• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제10권2호
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• pp.185-192
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• 2007

목 적: 본 연구에서는 소아 비만 환자에서 발생하는 비알코올성 지방간 질환의 발병에 TNF-${\alpha}$, adiponectin, leptin 등의 adipokine들이 미치는 영향을 알아보며, 이들 adipokine과 체지방분포 및 인슐린 저항성과의 연관성을 함께 살펴보고자 하였다. 방 법: 2004년 3월에서 2005년 6월까지 분당서울대병원 소아과에 내원한 비만한 소아 61명을 대상으로 하여 비알코올성 지방간 질환의 상태에 따라 대상 환자들을 지방간 질환이 없는 소아 비만 환자(n=23), 단순 지방간(n=20), 그리고 비알코올성 지방간염(n=18)의 세군으로 나누고, 각 환자에서 혈중 TNF-${\alpha}$, leptin, adiponectin 농도를 측정하고 인슐린 저항성의 지표로서 HOMA-IR을 계산하였으며 복부 전산화단층촬영에서 VSR (visceral-subcutaneous fat ratio)을 산출하였다. 결 과: 총 61명(남 : 여=42 : 19, 평균 연령 11.2${\pm}$1.3세)의 환아를 대상으로 지방간 질환에 따라 세 군으로 나누었을 때, 세 군 간의 성별, 연령별 차이는 없었다(p=0.422, p=0.119). 각 군의 혈중 TNF-${\alpha}$ 농도는 유의한 차이가 없었고(22.13${\pm}$6.37 vs. 21.35${\pm}$6.95 vs. 25.17${\pm}$9.30; p=0.342), leptin 농도에도 유의한 차이가 없었으나 (20.29${\pm}$8.57 vs. 16.42${\pm}$6.85 vs. 20.10${\pm}$7.86; p=0.330), adiponectin은 유의한 차이를 보여 비알코올성 지방간염에서 혈중농도가 의미 있게 감소하였다 (6.08${\pm}$1.38 vs. 5.69${\pm}$0.79 vs. 4.93${\pm}$1.75; p=0.026). 복부 전산화단층 촬영에서 산출한 VSR도 지방간염군에서 유의하게 증가된 소견을 보였다(0.31${\pm}$0.08 vs. 0.32${\pm}$0.11 vs. 0.47${\pm}$0.14; p=0.001). HOMA-IR도 세 군에서 유의한 차이를 보였다(4.77${\pm}$3.67 vs. 6.89${\pm}$7.05 vs. 10.42${\pm}$6.73; p=0.000). 그러나 adiponectin과 HOMA-IR 또는 VSR간에 유의한 상관관계는 보이지 않았다(r=-0.117; p=0.450 & r=-0.106; p=0.499). 결 론: 인슐린 저항성은 비만한 소아에서 간 내 지방 축적과 지방간염으로의 진행과정에 모두 영향을 미칠 것으로 추정되며, 비만한 소아의 지방조직에서 분비되는 adipokine 중에서 adiponectin이 단순지방간에서 지방간염으로의 이행하는 기전에 관여할 것으로 여겨진다.

• 생명과학회지
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• 제22권3호
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• pp.380-386
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• 2012

본 연구는 비만유아 7명과 정상체중유아 7명을 대상으로 유아체육프로그램이 신체조성, 체력, 혈중지질 및 성장관련인자의 변화를 분석하기 위해 실시되었다. 본 연구에서 실시한 유아체육프로그램이 체지방량을 감량시키는데 효과적인 결과를 얻지 못하였지만 비만군과 정상체중군 모두 체력은 향상되는 것으로 나타났다. 그리고 정상체중유아들의 경우 HDL-C와 제지방량의 증가는 본 연구에서 실시한 유아체육프로그램이 성인기의 비만과 성인병 예방 측면에서 정상체중유아들에게 권장될 수 있는 것으로 사료된다. 또한 성장관련인자 IGF-I은 성장을 촉진하는 활성 물질로 성장호르몬 분비의 증가에 따라 IGF-I 농도 역시 상승한다. 본 연구에서도 정상체중군에서 긍정적인 효과가 나타나 유아체육프로그램이 성장기 유아의 성장호르몬의 분비를 활성화시키고 성장을 촉진시키며 신체발달을 증진시키는데 도움을 줄 수 있을 것으로 생각한다.

• 한국시스템다이내믹스연구
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• 제6권1호
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• pp.177-192
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• 2005

A system dynamics model is developed to investigate policies for the school-age child weights and heights. The model is based upon the system dynamic model of Soonhee lee(2003), the purpose of which was policy analysis for obese control of adult people. Although the purpose and target people are different, the main structure can be applied to in the same way. Besides the carbohydrate, protein, and fat material, the new model covers hormone and heights with new input mechanisms for foods and activities. The simulation results matches well with the average school-age children in Korea with the average inputs data (foods and activities). The model can be used for various purposes such as policy analyses, care plan for obese children, etc.

