Oral glucose effectiveness and metabolic risk in obese children and adolescents.

AIM: To investigate whether GE is affected in children/adolescents with obesity and abnormalities of the metabolic syndrome (MetS). METHODS: Cross-sectional study of oral GE (oGE), insulin sensitivity and secretion (calculated on 5 time-points oral glucose tolerance test) and metabolic abnormalities in 1012 patients with overweight/obesity (aged 6.0-17.9 years old). A MetS risk score was calculated on the basis of distribution of fasting glucose, triglycerides, HDL-cholesterol, total cholesterol, systolic and diastolic blood pressure. Non-alcoholic fatty liver disease (NAFLD) was suspected based on thresholds of alanine aminotransferases. RESULTS: Four-hundred and eighty patients (47.73%) had low-MetS risk score, 488 medium (48.22% with 1-2 risk factors) and 41 (4.05% with ≥ 3 factors) high risk. oGE was significantly lower in subjects with obesity [3.81 (1.46) mg/dl/min- 1] than in those with overweight [4.98 (1.66) mg/dl/min- 1; p value < 0.001]. oGE was negatively correlated with BMI (ρ = - 0.79; p < 0.001) and BMI z score (ρ = - 0.56; p < 0.001) and decreased significantly among MetS risk classes (p = 0.001). The median difference of oGE from low to medium risk was estimated to be as - 4.9%, from medium to high as - 13.38% and from low to high as - 17.62%. oGE was not statistically different between NAFLD+ and NAFLD- cases. CONCLUSIONS: In children and adolescents with obesity oGE decreases. Noteworthy, it decreases as the Met score increases. Therefore, reduced oGE may contribute to the higher risk of these individuals to develop type 2 diabetes.

NutricheQ Questionnaire assesses the risk of dietary imbalances in toddlers from 1 through 3 years of age.

BACKGROUND: Although a nutrient-poor diet may affect children's growth, especially early in life, few tools to assess dietary imbalances in 1- to 3-year-old children have been developed. OBJECTIVES: To investigate the accuracy and test-retest reliability of the NutricheQ Questionnaire in the identification of toddlers with the risk of inadequate intake of micro- and macronutrients in a sample of Italian toddlers. DESIGN: A 3-day weighed food record was performed, and results were compared with outcomes of the NutricheQ Questionnaire in 201 toddlers (training set: 1-3 years old). The accuracy of NutricheQ in the identification of categories of nutritional risk was evaluated using the receiver operating characteristic (ROC) curves. Test-retest of the tool was estimated using the intraclass correlation coefficient (ICC) and the Cronbach's alpha statistic, in a validation set of 50 toddlers. RESULTS: The NutricheQ Questionnaire is a valid tool for the identification of toddlers at risk for dietary imbalances. Significant differences in nutrient intake (p<0.005) were found among the three groups of risk identified by the questionnaire: toddlers included in the high-risk group had a lower intake of key nutrients such as iron, vitamin D and other vitamins, and fibre compared to those included in the low-risk group. NutricheQ is also reliable between administrations, as demonstrated by its test-retest reliability. ICC and Cronbach's alpha were 0.73 and 0.83, respectively, for Section 1 of NutricheQ, and 0.55 and 0.70 for Section 2. CONCLUSIONS: The NutricheQ Questionnaire is a reliable and consistent tool for the assessment of possible dietary risk factors in Italian toddlers. It consistently identifies toddlers with a high probability of having poor iron and vitamin D intake, and other dietary imbalances.