DOI QR코드

DOI QR Code

12주간 복합운동과 영양교육이 비만중년여성의 신체조성, 간기능, 혈중지질 및 인슐린 저항성에 미치는 영향

Effect of 12 Weeks Combined Exercise and Nutrition Education on Body Composition, Liver Function, Serum Lipids and Insulin Resistance in Obese Middle-aged Woman

  • 김해열 (부산대학교 체육교육과) ;
  • 곽이섭 (동의대학교 체육학과) ;
  • 성기동 (부산대학교 체육교육과) ;
  • 손원목 (부산대학교 체육교육과) ;
  • 김도연 (부산대학교 체육교육과) ;
  • 백영호 (부산대학교 체육교육과)
  • Kim, Hae-Yeol (Department of Physical Education, Pusan nstional University) ;
  • Kwak, Yi-Sub (Department of Physical Education, Dong-Eui University) ;
  • Sung, Gi-Dong (Department of Physical Education, Pusan nstional University) ;
  • Son, Won-Mok (Department of Physical Education, Pusan nstional University) ;
  • Kim, Do-Yeon (Department of Physical Education, Pusan nstional University) ;
  • Baek, Yeong-Ho (Department of Physical Education, Pusan nstional University)
  • 투고 : 2017.04.04
  • 심사 : 2017.06.28
  • 발행 : 2017.07.30

초록

본 연구는 체지방률 30% 이상인 비만 중년여성을 대상으로 복합운동 영양교육군(n=7), 복합운동군(n=7), 대조군(n=7) 총21명을 대상으로 연구한 결과 다음과 같은 결론을 얻었다. 12주간 복합운동과 영양교육의 실시는 비만 중년 여성의 체지방률, 제지방량, GOT, TC, TG, HDL-C, 인슐린 저항성을 개선시키는 효과를 나타냈다. 이러한 결과는 복합운동과 영양교육이 비만중년여성의 신체조성, 간기능, 혈중지질, 및 인슐린 저항성에 긍정적인 영향을 미쳐 중년여성의 비만을 개선하는데 효과적인 프로그램 사료되며, 추후에도 비만중년여성의 운동방법, 운동빈도, 식이방법 등을 고려한 다양한 연구가 필요할 것으로 사료된다.

This study investigated the effect of 12 weeks combined exercise and nutrition education program on body composition, liver function, serum lipids and insulin resistance in obese middle-aged women. The combined exercise program was performed for 55 minutes 3 times per week during which the intensity progressively increased from RPE 13 to 14, 60-70%HRR (1~5 weeks), RPE 15 to 17, 70-80% HRR (6~12 weeks) and nutrition education was conducted 20 minutes one day per week. The subjects were 21 obese middle-aged women were composed of the nutrition education group (A, n=7), combined exercise group (B, n=7), and the control group (C, n=7). The results of the study in the nutrition education group and combined exercise group were as follows; The A and B group had significantly lower body composition than did the control group. The A group had significantly lower liver function, TC, TG, HDL-C, and HOMA-IR than did the control group. Consequently, combined exercise and nutrition education program effective in preventing diabetes caused by obesity in obese middle-aged woman. On the basis of the results of this study, the following recommendations are made for further studies: additional studies are needed to confirm the results of this study and to compare the effects of combined exercise on these variables in obese and non-obese men and women by age or exercise type; they are also needed to develop effective nutrition education programs for different age groups or body types.

