Unhealthy lifestyle and oxidative damage in childhood obesity

  • Rachele De Giuseppe
  • Valeria CalcaterraEmail author
  • Ginevra Biino
  • Matteo Manuelli
  • Noelia Rodriguez Mier
  • Melissa Mantelli
  • Maria De Filippo
  • Gianguido Cossellu
  • Hellas Cena
Original Article



Oxidized LDL cholesterol (oxLDL) has been considered as a sensor of oxidative stress (OS) in childhood obesity. We integrated and related our oxLDL existing results previously assessed in overweight/obese children to lifestyle variables to investigate OS-related lifestyle variables.


178 Caucasian children/adolescents have been evaluated and according to BMI percentiles have been classified as normal weight (BMI < 75th); overweight (BMI 75–97th) and obese (BMI > 97th). Serum oxLDL levels have been measured. The dietary habits and physical activity have been also assessed.


No differences between normal weight and overweight/obese children were detected according to the total score of dietary habits section. Normal weight subjects reported a higher total physical activity score (p = 0.001) compared to overweight/ obese children. No correlation between oxLDL and total dietary habits and physical activity scores was noted. Increased oxLDL in subjects drinking < 1 L/day of water (p = 0.022) and in daily consumers of chocolate drinks at breakfast (p = 0.029) was observed, while a decreased oxLDL was reported in subjects consuming a breakfast based mainly on fruits (p = 0.004). Moreover, “high-fat diet” and “always eating a dessert at the end of the meal” were correlated with increased oxLDL with a trend towards significance. As regards physical activity, no correlations were observed.


Diet and physical activity may not have an immediate impact on OS response in children with or without obesity. Unhealthy lifestyle, including increased fat, simple sugar intake, poor water intake, emerged as external exposome predictors of OS, that may be monitored to improve health status.

Level of evidence

Level III, case-control analytic studies.


Childhood obesity Dietary habits Physical activity Unhealthy lifestyle Oxidative damage 


Compliance with ethical standards

Conflict of interest

The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

Ethical statement

This study was conducted according to the Good Clinical Practice guidelines and was approved by the Human Ethic Committees of Fondazione IRCCS Policlinico S. Matteo of Pavia (Protocol number: 20150005231).

Informed consent

The informed written consent of a parent or legal guardian was required for subjects aged < 18, and the subjects aged ≥ 8 were asked to give their written assent. Patients’ parents and patients > 8 years gave their written consent to data publication. Ethics Committee also approved data publication.


