Department of Family Medicine, Taipei and Linkou Main Branches, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Metabolism and Obesity Institute, Taipei and Linkou Main Branches, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Front Public Health. 2023 Jun 12;11:1160647. doi: 10.3389/fpubh.2023.1160647. eCollection 2023.
Dietary behavior is a main contributing yet modifiable factor to the body weight status of children and may be involved in the pathophysiology of childhood obstructive sleep apnea (OSA). This study aimed to investigate the dietary profile of pediatric OSA patients, effects of educational counseling after adenotonsillectomy, and predictor for disease resolution.
This observational study included 50 pediatric OSA patients undergoing adenotonsillectomy with routine educational counseling (Group 1), 50 pediatric OSA patients undergoing adenotonsillectomy without formal educational counseling (Group 2), and 303 healthy children without OSA (Control). The three groups were matched by age. The consumption frequency of 25 food items/groups was assessed by the Short Food Frequency Questionnaire. Quality of life was evaluated by the OSA-18 questionnaire. Sleep architecture and OSA severity were measured by standard polysomnography. Between- and within-group comparisons were analyzed by non-parametric approaches and generalized estimating equations. Prediction of disease recovery was performed by multivariable logistic regression models.
Group 1 children consumed fruit drinks with sugar, vegetables, sweets, chocolate, rice, and noodles more frequently than Control Group children. At baseline, the distributions of sex, weight status, OSA-18 scores, and polysomnographic variables were comparable between Group 1 and Group 2. After a 12-month follow-up, Group 1 had better improvements in physical suffering, caregiver concerns, sleep architecture, and mean peripheral oxygen saturation compared to Group 2. Furthermore, Group 1 no longer had excessive consumption of fruit drinks with sugar, chocolate, and noodles; however, food consumption frequencies did not change significantly. Notably, younger age and reduced intake of butter/margarine on bread and noodles were independent predictors of cured OSA in Group 1.
The present study preliminarily characterized an unhealthy dietary profile among pediatric OSA patients and suggested that routine educational counseling in addition to adenotonsillectomy yielded some clinical benefits. Certain items/groups of food frequencies may be associated with disease recovery and further investigations are warranted.
饮食行为是导致儿童体重状况的主要可改变因素之一，可能与儿童阻塞性睡眠呼吸暂停（OSA）的病理生理学有关。本研究旨在调查儿科 OSA 患者的饮食状况，腺样体扁桃体切除术（adenotonsillectomy）后教育咨询的效果，以及疾病缓解的预测因素。
本观察性研究纳入 50 例行腺样体扁桃体切除术的儿科 OSA 患者（常规教育咨询组，Group 1），50 例行腺样体扁桃体切除术且未行正规教育咨询的儿科 OSA 患者（无教育咨询组，Group 2），以及 303 例无 OSA 的健康儿童（对照组）。三组按年龄匹配。采用短饮食频率问卷评估 25 种食物/组的摄入频率。采用 OSA-18 问卷评估生活质量。通过标准多导睡眠图测量睡眠结构和 OSA 严重程度。采用非参数方法和广义估计方程分析组间和组内比较。采用多变量逻辑回归模型预测疾病缓解。
Group 1 儿童比对照组儿童更频繁地食用加糖果汁饮料、蔬菜、甜食、巧克力、米饭和面条。在基线时，Group 1 和 Group 2 之间的性别、体重状况、OSA-18 评分和多导睡眠图变量的分布相似。经过 12 个月的随访，与 Group 2 相比，Group 1 的身体不适、照顾者担忧、睡眠结构和平均外周血氧饱和度的改善更好。此外，Group 1 不再过度食用加糖果汁饮料、巧克力和面条，但食物摄入量没有明显变化。值得注意的是，年龄较小和减少面包和面条上的黄油/人造黄油摄入是 Group 1 中 OSA 治愈的独立预测因素。
本研究初步描述了儿科 OSA 患者的不健康饮食模式，并表明腺样体扁桃体切除术加常规教育咨询有一定的临床获益。某些食物/组的食物频率可能与疾病缓解有关，需要进一步研究。
