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The state of hydration of the body depends on the balance between the amount of water and salt consumed and excreted (the urinary extraction of excess sodium requires water). Inappropriate nutrition, particularly consuming too much processed food, causes obesity in children and additionally causes excessive sodium consumption, thus increasing the risk of excessive water loss. The aim of this study was to assess the hydration status of children with obesity and the relation between hydration, body composition, urinary sodium extraction, and nutrient intake. The study group consisted of 27 patients with obesity, with a mean age of 12.89 ± SD 2.79. Each patient’s height, weight, body composition (electrical bioimpedance (BIA)), diet (7-day record), and biochemical tests were assessed. The hydration status was assessed using 24-hour urine collection, 24-hour urine osmolality, and an ultrasound of the vena cava (IVC/Ao index). Overall, 55% of children (n = 15) had urine osmolality values above 800 mOsm/kgH2O, which indicates significant dehydration, and 53% (n = 14) were dehydrated, based on the IVC/Ao index. Children with obesity and dehydration had a significantly higher BMI (31.79 vs. 27.32; p = 0.0228), fat mass percentage (37.23% vs. 30.07% p = 0.0051), and fat mass in kg (30.89 vs. 20.55; p = 0.0158), and significantly higher sodium intake from their diet (3390.0 mg vs. 2921.0 mg; p = 0.0230), as well as their sodium/potassium ratio (2.4 vs. 2.0; p = 0.0043). The 24-hour urinary sodium excretion and osmolality values were directly related to fat-mass percentage and fat-mass (in kg) in a simple linear correlation analysis. Our preliminary results confirm that obesity is related to dehydration. The overall high sodium excretion in children with obesity indicates an excessive salt intake along with low potassium intake, which is a significant predictor of dehydration, regardless of the total water intake (TWI).

Childhood obesity is one of the most important problems of public health. Searching was conducted by using PubMed/MEDLINE, Cochrane Library, Science Direct, MEDLINE, and EBSCO databases, from January 2022 to June 2022, for English language meta-analyses, systematic reviews, randomized clinical trials, and observational studies from all over the world. Five main topics were defined in a consensus join statement of the Polish Society of Pediatrics, Polish Society for Pediatric Obesity, Polish Society of Pediatric Endocrinology and Diabetes and Polish Association for the Study on Obesity: (1) definition, causes, consequences of obesity; (2) treatment of obesity; (3) obesity prevention; (4) the role of primary care in the prevention of obesity; (5) Recommendations for general practitioners, parents, teachers, and regional authorities. The statement outlines the role of diet, physical activity in the prevention and treatment of overweight and obesity, and gives appropriate recommendations for interventions by schools, parents, and primary health care. A multisite approach to weight control in children is recommended, taking into account the age, the severity of obesity, and the presence of obesity-related diseases. Combined interventions consisting of dietary modification, physical activity, behavioral therapy, and education are effective in improving metabolic and anthropometric indices. More actions are needed to strengthen the role of primary care in the effective prevention and treatment of obesity because a comprehensive, multi-component intervention appears to yield the best results.

Leptin (LEP) and omentin (OMEN) are proteins whose concentrations change with the development of the metabolic syndrome (MetS). There are few intervention studies using various forms of physical activity in people with MetS that aim to determine the impact of physical exercise on the fluctuations of the presented hormones, and their results are contradictory. The present study aimed to examine the effect of two types of exercise intervention on LEP and OMEN concentrations and indicators of lipid and carbohydrate metabolism in males with MetS. The study included 62 males with MetS (age 36.6 ± 6.9 years, body mass 110.31 ± 17.37 kg), randomly allocated to EG1, the examined group with aerobic training (n = 21); EG2, the examined group with combined aerobic and resistance training (n = 21), both for 12 weeks, and the control group (CG) without interventions (n = 20). Anthropometric measurements, body composition (body fat [BF], android body fat [ANDR]), as well as a biochemical blood analysis (omentin [OMEN], leptin [LEP], quantitative insulin sensitivity check index [QUICKI], high-density lipoprotein cholesterol [HDL-C] and nonHDL-C) were performed at baseline, and at 6 and 12 weeks of interventions and after 4 weeks after ending intervention (follow-up). Intergroup and intragroup comparisons were performed. In the intervention groups EG1 and EG2, a decrease in BF was observed as well as an improvement in carbohydrate metabolism parameters. In the EG1 group, the level of ANDR was reduced. In EG2 a decrease in LEP concentration between measurements was confirmed. However, no significant changes were found in the concentration of OMEN in any groups. Combined aerobic and resistance exercises led to a higher reduction of LEP concentration than applying only aerobic training in males with MetS.

