Frontiers in Nutrition · Published 2026-08-03 · DOI 10.3389/fnut.2026.1905544
Patrícia Zamberlan, Clara Doria, Ana Clara S. R. Praxedes, Ana Paula Scoleze Ferrer, Darusa C. Souza, Claudia B. Fonseca, Flávia C. Yarshell, Pedro Henrique P. Sampaio, Michele Luglio, Bruno Gualano, Rafael Almeida Azevedo, Katia Kozu, Nadia Emi Aikawa, Lucia Maria Arruda Campos, Andreia Watanabe, Marlene P. Garanito, Luiz Vicente R. F. Silva Filho, Ricardo Katsuya Toma, Caroline G. B. Passone, Louise Cominato, Antônio Carlos Pastorino, Clovis Artur Silva, Artur Delgado
IntroductionYouth with special health care needs (YSHCN) are particularly vulnerable during the transition from pediatric to adult healthcare. Although nutritional status is a potentially modifiable determinant of health, its relationship with transition readiness and health-related quality of life (HRQoL) during this period remains poorly understood.ObjectiveTo investigate the association of nutritional status and socioeconomic factors with transition readiness and HRQoL in YSHCN undergoing healthcare transition.MethodsThis cross-sectional study included 218 consecutive YSHCN followed at a tertiary university hospital in Brazil. Transition readiness was assessed using the Transition Readiness Assessment Questionnaire (TRAQ), and HRQoL was evaluated using the Pediatric Quality of Life Inventory 4.0 (PedsQL 4.0). Nutritional status was assessed using body mass index-for-age (zBMI/A) and height-for-age (zH/A) z-scores according to World Health Organization standards. Multivariable linear regression models were used to identify factors independently associated with TRAQ and PedsQL scores. Logistic regression analyses were performed to identify predictors of low transition readiness (TRAQ <3.5).ResultsNutritional status assessed by BMI-for-age (zBMI/A) was not associated with transition readiness or HRQoL. In multivariable analyses, female sex (β = 0.18, p = 0.002) and older age (β = 0.12, p = 0.001) were independently associated with higher TRAQ scores. Higher height-for-age (zH/A) (β = 1.86, p = 0.031) and higher family income (β = 2.87, p = 0.025) were independently associated with better HRQoL, whereas female sex was associated with lower HRQoL (β = −7.25, p = 0.001). In logistic regression analyses, younger age (OR = 0.82, 95% CI 0.70–0.96, p = 0.023) and male sex (OR = 0.48, 95% CI 0.25–0.92, p = 0.023) were significant predictors of low transition readiness, while nutritional risk was not associated with the outcome. The logistic model demonstrated modest discrimination (AUC = 0.689).ConclusionIn YSHCN undergoing healthcare transition, BMI-for-age was not associated with transition readiness or HRQoL. In contrast, linear growth and family income were independently associated with better HRQoL, highlighting the importance of developmental and socioeconomic factors in patient-reported outcomes. These findings reinforce the multifactorial nature of transition readiness and HRQoL and support the incorporation of nutritional, developmental, and psychosocial assessment into multidisciplinary healthcare transition programs.
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Zamberlan, P., Doria, C., Praxedes, A., et al. (2026). Linear growth is independently associated with health-related quality of life during healthcare transition in youth with special health care needs. Frontiers in Nutrition. https://doi.org/10.3389/fnut.2026.1905544