• 대한지역사회영양학회지
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• 제14권4호
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• pp.441-450
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• 2009

The prevalence of obesity in children has steadily risen during recent years in developed countries. Child obesity has become a major concern to health providers since it has grown to epidemic proportions over the past few decades. This study was conducted to investigate the biochemical status, dietary habits and life styles according to the obesity degree among obese children residing in the Gyungbuk area. The subjects were 148 elementary school students (boy 103, girl 45) and classified as mildly obese (n = 56), moderately obese (n = 61) and severely obese (n = 31) by the obesity index. The average body weight and height increased significantly according to the obesity degree (p < 0.05, p < 0.001). Serum cholesterol concentration came under the normal level in all groups. Serum AST activity increased according to the obesity degree but it was not significant. Serum ALT activity increased according to the obesity degree (p < 0.05). Dietary habit score was lower significantly according to the obesity degree (p < 0.01). Life style of the subjects was significantly different for the level of 'healthy state (p < 0.05)', 'body perception (p < 0.01)', 'watching TV and video (p < 0.05)', 'normal sleeping hour (p < 0.05)' and 'degree of stress (p < 0.05)' according to the obesity degree. A positive relationship between obesity index and blood pressure, ALT has been shown in the subjects. Obesity index and dietary habit scores were negatively associated. Therefore, these results suggest that a practical nutrition-exercise education program for the prevention of child obesity should be provided to elementary school children. (Korean J Community Nutrition 14(4) : 441${\sim}$450, 2009)

• 동아시아식생활학회지
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• 제18권4호
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• pp.489-498
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• 2008

This study was designed to evaluate the relationships among snack intake, obesity index, and blood parameters in obese elementary school children. Anthropometric measurements, nutrient intake from meals and snacks, serum cholesterol, glucose, GOT, GPT, and hemoglobin levels were obtained 36 obese elementary students (boys=28, girls=8). The average age, height, weight, % body fat, and obesity index were 11.9 years, 145.5cm, 53.5kg, 45.7%, and 32.4%, respectively. The mean energy intake was 1,818.7 kcal in boys and 1,818.1 kcal in girls. In addition, the energy intake from snacks was 470.4 kcal in boys and 479.4 kcal in girls. The levels of plant fat (p<0.05) and cholesterol (p<0.001) consumed during snacks (1,000 kcal per energy intake) were higher than those consumed during meals. The serum cholesterol, glucose, and hemoglobin levels were 177.4 mg/dL, 90.4 mg/dL, and 14.5 g/dL, respectively. In addition, the levels of serum GOT (p<0.001) and GPT (p<0.05) were higher in boys than in girls. Height was positively correlated with food intake (p<0.05), snack intake (p<0.05), and energy intake from snacks (p<0.05). Based on these results, further studies are needed in order to investigate the relationships among various aspects of snacking and obesity in elementary school children.

• 대한간호학회지
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• 제35권3호
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• pp.611-620
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• 2005

Purpose: The purpose of this study was to identify the effects of a school-based obesity control program based on behavior modification and self-efficacy for obese elementary school children. The program was composed of strategies to modify diet and exercise habits and to increase self-efficacy. Method: The subjects were 57 obese children (experimental group = 28, control group = 29) whose Rohler index was 150 and over. The program was implemented once a week for 12 weeks from September 16 to December 12, 2003. The data was analyzed by Fisher's exact probability, $x^2$-test, t-test, and Wilcoxon Rank Sum test. Result: The Rohler index, fat mass and lean body mass of the experimental group positively changed after the intervention more than those of the control group, but there was a significant difference in the Rohler index only (t=2.06, p=.045). In addition, obesity stress significantly decreased (z=-2.86, p=.047) and dietary self-efficacy significantly increased (t=2.35, p=.023) in the experimental group than those of the control group. Conclusion: This study supports that a school-based obesity control program based on behavior modification and self-efficacy can be effective in decreasing obesity stress and increasing dietary self-efficacy. Parents, school nurses and the other support groups should be encouraged to participate from the planning stage of the program to be effective in weight control of obese elementary school children. Also school-based program should be implemented as an essential course in the curriculum, not as an elective.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제23권5호
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• pp.439-446
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• 2020

Purpose: The evidence for an association between inflammatory bowel disease (IBD) and obesity is conflicting. Therefore, we set out to review the body mass index (BMI) at presentation of IBD to understand if the rise of the obesity rate in the general population, lead to an increase of obesity in patients with IBD at the time of diagnosis. Methods: Retrospective review of all patients with IBD seen at Children's Hospital and Medical Center from January 1st 2010 to December 31st 2014. From the initial visit and endoscopy, we obtained: age; sex; BMI; disease phenotype; disease severity. Results: We had a total of 95 patients, 35 patients were excluded due to incomplete data or referral being made after diagnosis was made. 28 were males and 32 were females, Age range was 2-17 years. A 37 had Crohn's disease, 19 ulcerative colitis, and 4 indeterminate colitis. Disease severity in 19 cases was mild, 29 moderate and 12 severe. BMI distribution was as follows-obese (5.0%), overweight (6.7%), normal weight (65.0%), mild malnutrition (8.3%), moderate malnutrition (15.0%), severe malnutrition (1.7%). Conclusion: Our data is consistent with other series. Showing most children had a normal BMI, regardless of disease severity or phenotypes. One confounding factor is the possibility of delay in referral to GI. This could mean some obese children may fall in the normal BMI range at the time of diagnosis due to ongoing weight loss. Future studies should include prospective cohort studies, comparing incidence of IBD in obese and non-obese patients, severity at presentation, duration of symptoms, and clinical outcomes.

