finding information and are less likely to attempt to look for it. Majority of respondents uses Internet and Google to look for healthy diet information. Only 23% of Polish respondents would turn to their GPs for healthy eating advice

Information behaviour of Poles in area of healthy eating : results of EATWELL survey

The rate of obesity in Poland increases rapidly, especially fast among children and adolescents. An important and also fully accepted by the society ways of fighting this phenomenon are social marketing and educational interventions. To make these activities effective they have to keep pace with changes in information behavior of target groups. But the importance of raising information competency of consumers is not fully understood by those who design and implement health programs and health Information behavior and literacy rarely are the subject of research. The goal of this study is to find where and how Polish citizens look for diet related information, what barriers they encounter, and whether they behave differently in comparison with citizens of other European countries. Method: A survey administered through computer-assisted on-line web-interviewing to a probabilistic, stratified by age and gender, sample of respondents in Poland (n = 600). Comparison sample – same number of respondents in Belgium, Denmark, Italy and UK. Results: 49% of surveyed Poles do not know where to look for healthy diet related information and have bigger problems with this task then the respondents in other surveyed countries. In comparison with Danish, a probability that a Pole knows where to look for such information decreases twice. Individual and environmental determinants strongly affect information knowledge and behavior. Men, educated, poorer and sicker persons have bigger problems with finding information and are less likely to attempt to look for it. Majority of respondents uses Internet and Google to look for healthy diet information. Only 23% of Polish respondents would turn to their GPs for healthy eating advice

Psychosocial and environmental risk factors of obesity and hypertension in children and adolescents—a literature overview

Childhood obesity has become a worldwide epidemic in the 21st century. Its treatment is challenging and often ineffective, among others due to complex, often not obvious causes. Awareness of the existence and meaning of psychosocial and environmental risk factors seems to be an essential element in the prevention and treatment of obesity and its complications, especially arterial hypertension. In this review, we will discuss the role of that risk factors linking obesity and increased cardiovascular disorders including the role of nutritional factors (including the role of unhealthy diet, inadequate hydration), unhealthy behaviors (e.g. smoking, alcohol and drugs, sedentary behavior, low physical activity, disrupted circadian rhythms, sleep disorders, screen exposure), unfavorable social factors (such as dysfunctional family, bullying, chronic stress, mood disorders, depression, urbanization, noise, and environmental pollution), and finally differences in cardiovascular risk in girls and boys