키워드

참고문헌

  1. An, J. H. 2005. The effects of the low calorie diet and aerobic exercise therapy on the body composition, exercise capacity and muscle strength in the obese women. Master's thesis Kwan Dong University, Gangwon, Korea.
  2. Beak, I. Y. 2009. Exercise and energy metabolism. Seoul: Daehanmedia.
  3. Beak, I. Y. 2013. Health & exercise. Seoul: Chenongsong.
  4. Brancaccio, P., Maffulli, N., Buonauro, R. and Limongelli, F. M. 2008. Serum enzyme monitoring in sports medicine. Clin. Sports Med. 27, 1-18. https://doi.org/10.1016/j.csm.2007.09.005
  5. Byun, J. C. and Woo, H. Y. 2009. Effects of long-term combined exercise training on body composition, blood lipids, inflammatory markers and ghrelin level in obese and non-obese men. Kor. J. Sport sci. 24, 455-465.
  6. Camacho, R. C., Galassetti, S. N., David, S. N. and Wasserman, D. H. 2005. Glucoregulation during and after exercise in health and insulin-dependent diabetes. Exerc. Sport Sci. Rev. 33, 17-23.
  7. Cho, J. Y. and Choi, W. J. 2014. The effect of 12 weeks combined exercise on blood lipid and inflammatory factors in the obese middle aged women. Kor. Soc. Grow. Develop. 22, 273-281.
  8. Choi, S. L. 2002. Effect of long-term bicycle exercise on blood lipids and serum enzyme in obese student. Master's thesis Chonnam National University, Gwangju, Korea.
  9. Cornette, R. 2008. The emotional impact of obesity on children. Worldviews Evid. Based Nurs. 5, 136-141. https://doi.org/10.1111/j.1741-6787.2008.00127.x
  10. Matthews, D. R., Hosker, J. P., Rudenski, A. S., Naylor, B. A., Treacher, D. F. and Tuner, R. C. 1985. Homeostasis model assessment: Insulin resistance and b-cell function from fasting plasma glucose and insulin concentration in man. Diabet 28, 412-419. https://doi.org/10.1007/BF00280883
  11. Durant, R. H., Baranowski, T., Rhodes, T., Gutin, B., Thompson, W. O. and Carroll, R. 1993. Association among serum lipid and lipoprotein concentrations and physical activity, physical fitness, and body composition in young children. J. Appl. Physiol. 123, 185-192.
  12. Ervin, R. B. 2009. Prevalence of metabolic syndrome among adults 20 years of age and over, by sex, age, race and ethnicity, and body mass index: United States, 2003-2006. Natl. Health Stat. Report. 5, 1-7.
  13. Evens, W. and Rosenberg, I. H. 1991. Biomarker. New York: Simon & Schuster.
  14. Fasshauer, M. and Paschke, R. 2003. Regulation of adipocytokines and insulin resistance. Diabetologia 46, 1594-603. https://doi.org/10.1007/s00125-003-1228-z
  15. Gill, J. M. 2007. Physical activity, cardiorespiratory fitness and insulin resistance: a short update. Curr. Opin. Lipodol. 18, 47-52. https://doi.org/10.1097/MOL.0b013e328012b8bd
  16. Gug, D. H. 2008. Effects of combined exercise on blood lipids, inflammatory markers, and obesity-related hormones in middle aged women. Doctoral disseration Chonnam National University, Gwangju, Korea.
  17. Go, S. M. 2005. The effect of circuit training regarding the body development of women in their thirties and forties with the ideal body composition. Master's thesis Inje University, Busan, Korea.
  18. Han, M. S. 2011. Metabolic syndrome emerging from menopause. J. Men. Med. 17, 127-135.
  19. Han, T. S. and Lean, M. E. J. 2011. Metabolic syndrome. Med. 43, 80-87.
  20. Hannukainen, J. C., Nuutila, P., Borra, R., Kaprio, J., Kujala, U. M. and Janatuinen, T. 2007. Increased physical activity decreases hepatic free fatty acid uptake: a study in human monozygotic twins. J. Physiol. 578, 347-358. https://doi.org/10.1113/jphysiol.2006.121368
  21. Hwkins, M. and Rossetti, L. 2005. Insulin resistance and its role in the Pathogenesis of type 2 Diabetes, Ed. Lippicott Willians & Wilkins.
  22. Henriksen, E. J. 2002. Invited review: Effects of acute exercise and exercise training on insulin resistance. J. Appl. Physiol. 93, 788-796. https://doi.org/10.1152/japplphysiol.01219.2001
  23. Horwitz, J. F. 2007. Exercise-induced alterations in muscle lipid metabolism improvement insulin sensitivity. Exerc. Sport. Sci. Rev. 35, 192-196. https://doi.org/10.1097/jes.0b013e318156e084
  24. Jeon, J. H. 2013. Effects of 12 weeks combined training on vascular compliance, insulin resistance and body composition in middle-aged obese women. Kor. Sport Soc. 11, 357-374.
  25. Jung, S. I. and Hong, S. M. 2010. Analysis of different dietary habits by classification of body mass index of middle school male students in Ulsan City. Kor. Soc. Comm. Nutr. 15, 342-350
