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Endocrine and Metabolic Effects of Nutrition in Children and Adolescents

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutrition and Metabolism".

Deadline for manuscript submissions: closed (24 March 2022) | Viewed by 32917

Special Issue Editors


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Guest Editor
Department of Pediatrics, Medical School and National Laboratory on Human Reproduction, University of Pécs, 7623 Pécs, Hungary
Interests: childhood obesity; intrauterine and infant nutrition; obesity-related diseases; metabolic syndrome; epigenetics
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Guest Editor
Department of Pediatrics, Medical School, University of Pécs, 7623 Pécs, Hungary
Interests: pediatric endocrinology; pediatric diabetes mellitus; childhood obesity; genetics
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Nutrition is a relatively young science. Nutritional science was born in the early years of the 20th century with the identification and synthesis of many of the known essential vitamins and minerals and their use to prevent and treat nutritional deficiency-related diseases including scurvy, beriberi, pellagra, rickets, xerophthalmia, and nutritional anemias. Presently, we face the double burden of malnutrition, which is characterized by the coexistence of undernutrition along with overweight and obesity, or diet-related noncommunicable diseases, already starting from childhood. Mal- and overnutrition are global challenges that all countries need to address. The scale of the problem is illustrated by WHO statistics: 47 million children under 5 years of age are wasted, 14.3 million are severely wasted, and 144 million are stunted, while 38.3 million are overweight or obese.

Nutritional alterations affect every aspect of the functioning of the endocrine system and metabolism, leading to serious disorders. Over the last few decades, the use of nutrition has shifted from ensuring that the diet contains sufficient macro- and micronutrients to consuming nutrition with the purpose of improving health.

The aim of this Special Issue entitled “Endocrine and Metabolic Effects of Nutrition in Children and Adolescents” is to gather original research manuscripts, meta-analyses, and new reviews dealing with the endocrine and metabolic consequences of malnutrition (under- and overnutrition), e.g., stunting, metabolic syndrome, type 2 diabetes, and Prader–Willi syndrome, and the latest developments in their prevention and treatment. The above-mentioned potential topics are suggestions; other relevant topics will be considered.

Dr. Dénes Molnár
Dr. Éva Erhardt
Guest Editors

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Keywords

  • Childhood and adolescence
  • Undernutrition
  • Overweight and obesity
  • Prader–Willi syndrome
  • Diabetes mellitus
  • Treatment and prevention

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Published Papers (6 papers)