• Nutritional Sciences
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• 제1권1호
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• pp.34-41
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• 1998

This study examined the proper roles of dietitian and nurse-teacher in the weight control program (WCP) in schools and the effect of the WCP on subjects with respect to anthropometric measurements, nutrition knowledge, dietary attiude, and behavior changes. The program consisted of six sessions of nutrition education and frequent face-to-face nutrition counseling. Subjects were 22 obese children in the 4th and 5th grade who underwent counseling and 18 obese children in another school who served as a control group. After two months of WCP, obesity index such as .elative body weight (RBW, from 135.7 to 132.5), tricep skinfold thickness (TSFT, from 34.9 to 32.8 mm), and body fat content (from 32.0 to 29.8%) had decreased significantly in the experimental group, while the control group showed no significant differences in these indices. The reductions in obesity indices were maintained in the experimental group except for fat content (32.6%), which returned to its original value within six months. The control group significantly increased fat content in the same period (from 31.2% to 36.2%). Both groups decreased RBW, TSFT, and fat content while midarm circumference and waist/hip ratio remained the same after one year. Subjects' nutrition knowledge was improved with average test scores from 15.1 to 16.7 while nutrition attitude and behavior test scores remained unchanged suggesting that behavior modification may require more time than knowledge acquirement. These results suggest that proper nutrition counseling can initiate weight reduction. However, the maintenance of controlled weight requires changes in attitude and behavior which have not been achieved by the present WCP. The role of school dietitian for WCP in this study was limited to assisting the nurse-teacher in nutrition education. Expansion of dietitian's role in nutrition education and counseling is needed.

• 한국의류학회지
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• 제33권8호
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• pp.1306-1314
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• 2009

This study investigates the progress of obesity in men from childhood to adulthood, by analyzing the measurement references from the 5th Size Korea. It also seeks to analyze the characteristics of obese figures through the comparison of body proportions to normal-weight people, to provide a basic reference for the development of new size categories and improved pattern grading. The age range is divided into three groups: children (2-7), teenagers (13-18), and adults (19-39). The results of research into the characteristics of body proportions of obese figures and the classification of different figure groups of obese people are as follows. The ratio between width and circumference for each part of the body was investigated according to body weight that was grouped into three different categories of low, normal, and obese body weights. The result demonstrated that in all the ranges of age, the obese groups had the lowest ratio between width and circumference in having a thick body shape. According to the results that compared the ratio of the circumference of each body part divided by the waist circumference, the obese group showed a low ratio that indicates that they have a bigger waist circumference than other parts of the body. Two factors are identified as contributing to obesity in analyzing the ratio of the circumference of body parts divided by waist circumference. Using the factor loadings of the upper and lower body obesity, a cluster analysis was carried out and three different categories of obesity were defined; lower body obesity, abdominal obesity, and upper body obesity. The obese groups of children and teenagers were mostly in body shape with lower obesity and abdominal obesity, whereas the adults group showed the obesity present in the upper body obesity that have fewer cases in lower body obesity.

• 대한지역사회영양학회지
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• 제6권4호
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• pp.577-591
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• 2001

This study was carried out to investigate the difference of the body image recognition, food habits, food behaviors and nutrient intake according to the obesity index(underweight-, normal-, obese group) in children(aged 10.8 ys, 47 boys, 33 girls). Subjects were eva1uated based an anthrofometric measurement and questionnaries including food record diary in Changwon. The results are summarized as follows. The weight, BMI, body fat, waist circumference, hip circumference and birth weight except height showed a significant difference between the three groups(p<0.001). The waist and hip circumference showed the possibility of being a predictor of obesity in children. The children's obesity was related to mother's weight(p<0.01), but not to father's. Ninety percent of the obese group, 47.8% of the normal group, and 37.8% of the underweight group preferred a thinner figure than their current status. The underweight group did more exercise regularly than the other groups. The underweight and obese groups had more irregular meal times and foster eating habits compared to the normal group. Most of subjects(89.9%) had an overeating habit, and tole ratio of the overeating habit increased with obesity. Fifty five percent of the subjects clad the habit of skipping meals, mainly breakfast. 46.8% of the subjects ate snacks more than twice per a day, the underweight and obese groups had snacks more of than the normal group. The preferred snack was 'cookies'and 'fruits ＆ juices'. 53.8% of the subjects had a prejudice for special food(especially 'pulses'(37.9%) and 'vegetables'(31.0%)). The assessment scores of food behaviors was relatively low in most of the subjects. Most nutrient intakes, except vitamin B$_1$, C and phosphate, were lower than those of Korean RDA. The nutrient intake of the normal group was higher than the underweight and obese groups. The results of this study showed some nutritional problems, which indicates the need for nutritional management for the children. To educate children, who are able to change their food habits and lifestyle, each means to help healthy growth and to help them become healthy adults.