Search Results (225)

Background/Objectives: Eustachian Tube Dysfunction (ETD) is a prevalent condition affecting middle ear pressure regulation, yet nationwide epidemiological data in Saudi Arabia remain limited. This study aimed to assess the prevalence of ETD and identify its associated factors among Saudi adults using a validated screening tool. Methods: A nationwide cross-sectional study was conducted between June 2024 and March 2025 among 1124 Saudi adults (aged ≥ 18 years) across five geographic regions. ETD was assessed using the validated Arabic version of the seven-item Eustachian Tube Dysfunction Questionnaire (ETDQ-7), with scores ≥ 14.5 indicating dysfunction. Data on demographic, anthropometric, clinical, and lifestyle characteristics were collected via an online questionnaire. Multiple linear regression analysis identified independent predictors of ETDQ-7 scores, with statistical significance set at p < 0.05. Results: The prevalence of ETD was 33.9% (95% CI: 31.1–36.8%), substantially higher than the 7% self-reported rate. Of affected participants, 29.6% had mild-to-moderate ETD and 4.3% had severe dysfunction. Multivariable regression analysis identified four significant independent predictors: higher body mass index (BMI) (β = 0.08; 95% CI: 0.03–0.16; p = 0.049), family history of hearing loss (β = 1.87; 95% CI: 0.90–2.83; p < 0.001), prior bariatric bypass surgery (β = 14.37; 95% CI: 3.33–25.41; p = 0.011), and allergies (β = 3.19; 95% CI: 2.30–4.07; p < 0.001). No significant associations were found with demographic factors, smoking, or other comorbidities. Conclusions: ETD affects approximately one-third of Saudi adults, with significant underdiagnosis. Obesity, genetic predisposition, bariatric surgery, and allergic conditions represent key modifiable and non-modifiable risk factors. These findings support implementing routine ETDQ-7 screening in primary care and targeted interventions for high-risk populations. Full article

Background: Childhood overweight and obesity represent growing public health challenges globally, driven by complex interactions between demographic, behavioral, and familial factors. This study assessed the prevalence and determinants of overweight and obesity among school-aged children and adolescents attending urban schools in the Aseer Region of Saudi Arabia (Abha and Khamis Mushait). Methods: A cross-sectional study was conducted among 413 urban school students aged 6–18 years. Anthropometric measurements were obtained using standardized procedures, and lifestyle behaviors were assessed through a structured questionnaire. Data were analyzed using descriptive statistics, Chi-square tests, and multivariate binary logistic regression. Variables with p < 0.05 in univariate analysis, alongside conceptually relevant predictors, were included in the final model. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were reported. Results: The combined prevalence of overweight and obesity was high, particularly among older age groups and secondary-school students. Significant associations were found between BMI category and age, school level, parental education, and family history of obesity. Lifestyle behaviors including fast-food consumption, low fruit and vegetable intake, prolonged screen time, and short sleep duration showed strong relationships with overweight/obesity. In the adjusted model, key predictors included frequent fast-food intake (AOR = 2.74), low fruit/vegetable intake (AOR = 2.20), physical inactivity (AOR = 1.70), high screen time (AOR = 2.40), short sleep duration (AOR = 1.55), and positive family history of obesity (AOR = 3.10). Conclusions: Childhood overweight and obesity in the Aseer Region are influenced by both modifiable lifestyle behaviors and familial predisposition. Targeted interventions promoting healthy dietary habits, adequate physical activity, reduced screen time, and sufficient sleep are essential. Preventive strategies should prioritize adolescents and children with a family history of obesity to effectively reduce obesity risk. Full article