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Research

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10 pages, 3979 KiB  
Article
Tryptophan Metabolism Is Associated with BMI and Adipose Tissue Mass and Linked to Metabolic Disease in Pediatric Obesity
by Julia Lischka, Andrea Schanzer, Margot Baumgartner, Charlotte de Gier, Susanne Greber-Platzer and Maximilian Zeyda
Nutrients 2022, 14(2), 286; https://doi.org/10.3390/nu14020286 - 11 Jan 2022
Cited by 18 | Viewed by 3453
Abstract
The obesity epidemic has contributed to an escalating prevalence of metabolic diseases in children. Overnutrition leads to increased tryptophan uptake and availability. An association between the induction of the tryptophan catabolic pathway via indoleamine 2,3-dioxygenase (IDO) activity and obesity-related inflammation has been observed. [...] Read more.
The obesity epidemic has contributed to an escalating prevalence of metabolic diseases in children. Overnutrition leads to increased tryptophan uptake and availability. An association between the induction of the tryptophan catabolic pathway via indoleamine 2,3-dioxygenase (IDO) activity and obesity-related inflammation has been observed. This study aimed to investigate the impact of pediatric obesity on tryptophan metabolism and the potential relationship with metabolic disease. In this prospective cohort study, plasma kynurenine, tryptophan, and serotonin levels were measured by ELISA, and IDO activity was estimated by calculating the kynurenine/tryptophan ratio in a clinically characterized population with severe obesity (BMI ≥ 97th percentile) aged 9 to 19 (n = 125). IDO activity and its product kynurenine correlated with BMI z-score and body fat mass, whereas concentrations of serotonin, the alternative tryptophan metabolite, negatively correlated with these measures of adiposity. Kynurenine and tryptophan, but not serotonin levels, were associated with disturbed glucose metabolism. Tryptophan concentrations negatively correlated with adiponectin and were significantly higher in prediabetes and metabolically unhealthy obesity. In conclusion, BMI and body fat mass were associated with increased tryptophan catabolism via the kynurenine pathway and decreased serotonin production in children and adolescents with severe obesity. The resulting elevated kynurenine levels may contribute to metabolic disease in obesity. Full article
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12 pages, 826 KiB  
Article
An Attempt to Assess the Impact of Pandemic Restrictions on the Lifestyle, Diet, and Body Mass Index of Children with Endocrine Diseases—Preliminary Results
by Agnieszka Zachurzok, Małgorzata Wójcik, Aneta Gawlik, Jerzy B. Starzyk and Artur Mazur
Nutrients 2022, 14(1), 156; https://doi.org/10.3390/nu14010156 - 29 Dec 2021
Cited by 8 | Viewed by 3402
Abstract
Background: Home isolation during the coronavirus 2019 (COVID-19) pandemic lockdown strongly impacted everyday life, affecting, in particular, eating habits and everyday activity. The aim of this study was to analyze the impact of the pandemic on behaviors and subsequent changes in body mass [...] Read more.
Background: Home isolation during the coronavirus 2019 (COVID-19) pandemic lockdown strongly impacted everyday life, affecting, in particular, eating habits and everyday activity. The aim of this study was to analyze the impact of the pandemic on behaviors and subsequent changes in body mass index (BMI) in children from Southern Poland. Methods: The study included 206 participants (104 females and 102 males) with a complete analysis of 177 participants (96 females and 81 males) with a mean age of 12.8 ± 2.6 years admitted to three pediatric endocrinology clinics (Rzeszów, Kraków, and Katowice) due to simple obesity, type 1 diabetes mellitus, somatotropin pituitary deficiency on growth hormone replacement therapy, and other endocrine and metabolic disorders between June and September 2020. The study used a self-prepared questionnaire regarding eating habits, physical activity, screen time, and sleep before and during the lockdown. Anthropometric measurements were performed under clinical settings twice (before the pandemic in January–March 2020, and in June–September 2020). Results: During the lockdown, BMI z-scores increased over the whole group, especially in obese children (0.073 ± 0.18, p = 0.002). The number of children who declared low and high physical activity of more than 60 min per day declined from 41.2% and 18.6% to 31.1% and 6.2% (p = 0.03 and p < 0.001), respectively; sleep times over 8 h increased (46.9% vs. 60.4% p = 0.007); screen times over 5 h daily increased (14.7% to 46.9%, p < 0.001). Eating habits did not change significantly. Conclusions: Daily physical activity and sleep levels were affected by the pandemic leading to the increase of BMI, especially in obese patients with endocrine disorders. During the COVID-19 pandemic, forward-thinking strategies must be developed to prevent childhood obesity. Full article
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Review

