• Nutrition Research and Practice
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• v.14 no.3
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• pp.262-275
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• 2020

BACKGROUND/OBJECTIVES: Evidence-based customized nutritional interventions are required for effective treatment of moderate to severe obese children and adolescents. SUBJECTS/METHODS: Sixty six (64.1% of 103) of the eligible participants who joined the usual care or physical activity group in the clinic were involved in 16-week intervention. Customized nutritional intervention was implemented for each participant based on a nutrition care process (NCP) model. Sociodemographic assessment, anthropometrics data, health- and dietary-related behaviors, and dietary intake of the study subjects were assessed at baseline and follow-up. All participants engaged in 30-minute nutritional sessions on a monthly basis. RESULTS: After 16 weeks, there were significant improvements in body composition [BMI (-0.8 ± 0.9, P < 0.05), BMI z-score (-0.3 ± 0.2, P < 0.001), body fat (kg) (-1.3 ± 2.1, P < 0.05), and body fat (%)(-1.5 ± 1.9, P < 0.05)] as well as macronutrient intake [total energy intake (kcal) (-563.7 ± 656.8, P < 0.05), energy (%) (-26.5 ± 30.0, P < 0.05) and fat (g) (-28.3 ± 40.6, P < 0.05)] in the adherent group than the non-adherent group. The SOC was higher in both groups after the intervention (P < 0.001). CONCLUSIONS: Our results highlight the positive effects of an evidence-based approach as a multidisciplinary intervention for people-centered nutritional care and weight management.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.3 no.2
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• pp.175-180
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• 2000

Purpose: Leptin is an adipocyte-derived blood-borne satiety factor that acts on its cognate leptin receptor in the hypothalamus, thereby regulating food intake and energy expenditure. We measured the leptin concentrations in serum of normal and obese children with human leptin ELISA kit, unlike previous study with leptin RIA kit and investigated the relationship between leptin concentrations and body mass index, gender, and age. Methods: We measured serum concentrations of leptin in 67 children who were visited to the Department of Pediatrics, Chungnam National University Hospital during the period of 5 months from February, 1999 to June, 1999. Height, weight, obesity index, and body mass index were measured in 67 subjects. Leptin values in serum were measured by sandwich ELISA method. Data analysis was done according to the obesity, body mass index, gender and age. Results: The mean concentration of leptin was $7.69{\pm}8.83\;ng/ml$ in normal children group and $36.34{\pm}18.57\;ng/ml$ in obese group. Serum leptin concentrations were significant correlation with the body mass index (p<0.01). Serum leptin concentration was significant higher in the group of over 10 years of age (p<0.01). Leptin levels showed no significant difference by gender. Conclusion: Serum leptin levels were significantly higher in obesity group than in control one, and they were correlated with body mass index and age. Measurements of leptin value by sandwich ELISA method are very useful and easily applicable to determine obesity.

• Child Health Nursing Research
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• v.19 no.4
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• pp.262-269
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• 2013

Purpose: The aims of this study is to analysis the effects of obesity management programs for children and to measure the differences in the effects by type and dependent variables in order to analyze the structures of the programs. Methods: Sixty-one peer-reviewed journals including child obesity and intervention studies published between 2000 and 2010 were included for meta-analysis. Effect size and statistics of homogeneity were by STAT 10.0. Results: A total of 61 studies were used in the analysis, and the effect size of the independent studies was determined to be -0.23 (95% CI, -0.32 ~ -0.15). Serum Leptin and Insulin were the big effect size among the studies that used dependent variables. The theses used in the research did not display publishing bias. Conclusion: Obesity management programs that have been confirmed to be effective need to be developed into regional protocols. A continuous control of obese children and research for effective intervention program are in need.

