• Journal of the Korean Society of School Health
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• v.22 no.1
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• pp.61-65
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• 2009

AIMS: Korean National Growth Chart was newly developed at 2007. Prevalence of obesity is expected to be changed according to reference data. This study was performed to compare the prevalence of obesity based on the newly developed growth curve with that of previous data. We also investigate the incidence of obesity, overweight, and normal criteria by two kinds of growth curves. Method: We obtained weight, height from 438 middle school students and 1786 high school students. We divided enrolled students into four groups (middle school boys, middle school girls, high school boys, high school girls). The obese, over weight group was defined as BMI(body mass index) more than 95th, 85th${\sim}$94th percentile respectively for age and sex. Obesity by relative weight was defined more than 20% of ideal body weight. We compare the prevalence of obesity in each group by the newly developed Korean National Growth Chart in 2007 and that in 1998. Result: Prevalence of obesity by BMI based on 2007 Korean National Growth Chart and that in 1998 were 8.2-12.9% and 9.0-20.4% respectively. The concordance rate were 99.0%-100% in obese group and 45.0%-91.9% in overweight group according to two kinds of reference data. Prevalence of obesity by relative weight was 11.7-23.0% that was same between 2007 Korean National Growth Chart and that in 1998 except middle school boys group. Conclusion: We found that there is a decrease in prevalence of Obesity by BMI based on 2007 Korean National Growth Chart. It is necessary to evaluate correlation between criteria for obesity and obesity related comorbid conditions for finding proper BMI or relative weight cut off value to prevent obesity and obesity related complications effectively.

• Journal of Nutrition and Health
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• v.31 no.2
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• pp.166-178
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• 1998

The purpose of this study was no investigate serum lipid levels of primary school children and to estimate their intakes of total fat and fatty acids. Subjects fasting blood samples were obtained and analyzed for serum triglycerides(TG), total cholesterol(Chol) and high density lipoprotein-cholesterol (HDL-Chol). Low density lipoprotein cholesterol (LDL-Chol), LDL-Chol/HDL-Chol ratio(LPH), and atherogenic index(AI) were calculated,. Dietary intake of nutrients was assessed by means of a 24-hour recall method using food models and other measuring tools . The serum levels of TG, Chol and LDL-Chol in girls were higher than those in boys, but the serum HDL-Chol level of girls was lower than that of boys. As the degree of obesity increased, the serum TG level of girls was lower than that of boys. As the degree of oesity increased , the serum TG level of girls increased. The serum LDL-Chol level was higher in obese boys than in normal ones. Percentage s of subjects at risk of cardiovascular disease based on corresponding criteria of TG, Chol,HDL-CHol and LDL-Chol were 25.9%, 7.6%, 20.7% and 10.1%, respectively. The serum TG level of children provided with the national school lunch program(NSLP) was lower than that of children without NLSP. The total fat intake of boys was higher than that of girls, but calorie-adjusted fat intake became similar between the two groups. Intakes of polyunsaturated fatty acids(PUFA), monounsaturated fatty acids(MUFA) and saturated fatty acids(SFA) were 13.3$\pm$9.5g, 16.1$\pm$9.3g and 21.4$\pm$14.2g in boys, respecitively , and 12.6$\pm$11.3g, 15.3$\pm$9.7g and 19.9$\pm$13.1g in girls, respectively . The ratios of polyunsaturated /monoun-saturated /saturated /saturated fatty acids(P/M/S) in boys and girls were 0.7/0.8/1.0 and 0.8/0.8/1.0 respectively. The ratios of $\omega$6/$\omega$3 fatty acids in boys and girls were found to be 12.1 /1.0 and 8.6/1.0 , respectively. These results indicated the urgent need of nutritional education in primary schools to prevent further increase in childhood obesity and hyperlipidemia . Therefore, this study will contribute to the establishment of dietary guidelines and health recommendation for school children.