  26. Kang, J. S. and Kim, H. S. 2004. A study on the evaluation of a nutritional education program for the middle aged obese women. J. Kor. Soc. Food. 17, 356-367.
  27. Kang, C. K., Lee, M. G. and Lim, M, J. 2008. Effects of a 10-weeks rope skipping training on body composition. physical fitness, blood lipid profiles, and insulin sensitivity in general collegiate students. Kor. J. Physi. Educ. 47, 359-369.
  28. Kang, H. S., Kim, G. J., Kim, T. U., Jang, G. T., Jeon, J. G. and Jo, H. C. 2006. Physiology of sport and exercise. Seoul: Daehanmedia.
  29. Kelly, D. E. and Coodpaster, B. H. 1999. Effects of physical activity on insulin action and glucose tolerance in obesity. Med. Sci. Sports Exerc. 31, 619-623. https://doi.org/10.1097/00005768-199904000-00021
  30. Ki, S. K., Paik, J. K., Oh, M. S. and Lee, M. S. 2015. The Effects of combined exercise on the body composition, health related physical fitness and blood lipids in Obese mothers. Kor. J. Physi. Educa. 24, 1533-1544.
  31. Kim, D. H., Kuk, D. H., Lee, H. Y., Kim, M. G. and Shin H. J. 2010. The effects of combined exercise on blood inflammatory markers, leptin and adiponectin in middle aged women. Kor. Soc. Grow. Develop. 18. 25-30.
  32. Kim, E. M. and Kim, S. H. 2012. The complex of exercise for 12 weeks on body composition, blood Lipids, cardiovascular diseases risk factors in obese middle-aged women. J. Physi. Educ. 8, 31-39.
  33. Kim, E, S., Hong, S. M. and Lee, E. Y. 2011. Effect of combined exercise on indices of obesity and liver function in obese high school students. J. Wellness. 6, 325-334.
  34. Kim, H. D., Kim, J. S., Kim, D. J. and Jo, H. C. 2011. The effects of combined exercise program on body composition and obesity related factors in obese middle-aged women. Kor. Soc. Sport. Leis. Study 45, 811-820.
  35. Kim, J. H., No, J. C. and Kang, S. J. 2013. Effects of aerobic and resistance exercise on insulinresistance, c-reactive protein, and physical fitness in middle-aged women with metabolic syndrome. J. Kor. Ass. Certi. Exerc. Profess. 15, 81-91.
  36. Kim, S. H. 2010. The effects of aerobic and resistance exercise on physical fitness and liver inflammatory factor and Adiponectin in obese university students with non-alcoholic fatty Liver disease(NAFLD). Master's thesis Dong-A University. Busan, Korea.
  37. Kim, S. H., Kim, J. Y., Ryu, G. A. and Son, J. M. 2007. Evaluation of the dietary diversity and nutrient intakes in obese adults. Kor. Soc. Comm. Nutr. 12, 583-591.
  38. Kim, Y. S., Park, K. D., Kang, H. J., Lee, D. C., Lee, J. H. and Kwon, H. S. 2005. The effects of exercise and nutrition education on insulin resistance, cardiopulmonary function and body composition in metabolic syndrome. Kor. J. Sport Sci. 16, 54-63
  39. Lawlor, D. A., Sattar, N., Smith, G. D. and Ebrahim, S. 2005. The association of physical activity and adiposity with alanine aminotransferase and gamma-glutamyltransferase. Am. J. Epidemiol. 161, 1081-1088. https://doi.org/10.1093/aje/kwi125
  40. Lee, J. W., Lee, H. S., Chang, N. S. and Kim, J. M. 2009. The relationship between nutrition knowledge scores and dietary behavior, dietary intakes and anthropometric parameters among primary school children participating in a nutrition education program. J. Nutr. Health. 42, 338-349.
  41. Lee, J. Y. and Kim, Y. K. 2014. Effect of 12 weeks combined exercise on insulin resistance and c-reactive protein in obese women. Kor. Soc. Sci. 32, 1229-1239.
  42. Lee, K. N. 2003. Clinical Laboratory Tests. Seoul: Medical Cultural History.
  43. Lee, K. S., Kim, K. H. and Cho, Y. C. 2009. Prevalence of fatty liver and its association with indices of obesity, liver function and hyper lipidemia among adult males. Kor. Acade. Indust. Cooper. Soc. 10, 1414-1423. https://doi.org/10.5762/KAIS.2009.10.6.1414
  44. Lee, S. Y., Choi, S. H. and Kim, Y. J. 2002. Impact of weight change on hepatic markers in overweight, middle-aged patients. J. Kor. Soc. Study. Obes. 11, 362-368.
  45. Lim, S, T. and Jung, H. H. 2012. Effects of combined exercise on health related fitness and GLP-1 in middle aged women with obesity. Kor. J. Sports Sci. 21, 1139-1147.
  46. Ministry of Health and Welfare. 2014. Korean health statistics; korean national health and nutrition examination survey(KNHANES VI-1). Ministry of Health & Welfare, 564-565.
