• Clinical and Experimental Pediatrics
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• 제48권6호
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• pp.588-593
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• 2005

목 적 : 비만아에서 폐기능 검사와 체성분 분석을 시행함으로써 비만이 폐기능과 체성분에 미치는 영향을 밝히고자 하였다. 방 법 : 9세에서 12세의 중등도 이상의 비만 소아 27명과 정상 대조군 20명을 대상으로 체성분(세포내액, 세포외액, 단백질, 무기질, 근육량, 체지방량, 체지방률, 복부지방률)을 분석하였다. 헤모글로빈, 혈당, aspartate aminotransferase(AST), alanine aminotransferase(ALT), 총 콜레스테롤, 혈중 중성지방을 측정하였고 폐기능 검사를 시행하였다. 결 과 : 중등도 이상의 비만 소아에서 peak expiratory flow rate(PEFR)이 정상군에 비해 유의하게 감소하였고, 고도 비만아에서 중등도 비만아보다 세포내액, 단백질, 체지방량, 체지방률, 복부지방률이 유의하게 높았고, peak expiratory flow rate(PEFR)은 고도 비만아에서 유의한 감소를 보였다. peak expiratory flow rate(PEFR)이 비만 소아 중 37.0%에서 감소하였고, forced expiratory flow 25%($FEF_{25}$)와 mid-expiratory flow rate(MEFR)이 14.8%에서, forced expiratory flow 50%($FEF_{50}$)이 11.1%에서, forced expiratory volume in 1st second($FEV_1$)과 FVC가 3.7%에서 감소하였다. 결 론 : 본 연구 대상인 9-12세 소아에서 비만도, 체지방률과 폐기능 측정치와 상관성은 없었지만, 중등도 이상의 비만 소아에서 peak expiratory flow rate(PEFR)이 감소하는 결과를 보이므로 중등도 비만 소아에서 폐기능 검사를 시행하는 것이 좋으며 앞으로 다른 연령군의 비만 소아에서 폐기능 검사에 대한 연구가 필요할 것으로 생각한다.

• Journal of Nutrition and Health
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• 제37권3호
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• pp.193-201
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• 2004

The objective was to evaluate the factors influencing on the growth of children aged 3 - 6 years by mini dietary assessment and anthropometric indices in 556 children and by analyzing mineral contents of hair from 273 children by inductively coupled plasma mass spectrometry (ICP-MS). The mean concentration of zinc (Zn) in hair was 68.9 $\pm$ 31.1 ppm and the zinc level of 91 ％ children was less than 60％ of the reference value of 180 ppm. The mean content of lead (Pb) in hair was 1.76 $\pm$ 1.20 ppm, but only 67％ of 273 children was within the reference value of 2 ppm and the lead level of 33％ of children was 2 - 4 times higher than the reference value. The level of Zn was negatively correlated with Pb content (r = -0.305, p 〈 0.01). Hair Zn content, regardless of age, was significantly positively correlated with height (r = 0.214) and body weight (r = 0.159). The height of 95.3％ children was belonged to the normal range of 90 - 109.9％ of standard value and the body weight of 49.8％ children was in the range of 90 - 109.9％ of standard value. However, 8.1 ％ children was overweighted (110 - 119.9％ of standard) and 9.4％ children was obese (120 - 149.9％ of standard) and 0.9％ children was severe obese (〉 150％) which resulted in total 10.3％ obese. Contrary to our expectation, 32.8％ children was underweight (70 - 89.9％ of standard) and 36％ of the underweight children showed the low content of zinc (10 - 49 ppm) in hair. There was no significant correlation between dietary intake of Zn and hair Zn content. Hair Zn content was low even though children consumed greater than 75％ of their requirement for zinc. Regardless of dietary intake of Zn, hair Zn level was rather negatively correlated to the content of Pb in hair. 38.8％ children had an unbalanced diet which resulted in lower intake of calorie, Ca, Zn, vitamin B$_2$ compared with those consuming variety of foods. Therefore, it would be needed that new approach for nutrition education to improve eating habit having the unbalanced diet in preschool children. It might be also suggested to develop new food products to complement the nutrients of Zn, Ca, Fe as snacks or dietary supplement for Korean preschool children.