• Clinical and Experimental Pediatrics
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• v.51 no.10
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• pp.1052-1057
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• 2008

Purpose : This study was to examine the relations of perception of physique with self-esteem, sociality and problematic behaviors in children. Methods: Four hundred sixty five (231 boys and 234 girls) children were divided into three groups according to their height or body mass index according to the physical growth standard table had been presented in 2007 by the Korean Pediatric Society. The group 1, 2, and 3 was short, borderline and normal or obese, overweight and normal, respectively. Their perception and satisfaction of height and weight were investigated, and their self esteem and behavior styles were examined with Self-Esteem Inventory (SEI) and Korean Child Behavior Checklist (K-CBCL). We compared the numbers of appropriate perception, satisfaction, self-esteem and problematic behaviors in each group, and analyzed the relationship among perception of physique, self-esteem, sociality, and behavioral characteristics. The collected data were analyzed with chi-square test, ANOVA and Pearson correlation coefficient used with SPSS (ver. 12.0). Results : There were significant mismatches among their real physique perception and satisfaction (P<0.05). There were no significant differences of their self-esteem, sociality, and problematic behaviors according to their actual height and weight. There were significant differences of their self-esteem according to their perception or satisfaction of their height and weight (P<0.01). Conclusion : The children who considered themselves have short stature or obesity had problematic behaviors or low self-esteem. Therefore, children should be educated to have the appropriate perception of their own body image.

• Clinical and Experimental Pediatrics
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• v.53 no.3
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• pp.341-348
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• 2010

Purpose : Body composition is important to define and manage obesity and undernutrition. Obesity is a significant health problem with medical and psychological consequences for children and adolescents. Body composition analysis (BIA) is a simple, rapid, noninvasive, and reproducible technique. However, comparative analysis of body composition has not been done in young children below 7 years old. The aim of this study is to estimate antropometric data and body composition by BIA, and to investigate the correlation between anthropometric data and fat mass or fat percent in young children. Methods : We measured height, weight, body mass index (BMI), fat mass, and fat percent by BIA in 1,376 children aged 3-6 years of whom 688 were males and 688 were females. Results : Fat mass, fat percent, intracellular fluid, extracellular fluid, protein, and minerals were significantly higher in the obese group. A significant positive correlation exists between fat mass and BMI or weight. A significant positive linear correlation was also noted between fat percent and BMI. Protein, weight, fat mass, and fat percent were significantly different among groups. Conclusion : BIA is an objective, accurate method to estimate body fat in childhood obesity cases. Fat mass and fat percent data acquired by using BIA highly correlated with BMI. However, a large-scale study is needed to diagnose obesity in young children.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.9 no.2
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• pp.218-225
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• 2006

Purpose: With a remarkable increase in the prevalence of childhood obesity, the prevalence of nonalcoholic fatty liver disease is assumed to be increasing. The aim of this study is to evaluate the prevalence of nonalcoholic fatty liver disease, hyperlipidemia, and glucose intolerance in normal and obese children. Methods: A total of 2,206 elementary students (boys: 1340, girls: 866) were grouped according to obesity index; normal group and obesity group (mild, moderate, severe). Aspartate aminotransferase (AST, SGOT) and alanine aminotransferase (ALT, SGPT) were measured with total cholesterol, triglyceride, and fasting blood glucose. Results: Compared with the 4.6% of elevated aminotransferases in normal group, obese groups showed significantly higher prevalence; 12.1% in mild obesity group, 19.4% in moderate group, and 21.6% in severe group (p<0.0001). The prevalence of hypertriglyceremia was 16.9% in normal weight group, which was significantly lower than obesity group (mild obesity group 30.3%, moderate and severe 37.6%, 38.2% each). In boys, the prevalences of elevated aminotransferases in normal weight and obese groups (mild, moderate, severe) were 6.8%, 18.0%, 23.0%, and 26.0%, respectively (p<0.0001). In girls, those were 2.1%, 5.1%, 12.0%, and 12.6%, respectively (p< 0.0001). The prevalence of hypertriglyceremia was relative to severity of obesity in boys and girls (p<0.0001). Conclusion: The prevalence of elevated serum liver enzymes increased with severity of obesity. For the prevention and treatment of fatty liver and hypertriglycemia, it is important to lower the obesity degree and enforce the education for a weight loss in the student and the parents.

