Abstract Nutritional status affects every aspect of a child?s health. Thorough nutritional assessment is hampered by the lack of a single comprehensive tool, which can cover all aspects of nutritional assessment. In three distinct studies, this thesis investigated the nutritional status of hospitalised children, children with coeliac disease and children with inflammatory bowel disease. Study 1 The objectives of this study were to assess prevalence of malnutrition and nutritional risk, and define demographic and anthropometric factors associated with nutritional risk among hospitalized children. In this cross sectional study, 157 hospitalised children were assessed for nutritional status using nutritional risk score (NRS) and anthropometric measurements. We found that 4.5%, 8.9%, 15.1% and 10.4% children were wasted, stunted, overweight and obese respectively. However, with the NRS, 47.8% of the children were at high nutritional risk. These children at high risk had lower weight for age (p=0.02), lower BMI percentiles for age (p=0.001) and longer hospitalization (p=0.001) than children at no risk. Study 2 The objectives of this study were to determine nutritional parameters in children with coeliac disease. Twenty-five children with coeliac disease and an equal number of age and gender matched controls were enrolled and anthropometric measurements, BIA and leptin levels were analysed in all. No significant differences were found between the children with coeliac disease and controls in these parameters. BMI percentile correlated with leptin levels in children with coeliac disease. Study 3 The objectives of this study were to determine anthropometric parameters and leptin levels in children with IBD and ascertain if BMI correlates with leptin levels in these children. Thirty children with IBD and 60 age and gender matched controls were enrolled. Anthropometric measurements and leptin levels were analysed and compared with controls. IBD children had significantly low weight for age (p=0.002), BMI percentiles (p=0.001) and leptin levels (p=0.009) compared to controls. There was a correlation between BMI and leptin levels in IBD children. In conclusion, this thesis has shown that one quarter of hospitalized children were overweight or obese, and further, that half of the hospitalised children were at high risk of nutritional deterioration and these children had longer hospital stay than children at no risk. Children with coeliac disease had similar anthropometric measurements, body compartments and leptin levels to controls. However, children with IBD had lower anthropometric measurements and leptin levels, indicating under-nutrition. Nutritional assessment should be a mandatory part of clinical management with nutritional status assessed by various tools including NRS, anthropometry, BIA and leptin levels.

Abstract Nutritional status affects every aspect of a child?s health. Thorough nutritional assessment is hampered by the lack of a single comprehensive tool, which can cover all aspects of nutritional assessment. In three distinct studies, this thesis investigated the nutritional status of hospitalised children, children with coeliac disease and children with inflammatory bowel disease. Study 1 The objectives of this study were to assess prevalence of malnutrition and nutritional risk, and define demographic and anthropometric factors associated with nutritional risk among hospitalized children. In this cross sectional study, 157 hospitalised children were assessed for nutritional status using nutritional risk score (NRS) and anthropometric measurements. We found that 4.5%, 8.9%, 15.1% and 10.4% children were wasted, stunted, overweight and obese respectively. However, with the NRS, 47.8% of the children were at high nutritional risk. These children at high risk had lower weight for age (p=0.02), lower BMI percentiles for age (p=0.001) and longer hospitalization (p=0.001) than children at no risk. Study 2 The objectives of this study were to determine nutritional parameters in children with coeliac disease. Twenty-five children with coeliac disease and an equal number of age and gender matched controls were enrolled and anthropometric measurements, BIA and leptin levels were analysed in all. No significant differences were found between the children with coeliac disease and controls in these parameters. BMI percentile correlated with leptin levels in children with coeliac disease. Study 3 The objectives of this study were to determine anthropometric parameters and leptin levels in children with IBD and ascertain if BMI correlates with leptin levels in these children. Thirty children with IBD and 60 age and gender matched controls were enrolled. Anthropometric measurements and leptin levels were analysed and compared with controls. IBD children had significantly low weight for age (p=0.002), BMI percentiles (p=0.001) and leptin levels (p=0.009) compared to controls. There was a correlation between BMI and leptin levels in IBD children. In conclusion, this thesis has shown that one quarter of hospitalized children were overweight or obese, and further, that half of the hospitalised children were at high risk of nutritional deterioration and these children had longer hospital stay than children at no risk. Children with coeliac disease had similar anthropometric measurements, body compartments and leptin levels to controls. However, children with IBD had lower anthropometric measurements and leptin levels, indicating under-nutrition. Nutritional assessment should be a mandatory part of clinical management with nutritional status assessed by various tools including NRS, anthropometry, BIA and leptin levels.