  47. Moon, M, J. 2005. Study on the effect of combined exercise and nutritional education on the body composition, physical fitness, bone mineral density, and dietary habits of middle-aged women. Master's thesis Pusan National University. Busan, Korea.
  48. Morino, K., Petersen, K. and Shulman, G. 2006. Molecular mechanisms of insulin resistance in humans and their potential links with mitochondrial dysfunction. Diabetes 55, 9-15. https://doi.org/10.2337/db06-S002
  49. Na, S, H. 2007. The effects of a composite exercise program for middle-age obese women on body composition, adiponectin and c-reactive protein. Kor. Soc. Sport. Leis. Study 31, 1025-1032.
  50. Nybo, L., Sundstrup, E., Jakobsen, M. D., Mohr, M., Hornstrup, T. and Simonsen, L. 2010. High-intensity training versus traditional exercise interventions for promoting health. Med. Sci. Sport. Exer. 42, 1951-1958. https://doi.org/10.1249/MSS.0b013e3181d99203
  51. Parizkova, J. 2008. Impact of education on food behaviour, body composition and physical fitness in children. Br. J. Nutr. 99, 26-32.
  52. Park, C, H., Heo, T, I. and Kim, T, U. 2009. The Effect of weight circuit with rhythmic rope skipping on physical fitness, body composition and metabolic syndrome in overweight and obese middle school girls. J. Life. Sci. 11, 221-235.
  53. Park, S, Y., Yang, Y, J. and Kim, Y, R. 2011. Effects of nutrition education using a ubiquitous healthcare (u-Health) service on metabolic syndrome in male workers. J. Nutr. Health. 44, 231-242.
  54. Press, V., Freestone, I. and George, C. F. 2003. Physical activity: The evidence of benefit in the prevention of coronary heart disease. Int. J. Med. 96, 245-251.
  55. Reaven, G. 2004. The metabolic syndrome or the insulin resistance syndrome? Different names, different concepts, and different goals. Endocrinol. Metb. Clin. North Am. 33, 283-303. https://doi.org/10.1016/j.ecl.2004.03.002
  56. Rod, K. D., Richad, A. A. and Gregory, W. H. 2004. Physical activity epidemiology. Human Kinetics.
  57. Sanz, C., Gautier, J. F. and Hanaire, H. 2010. Physical exercise for the prevention and treatment of type 2 diabetes. Diabetes. Metab. 36, 346-351. https://doi.org/10.1016/j.diabet.2010.06.001
  58. Shin, D, S., Lee, C. J., Im, K. C., Roh, D. J., Kim, S. M. and Kim, S. 2013. Effects of combined exercise on body composition, atherogenic index and insulin resistance in obese middle-aged women. Kor. Soc. Sci. 22, 1217-1228.
  59. Solinas, G., Vilcu, C., Neels, J. G., Bandyopadhyay, G. K., Luo, J. L. and Naugler, W. 2007. JNK1 in hematopoietically derived cells contributes to diet-induced inflammation and insulin resistance without affecting obesity. Cell Metab. 6, 386-397. https://doi.org/10.1016/j.cmet.2007.09.011
  60. Son, J. C., Chio, B. H., Kim, G. M. and Kim, B. T. 2002. Correlation of homa index and body measurements, body composition, blood lipid profile. J. Kor. Soc. Study Obes. 11, 309.
  61. Tuomilehto, J. 2005. Cardiovascular risk : Prevention and treatment of the metabolic syndrome. Diabetes Res. Clin. Pract. 68, 28-35. https://doi.org/10.1016/j.diabres.2005.03.018
  62. Wang, S. W. 2004. The effects of 12 weeks training depending on existing or non-existing obese genes to metabolic regulatory hormones, blood lipids and body compositions. Kor. J. Physi. Educa. 43, 699-711.
  63. Weiss, R., Dziura, J., Burgert, T. S., Tamborlane, W. V., Taksali, S. E. and Yeckel, C. W. 2004. Obesity and the metabolic syndrome in children and adolescents. N. Engl. J. Med. 350, 2362-2374. https://doi.org/10.1056/NEJMoa031049
  64. World Health Organization. (2015, January). Obesity and overweight. Fact sheet $N^{]circ}311$, from http://www. who.int/mediacentre/factsheets/fs311/en/
  65. Yang, K. M. and Jang, J, H. 2009. Biochemical analysis overweight or obese women through a herbal medicine-based nutritional education program. J. Life. Sci. 15, 293-302.
  66. Yang, H. R., Ko, J. S. and Seo, J. K. 2007. The role of adipokines in the pathogenesis of non-alcoholic fatty liver disease in obese children; the relationship between body Fat distribution and insulin resistance. Kor. J. Pediatr. Gastr. Nutr. 10, 185-192.
  67. Yoon, J. W., Jeon, J. G. and Lee, W. G. 2009. Effects of combined exercise program with nutrition education on body composition, physical fitness and blood ingredient in obese women. Kor. Alli. Health Physi. Educa. 47, 172-173.