Vitamin K2 activates vitamin K-dependent proteins that support many biological functions, such as bone mineralization, the inhibition of vascular stiffness, the improvement of endothelial function, the maintenance of strong teeth, brain development, joint health, and optimal body weight. Due to the transformation of food habits in developed countries over the last five decades, vitamin K and, specifically, vitamin K2 intakes among parents and their offspring have decreased significantly, resulting in serious health implications. The therapeutics used in pediatric practice (antibiotics and glucocorticoids) are also to blame for this situation. Low vitamin K status is much more frequent in newborns, due to both endogenous and exogenous insufficiencies. Just after birth vitamin K stores are low, and since human milk is relatively poor in this nutrient, breast-fed infants are at particular risk of a bleeding disorder called vitamin K deficiency bleeding. A pilot study showed that better vitamin K status is associated with lower rate of low-energy fracture incidence. An ongoing clinical trial is intended to address whether vitamin K2 and D3 supplementation might positively impact the biological process of bone healing. Vitamin K2 as menaquinone-7 (MK-7) has a documented history of safe and effective use. The lack of adverse effects of MK-7 makes it the ideal choice for supplementation by pregnant and nursing women and children, both healthy and suffering from various malabsorptions and health disorders, such as dyslipidemia, diabetes, thalassemia major (TM), cystic fibrosis (CF), inflammatory bowel diseases (IBD), and chronic liver diseases. Additionally, worthy of consideration is the use of vitamin K2 in obesity-related health outcomes.

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.

A rise in the incidence of infections with severe acute respiratory syndrome coronavirus 2 has sparked the search for protective strategies against the new pathogen. It is known that individual food components can interact with different immune cells, modulating the immune response of the body. The aim of this study was to develop an index assessing the immunomodulatory potential of diet (POLA index) and to test its utility for the prediction of coronavirus disease 2019 (COVID-19) in a group of healthy young people following a traditional or vegetarian diet. Data on body composition, anthropometric measurements, physical activity, dietary intake, and gut microbiota were obtained from 95 adults (mean age, 34.66 ± 5.76 years). There was a strong correlation between the dietary inflammatory index and the POLA index (r = 0.90; p < 0.0001). Based on Cohen’s kappa statistic, there was a good agreement in qualitative interpretation between the two indices (kappa = 0.61; p < 0.0001). People on a diet with beneficial immunomodulatory effects had a lower risk of COVID-19 of approximately 80%, as compared with those on a diet with highly unbeneficial immunomodulatory effects. In daily practice, the POLA index might serve as a useful tool for dietitians to identify individuals whose diet is deficient in ingredients for optimal immune system function and change their dietary behavior to ensure optimal immune function that reduces the risk of infection.

Celiac disease (CD) may cause numerous nutrient deficiencies that a proper gluten-free diet (GFD) should compensate for. The study group consists of 40 children, aged 8.43 years (SD 3.5), on average, in whom CD was diagnosed on the basis of clinical symptoms, immunological and histopathological results. The patients’ height, weight, diet and biochemical tests were assessed three times: before diagnosis, after six months, and following one year of GFD. After one year, the patients’ weight and height increased but nutritional status (body mass index, BMI percentile) did not change significantly. The children’s diet before diagnosis was similar to that of the general Polish population: insufficient implementation of the dietary norm for energy, fiber, calcium, iodine, iron as well as folic acid, vitamins D, K, and E was observed. Over the year, the GFD of the children with CD did not change significantly for most of the above nutrients, or the changes were not significant for the overall assessment of the diet. Celiac patients following GFD may have a higher risk of iron, calcium and folate deficiencies. These results confirm the need for personalized nutritional education aimed at excluding gluten from the diet, as well as balancing the diet properly, in patients with CD.