Abstract Nutritional status affects every aspect of a child?s health. Thorough nutritional assessment is hampered by the lack of a single comprehensive tool, which can cover all aspects of nutritional assessment. In three distinct studies, this thesis investigated the nutritional status of hospitalised children, children with coeliac disease and children with inflammatory bowel disease. Study 1 The objectives of this study were to assess prevalence of malnutrition and nutritional risk, and define demographic and anthropometric factors associated with nutritional risk among hospitalized children. In this cross sectional study, 157 hospitalised children were assessed for nutritional status using nutritional risk score (NRS) and anthropometric measurements. We found that 4.5%, 8.9%, 15.1% and 10.4% children were wasted, stunted, overweight and obese respectively. However, with the NRS, 47.8% of the children were at high nutritional risk. These children at high risk had lower weight for age (p=0.02), lower BMI percentiles for age (p=0.001) and longer hospitalization (p=0.001) than children at no risk. Study 2 The objectives of this study were to determine nutritional parameters in children with coeliac disease. Twenty-five children with coeliac disease and an equal number of age and gender matched controls were enrolled and anthropometric measurements, BIA and leptin levels were analysed in all. No significant differences were found between the children with coeliac disease and controls in these parameters. BMI percentile correlated with leptin levels in children with coeliac disease. Study 3 The objectives of this study were to determine anthropometric parameters and leptin levels in children with IBD and ascertain if BMI correlates with leptin levels in these children. Thirty children with IBD and 60 age and gender matched controls were enrolled. Anthropometric measurements and leptin levels were analysed and compared with controls. IBD children had significantly low weight for age (p=0.002), BMI percentiles (p=0.001) and leptin levels (p=0.009) compared to controls. There was a correlation between BMI and leptin levels in IBD children. In conclusion, this thesis has shown that one quarter of hospitalized children were overweight or obese, and further, that half of the hospitalised children were at high risk of nutritional deterioration and these children had longer hospital stay than children at no risk. Children with coeliac disease had similar anthropometric measurements, body compartments and leptin levels to controls. However, children with IBD had lower anthropometric measurements and leptin levels, indicating under-nutrition. Nutritional assessment should be a mandatory part of clinical management with nutritional status assessed by various tools including NRS, anthropometry, BIA and leptin levels.