• Clinical and Experimental Pediatrics
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• v.48 no.8
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• pp.857-864
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• 2005

Purpose : The objectives of this study was to evaluate the correlations between the indices of insulin sensitivity using fasting glucose and insulin level, and the body fat mass measured by bioelectrical impedance analysis(BIA) and dual energy X-ray absorptiometry(DEXA), and to determine the clinical usefulness of insulin sensitivity indices when obese children were followed up. Methods : In this study, 28 simple obese children and adolescents were included. Anthropometric data including body weight, height, obesity degree(OD), body mass index(BMI), and waist-to-hip ratio were collected and then body fat mass was measured by using BIA and DEXA. For metabolic data, 12 hour fasting serum glucose, insulin and lipid profiles were measured and indices for insulin sensitivity(G/I ratio, $log_{insulin}$, HOMA-IR, $log_{HOMA-IR}$, QUICKI) were calculated. Results : BMI had a higher correlation with insulin sensitivity indices than OD(G/I ratio, -0.463 vs -0.209; $log_{insulin}$, 0.417 vs 0.196; HOMA-IR, 0.301 vs 0.238; $log_{HOMA-IR}$, 0.403 vs 0.198; QUICKI, -0.451 vs -0.224). But OD had a higher correlation with body fat mass measured by BIA and DEXA than BMI(BIA, 0.612 vs 0.316; DEXA, 0.667 vs 0.512). The G/I ratio was correlated with body fat mass in BIA(r=-0.420, P<0.05) and DEXA(r=-0.512, P<0.01), percentage of body fat(percentage of fat) in BIA(r=-0.366, P<0.05) and DEXA(r=-0.449, P<0.01). HOMA-IR was only correlated with body fat mass in DEXA(r=0.341, P<0.05). Conclusion : This study revealed that G/I ratios had a statistically significant correlation with anthropometric obesity indices(OD and BMI) and also had a correlation with both body fat mass and percentage of fat. These results suggest that G/I ratios could be used as useful index when obese children and adolescence are followed up.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.11 no.2
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• pp.150-159
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• 2008

Purpose: To assess the relationship between lifestyle and metabolic syndrome in obese children and adolescents. Methods: We retrospectively reviewed the medical records and laboratory results of 109 subjects (7~15 years of age) who visited our pediatric obesity clinic between January 2004 and December 2007. They completed the parent- and self-report questionnaire developed by the Committee on Nutrition of the Korean Pediatric Society to assess lifestyle. The metabolic syndrome was defined as having 3 or more of the following metabolic risk factors: obesity, hypertension, serum triglycerides ${\geq}$110 mg/dL, HDL-cholesterol ${\leq}$40 mg/dL, fasting glucose ${\geq}$110 mg/dL, and insulin ${\geq}20{\mu}IU/mL$. Results: All subjects had at least 1 risk factor (obesity). Sixty-three percent of subjects had 2 or more risk factors, 32% of subjects had 3 or more risk factors, and 10% had 4 or more metabolic risk factors. Hypertriglyceridemia (36%), hypertension (32%), hyperinsulinemia (24%), and HDL-hypocholesterolemia (20%) were observed. Fasting blood glucose levels were normal in all subjects. Hypertension was significantly associated with an unbalanced diet and hyperinsulinemia was significantly associated with parental obesity (p<0.05). Those who ate after 8 PM were at a risk of hypertension (odds ratio, 2.5; 95% CI, 1.0~6.1). Those who did not have a preference for exercise were at a risk of hyperinsulinemia (odds ratio, 10.4; 95% CI, 2~54.1). Those who watched TV for ${\geq}$3 hours/day were at a risk of metabolic syndrome (odds ratio, 4.8; 95% CI, 1.2∼18.8). Conclusion: Lifestyle, such as eating late, no preference for exercise, and TV watching ${\geq}$3 hours/day, were related to metabolic syndrome in obese children and adolescents.

• Journal of the Korean Society of School Health
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• v.12 no.2
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• pp.217-230
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• 1999