Background: The relationship between obesity, arterial hypertension, and excessive salt intake has been known for a long time; however, the mechanism of this relationship remains not clear. Methods: The paper presents a current literature review on the relationship between salt consumption and the development of arterial hypertension in children and adolescents with obesity. Results: In addition to the traditional theory of hypertension development due to the increase in intravascular volume and disturbances of sodium excretion, recent studies indicate the existence of a complex mechanism related to excessive, pathological secretory activity of adipocytes, insulin resistance, and impaired function of the renin–angiotensin–aldosterone axis. That makes obese children and adolescents particularly vulnerable to the development of salt-sensitive arterial hypertension. Studies performed in many countries have shown that children and adolescents consume more sodium than recommended. It is worth noting, however, that the basis for these recommendations was the extrapolation of data from studies conducted on adults. Moreover, more important than sodium intake is the Na/K ratio and water consumption. Conclusion: Regardless of the population-wide recommendations on reducing salt intake in children, specific recommendations for overweight and obese patients should be developed.

Wstęp: Właściwy sposób odżywiania w okresie ciąży i laktacji, jak również dieta małego dziecka mogą mieć wpływ na ryzyko rozwoju chorób w kolejnych latach życia dziecka. Cel: Ocena wiedzy kobiet w ciąży i w okresie laktacji na temat roli diety w rozwoju dziecka. Materiał i metody: Badaniem objęto 320 kobiet w okresie ciąży lub laktacji. Posłużono się autorską ankietą, składającą się z 30 dotyczących żywienia pytań jednokrotnego wyboru oraz metryczki. Wyniki: W badaniu wykazano, że wiedza kobiet na temat sposobu żywienia i stosowanych suplementów jest mała, zwłaszcza w odniesieniu do diety w okresie karmienia piersią, kontroli masy ciała w ciąży, znaczenia rodzaju porodu, a także rozszerzania diety dziecka. Wnioski: Wyniki badania wskazują potrzebę zwiększenia edukacji dotyczącej żywienia w okresie ciąży i laktacji oraz diety małego dziecka jako niezbędnego elementu profilaktyki chorób cywilizacyjnych.

Niniejszy tekst został poświęcony tematyce zależności opóźnienia w rozwoju mowy a anatomicznymi i fizjologicznymi uwarunkowaniami funkcji pokarmowych. Składa się on z trzech części. W pierwszej przedstawione zostały definicje i podziały ORM w kontekście innych jednostek chorobowych lub zaburzeń zaklasyfikowanych w IDC-10. W kolejnej zaprezentowano korelację między ORM a trudnościami w jedzeniu i piciu. Na końcu opisano studium przypadku chłopca z ORM oraz wybiórczością pokarmową.

Background Elevated chemerin level is observed in patients with arterial hypertension. The aim of the study was to determine the relationship between chemerin level, and parameters of blood pressure and arterial stiffness in children and adolescents with obesity but without arterial hypertension. Methods In 23 children with obesity (13 girls, mean age 9.3, SD 1.9, mean BMI SDS 3.9, SD 1.7) 24 h ABPM (Spacelabs 90,217, USA), common carotids and abdominal aorta intima media thickness measurements (Voluson 730, GE Medical System 8.5 and 3.5 MHz probes), body composition analysis (Tanita BC 418 S MA, Tokyo, Japan) were performed. Glucose, triglycerides, total, LDL and HDL cholesterol, liver enzymes, uric acid, creatinine, sodium, insulin and chemerin levels were assessed in blood sample taken after a 12-h fasting period. Results There was a significant correlation of circulating chemerin level with systolic blood pressure load in ABPM (r=0.5, p Conclusion Elevated chemerin level may be associated with increased systolic blood pressure in obese children.

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 &lt, 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.

For many years vitamin K has been considered to be associated only with blood clotting processes. Thanks to the research of last thirty years its other equally important role has been discovered. Vitamin K acts as a cofactor for the posttranslational γ-carboxylation of glutamate residues in proteins such as osteocalcin or matrix Gla protein (MGP). Thus the diet reach in vitamin K or supplementation of this vitamin on early stages of development may decrease risk of diseases such as rickets, osteoporosis or cardiovascular diseases.

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.