Qualidade de vida e comportamento alimentar associados à constipação intestinal funcional em crianças

Abstract

Introduction: Functional constipation (FIC) is prevalent in children, affecting 9.5% of the pediatric population, but approximately 90% has a functional cause. Associated factors such as physical activity, screen time, and adequate fiber and water intake have conflicting results in the literature. The occurrence of FIC can impact the quality of life of children and adolescents. Eating behavior has been incipiently reported as an associated factor. Objective: To compare quality of life (QoL), eating behavior, social, demographic, and clinical characteristics, water intake, physical activity, and screen time between children with and without FIC, in addition to correlating age with QoL domains and subscales of the eating behavior questionnaire. Methods: Case-control study with children aged 2 to 10 years. Sociodemographic and lifestyle variables were assessed, and validated questionnaires for analyzing QoL and eating behavior (PedsQL 4.0 and CEBQ) were administered. The SPSS software (version 24.0) was used to apply the Mann-Whitney U test to continuous variables and the Fisher's exact test to categorical variables, in addition to Spearman's correlation to assess the relationships between age and scale domains, adopting a statistical significance of p < 0.05. Results: Forty-four participants were included (21 with CF and 23 without). The mean age (Standard Deviation [SD]) was 5.48 (± 2.46) years in the CF group and 4.96 (± 2.18) years in the control group, with no significant difference between the groups. Most participants lived in rural areas, and most caregivers had completed high school (38.1% and 52.2%, respectively). Both groups exhibited a higher proportion of eutrophic children (71.4% in the CF group and 65.2% in the control group; p = 0.302). All participants in the control group and 71.4% of those in the CF group were born at term. Exclusive breastfeeding for at least six months was reported in 52.4% of children with CF, compared with 43.5% in the control group. Children with CF had a higher frequency of excessive emotional eating. Both groups demonstrated insufficient water intake and physical activity levels. Overall QOL scores were comparable between groups. In the CF group, a strong negative correlation was found between age and "desire to drink" (rs = -0.82, p = 0.005), and a moderate positive correlation between age and school activity (rs = 0.48, p = 0.018). In the control group, a moderate negative correlation was observed between age and physical capacity (rs = -0.45, p = 0.038), while a strong positive correlation was found between age and school activity (rs = 0.68, p = 0.001). Conclusions: The study showed that children with functional constipation present greater emotional overeating. Water intake was insufficient and screen time was excessive in both groups. Although there were no significant differences in overall quality of life, aspects such as school activity were more impacted in constipated children. These findings may suggest the need for a multidisciplinary approach that considers emotional, behavioral, and environmental factors for more effective management of the disorder.