  1. 1.
    Nishtar S, Gluckman P, Armstrong T (2016) Ending childhood obesity: a time for action. Lancet 387:825–827. CrossRefPubMedGoogle Scholar
  2. 2.
    Ho E, Karimi Galougahi K, Liu CC, Bhindi R, Figtree GA (2013) Biological markers of oxidative stress: applications to cardiovascular research and practice. Redox Biol 1:483–491. CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Yadav UC, Rani V, Deep G, Singh RK, Palle K (2016) Oxidative stress in metabolic disorders: pathogenesis, prevention, and therapeutics. Oxid Med Cell Longev 2016:9137629. CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Lechuga-Sancho AM, Gallego-Andujar D, Ruiz-Ocaña P, Visiedo FM, Saez-Benito A, Schwarz M, Segundo C, Mateos RM (2018) Obesity induced alterations in redox homeostasis and oxidative stress are present from an early age. PLoS One 13:e0191547. CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Kilic E, Özer ÖF, Erek Toprak A, Erman H, Torun E, Kesgin Ayhan S, Caglar HG, Selek S, Kocyigit A (2016) Oxidative stress status in childhood obesity: a potential risk predictor. Med Sci Monit 22:3673–3679. CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Calcaterra V, De Giuseppe R, Biino G, Mantelli M, Marchini S, Bendotti G, Madè A, Avanzini MA, Montalbano C, Cossellu G, Larizza D, Cena H (2017) Relation between circulating oxidized-LDL and metabolic syndrome in children with obesity: the role of hypertriglyceridemic waist phenotype. J Pediatr Endocrinol Metab 30:1257–1263. CrossRefPubMedGoogle Scholar
  7. 7.
    EFSA Panel on dietetic Products, Nutrition and Allergies (NDA) (2011) Guidance on the scientific requirements for health claims related to antioxidants, oxidative damage and cardiovascular health. EFSA J 9:2474. CrossRefGoogle Scholar
  8. 8.
    Cole TJ, Lobstein T (2012) Extended international (IOFT) body mass index cut-offs for thinness, overweight and obesity. Pediatr Obes 7:284–294. CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Turconi G, Celsa M, Rezzani C, Biino G, Sartirana MA, Roggi C (2003) Reliability of a dietary questionnaire on food habits, eating behavior and nutritional knowledge of adolescents. Eur J Clin Nutr 57:753–763. CrossRefPubMedGoogle Scholar
  10. 10.
    Bass R, Eneli I (2015) Severe childhood obesity: an under-recognised and growing health problem. Postgrad Med J 91:639–645. CrossRefPubMedGoogle Scholar
  11. 11.
    Fonte ML, Casali MP, Roggi C, Turconi G, Cena H (2014) Does physical activity and sport practice lead to a healthier lifestyle and eating habits in male adolescents? J Nutr Health Sci 1:1. CrossRefGoogle Scholar
  12. 12.
    Fogelholm M (2008) How physical activity can work? Int J Pediatr Obes 3:10–14. CrossRefPubMedGoogle Scholar
  13. 13.
    Hills AP, Andersen LB, Byrne NM (2011) Physical activity and obesity in children. Br J Sports Med 45:866–870. CrossRefPubMedGoogle Scholar
  14. 14.
    Daniels MC, Popkin BM (2010) Impact of water intake on energy intake and weight status: a systematic review. Nutr Rev 68:505–521. CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Milla-Tobarra M, García-Hermoso A, Lahoz-García N, Notario-Pacheco B, Lucas-de la Cruz L, Pozuelo-Carrascosa DP, García-Meseguer MJ, Martínez-Vizcaíno V (2016) The association between water intake, body composition and cardiometabolic factors among children: the Cuenca study. Nutr Hosp 33:19–26. CrossRefGoogle Scholar
  16. 16.
    Khan N, Monagas M, Andres-Lacueva C, Casas R, Urpi-Sarda M, Lamuela-Raventos RM, Estruch R (2012) Regular consumption of cocoa powder with milk increases HDL cholesterol and reduces oxidized LDL levels in subjects at high-risk of cardiovascular disease. Nutr Metab Cardiovasc Dis 22:1046–1053. CrossRefPubMedGoogle Scholar
  17. 17.
    Kesh SB, Sarkar D, Manna K (2016) High-fat diet-induced oxidative stress and its impact on metabolic syndrome: a review. Asian J Pharm Clin Res 9:47–52. CrossRefGoogle Scholar
  18. 18.
    Jung S, Smith-Warner SA, Willett WC, Wang M, Wu T, Jensen M, Eliassen AH (2016) Healthy dietary patterns and oxidative stress as measured by fluorescent oxidation products in nurses’ health study. Nutrients 8:587. CrossRefPubMedCentralGoogle Scholar
  19. 19.
    Holt EM, Steffen LM, Moran A, Basu S, Steinberger J, Ross JA, Sinaiko AR (2009) Fruit and vegetable consumption and its relation to markers of inflammation and oxidative stress in adolescents. J Am Diet Assoc 109:414–421. CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  • Rachele De Giuseppe
    • 1
  • Valeria Calcaterra
    • 2
    • 3
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  • Ginevra Biino
    • 4
  • Matteo Manuelli
    • 1
  • Noelia Rodriguez Mier
    • 1
    • 5
  • Melissa Mantelli
    • 6
  • Maria De Filippo
    • 2
    • 3
  • Gianguido Cossellu
    • 7
  • Hellas Cena
    • 1
    • 8
  1. 1.Dietetics and Clinical Nutrition Laboratory, Department of Public Health, Experimental and Forensic MedicineUniversity of PaviaPaviaItaly
  2. 2.Department of Maternal and Children’s Health, Pediatric Endocrinology UnitFondazione IRCCS Policlinico S. MatteoPaviaItaly
  3. 3.Department of Internal MedicineUniversity of PaviaPaviaItaly
  4. 4.Institute of Molecular GeneticsNational Research Council of ItalyPaviaItaly
  5. 5.KU LeuvenLeuvenBelgium
  6. 6.Immunology and Transplantation Laboratory/Cell Factory/Pediatric Hematology/Oncology DepartmentFondazione IRCCS Policlinico S. MatteoPaviaItaly
  7. 7.Department of Biomedical, Surgical and Dental SciencesUniversity of Milan, Fondazione IRCCS Ca’ GrandaMilanoItaly
  8. 8.Clinical Nutrition and Dietetics Service, Unit of Internal Medicine and Endocrinology, ICS Maugeri IRCCSUniversity of PaviaPaviaItaly

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