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10 pages, 301 KiB  
Review
Prader–Willi Syndrome: Possibilities of Weight Gain Prevention and Treatment
by Éva Erhardt and Dénes Molnár
Nutrients 2022, 14(9), 1950; https://doi.org/10.3390/nu14091950 - 6 May 2022
Cited by 14 | Viewed by 4481
Abstract
Prader–Willi syndrome (PWS) is a complex genetic disorder which involves the endocrine and neurologic systems, metabolism, and behavior. The aim of this paper is to summarize current knowledge on dietary management and treatment of PWS and, in particular, to prevent excessive weight gain. [...] Read more.
Prader–Willi syndrome (PWS) is a complex genetic disorder which involves the endocrine and neurologic systems, metabolism, and behavior. The aim of this paper is to summarize current knowledge on dietary management and treatment of PWS and, in particular, to prevent excessive weight gain. Growth hormone (GH) therapy is the recommended standard treatment for PWS children, because it improves body composition (by changing the proportion of body fat and lean body mass specifically by increasing muscle mass and energy expenditure), linear growth, and in infants, it promotes psychomotor and IQ development. In early childhood, the predominant symptom is hyperphagia which can lead to early onset, severe obesity with different obesity-related comorbidities. There are several studies on anti-obesity medications (metformin, topiramate, liraglutide, setmelanotide). However, these are still limited, and no widely accepted consensus guideline exists concerning these drugs in children with PWS. Until there is a specific treatment for hyperphagia and weight gain, weight must be controlled with the help of diet and exercise. Below the age of one year, children with PWS have no desire to eat and will often fail to thrive, despite adequate calories. After the age of two years, weight begins to increase without a change in calorie intake. Appetite increases later, gradually, and becomes insatiable. Managing the progression of different nutritional phases (0–4) is really important and can delay the early onset of severe obesity. Multidisciplinary approaches are crucial in the diagnosis and lifelong follow-up, which will determine the quality of life of these patients. Full article
13 pages, 375 KiB  
Review
Promoting Fruit and Vegetable Consumption for Childhood Obesity Prevention
by Frans Folkvord, Brigitte Naderer, Anna Coates and Emma Boyland
Nutrients 2022, 14(1), 157; https://doi.org/10.3390/nu14010157 - 29 Dec 2021
Cited by 22 | Viewed by 10902
Abstract
Currently, food marketing for unhealthy foods is omnipresent. Foods high in fat, salt, and sugar (HFSS) are advertised intensively on several media platforms, including digital platforms that are increasingly used by children, such as social media, and can be bought almost everywhere. This [...] Read more.
Currently, food marketing for unhealthy foods is omnipresent. Foods high in fat, salt, and sugar (HFSS) are advertised intensively on several media platforms, including digital platforms that are increasingly used by children, such as social media, and can be bought almost everywhere. This could contribute to the obesity epidemic that we are facing. As the majority of children and adolescents do not eat the recommended amount of fruits and vegetables (F&V), which leads to chronic diseases, we need to change the obesogenic environment to a healthogenic environment. Reducing the marketing of energy-dense snacks to children and increasing the promotion of healthier foods, such as fruits and vegetables, may be an effective and necessary instrument to improve the dietary intake of children and reduce the risk of their experiencing some chronic diseases later in life. With this focused narrative review, we provide an overview of how children and adolescents react to food promotions and how food promotional efforts might be a useful tool to increase the attractiveness of fruit and vegetables. This review therefore contributes to the question of how changing the advertising and media environment of children and adolescents could help create a world where the healthy choice is the easier choice, which would reduce childhood obesity and improve children’s health, as well as to make the food system more sustainable. Full article
10 pages, 620 KiB  
Review
Obesity, Sodium Homeostasis, and Arterial Hypertension in Children and Adolescents
by Małgorzata Wójcik and Agnieszka Kozioł-Kozakowska
Nutrients 2021, 13(11), 4032; https://doi.org/10.3390/nu13114032 - 11 Nov 2021
Cited by 26 | Viewed by 4817
Abstract
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 [...] Read more.
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. Full article
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Other

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18 pages, 588 KiB  
Systematic Review
The Role of Protein and Fat Intake on Insulin Therapy in Glycaemic Control of Paediatric Type 1 Diabetes: A Systematic Review and Research Gaps
by Dieter Furthner, Andreas Lukas, Anna Maria Schneider, Katharina Mörwald, Katharina Maruszczak, Petra Gombos, Julian Gomahr, Claudia Steigleder-Schweiger, Daniel Weghuber and Thomas Pixner
Nutrients 2021, 13(10), 3558; https://doi.org/10.3390/nu13103558 - 11 Oct 2021
Cited by 20 | Viewed by 4572
Abstract
Carbohydrate counting (CHC) is the established form of calculating bolus insulin for meals in children with type 1 diabetes (T1DM). With the widespread use of continuous glucose monitoring (CGM) observation time has become gapless. Recently, the impact of fat, protein and not only [...] Read more.
Carbohydrate counting (CHC) is the established form of calculating bolus insulin for meals in children with type 1 diabetes (T1DM). With the widespread use of continuous glucose monitoring (CGM) observation time has become gapless. Recently, the impact of fat, protein and not only carbohydrates on prolonged postprandial hyperglycaemia have become more evident to patients and health-care professionals alike. However, there is no unified recommendation on how to calculate and best administer additional bolus insulin for these two macronutrients. The aim of this review is to investigate: the scientific evidence of how dietary fat and protein influence postprandial glucose levels; current recommendations on the adjustment of bolus insulin; and algorithms for insulin application in children with T1DM. A PubMed search for all articles addressing the role of fat and protein in paediatric (sub-)populations (<18 years old) and a mixed age population (paediatric and adult) with T1DM published in the last 10 years was performed. Conclusion: Only a small number of studies with a very low number of participants and high degree of heterogeneity was identified. While all studies concluded that additional bolus insulin for (high) fat and (high) protein is necessary, no consensus on when dietary fat and/or protein should be taken into calculation and no unified algorithm for insulin therapy in this context exists. A prolonged postprandial observation time is necessary to improve individual metabolic control. Further studies focusing on a stratified paediatric population to create a safe and effective algorithm, taking fat and protein into account, are necessary. Full article
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