• Nutrition Research and Practice
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• 제7권3호
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• pp.207-215
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• 2013

The objective of this study was to investigate the associations between the prevalence of overweight and obesity and the degree of adherence to the Korean Dietary Action Guides for Children (KDAGC). In a cross-sectional study based on a child care center-based survey in Seoul, Korea, we collected parental-reported questionnaires (n = 2,038) on children's weight and height, frequency of fruit and vegetable consumption, and the quality of dietary and activity behaviors based on the 2009 KDAGC Adherence Index (KDAGCAI) which was developed as a composite measure of adherence to the KDAGC. Overweight and obesity were determined according to age- and sex-specific BMI percentile from the 2007 Korean national growth chart. Associations were assessed with generalized linear models and polytomous logistic regression models. Approximately 17.6% of Korean preschool children were classified as overweight or obese. Obese preschoolers had lower adherence to the KDAGCAI compared to those with lean/normal weight. Preschoolers with a high quality of dietary and activity behaviors had a 51% decreased odds ratio (OR) of being obese (highest vs. lowest tertile of KDAGCAI-score, 95% CI 0.31, 0.78; P = 0.001); the associations were more pronounced among those who were older (P = 0.048) and lived in lower income households (P = 0.014). A greater frequency of vegetable consumption, but not fruit, was associated with a borderline significant reduction in the prevalence of obesity. Our findings support the association between obesity prevention and high compliance with the Korean national dietary and activity guideline among preschool children.

• Journal of Nutrition and Health
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• 제26권1호
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• pp.56-66
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• 1993

Interactive effects among eating behavior, obesity and serum lipid levels were studied in 117, 4~12 year old children residing suburban Seoul. Fasting blood samples are obtained and analyzed for serum triglycerides (TG), total cholesterol(TC), high density lipoprotein-cholesterol(HDL-C) and hematochrit. Obesity was determined by weight for length index(WLI)and the information on eating behavior including food habits and dietary intakes was obtained by questionaire using food record method for 2-consecutive days. Over 40% of children was classified overweight or obese by WIL and children's physical parameters were closely related to those of parents implying genetic influence on obesity. Although it did not reach the statistical significance, there was a tendency of higher TG, TC and low density lipoprotein-cholesterol(LDL-C)levels among girls compared to boys. Blood lipid levels of obese children were similar to those of other groups except TG, which was significantly higher(p<0.05) in obese group. Nutrient intakes seemed adequate in all subjects except iron, calcium and total calorie which were lower than RDAs. Lacking significant relationship between individual nutrient intake and obesity, there was significant correlation between food intake and blood lipid level especially in 10-12 year old group. Vegetable intake was negatively related to TG, LPH(LDL-C/HDL-C) and atherogenic index(AI), and positively to HDL-C. Skipping breakfast and frequent eating out appeared to cause imbalances in nutrient intake. These findings clearly revealed the influence of eating behavior on childhood obesity along with blood lipid profile. To ensure the proper growth and health of these children, devising method and developing media for nutrition education suited to our society should be accomplished first. With well-planned nutrition surveys and thorough intention, childhool obesity could be prevented from progress into adulthood obesity.

• 한국보건간호학회지
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• 제27권3호
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• pp.619-632
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• 2013

Purpose: The purpose of this study was to develop an obesity management program for obese children and examine its effects on body composition, self-efficacy, and health promotion. The obesity management program was based on a KAP & HBM mixed model and consisted of health education and group playing exercises. Method: This study was implemented at one elementary school in K city for a total of 12 weeks. The study subjects were a single group, and their body composition, self-efficacy, and health promotion were assessed at both pre-treatment and post-treatment. Data were analyzed by Wilcoxon Signed Rank Test using SPSS WIN 20.0. Result: After the program, the average height of subjects increased by 0.9cm (p=.001), whereas BMI decreased by $0.64kg/m^2$ (p=.003), obesity index decreased by 3.79% (p=.003), and body fat decreased by 1.34% (p=.002). There were significant effects on diet self-efficacy (p=.027), exercise self-efficacy (p<.001), and health promotion (p=.001). Conclusion: This obesity management program reduced the degree of obesity and improved self-efficacy and health promotion. Therefore, the obesity management program is an effective intervention method for elementary-aged obese children.

