Aim of the study: In 2006-2008 a survey analyzing food patterns, intake of main food items and leisure time activities of 5,410 schoolchildren was carried out. Methods: The study was performed in 13 randomly selected regions of Slovakia. 5,410 elementary school children (2,848 girls and 2,562 boys) aged from 6.3 to 15.9 years, mean age was 11±2.6 years, were included. The data collected by questionnaire concerned nutrition and leisure time activities. Results: Noteworthy results are that only 63% of participants eat breakfast regularly. Almost all of the children eat lunch during workdays regularly and 60.9% prefer a cooked (hot) dish for supper. Although dairy products are a substantial part of child nutrition, in general their consumption in our sample was low. Only 50.1% of children consume these daily and 62% of children drink milk daily, more often boys than girls. A striking observation is that only 65.5% of interviewed pupils eat fruit every day and 30.9% of them eat vegetables daily. The frequency of consumption of poultry and pork in our sample was almost the same, however, the analysis showed that only 14% of children consume fish once per week. Moreover, only 12.6% of subjects prefer wholegrain bread. In our sample 56.8% of children eat sweets daily, 32% prefer a salty snack almost 2 times per week. Within the group of pupils 35.8% do not attend physical trainings even once a week. Almost every child is used to watch TV and 64% of them play PC games daily. While both girls and boys watched TV on average over 2 hours, boys spend more time on PC per day than girls (girls 0.72 hours per day vs. boys 1.13 hours per day, p<0.001). The food patterns and leisure time activities of children older than 11 years and rural pupils were less favourable. Conclusions: According to results of our analysis we recommend to increase the consumption of dairy products, fresh fruits and vegetables in Slovak schoolchildren and spare no effort in making children to take breakfast regularly. It is necessary to promote daily moderate physical activity. Nutritional and lifestyle education should begin already in childhood.

SGA-born children are more prone to developing endocrine-metabolic abnormalities than non-obese children born AGA, but they are at less risk than obese AGA-born children. We should provide specialized care for obese children already in prepubertal age and pay attention to SGA-born children.

Melanocortin-4 receptor (MC4R) deficiency is the most frequent monogenic form of obesity. The contribution of MC4R mutations to the Slovak population has not been investigated as yet. We screened the coding sequence of the MC4R gene in a cohort of 210 Slovak obese children and adolescents. We identified four different mutations in four patients, giving a mutation detection rate of 0.95%. Of these, three were missense mutations previously identified and characterized by other research groups (p.R7C, p.S127L and p. R305W, respectively). One was a novel nonsense mutation p.W174* detected in a severely obese 7-year-old boy. This mutation was further analyzed in family segregation analysis and exhibited variable penetrance. Two known amino acid polymorphisms (p.V103I and p.I251L) were also identified in seven subjects of our cohort group. We also performed multifactorial statistical analysis to determine the influence of genotypes on standard biochemical blood markers. No significant influence was observed in carriers of DNA variants on tested parameters. We conclude that rare heterozygous MC4R mutations contribute to the onset of obesity only in a few cases in the Slovak population.

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