Association of dietary behaviors, biochemical, and lifestyle factors with metabolic phenotypes of obesity in children an
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Diabetology & Metabolic Syndrome Open Access
RESEARCH
Association of dietary behaviors, biochemical, and lifestyle factors with metabolic phenotypes of obesity in children and adolescents Mostafa Qorbani1,2, Pouria Khashayar3, Hadith Rastad4, Hanieh‑Sadat Ejtahed5,6, Ehsan Shahrestanaki7, Ehsan Seif8, Seyede Shahrbanoo Daniali9, Masoomeh Goudarzi9, Mohammad Esmaeil Motlagh10, Zeinab Khodaparast11, Ramin Heshmat2,6*† and Roya Kelishadi9*†
Abstract Background and aims: To examine the association of dietary behaviors, lifestyle, and biochemical factors with meta‑ bolic phenotypes of obesity among obese Iranian children and adolescents. Methods: This cross-sectional study was conducted within the framework of the fifth phase of CASPIAN study. Of 3840 students aged 7–18 years of 30 Iranian provinces, 408 subjects were diagnosed as obese; they were divided into metabolically healthy obese (MHO) and metabolically unhealthy obese (MUO) groups. Biochemical factors, anthropo‑ metric measures, dietary, and lifestyle habits were compared between groups. Results: Of the 408 obese subjects, 68 (16.7%) were the MUO; the remaining 340 (84.3%) fall in the MHO group. The MUO group had significantly higher systolic and diastolic BPs, FBS, TG, ALT, anthropometric measures, and lower HDL levels than MHO groups (all p-value 4000 gr) was significantly higher in the MUO group than the MHO group (p-value: 0.04). A higher percentage of individuals with breastfeeding dura‑ tion ≥ 6 month was found in the MUO group (95.5% (95% CI 86.1–98.6%)) compared to MHO group (85.7% (95% CI 80.4–89.7%)) (p-value = 0.04). Among dietary and lifestyle-related behaviors, only the frequency of salty snack con‑ sumption and eating food according to the parents’ request was significantly higher in the MUO group than the MHO group (p-value 0.5; (5) Either SBP or DBP ˃ 90th percentile for age, sex, and height [12]. Lifestyle and dietary behaviors assessment
The demographic questionnaire for pediatrics, including information about birth weight, duration of breastfeeding, eating behaviors, screen time, physical activity, and sleep duration, was completed. For evaluating eating behaviors, information about breakfast consumption (skipper, non-skipper), eating speed (slow, medium, fast), consumption at least 3 meals/day (yes/no), consumption of sugar-sweetened beverages, junk foods (including Salty snack, Sweet consumption, and Fast food), fruits, and vegetables was filled out by all the students. Information concerning eating speed was self-reported according to the question “How fast is your eating speed compared to others?” in the questionnaire. The response was based on three possible semi-quantitative categories: “slow”, “medium”, and “fast”. Screen time (ST) was defined as the average hours per day spent watching television or using a personal computer [13]. The physical activity (PA) pattern of the students was assessed using a validated questionnaire, where questions on leisure-time physical activity, causing heavy sweating or large increases in heart
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