• Journal of Nutrition and Health
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• 제35권5호
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• pp.524-530
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• 2002

To evaluate the role of obesity and nutrient intake on serum IGF-1 and serotonin levels in 80 elementary school children (aged 10. 8 yr, 47 boys, 33 girls), we investigated the anthropometric data and the nutrient intake by questionnaries including food daily record, and measured serum IGF-1 and serotonin using RIA and HPLC F-1050 respectively. We obtained the following results by obesity index (underweight-, normal-, obese group). The protein intake of normal group was higher than the others (p < 0.05). The underweight and obese groups had snacks more often than the normal group. The obese group preferred‘cookies’and‘fries’more than the other groups. The serum serotonin levels showed weak correlation with fat (r = 0.315, p < 0.01), fiber (${\gamma}$ = 0.280, p < 0.05) and energy intake (r = 0.242, p < 0.05), but no differences in anthropometric data by obesity index. The serum IGF-1 level was significantly correlated height (r = 0.649, p < 0.001), weight (r = 0.437, p < 0.001) and hip (r = 0.417, p < 0.001), but showed weak correlation with energy intake (r = 0.232, p < 0.05) and carbohydrate intake (r = 0.244, p < 0.05). In this study, we could see only partly correlation among the serum IGF-1 and serotonin and obesity and nutrient intake. Forker research is required into consideration of the essential role of these hormones during a growth period.

• 대한지역사회영양학회지
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• 제7권4호
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• pp.475-483
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• 2002

The purpose of this study was to investigate the relationship among eating habits, eating behaviors, obesity indices and serum leptin levels of 97 school children in the Daegu and Kyungpuk areas. The subjects consisted of 42 boys and 55 girls from the 4th and 5th grades. The prevalence rate of obesity was 63.6% in the males and 36.4% in the females. The nutritional status of the subjects was assessed using 24-hour dietary recalls and blood analyses. The mean serum leptin levels of the obese group (12.84 $\pm$ 6.97 ng/ml) were significantly higher than those of the non-obese group (2.43 $\pm$ 1.53 ng/ml) (p < 0.001) . The mean eating behavior scores and MAR were significantly different in the two groups. Nutrient intakes were low and fell short of the RDA. Serum leptin levels showed a significant negative correlation with eating habit (r= -0.24) and eating behavior scores (r= -0.40) (p < 0.05, p < 0.001). It was speculated that nutritional intervention and education about the appropriate nutrient intake requirements of developing children might be necessary.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제7권2호
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• pp.228-238
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• 2004

목적: 소아 비만클리닉에서 시행하는 선별검사로 대사증후군의 위험인자를 미리 인지하여 비만아가 치료를 지속적으로 할 수 있도록 지도하는데 도움을 주고자 하였다. 대상: 2000년 2월부터 2004년 6월까지 이대 목동병원 소아 비만클리닉을 방문한 비만아에서 의무기록이 충실하고 체질량지수(BMI)가 95 백분위수 이상인 88명(남 52명, 여 36명)을 대상으로 하였다. 방법: 비만아에서 BMI를 계산하고 혈압은 안정 상태에서 두 번 측정하여 평균을 구하였다. 12시간 공복 후에 혈청 지질(중성지방, 총콜레스테롤, 고밀도 콜레스테롤, 저밀도 콜레스테롤), 혈당과 혈중 인슐린 농도를 측정하였다. 인슐린 저항성 지표로 fasting insulin to glucose ratio (FIGR), homeostasis model assessment of insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI)를 이용하였다. 결 과: 비만아 88명 중 53명(60.2%)에서 하나 이상의 대사증후군의 위험 인자를 보였다. 고혈압은 13명(14.8%), 중성지방 ${\geq}150mg/dL$ 13명(14.8%), 총콜레스테롤 ${\geq}200mg/dL$ 23명(26.1%), 고밀도 콜레스테롤 ${\leq}40mg/dL$ 13명(14.8%), 저밀도 콜레스테롤 ${\geq}130mg/dL$ 11명(12.5%)이었으며 고인슐린 혈증은 11명(12.5%)이었다. BMI는 수축기 혈압(r=0.535), 고밀도 콜레스테롤(r=-0.214), 인슐린 농도(r=0.342), HOMA-IR (r=0.346), FIGR (r=0.329), QUICKI (r=-0.22)와 유의한 상관 관계를 보였다. 인슐린 농도(r=0.233), HOMA-IR (r=0.234)은 수축기 혈압과, FIGR은 수축기 혈압(r=0.227) 및 저밀도 콜레스테롤(r=0.223)과, QUICKI는 혈당(r=-0.308)과 각각 유의한 상관관계를 보였다. 선별검사에서 대사증후군의 위험 인자가 많을수록 인슐린 저항성(HOMA-IR, FIGR)이 유의하게 증가하였다. 한편 인슐린 저항성을 가장 잘 설명하는 인자로는 BMI, 중성지방, 총콜레스테롤이었다. 결론: 소아 비만클리닉을 방문하는 비만아에서 이미 대사증후군이 시작되고 있으므로 행동 수정, 식사조절 및 운동 처방뿐 아니라 혈압, 지질, 혈당, 인슐린 농도 등을 정기적으로 검사하여 적극적으로 관리해야 한다.