Background: Rapid weight loss (RWL) is a widespread practice among judo athletes seeking to compete in lower weight categories. Restrictive nutritional and behavioral strategies used to achieve short-term reductions in body mass may impair physiological and psychological functioning. This study aimed to assess dietary behaviors, weight-cutting methods, and short-term physical and psychological effects of RWL among competitive judo athletes. Methods: A cross-sectional study was conducted between August and December 2024 among 70 judo athletes (17 women, 53 men) competing at national and international levels. Data were collected using an author-designed questionnaire addressing anthropometric variables, training history, RWL strategies, dietary restrictions, hydration manipulation, and post-weigh-in eating behaviors. Physical and psychological symptoms were assessed using frequency-based self-report measures. Results: Most athletes (95.7%) reported engaging in RWL, typically beginning between ages 13 and 16 years (65.7%). Athletes reduced an average of 3.64 ± 1.74 kg (2–5% of body mass). Common strategies included decreasing meal frequency (74.29%), increasing training load (72.86%), restricting fluids (68.57%), and using saunas (62.86%). Reported physical symptoms included weakness (71.43%), headaches (51.43%), and dizziness (45.71%), while psychological symptoms included irritability (57.14%), reduced motivation (40%), and tension (38.57%). Post-weigh-in binge eating occurred in 65.71% of athletes and was significantly associated with higher RWL magnitude (p < 0.05). Discomfort during competition related to overeating (55.71%) or insufficient intake (41.43%) was also frequent. Conclusions: RWL is highly prevalent among judo athletes and often begins early in training history. The strategies used are associated with adverse physical and psychological symptoms and maladaptive compensatory behaviors. These findings highlight the need for evidence-based nutritional education and individualized weight-management approaches to support athlete health and performance. Full article

Vasovagal syncope (VVS) affects 17% of children, significantly impairing quality of life. Machine learning (ML) models achieve high predictive accuracy of VVS in adults using blood pressure (BP) monitoring, but pediatric implementation remains challenging. The aim of the study was to evaluate whether ML models incorporating anthropometric data and heart rate variability (HRV) can predict VVS without BP monitoring in children with prior syncope or suspected VVS. We analyzed 87 participants (7–18 years) with VVS history. HRV indices (time-domain, frequency-domain, and nonlinear) were extracted from 5 min supine and standing ECG recordings using NeuroKit2. Multiple algorithms were tested with 10-fold cross-validation; SHAP analysis identified feature importance. AdaBoost achieved the performance of 71.0% accuracy, 76.3% sensitivity, and 63.3% specificity—78% of adult BP-dependent algorithm sensitivity. Weight, multifractal detrended fluctuation analysis during standing, and normalized low-frequency power were most influential. Alterations in symbolic dynamics and multiscale entropy indicated compromised autonomic complexity. ML models with anthropometric and HRV data show potential as an adjunctive screening tool to identify children at higher risk for syncope recurrence, requiring clinical confirmation. Full article

Background: Pediatric hypertension is an increasingly recognized health concern and is commonly influenced by modifiable factors such as dietary sodium intake and obesity and non-modifiable factors like family history of hypertension. Urinary sodium excretion provides an objective surrogate marker of sodium consumption and may be associated with blood pressure severity. This study aimed to evaluate urinary sodium excretion in children with primary hypertension (PH) and to test the hypothesis that higher sodium excretion is associated with less favorable clinical, biochemical, and blood pressure parameters. Methods: This retrospective, cross-sectional, single-center study analyzed data from 369 hypertensive patients and 59 healthy children. Patients with a confirmed diagnosis of PH and ambulatory blood pressure monitoring results were included in the study group. Clinical, anthropometric, laboratory, echocardiographic, and blood pressure data were examined, and sodium excretion was evaluated using both the spot urine sodium-to-creatinine ratio and 24-h urinary sodium per kilogram of body weight. Results: Children with hypertension exhibited higher urinary sodium excretion compared to the control group. Sodium excretion of the hypertensive group, measured using the sodium/creatinine ratio and 24 h urinary sodium excretion per kilogram, was positively correlated with 25-hydroxyvitamin D, the urinary potassium/creatinine ratio, and the urinary uric acid/creatinine ratio. Moreover, negative correlations were observed for both parameters with age, body weight, serum uric acid, and left ventricular mass. In the multivariate analysis, weighted Z-score (beta = −0.393), age (beta = −0.293), 25-OHD (beta = 0.182), and arterial hypertension in the father (beta = 0.166) predicted 24 h urinary sodium excretion. Children with excessive sodium excretion had a significantly higher systolic blood pressure load over 24 h. Conclusions: Urinary sodium excretion is elevated in children with PH. Children with a lower weight for their age, who are younger, and who have a father with arterial hypertension might be at higher risk of excessive urine excretion. Our findings underscore the clinical importance of dietary sodium reduction as a non-pharmacological therapeutic target, especially in these patient populations. Prospective studies are needed to evaluate its impact on long-term cardiovascular outcomes in this population. Full article

