• Perspectives in Nursing Science
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• 제16권2호
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• pp.75-83
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• 2019

Purpose: This study aimed to identify the characteristics of an intervention program for school-aged overweight and obese children through an integrated literature review. Methods: We used five databases (MEDLINE [PubMed], CINAHL, Embase, DBpia, and RISS) to search for studies published between January 1, 2013, and April 18, 2018. The studies were reviewed according to specific inclusion and exclusion criteria. Results: Finally, nine studies were selected and classified into three types: school-based, community-based, and home-based. Specific intervention methods were identified, including exercise, diet, exercise and diet, and cognitive behavioral therapy. Conclusion: Most studies have shown the effectiveness of obesity intervention programs. However, the variables, tools, and methods of measuring the effectiveness of intervention varied, making it difficult to compare the intervention studies. Therefore, future studies should develop objective and integrated measurement tools and evaluate the effects with long-term follow-up.

• Clinical and Experimental Pediatrics
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• 제64권5호
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• pp.196-207
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• 2021

Over the last few decades, the rates of pediatric obesity have more than doubled regardless of sociodemographic categorization, and despite these rates plateauing in recent years there continues to be an increase in the severity of obesity in children and adolescents. This review will discuss the pediatric obesity mediated cardiovascular disease (CVD) risk factors such as attenuated levels of satiety and energy metabolism hormones, insulin resistance, vascular endothelial dysfunction, and arterial stiffness. Additionally, early intervention to combat pediatric obesity is critical as obesity has been suggested to track into adulthood, and these obese children and adolescents are at an increased risk of early mortality. Current suggested strategies to combat pediatric obesity are modifying diet, limiting sedentary behavior, and increasing physical activity. The effects of exercise intervention on metabolic hormones such as leptin and adiponectin, insulin sensitivity/resistance, and body fat in obese children and adolescents will be discussed along with the exercise modality, intensity, and duration. Specifically, this review will focus on the differential effects of aerobic exercise, resistance training, and combined exercise on the cardiovascular risks in pediatric obesity. This review outlines the evidence that exercise intervention is a beneficial therapeutic strategy to reduce the risk factors for CVD and the ideal exercise prescription to combat pediatric obesity should contain both muscle strengthening and aerobic components with an emphasis on fat mass reduction and long-term adherence.

• 한국학교ㆍ지역보건교육학회지
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• 제9권1호
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• pp.17-31
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• 2008

Objectives: The purpose of this study was to examine the effects of child health program on body composition, body balance, physical fitness, health promotion behavior in obese elementary school. Methods: They ranged from the third to fith grade with over 20% body fat ratio. The subjects consisted of 20 obese elementary school children who participated in child health program. The contents of the program for 12 weeks from contained obese education, counseling and music rope jump twice a week. The program lasted from Sep. 3 to Nov. 30, 2007. The data were analysed with SAS 8.2. Results: Muscle mass(z=2.86, p=0.028), skeletal muscle mass(z=2.56, p=0.008), and fat free mass(z=2.57. p=0.006) in body composition were significantly increased. right arm balance(z=4.12. p=0.001), left arm balance(z=2.96, p=0.010), and trunk balance(z=3.70, p=0.001), right leg balance(z=2.42 p=0.013) in body balance were also significantly increased. endurance(z=2.61. p=0.028), agility(z=3.43, p=0.006), flexibility(z=4.37, p=0.000), power(z=6.94, p=0.000) in physical fitness were significantly increased. Health promotion and behaviors were significantly increased(z=2.21. p=0.012). Conclusions: Child health promotion seemed to be useful for body composion, body balance. physical fitness and health promotion behavior.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제18권2호
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• pp.108-114
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• 2015