• 대한한방소아과학회지
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• 제24권2호
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• pp.31-39
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• 2010

Objectives The recent prevalence rate of obesity in children is increasing, but so far the majority of ongoing research is focused on obesity in adults. Even comparison studies between obesity in adults and in children are insufficient at this stage. Thus, our research will investigate the characteristics of obesity in children based on the comparison with adults. Methods The blood levels including glucose, cholesterol, AST, ALT of obese children and obese adults were compared and analyzed. Results From comparison studies, the levels of glucose, cholesterol, ALT in adults were higher than in children. In order to take account the age differences, only the rate of abnormal levels based on the reference range were compared. As a result, the abnormal rate in blood cholesterol level was higher in children. Conclusions Childhood obesity may develop complications at early age and has high potential risk to result in adult obesity as well. Therefore, child obesity needs to be treated with more caution and careful attention.

• Clinical and Experimental Pediatrics
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• 제48권11호
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• pp.1219-1224
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• 2005

목 적 : 최근 소아 및 청소년의 비만이 빠르게 증가하고 있다. 고도 비만아들에서 단백뇨 및 FSGS가 발현될 수 있고, 그 기전으로 과여과, 신정맥압 증가, 사구체비대, 고지혈증, angiotensin II, insulin, leptin, $TGF-{\beta}1$의 합성 증가 등이 보고되고 있다. 본 연구에서는 BMI와 비만도에 따른 GFR의 변화를 조사하여 과여과 여부를 알아보았고, 혈청 cystatin C 농도를 측정하여 비만과의 상관관계와 유용성을 알아보고자 하였다. 방 법 : 2004년 5월부터 12월까지 중앙대학교 용산병원을 방문하여 혈액검사를 시행받은 6세 이상의 환아들 중에서 임상적으로나 검사상으로 명백한 신질환의 증거가 없는 115명의 환아들을 대상으로 BMI와 비만도를 측정하였고, Schwartz's formula로 GFR을 추정하였다. 혈청 cystatin C 농도는 particle enhanced nephelometric immunoassay를 이용하여 Behring Nephelometer II로 측정하였다. 결 과 : GFR은 BMI로 구분한 경우 비만군이 정상군에 비해 유의하게 높았다. GFR은 비만도로 구분한 경우에는 비만군과 정상군 사이에 유의한 차이를 보이지 않았지만 고도 비만군은 정상군에 비해 유의하게 높은 값을 나타내었다. BMI와 GFR은 양의 상관관계를 보였으나, 비만도와 GFR은 유의한 상관관계를 보이지 않았다. 혈청 cystatin C 농도는 BMI로 구분한 경우와 비만도로 구분한 경우 모두 비만군과 정상군 사이에 유의한 차이를 보이지 않았고, BMI나 비만도와 통계학적으로 유의한 상관관계를 나타내지 않았다. 결 론 : 비만으로 인해 과여과와 같은 신기능의 변화가 초래되고 단백뇨 및 FSGS와 같은 신병증이 발현될 수 있으므로 비만에 대한 적절한 관리와 치료가 필요할 것으로 생각된다.