Widespread increases in the prevalence of childhood obesity have raised the prospect of serious public health consequences in many countries. New Zealand is no exception; according to the most recent national estimates, approximately one in three children is overweight or obese. As a consequence, an understanding of the specific risk factors that predict this condition in children is becoming increasingly important. It is generally accepted that the promotion of physical activity is a key strategy for reducing the risk of childhood obesity. However, there is limited information describing physical activity and its relationship with body fatness in young New Zealanders. The overall aim of this thesis was to gain insight into the associations between excess fatness and physical activity in New Zealand children from a diverse range of socio-demographic groups. Three related studies were conducted to achieve this aim: a large descriptive survey of obesity and physical activity patterns in primary-aged children, and two preceding studies which develop the methodology for objective assessment of physical activity in this population. The first study provided the only validation data for the NL-2000 multiday memory (MDM) pedometer in children. In a sample of 85 participants aged 5-7 and 9-11 years, the NL-2000 offered similar accuracy and better precision than the widely used SW-200 pedometer (NL-2000: mean bias = -8.5 ± 13.3%; SW-200: mean bias = -8.6 ± 14.7%). The second study investigated reactivity to wearing pedometers over four 24-hour testing periods in 62 children aged 5-11 years. The sample was divided into two groups: one was given a full explanation of the function of the pedometer, while the other received no information prior to testing. The absence of significant differences in step counts between the first and last test periods indicated that there was no evidence of reactivity to this device for either preparation procedure. The central study presented in this thesis was the measurement of physical activity, body composition, and dietary patterns in 1,226 children aged 5-12 years, from which four chapters (4-7) were derived. The sample was ethnically diverse, with 46.8% European, 33.1% Polynesian, 15.9% Asian, and 4.1% from other ethnicities. Physical activity levels over three weekdays and two weekend days were assessed using NL 2000 pedometers. Percentage body fat (%BF) was determined using hand-to-foot bioelectrical impedance analysis with a prediction equation previously developed for New Zealand children. Waist and hip girths, height, and weight were measured using standard anthropometric techniques. Parent proxy questionnaires were used to assess demographic and lifestyle factors and pedometer compliance. The first reported analyses of this dataset (Chapter 4) examined the effect of weather conditions on children’s activity levels. In boys, a 10ºC rise in ambient temperature was associated with a 10.5% increase in weekday steps and a 26.4% increase in weekend steps. Equivalent temperature changes affected girls’ step counts on weekdays only (16.2% increase). Precipitation also had a substantial impact, with decreases in weekday and weekend step counts during moderate rainfall ranging from 8.3% to 16.3% across all sex, age, and socioeconomic (SES) groups. The aim of Chapter 5 was to understand the relationship between children’s step counts and their body mass index (BMI), waist circumference (WC), and %BF. Mean step counts for this sample were 16,133 ± 3,864 (boys) and 14,124 ± 3,286 (girls) on weekdays, and 12,702 ± 5,048 (boys) and 11,158 ± 4,309 (girls) on weekends. Significant associations were detected between steps.day-1 and both WC and %BF, but not between steps.day-1 and BMI. The findings in Chapter 6 extended these results by estimating the number of steps required to reduce the risk of excess adiposity in children (16,000 and 13,000 steps.day-1 for boys and girls, respectively). Finally, the study described in Chapter 7 examined the associations between excess adiposity and a series of demographic and lifestyle variables, providing the first assessment of body fat correlates in young New Zealanders. Our results indicated that children aged 11-12 years were 15.4 times more likely to be overfat (boys, %BF ≥ 25%; girls, %BF ≥ 30%) than those aged 5-6 years. In addition, the odds of overfat were 1.8 times greater in Asian children than in European children, and 2.7 times greater in the low SES group when compared with the high SES group. Three modifiable behaviours related to fat status were also identified: low physical activity, skipping breakfast, and insufficient sleep on weekdays. Clustering of these risk factors resulted in a cumulative increase in the prevalence of overfat.

CHARLES UNIVERSITY IN PRAGUE FACULTY OF PHYSICAL EDUCATION AND SPORT ADIPOSE TISSUE DISTRIBUTION BY PRESCHOOL CHILDREN- COMAPARATIVE STUDY ABSTRACT Head of the dissertation: Author: Prof. MUDr. Ivan Dylevský, DrSc. Mgr. Dominika Petrů Prague, 2014 Abstract The dissertation provides information about the distribution of subcutaneous adipose tissue in preschool-aged /5-6 years, n=141/ and younger school-aged children /8- 9 years, n=137/ in the Ústí region. In this review, we describe and evaluate the child's body with anthropometric parameters, skinfold, bioelectrical impedance analysis and selected sample /n=31/ with ultrasonography. We found an increased distribution of adipose tissue in older file with a concentration in the abdominal area and a higher reliability of skinfold than the BIA, considering the ultrasound examination. Key words: subcutaneous fat, skinfold, bioelectrical impedance analysis, ultrasonography