Background/Objectives: This study aimed to assess the associations between the Lifestyle Inflammation Score (LIS) and gestational diabetes mellitus (GDM), and glucose metabolism alterations (GMA) postpartum. Methods: A secondary analysis was conducted on 378 pregnant women at the end of pregnancy. Anthropometric, clinical, biochemical, and dietary parameters were evaluated. Postpartum reclassification was based on fasting serum glucose (>100 mg/dL), HbA1c (>5.7%), and/or a 2-h oral glucose tolerance test (>140 mg/dL). The LIS was calculated using a proxy index including smoking status, physical activity, and pregestational BMI, applying the beta coefficient from the original LIS model. Tertiles were created, with T3 indicating the highest level of proinflammatory exposure. Statistical analyses included Kruskal–Wallis, one-way ANOVA, linear-by-linear association, and multivariate logistic regression, adjusted for family history, gestational weight gain, carbonylated proteins, and adiponectin to evaluate associations between LIS and GDM, and adjusted for pharmacological treatment, gestational weight gain, and breastfeeding for LIS and GMA. Results: Higher LIS values were more common among women with GDM (T1 = 45.9%, T2 = 62.2%, T3 = 74.8%, p < 0.001) and among those with GMA (T1 = 34.4%, T2 = 45.6%, T3 = 53.7%, p = 0.019). Compared with the lowest tertile, the highest tertile of LIS was associated with greater odds of GDM (OR 3.72; 95% CI: 1.19–11.64, p = 0.024) and GMA (OR 2.69; 95% CI: 1.25–5.76, p = 0.011). Conclusions: A more proinflammatory lifestyle, as reflected by a higher LIS, increases the risk of progression to GDM and later to GMA. Full article

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is closely intertwined with glucose metabolism status (GMS). Bi-national comparative epidemiological data are lacking; therefore, this study aimed to provide new insights into MASLD and fibrosis prevalence and risk factors in Belgium, while comparing data from The Netherlands to uncover cross-country differences. Materials and Methods: A prospective cohort study (2019–2024) in Belgian primary and secondary care was compared with the Dutch Maastricht Study. Liver fat was measured using CAP (FibroScan^®), and anthropometric, clinical, and biochemical data were collected. Associations with CAP were analysed using multivariable linear regression, including sex, age, BMI, MetS, high SBP, CVD history, and country. Results: A total of 2436 individuals (Belgium and The Netherlands) were screened, of which 1928 were eligible: MASLD with normal GMS (38.3%), prediabetes (19.2%), and type 2 diabetes mellitus (T2DM; 42.5%). Belgian participants with T2DM had higher BMI and prevalence of MASLD. CAP values were significantly associated with female sex (−7.5 dB/m, 95%CI (−11.834; −3.056), p < 0.001), BMI (5.184 dB/m, 95%CI (4.627; 5.741), p < 0.001), and MetS (13.7 dB/m, 95%CI (8.456; 18.994), p < 0.001). Country-specific interactions showed differing effects of high SBP and CVD on CAP between Belgium and The Netherlands, with only the inverse association of CVD history (−10.756, 95%CI (−17.485; −4.027), p = 0.002) with CAP in The Netherlands being significant. Conclusions: MASLD and fibrosis are common in people with prediabetes and T2DM, underscoring the need for early detection and management. Obesity and metabolic risk were key factors, while a history of CVD appeared protective in the Dutch cohort but not in the Belgian one. Full article

Objectives: To examine age-specific growth patterns derived from Japanese cross-sectional data according to infants’ feeding and determine whether differences persist through preschool age. Methods: We analyzed secondary data from the 2023 National Growth Survey on Preschool Children in Japan, a single-wave nationwide cross-sectional survey. The participants were 8028 singleton, term-born, appropriate-for-gestational-age children aged 0–60 months without major health conditions. The feeding history up to 24 months was reported by parents and categorized as breastfed, formula-fed, or mixed-fed. Anthropometric measurements were obtained at a 1-month postnatal checkup or at checkups arranged for the survey, converted to standard deviation scores using Japanese references, and modeled with growth curves using the Lambda–Mu–Sigma method to summarize cross-sectional distributions by age. The feeding groups were compared at selected ages. Results: Breastfed infants were smaller in length/height and weight than formula-fed peers during the first 2 years, with the largest differences in infancy. The mean stature in the feeding groups became similar at older ages; by 60 months, standard deviation scores for stature and weight were comparable across the feeding groups. Head circumference patterns up to 36 months were not different by the feeding category. Conclusions: In Japan, early size differences by the feeding group show age-related convergence of cross-sectional group means by preschool, and head circumference patterns are similar across the groups. These findings support breastfeeding as sufficient for long-term growth without unnecessary formula supplementation. Full article