• Journal of the Korean Society of School Health
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• v.12 no.1
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• pp.27-44
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• 1999

Obesity in children is a major concern of public health. This study was performed to illuminate its effect on weight control program and the associated factors of obesity-related habits and obesity index in primary school obese children. Weight control program consisted of behavioral modification, nutrition education and exercise during 17 weeks. The sample consisted of treatment group(n=42) and control group(n=41). There was no statistical difference between the two groups in obesity index, socioeconomic status and grade. To assess the effects of weight control program, the subjects were given pre-test and post-test such as the measurement of anthropometric values and self-reporting questionnaire. This result of this study were as follows; 1. After weight control program was applied, there was a significant decrease in obesity index among the treatment group. Obesity-related habits score of the treatment group increased significantly, While there was not much difference between the pre-test and the post-test among the control group. But exercise habit didn't increase significantly in the both groups. 2. Correlation between obesity-related habits and obesity index were not evident. 3. After application of weight control program, the factors associated with change of eating habit were children's past experience of weight control, motivational change toward weight control program and friends' support for treatment group. The factors associated with change of exercise habit were post-test motivation score and friends' support. Motivational change toward weight control and pre-test self-efficacy of exercise behavior were counter-related to exercise habit. For change of other obesity-related habits, initial obesity index, motivational change, post-test self-efficacy score of exercise behavior and paternal educational status were closely associated. But post-test self-efficacy score of eating behavior was unrelated. 4. Only the factor of experience of weight control was associated with change of obesity index. 5. For the both groups, the factors associated with change of eating habits were post-test self-efficacy of eating behavior and family's support. The factors associated with change of exercise behavior were self-efficacy changes of exercise behavior and friends' support. The factors associated with change of other obesity-related habits were self-efficacy change of eating behavior. Initial obesity index was associated with change of obesity index. 6. The rate of dropouts from weight control program was 28.6% (12/42) in treatment group. Initial obesity index, other obesity-related habits except eating exercise habits, friend's support were associated with dropout. In conclusion, these results indicated that weight control program in primary school settings was effective. Direct exercise regimen and practice was demanded. In addition to the program itself, much of the success is dependent on the degree of motivation of the children involved and support provided by their parents and friends. Further study need to be performed under the condition that the weight control progrom is applied for a longer period.

• Korean Journal of Community Nutrition
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• v.15 no.3
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• pp.329-341
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• 2010

The purpose of this study was to examine vegetable & fruit (V/F) intakes, beliefs and self-efficacy regarding V/F consumption, nutrition knowledge and eating behavior of elementary students. A survey was conducted to the 4th graders (n = 234) at two elementary schools in Guri, Kyunggi-do. About one-fourth of subjects were overweight or obese. Subjects had 4.2 servings of V/F a day, consuming 340.2 g of V/F. Girls consumed significantly more amounts of vegetables than boys (p < 0.05). Girls were more favorable regarding V/F consumption (p < 0.01), and believed more strongly on advantages of having V/F such as “good for skin” constipation prevention (p < 0.001) and cancer prevention (p < 0.05). Boys felt more strongly in disadvantages or barriers of eating V/F, including mother's cooking time constraints (p < 0.01), lack of past experience of eating V/F, and family members' disliking of V/F (p < 0.05). Girls felt more confident in eating V/F (p < 0.05) than boys; they also felt more confident in specific items of "eating fruits/salads instead of cookies/chips for snack" and "eating fruit juice/vegetable juice instead of soda"(p < 0.01). Subjects showed low level of nutrition knowledge, especially in items such as balanced meals, recommended servings of V/F and vitamin deficiency. Compared to boys, girls had more desirable eating behavior such as eating adequate amount of meals (p < 0.001), having a variety of foods, eating fruits daily, and having fatty foods less frequently (p < 0.05). Intakes of Ca and K were quite below the recommended level, while the intakes of protein, Na and vitamin A intake were much above the Dietary Reference Intakes (DRI) for 9-11 old children. Nutrient intakes expressed as %DRI was higher in girls for vitamin A (p < 0.01), energy and riboflavin (p < 0.05). High V/F consumption group (${\geq}5$ servings of V/F a day) compared to the counterparts showed higher self-efficacy and had better eating behaviors. Nutrition education for children should focus on increasing consumption of V/F, by helping them to increase self-efficacy for eating V/F and to recognize the benefits and reduce the barriers of eating V/F, especially in boys. It is also needed to provide nutrition information for balanced meals or increasing V/F consumption, and help the children to adopt desirable eating behavior.