The purpose of this study is to find out problems in obesity management through survey and analysis of the actual conditions from the view of a elementary schools school-nurses and to establish fundamental data for efficient obesity management. The subjects for this study were 313 numbers of elementary school-nurses in Kyung-Sang-Pook-Do. The data were collected through mail questionaries from November 1 to November 30, 1997. The major findings in this survey were as follows: 49.8% of the school-nurses who responded in the survey were in their 30s. The average career was 7.3years. The average service duration in their present school was 2.3 years, 55.6% of them were serving at schools which have less than ten classes total 77.2% of them were serving rural areas, 79.6% of them were serving at schools with fewer than 100 obese students. The total obesity prevalence rate was 11.4%, 13.3% were girls, 9.3% were boys. The measurement of height and weight is performed once a year for all surveyed students (91.7%), but obese students were measured as much five times (51.1%). The rate of obesity management planning was 74.1%, however the rates of evaluation and role assignment were 41. 2%, and 24.3%. 79.6% of the surveyed schools have health education classes for obesity, the rate compared (8.0 periods per year) to the whole of health education (79.1 periods per year) is 10.1%. 99.9% of the schools had counseling rooms for obesity (combined with nursing rooms) but they were used. The roote of individual counseling was 84.3%. The frequency counseling was six times a year for about 15 minutes. Obesity counseling records were kept 93.6% of the time and individual information cards were kept 98.7% of the time. The frequency of parents counseling was 42.8% and the survey shows that the main problem here was insufficient counseling facilities. The frequency of dietary guidance and exercise therapy was 84.3% and the dietary instructor was usually the school nurse at 51.7%. The frequency of obesity student exercise was 1-2 times a week and more-than-10-minutes at a time. They skip rope during the morning self-study class. The number on problem of exercise guidance at 56.2% was students' non-cooperativeness. School-nurses, 87.9%, answered that obesity management at school is necessary and 86.9% mentioned the shortage of obesity related information in present physical exercise books. From the plural responses of executing the obesity management, there are many similar problems: lack of knowledge and non-cooperation in parents at 41.9%, is predominant followed by of knowledge and non-cooperation in the children. The third problem is the lack of funds and facilities.

• Korean Journal of Community Nutrition
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• v.17 no.2
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• pp.226-242
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• 2012

Consumption of foods with high energy and low nutrient values has been linked to various health issues including obesity and chronic diseases. This study investigated the high-energy/low-nutrient food consumption status and its relationship with obesity status and intake of energy and nutrients, using the Korea National Health and Nutrition Examination Survey (KNHANES) and the Korea Youth Risk Behavior Web-based Survey (KYRBWS). The prevalence of overweight and obesity among 2-18 year-olds was 8.4% and 10.8% in 2008 and 8.5% and 9.0% in 2009, respectively, in KNHANES. The prevalence of obesity among 12-18 year-olds was 13.9% in 2008 and 11.4% in 2009 in KNHANES, while it was 8.1% in 2008 and 8.2% in 2009 in KYRBWS. Consumption patterns of high-energy/low-nutrient foods were diverse depending on the particular food type. High-energy/low-nutrient foods such as cookies were most often consumed more frequently (2~3 times per week), but fast food type foods were generally consumed less frequently (once per week or less). No significant relationships between highenergy/ low-nutrient food consumption and level of energy and nutrient intakes were found in either datasets. Adolescents who were not obese more frequently consumed ramen (p < 0.001), cookies (p < 0.001) and fast food (p < 0.001) than those who were obese in KYRBWS, however, such relationships were not found in KNHANES. This direction of the relationship could be probably attributed to the cross-sectional nature of the datasets. This study was limited by the cross-sectional nature of the data, therefore, further longitudinal research using various study techniques would be necessary to understand the effects of high-energy/low-nutrient foods on child obesity.

• Journal of the Korean Applied Science and Technology
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• v.34 no.4
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• pp.737-745
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• 2017

The aim of this study was to develop a community based participatory obesity control program and measure the effects of the program on obesity, exercise habit, eating habit and life habits among obese elementary school children. The community based participatory obesity control program was provided for the experimental group of $4^{th}$ grade elementary school students for 10 weeks. The program included obesity related health educations and counseling once a week, jump rope classes twice a week and folk game classes held once a week. Method: There were 24 students with obesity in the experimental and 27 in the control groups. The collected data were analyzed by the Kolmogorov-Smirnov test, ${\chi}^2$-test, independent t-test and repeated measure ANOVA. Results: After 10weeks of participation in the program, the experimental group showed significantly lower Body Mass Index (p<.001) and waist hip ratio (p=.036), significantly higher exercise habit (p=.004), eating habit (p=.003) and life habit (p=.001) than those in the control group. Conclusion: This study provides evidence that community based participatory obesity management program is effective nursing intervention for managing child obesity.