Modified metabolic risk factors in children: The role of diet and hydration

Abstract

In press

Background. The rapid increase in the prevalence of overweight and obesity among children requires a deep understanding of the role of modifiable lifestyle factors, including destructive dietary patterns and hydration status, against the background of hereditary predisposition.

Aim. To study the clinical and anamnestic characteristics and the specifics of eating disorders and hydration regimes in overweight or obese children compared to their normal-weight peers to identify the leading dietary risk factors for metabolic disorders.

Materials and Methods. A total of 171 children aged [10÷18] years were examined and divided into groups: Group 1 included 82 children with a body mass index (BMI) within the 15^th to 85^th percentiles; Group 2 included 89 patients with overweight/obesity (BMI > 85^th percentile). A questionnaire regarding life history, dietary habits, and hydration was conducted. We also analyzed the non-modifying factor – maternal obesity. Statistical processing was performed using Statistica 13.3 software (TIBCO Software Inc., USA), utilizing Pearson's chi-squared test and calculating the Odds Ratio (OR) with a 95% confidence interval. The study was conducted within the framework of a research project with state registration number 0123U101768.

Research Ethics. The study was conducted in accordance with the World Medical Association Declaration of Helsinki (1964–2024) and Order No.690 of September 23, 2009, of the Ministry of Health of Ukraine. Written informed consent was obtained from the children and parents of all participants.

Results. Maternal obesity is a significant unmodifiable predictor, which increased the odds of developing this pathology in a child by 5.73 times (OR=5.73; p<0.0001). Systematically skipping breakfast increased the odds of developing obesity by 6.71 times (OR=6.71; p<0.0001), while eating directly in bed before sleep increased it by 9.98 times (OR=9.98; p<0.0001). Having dinner on time showed a protective effect (OR=0.18; p<0.0001). Irregular vegetable consumption was associated with a 4.12-fold increase in metabolic risk (OR=4.12; p=0.0005). The habit of replacing a full meal with fruit raised the odds of developing obesity by 4.42 times (OR=4.42; p=0.0008). Systematic consumption of liquid calories increased the risk of obesity by 3.12 times (OR=3.12; p=0.0011), whereas prioritizing plain water provided a pronounced protective effect (OR=0.16; p<0.0001).

Conclusions. Prevention of childhood obesity requires a comprehensive approach aimed at modifying family eating habits, restoring the culture of daily breakfast, eliminating late-night snacks before sleep, and popularizing plain water as the main source of hydration.

Keywords: pediatrics and neonatology, obesity, risk factors, nutrition.