• Nutrition Research and Practice
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• v.10 no.6
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• pp.597-605
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• 2016

BACKGROUND/OBJECTIVES: Childhood obesity has increased in recent decades in Korea. This study was designed to examine differences in the eating habits, physical activity (PA), nutrition knowledge, and self-efficacy of children by obesity status. SUBJECTS/METHODS: Subjects were 5th-grade children from 70 elementary schools in 17 cities nationwide. Two-stage stratified cluster sampling was employed. Survey questionnaire included items related to general characteristics, eating habits, PA, nutrition knowledge and self-efficacy. Excluding incomplete responses, 3,531 data were analyzed using SPSS. Subjects were categorized into overweight obesity (OW) and normal weight (NW) groups based on body mass index percentiles for age by sex. RESULTS: A total of 21.5% of subjects was overweight or obese. There were significant differences in gender, perceived stress, perception of body shape, body satisfaction, and interest in weight control between the OW and NW groups (P < 0.001). With respect to eating habits, the OW group ate breakfast (P < 0.05) and snacks (P < 0.01) less frequently, ate bigger meals (P < 0.001), and demonstrated less desirable behaviors during meals (P < 0.05 in boys) compared to the NW group. The OW group participated in less PA than the NW group, especially boys. OW boys spent less time walking during weekdays (P < 0.05) or the weekend (P < 0.001), spent more time being sedentary during weekdays or the weekend (P < 0.001), and exercised a fewer number of days (P < 0.01). For girls, the OW group spent more time being sedentary during the weekend (P < 0.01) and exercised a fewer number of days by walking or bicycle riding (P < 0.05) than the NW group. Nutrition knowledge was not significantly different between the OW and NW groups. Self-efficacy (P < 0.01 in boys), especially PA self-efficacy (P < 0.01), was significantly lower in the OW than NW group. CONCLUSIONS: This study revealed differences in eating habits, PA, and self-efficacy between OW and NW children. Obesity management programs for children need to focus on increasing self-efficacy, modifying eating habits, and increasing PA.

• Korean Journal of Community Nutrition
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• v.14 no.1
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• pp.55-66
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• 2009

This study was aimed to examine nutrition knowledge, dietary attitudes, and eating habits of elementary school students and to examine if their characteristics differ by gender. Subjects were 5th and 6th graders of an elementary school (n = 317) in Seoul, and the survey was done during July 2007. Mean height, weight, BMI of subjects was 148.1 cm. 41.7 kg, 19.0, and 14.3% of subjects were categorized as the overweight/obese group. Anthropometric data were not significantly different by gender. Mean score of nutrition knowledge was 14.9 out of 20 showing moderate knowledge levels, and girls scored higher on nutrition knowledge than boys (p < 0.05). Subjects showed knowledge deficit in areas such as nutrients, food groups and specific weight control information. The percentages of correct answers regarding meals for brain function were significantly higher in girls than in boys (p < 0.05). They got nutrition information mainly from mass media and family/relatives. The mean score of dietary attitudes was 41.2 (possible score: 10-50) indicating somewhat positive attitudes, and the score of eating behaviors was 34.8 (possible score: 15-45). Subjects showed problems in eating habits such as having unbalanced diets and snack foods. 82.6% of subjects had unbalanced meals, and these percentages were higher in girls (87.2%) than in boys (78.1%, p < 0.05). Vegetables and fish/shellfish were the most disliked foods. Specific eating behaviors, such as eating slowly, eating grains and having processed foods less frequently, were better in girls than in boys (p < 0.05). Results also showed that majority of subjects need to improve specific behaviors including having diverse foods, eating meals slowly, having meals at regular times, having adequate foods in each food groups, and eating sweets or salty foods less frequently. Only 52.7% of subjects perceived their body images as normal, and 56.4% had experience of weight control. Reasons for weight control were different by gender (p < 0.05). Based on these findings, nutrition education for school children should focus on modifying eating habits or eating behaviors, by suggesting practically applicable methods and providing nutrition information that is interesting and suitable to school-aged children.