Purpose: The aim of this study is to evaluate the relationship between abdominal subcutaneous fat thickness measured by ultrasonography (US) and serum lipid profile and liver transaminases in obese children. Methods: One hundred and sixty-six children diagnosed with obesity from May 2001 to December 2013 were included in this study. Data on serum lipid profile and liver transaminases were collected from clinical records. Abdominal subcutaneous fat thickness and grade of hepatic steatosis were evaluated by US. Results: Of the 166 children, 107 were diagnosed with hepatic steatosis by US, 46 with grade I, 56 with grade II, and five children with grade III. According to the grade of hepatic steasosis, the average values of midline abdominal subcutaneous fat thickness and right flank abdominal subcutaneous fat thickness measured $2.9{\pm}0.8cm$ and $1.9{\pm}0.7cm$ in the normal group, $3.3{\pm}0.8cm$ and $2.0{\pm}0.7cm$ in grade I, $3.8{\pm}0.8cm$ and $2.3{\pm}0.8cm$ in grade II, and $4.1{\pm}0.8cm$ and $2.8{\pm}1.4cm$ in grade III, respectively. Abdominal subcutaneous fat thickness correlated with grade of hepatic steatosis (p<0.01). In addition, abdominal subcutaneous fat thickness correlated with concentration of serum lipids and liver transaminases in the age group of 12-14 years (p<0.01). Conclusion: Abdominal subcutaneous fat thickness measured by US can be used as a reliable predictor of possible hyperlipidemia and steatohepatitis in children, especially during the adolescent stage.

• 대한지역사회영양학회지
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• 제2권5호
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• pp.680-686
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• 1997

The purpose of this study is to examine the relationships among body composition, dietary intake, exercise, and life style in children(M=80, f=102) of the 5th and 6th grades of elementary school. Anthropometry and multifrequency bioelectrical impedance analysis were conducted to estimate body composition. Dietary intake, exercise, and life style were determined by using questionnaires. When obesity was classified greater than 120% of the ideal body weight, the prevalence rates of obesity were 31.2% for boy and 20.6% for girl. There were significant differences in body composition between nonobese(NO) and obese(OB) groups. Mean fat mass(FM) and lean body mass(LBM) were 8.6kg and 27.7kg for NO group and 16.7kg and 32.3kg for OB group, respectively. Also a significant difference was found in hydration rate(TBW/body weight)between groups( <0.01). No significant difference was found I total calorie intake and nutrient intakes between groups. No difference was found in the frequency and duration of outdoor exercise and indoor activities. Mean sleeping hours was 8-9hours for 62% of nonobese children and for 59% of obese children. However, calorie intake per body weight was significantly lower inobese children than in nonobese. The present study showed that significant differences existed in their body size and composition between NO and OB groups , while no differences existed in daily calorie intake, excercise , and life style. This may indicate that important obesity-promoting factors of early onset obesity may rely on other factors such as hereditary or environmental factors besides factors considered. Further studies are required to understand obesity-promoting factors in children. (Korean J Community Nutrition 2(5) : 680∼686, 1997)

• 한국학교보건학회지
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• 제22권1호
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• pp.119-128
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• 2009

Purpose : The purpose of this study was to examine the effects of a self-efficacy promotion program on obesity in elementary school students. Methods : Forty five obese children from a elementary school were select for an experimental group and 53 obese children from another elementary school were chosen for the control group. Both schools located in Kimpo area. Obesity was defined as children whose age-specific BMI was 85th percentile or higher. Pre and post test were conducted to examine the effects of the self-efficacy promotion program. Chi-square test, t-test, paired t-test were used for analyses. SPSS 10.0 was used. Results : The decrease of BMI was significantly greater in the experimental group than the control group. Students' knowledge about obesity was significantly increased in the experimental group compared to the control group. Self-efficacy score was significantly increased in the experimental group. In addition, self-care behavior score was significantly increased in the experimental group. Therefore, the experimental group showed significant improvement in their knowledge, self-efficacy and self-care behavior compared to the control group. Conclusion : The results of this study suggest that self-efficacy promotion programs may have significant effects on the management of obesity in elementary school children. Thus, the results strengthen further research to develop effective intervention programs focusing on self-efficacy for obesity in elementary school children.