Background: Eating disorders (EDs) adversely affect health and athletic performance, yet their prevalence in adolescent female team athletes is understudied. Objectives: This exploratory pilot study assessed ED presence and associated factors in female basketball players aged 10–18 years from a high-level club in Granada, Spain. Methods: This cross-sectional pilot study examined 36 participants (mean age 13.3 ± 2.2 years) who completed the Spanish Eating Disorder Examination Questionnaire (S-EDE-Q). Body composition (Tanita TBF-300), sociodemographic characteristics, and sport-related factors were recorded. Associations between these covariates and S-EDE-Q global scores (GS) were examined via linear regression. Results: A higher Global Score (GS), indicating increased ED risk, correlated significantly with several factors: Lower paternal education (primary vs. university: p < 0.005) and lower socioeconomic level. Older age (AME = 0.30; p < 0.005) and greater muscle mass (p < 0.001). National competition level (p < 0.001), being a player in the pivot position (mean GS = 1.62), and presence of sport-related medical history (mean GS = 1.07). No associations were found with sport experience or weekly training hours. Conclusions: Although the overall risk of EDs is low, the association with specific factors (sociodemographic, anthropometric, and sports-related) allows vulnerable players to be identified. Longitudinal and larger-scale research is needed to confirm these initial findings and design targeted and early prevention strategies. Full article

Background/Objectives: Canada’s Food Guide 2019 includes advice such as “Cook more often” and “Eat meals with others”, which are considered healthy eating practices. However, mothers with a history of gestational diabetes mellitus (GDM) may face specific barriers to adopting healthy eating practices. This study aimed to compare eating practices between mothers with (GDM+) and without (GDM−) a history of GDM, and to explore the associations between eating practices, diet quality, and the anthropometric and cardiometabolic profile of these mothers. Methods: The cross-sectional study was conducted in Quebec (Canada) between 2012 and 2017. Eating practices were assessed using a self-administered questionnaire. Diet quality was evaluated by the Healthy Eating Food Index 2019 through a validated food frequency questionnaire. Weight, height, and waist circumference were measured, and body composition was obtained by absorptiometry. Results: Data from 105 GDM+ and 38 GDM− mothers were analyzed (mean age 37.5 years ± 4.9). GDM+ mothers were more likely to prepare a greater proportion of dinners (≥1 per week) using pre-prepared or processed foods than GDM− mothers (49.0% vs. 34.2%; p = 0.016). Among GDM+ mothers, those who prepared ≥1 dinners per week using pre-prepared or processed foods showed lower adherence to the “Whole-grain foods” (1.1 ± 0.8 vs. 1.9 ± 1.2; p = 0.002) and “Sodium” (4.9 ± 2.0 vs. 5.8 ± 2.0, p = 0.013) recommendations, had a higher percentage of total body fat (37.5% ± 7.6 vs. 34.0% ± 7.7; p = 0.041), a higher waist circumference (91.6 cm ± 13.9 vs. 87.1 cm ± 16.3; p = 0.030), and a higher glycated hemoglobin (5.6% ± 0.5 vs. 5.5% ± 0.3; p = 0.025) than those who used less pre-prepared or processed foods. Conclusions: GDM+ mothers were more likely than GDM− mothers to prepare dinners using pre-prepared or processed foods, an eating practice associated with less favorable components of diet quality and some altered anthropometric and cardiometabolic variables. Further investigation into the factors influencing cooking from scratch within this population is warranted. Full article

Background/Objectives: Osteoporosis is considered a surgical indication in primary hyperparathyroidism (PHPT), regardless of menopausal status. This pilot study aimed to evaluate the impact of menopause and PHPT on bone mineral density (BMD) and to explore additional clinical factors that may influence bone health. Methods: We conducted an observational pilot study including 204 postmenopausal women with osteopenia or osteoporosis who underwent surgery for sporadic PHPT between 2009 and 2021 at Cruces University Hospital (Spain). Demographic data, anthropometric data, date of last menstrual period, years since menopause (YSM), and the clinical history of bone fragility were collected prior to parathyroidectomy. Biochemical parameters and months with hypercalcemia (MHCa)—as a surrogate for PHPT exposure—were analyzed. BMD results were expressed as a densitometric index, the T-Score. Results: Higher age (p = 0.043), greater body mass index (BMI) (p = 0.039), more YSM (p = 0.027), lower serum calcium levels (s-Ca) (p = 0.04), and glucocorticoid treatment antecedents (GcT) (p = 0.029) were all significantly associated with femoral osteoporosis. Similarly, higher weight (p = 0.004), greater MHCa (p = 0.01), lower height (p = 0.01) and s-Ca levels (p = 0.002) were significantly associated with spinal osteoporosis. Furthermore, logistic regression multivariate analysis determined that femur density was independently influenced by YSM (p < 0.001), s-Ca (p = 0.018), BMI (p = 0.002) and GcT (p = 0.006). Osteoporosis of the spine was also independently associated with YSM (p = 0.036), s-Ca (p = 0.031) and also with body weight (p = 0.003). Conclusions: The duration of menopause (YSM), rather than PHPT severity, is an independent predictor of osteoporosis in postmenopausal women. Full article