• Journal of Nutrition and Health
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• v.49 no.6
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• pp.447-458
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• 2016

Purpose: This study was conducted among 235 children aged 3 up to 11 yrs to examine the relationship between subjects' eating behaviors and obesity. Methods: The subjects were divided into three age groups: preschoolers aged 3 to 5 yrs, early elementary school students aged 6 to 8 yrs, and late elementary school students aged 9 to 11 yrs. As a tool for eating behaviors, the recently developed nutrition quotient (NQ) questionnaire was utilized. By age group, scores were gathered and calculated in the five factors, "Balance", "Diversity", "Moderation", "Regularity", and "Practice", which make up the NQ scores. Results: The NQ scores among those aged 3 to 5, 6 to 8, and 9 to 11 yrs did not exhibit any significant differences. Among the scores for the five factors of the NQ, the Diversity scores of those aged 9 to 11 yrs were significantly higher than the scores of those aged 3 to 5 and those aged 6 to 8 yrs. The scores of those aged 3 to 5 and those aged 6 to 8 yrs were higher than the scores of those aged 9 to 11 yrs in Moderation and Regularity. When the subjects were divided into loww-eight/normal and overweight/obese groups, among those aged 6 to 8 yrs, the NQ scores, Moderation, Regularity, and Practice scores were higher in the overweight/obese group than those in the low-weight/normal group. Among those aged 9 to 11 yrs, the overweight/obese group scored higher than the low-weight/normal group only in the Moderation component. Conclusion: From the results, to prevent obesity in elementary school students, it is practical to focus on training related to eating behavior items included in the Moderation component. Furthermore, personalized instructions on eating behaviors and nutritional education based on age are necessary to prevent obesity in children.

• Child Health Nursing Research
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• v.17 no.4
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• pp.247-255
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• 2011

Purpose: The purpose of this study was to investigate knowledge related to child obesity of child daycare center workers. Methods: The participants in this study were 360 child daycare center workers in 2 cities in South Gyeongsang Province. Data were collected from February to June, 2011, using self-report questionnaires including questions about the general characteristics of the daycare center workers and their knowledge related to child obesity. Frequency, percentage, arithmetic mean, standard deviation, t-test and ANOVA were used to analyze the data with the SPSS WIN 16.0 program. Results: The knowledge scores of child daycare center workers about child obesity averaged 74.8. The domains of diet (0.87 points) and prevention (0.86 points) had high scores, while, the domains of general characteristics (0.64 points) and diagnosis (0.59 points) had low scores. Conclusion: These results indicate that obese education programs for child daycare center workers should be developed in order to identify and teach children with obesity appropriately.

• Clinical and Experimental Pediatrics
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• v.48 no.12
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• pp.1295-1309
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• 2005

Nowadays, the nutritional deficits are rarely seen in Korea. However, an increased availability of the highly palatable energy dense, nutrient-poor foods increases the risks of obesity and deficits of vitamins and minerals in the general population. Also, optimum intake of vitamins and minerals, which varies with age and genetic back ground, might not suffice the poor, young, obese, and elderly people. Young girls and individuals participating in weight reductions and aesthetic components are prone to micronutrient deficiencies because they restrict food intake and specific micronutrient rich foods. An inadequate intake of vitamins or minerals is associated with reduced physical performance and exercise capacity, increased obesity, decreased cognitive function, increased DNA damages such as single- and double-stranded breaks or oxidative DNA lesions, and accelerated aging process and increased neuronal damages with mitochondrial oxidative decay. Most of these deleterious effects of the deficit could be prevented by a one tablet of multivitamins with a good balanced diet. High dose B vitamins are frequently administered to overcome the metabolic inadequacy to the people with the less functional enzymes with increased Km values for their coenzymes due to the single gene mutation or due to the single nucleotide polymorphisms. And some certain antioxidant vitamins are also used in large quantities to overcome the oxidative stress and to repair the damages. In this review, new nutritional concepts of some vitamins and minerals, which are widely used and useful for the children, will be discussed.