• 생명과학회지
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• 제18권10호
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• pp.1384-1389
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• 2008

비만 남자 초등학생을 대상으로 식사 조절과 병행한 유산 소운동을 HRmax의 60-70% 강도로 1일 100분, 주 5회, 9주간 실시하여 이들의 혈중지질과 아포지단백에 미치는 효과에 대해 알아보았다. 혈중지질의 TC, TG, HDL-C 농도와 TC/ HDL-C비가 개선되었는데 이는 규칙적인 유산소운동과 에너지섭취량 제한(식사제한)이 아닌 1일 영양권장량에 준하는 정상적인 에너지 섭취를 통해 비만아동의 체중감량과 더불어 CHD 위험인자인 혈중지질에 긍정적인 효과를 미칠 수 있음을 확인하였다. 또한 아포지단백의 Apo AII, B, CIII 농도가 감소하였는데 이는 유산소운동과 식사조절 병행이 성인의 경우와 유사하게 비만 남자아동들에게도 동맥경화 질환의 예방에 효과적인 방법이 될 수 있음을 증명하는 결과로 사료된다. 그렇지만 아직 운동에 따른 Apo 반응에 대한 연구들이 미흡하고 특히 Apo CII와 CIII에 대한 연구는 더욱 미흡한 상황이므로 향후 이에 관련된 후속 연구가 진행되어야할 것으로 생각된다.

• Clinical and Experimental Pediatrics
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• 제48권3호
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• pp.276-283
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• 2005

목 적 : 내장 지방은 비만 합병증의 위험 인자이며 성인에서 지방간은 내장 지방과 관련이 있음이 알려져 있다. 소아 비만의 진단기준인 BMI가 내장 지방 정도를 반영하는지를 살펴보고 소아 지방간 환아에서 BMI, 체지방 분포, 간 효소치와 복부 CT상 지방간 정도 사이의 상관관계를 알아보고자 하였다. 방 법 : 2000년 1월부터 2004년 2월까지 BMI를 기준으로 비만위험 또는 비만에 동반된 간 효소치 이상을 주소로 서울대학교 어린이병원 소아과에 내원하여 비조영증강 복부 CT 검사로 지방간을 진단받은 소아 23례(남아 19명, 여아 4명)를 대상으로 하여 CT로 복부 지방 면적을 측정하였다. BMI와 내장 지방과의 상관관계, 복부 CT상 지방간의 정도와 BMI, VAT, VSR, 간 효소치간의 상관관계를 분석하였다. 결 과 : BMI는 TAF(r=0.91476, P<0.0001), VAT(r=0.51719, P=0.0115), SAAT(r=0.88302, P<0.0001)와 유의한 상관관계가 있었다. CTL/CTS비와 BMI(r=-0.11938, P=0.5876), TAF(r=-0.14936, P=0.4964), VAT(r=-0.31234, P=0.1468), SAAT(r=-0.08154, P=0.7115), VSR(r=-0.19202, P=0.3801), AST(r=0.12729, P=0.5628), ALT(r=-0.00179, P=0.9935) 및 AST/ALT비(r=0.20762, P=0.3418) 사이에 유의한 상관관계가 없었다. 결 론 : 소아 비만에서 BMI는 내장 지방 정도를 반영하나 복부 CT상 지방간의 정도와 간 효소치, BMI, 내장 지방량 사이에 유의한 상관관계가 없었다.