M.Tech. (Chiropractic) / Purpose: Low back pain affects the general population worldwide. Low back pain is a multi-factorial problem with debate as to the exact aetiology of low back pain. Thus, this study examines the relationship between lumbar spine lordosis, body fat percentage, physical activity level, lumbar spine range of motion and the incidence of low back pain. Method: There was a total of one hundred female participants between and including eighteen and thirty-five years of age. These females were symptomatic or asymptomatic of mechanical low back pain. Potential candidates were examined and accepted based on the inclusion and exclusion criteria. Participants were evaluated once. No treatment was administered. Procedure: Subjective responses were acquired through the Visual Analog Scale, the International Physical Activity Questionnaire and an Oswestry Low Back Pain and Disability Questionnaire. The objective evaluation included a physical examination and a lumbar spine regional examination. The participant’s height was measured using a stadiometer. The Bioelectrical Impedance Analysis (BIA) measured the participant’s weight, water content, lean tissue mass and body fat percentage. BMI was calculated from the weight and height recordings. Range of motion of the lumbar spine was measured with a Digital Inclinometer. A flexi curve ruler molded the lumbar spine lordosis of each participant, which was then traced onto a piece of paper to measure the magnitude of lumbar spine lordosis. Results: A clinical relationship did not exist between a hyperlordotic lumbar spine posture, the incidence of low back pain, body fat percentage and lumbar spine range of motion. A clinical relationship was evident between a hyperlordotic lumbar spine posture and the level of physical activity. Conclusion: Given that a clinical relationship exists between a hyperlordotic lumbar spine posture and the level of physical activity, physical activity specifically exercise to strengthen the abdominal muscles should be included in a treatment protocol to reduce the degree of lumbar spine lordosis if the degree is excessive.

Obezita představuje ve vyspělých zemích závažný zdravotní problém a hlavní rizikový faktor rozvoje kardiovaskulárních onemocnění, cukrovky 2. typu, nemocí pohybového aparátu a některých nádorových onemocnění. Je také provázena řadou komplikací a výrazně zhoršuje kvalitu života. 27 pacientů, kteří byli hospitalizováni za účelem redukce hmotnosti na oddělení D3 III. interní kliniky Všeobecné fakultní nemocnice v Praze v období ledna až počátku dubna roku 2017 byli sledováni z hlediska výskytu komorbidit a příjmu a výdeje energie za použití aplikace kaloricketabulky.cz, portálu casprozdravi.cz a krokoměrů Garmin Vivofit. Byla hodnocena vhodnost bioimpedanční metody pro sledování změn složení těla pacientů během redukčních pobytů za použití přístroje InBody S10. V souladu s teorií se ve sledované skupině pacientů vyskytovala v důsledku extrémní obezity celá řada komplikací. Diagnostická kritéria pro metabolický syndrom splňovalo 23 (85%) pacientů. Rozdílné hodnoty obsahu energie a jednotlivých živin v aplikacích kaloricketabulky.cz a Nutriservis jsou příčinou průměrného denního rozdílu 717 kJ mezi záznamy pacientů a nemocničním rozpisem. Průměrně pacienti ušli denně 4713 kroků. Pacienti průměrně zredukovali hmotnost o 7,6 kg (SD ±3,54). Bioimpedanční metoda vykazuje příliš vysokou variabilitu a není...

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第18646号 / 医博第3945号 / 新制||医||1006(附属図書館) / 31560 / 京都大学大学院医学研究科医学専攻 / (主査)教授 川上 浩司, 教授 横出 正之, 教授 千葉 勉 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

京都大学 / 0048 / 新制・課程博士 / 博士(人間健康科学) / 甲第21304号 / 人健博第60号 / 新制||人健||5(附属図書館) / 京都大学大学院医学研究科人間健康科学系専攻 / (主査)教授 古田 真里枝, 教授 藤井 康友, 教授 横出 正之 / 学位規則第4条第1項該当 / Doctor of Human Health Sciences / Kyoto University / DGAM

CHARLES UNIVERSITY IN PRAGUE FACULTY OF PHYSICAL EDUCATION AND SPORT ADIPOSE TISSUE DISTRIBUTION BY PRESCHOOL CHILDREN- COMAPARATIVE STUDY ABSTRACT Head of the dissertation: Author: Prof. MUDr. Ivan Dylevský, DrSc. Mgr. Dominika Petrů Prague, 2014 Abstract The dissertation provides information about the distribution of subcutaneous adipose tissue in preschool-aged /5-6 years, n=141/ and younger school-aged children /8- 9 years, n=137/ in the Ústí region. In this review, we describe and evaluate the child's body with anthropometric parameters, skinfold, bioelectrical impedance analysis and selected sample /n=31/ with ultrasonography. We found an increased distribution of adipose tissue in older file with a concentration in the abdominal area and a higher reliability of skinfold than the BIA, considering the ultrasound examination. Key words: subcutaneous fat, skinfold, bioelectrical impedance analysis, ultrasonography