Introduction: Over the last two decades, obesity has evolved into a global pandemic. Environmental pollutants, as endocrine disruptors, may play a key role in the development of obesity. The study aimed to assess the relationship between the concentration of certain trace elements and heavy metals (Cu, Zn, Mn, Co, Cr and Fe) and ferritin in blood serum, with anthropometric and physiological parameters associated with overweight and obesity in individuals following myocardial infarction and without a previous myocardial infarction. Method: The study was conducted in a group of 146 respondents divided into two groups: a study group (SG) of patients that had a history of myocardial infarction (n = 74) and a control group (CG) of patients that had no history (n = 72). The inductively coupled plasma mass spectrometry was employed to assess the concentration of trace elements and heavy metals. Measurements were taken to determine the anthropometric indices associated with overweight and obesity. Results: In the SG, there was a positive correlation between Cr concentration and body adiposity index (BAI) and a negative correlation between Zn, Zn/Cu, and ferritin level and percentage body fat (FM%). In the CG, there was a positive correlation between Zn concentration and WHtR and between ferritin level and BMI, WC, WHR and WHtR. Additionally, a negative correlation was found between Mn concentration and WHR and ferritin level and BAI and FM%. Conclusions: This study found a link between certain blood concentrations of trace elements and heavy metals and anthropometric and physiological indices associated with overweight and obesity. It, therefore, has substantial implications for public health. Full article

Background: Adherence to Medical Nutrition Therapy (MNT) is a key determinant of therapy success, particularly in chronic diseases like chronic kidney disease (CKD). MNT in CKD requires significant changes in patient’s dietary habits, which can affect long-term adherence. This study aims to evaluate the adherence to MNT in stage 5 CKD patients undergoing conservative kidney management (CKM), identifying potential challenges and strengths of nutritional intervention. Methods: We enrolled in 94 stage 5 CKD patients undergoing CKM at the University Hospital of Modena, Italy. We collect clinical data from medical and nutrition records. The inclusion criteria comprised patients of all genders, ages, and ethnicity with stage 5 chronic kidney disease (CKD), in pre-dialysis, enrolled in the nephrology and dietetics program, who had access to 24-h urine tests, anthropometric measurements, and dietary history records. Exclusion criteria included patients with CKD stages lower than 5, those who had not undergone at least one nutritional assessment, or lacked accessible 24-h urine data. The study utilized medical and dietary records from September 2017 to March 2025. The primary outcome was the assessment of adherence to medical nutrition therapy (MNT), comparing prescribed protein intake with actual intake, estimated from dietary history (DH). Protein intake was compared with normalized protein nitrogen appearance (nPNA) as stated by recent guidelines. Additional factors influencing adherence, such as age, gender, comorbidities, physical activity, and prior dietary interventions, were also evaluated. Anthropometric measurements and biochemical tests were collected, and dietary intake was assessed using a seven-day DH. Results: Data were analyzed using descriptive statistics, linear correlation models, univariate logistic regression, t-tests, paired t-tests, and chi-square tests, with significance set at p < 0.05. Most of the patients follow suggested energy and protein intakes limits; however, substantial individual variability emerged Bland–Altman analysis indicated a moderate bias and wide limits of agreement for energy intake (+116 kcal; limits of agreement –518.8 to +751.3 kcal), revealing frequent overestimation in self-reports. Protein intake showed less systematic error, but discrepancies between dietary recall and biochemical markers persisted. Protein intake decreased significantly over time (p < 0.001), while correlation with nPNA did not reach statistical significance (ρ = 0.224, p = 0.051). No significant associations were identified between adherence and most clinical or lifestyle factors, although diabetes was significantly associated with lower adherence to protein intake (p = 0.042) and a predominantly sedentary lifestyle showed a borderline association with energy intake adherence (p = 0.076), warranting further investigation. Longitudinal analysis found stable BMI and body weight, alongside notable reductions in sodium (p = 0.018), potassium (p = 0.045), and phosphorus intake (p < 0.001) over time. Conclusions: Assessing dietary adherence in CKD remains complex due to inconsistencies between self-reported and biochemical estimates. These findings highlight the need for more objective dietary assessment tools and ongoing, tailored nutritional support. Multifaceted interventions—combining education, personalized planning, regular monitoring, and promotion of physical activity—are recommended to enhance adherence and improve clinical outcomes in this vulnerable population. Full article