• 생명과학회지
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• 제18권2호
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• pp.193-199
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• 2008

본 연구의 목적은 운동프로그램이 과체중 및 비만아동의 시기에 따른 C-반응성단백질 및 심혈관질환 위험인자의 변화에 미치는 영향을 알아보고자 과체중 및 비만 아동을 대상으로 12주 간의 걷기와 밴드운동을 실시하고, 운동전, 4주 후, 12주 후의 신체조성, 혈중지질, 인슬린, C-반응성단백질를 측정 분석하였다. 연구의 대상자는 연령과 성별에 따른 체질량지수 백분위 수 85 이상(BMI${\geq}$21.3)인 과체중 및 비만아동 16명을 프로그램에 참여하는 운동군에 8명, 대조군에 8명으로 무선배치 하였다. 운동군은 주 2회의 걷기운동 50분과 주 2회의 밴드저항운동을 12주 동안 실시하였다. 연구결과 운동군 내 에서는 체중(p<0.001), BMI (p<0.001), 체지방량(p<0.001), 체지방률(p<0.001), TC (p<0.05), 인슐린(p<0.05), HOMA-IR (p<0.05)이 감소하였고, 제지방률(p<0.001), HDL-C (p<0.01)는 증가하였다. 측정시기를 고려하여 집단간의 차이를 분석한 결과 체중(p<0.001), BMI (p<0.001), 체지방량(p<0.001), 체지방률(p<0.001), 제지방량(p<0.05), 제지방률(p<0.001), 인슐린(p<0.05), HOMA-IR (p<0.05)에서 통계적으로 유의한 차이가 있는 것으로 나타났다. 이상의 연구결과 12주 걷기와 밴드운동에 의해 과체중 및 비만아동의 심혈관질환 위험인자를 일부 개선되지만, C-반응성단백질 농도는 개선되지 않음을 알 수 있었다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제27권2호
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• pp.119-129
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• 2016

Objectives: The purpose of this study was to investigate mental health problems in obese child and adolescent patients. We assess the frequency of mental health problems and their differences according to sex, school grade and severity of obesity. Methods: The sample consisted of 106 children and adolescents aged 8-16 years (61 boys with mean age $10.98{\pm}2.26$, 45 girls with mean age $9.74{\pm}1.96$, p=.004) who were diagnosed with obesity and recruited at the Department of Pediatrics of Jeju National University Hospital. The participants completed the Korean-Child Behavior Checklist (K-CBCL), Children's Depression Inventory (CDI), Korean version of the Eating Attitude Test-26 (KEAT-26), and somatotype drawings. Results: The percentage of participants having a T-score in clinical range on one or more CBCL subscale was 37.7%. The percentage of participants in the high risk group for depression (CDI score above 17) was 20.8% and that in the high risk group for eating disorder (EAT-26 score above 20) was 6%. The girls showed significantly lower CBCL T-scores in social competence ($48.39{\pm}15.66$ vs. $38.91{\pm}22.04$, p=.011), adjustment function ($49.51{\pm}17.35$ vs. $40.38{\pm}22.58$, p=.020) and school competence ($53.34{\pm}10.47$ vs. $48.22{\pm}15.11$, p=.042) than the boys, but the percentages of boys and girls in clinical range were not significantly different. The middle school students showed (significantly) higher CBCL T-scores in somatic symptoms ($60.86{\pm}9.44$ vs. $55.74{\pm}6.76$, p=.005), aggressive behavior ($58.81{\pm}6.74$ vs. $54.68{\pm}6.22$, p=.009), total problems ($59.86{\pm}9.91$ vs. $54.88{\pm}9.76$, p=.039) and externalizing problems ($57.90{\pm}10.57$ vs. $52.44{\pm}9.38$, p=.022) than the elementary school students. The severe obesity group showed significantly higher CBCL T-scores in attention problems ($59.18{\pm}9.45$ vs. $54.15{\pm}5.34$, p=.001), social problems ($59.25{\pm}8.59$ vs. $55.96{\pm}6.50$, p=.038), delinquent behavior ($58.07{\pm}6.97$ vs. $54.73{\pm}6.00$, p=.017) and total problems ($59.21{\pm}11.65$ vs. $54.67{\pm}9.03$, p=.037) than the mild to moderate obesity group. Conclusion: Significant proportions of obese children and adolescents suffer from mental health problems. Clinicians need to pay attention to the mental health risk, especially in obese adolescents and severely obese children and adolescents.