Background: There are limited data on the association between B12 levels, objective sleep quality, and cardiovascular disease in patients with obstructive sleep apnoea (OSA). Therefore, the aim of our study was to assess vitamin B12 levels in a sleep clinic population in Crete, Greece, and investigate possible correlations with polysomnographic parameters and prevalent cardiovascular disease (CVD). Methods: In this cross-sectional study, data from 1468 recruited patients with OSA from the clinical database of the Sleep Disorders Center, Department of Respiratory Medicine, School of Medicine, University of Crete, were analyzed. OSA was defined as an apnoea–hypopnoea index ≥ 5 events per hour of sleep after type-1 Polysomnography (PSG). Data regarding anthropometrics, socio-demographics, and medical history was obtained. Logistic regression analysis was applied to examine the effect of vitamin B12 levels on PSG parameters and prevalent CVD after controlling for potential explanatory variables, including age, gender, obesity, smoking status, and co-morbidities. Results: The median vitamin B12 was 380.5 (301, 490) pg/mL. After adjustments, Vitamin B12 levels < 380.5 were associated with 24% higher odds of prolonged sleep latency (≥40 min) prevalence (OR = 1.240, 95% CI = 1.005–1.531, p = 0.045) and alterations in the proportion of NREM and REM sleep stages with 2.3 times higher likelihood of elevated NREM sleep > 80% of total sleep time (OR = 2.312, 95% CI = 1.049–5.096, p = 0.038) and 2.9 times higher likelihood of low REM sleep < 20% of total sleep time (OR = 2.858, 95% CI = 1.197–6.827, p = 0.018). Moreover, Vitamin levels < 380.5 were significantly associated with a 59.9% increase in the odds of prevalent CVD (OR = 1.599, 95% CI = 1.035–2.471, p = 0.034). Conclusions: In conclusion, our results suggest that vitamin B12 status may be associated with impaired objective sleep quality in OSA patients, potentially influencing prevalent CVD. However, further prospective research is needed to establish causality and elucidate the potential underlying mechanisms that could link vitamin B12 levels to various sleep parameters and cardiovascular disease in patients with OSA. Full article

Background and Objectives: Developmental dysplasia of the hip (DDH) in children can result in long-term skeletal complications, including a reduced bone mineral density (BMD) and an increased risk of osteoporosis. This study aimed to evaluate BMD in children with DDH and to identify clinical, functional, and nutritional factors associated with reduced BMD. Materials and Methods: A cross-sectional study was conducted on 25 children aged 5–10 years with confirmed DDH. Bone mineral density was measured at the total body, subtotal, and lumbar spine using dual-energy X-ray absorptiometry (DXA), and Z-scores were calculated. Functional assessments included isometric muscle strength, weight-bearing symmetry, and physical activity measured via accelerometry. Demographic data and daily calcium intake were recorded. Correlation and multiple linear regression analyses were performed to determine predictors of BMD. Results: Most participants exhibited normal growth and mobility, with mild asymmetries in limb strength and length. The mean total BMD was within normative ranges, whereas the lumbar spine Z-score (−1.41 ± 1.72) was mildly reduced. BMD positively correlated with age, anthropometric measures, weight-bearing capacity, and calcium intake, and negatively correlated with a family history of osteoporosis. Multiple regression analysis identified the muscle strength symmetry index as the strongest independent predictor of BMD across all sites (subtotal Z-score: β = 1.000, p < 0.001; total Z-score: β = 0.425, p = 0.023; lumbar Z-score: β = 0.499, p = 0.014). Physical activity levels showed no significant associations with BMD. Conclusions: Children with DDH generally demonstrate preserved overall BMD; however, mild lumbar spine deficits may occur. Muscle strength symmetry appears to be the most influential modifiable factor for optimizing bone health in this population, highlighting the importance of targeted physiotherapy interventions. Full article