• Clinical and Experimental Pediatrics
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• 제48권10호
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• pp.1076-1081
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• 2005

목 적 : 인슐린 저항성은 소아 및 청소년 비만증에서 내당능 장애, 당뇨병증, 심혈관계질환을 일으키는 중요한 위험요인 중 하나로 알려져 있다. 따라서 이 연구의 목적은 비만증 청소년이 소아에 비해 인슐린저항성이 증가하는가 그리고 성별에 따른 차이점을 규명하며 인슐린저항성에 영향을 미치는 요인들을 분석하고자 한다. 방 법 : 5-16세의 학생 9,837명을 신체검사하여 92명의 비만증 소아와 187명의 비만증 청소년을 선별하였고, 이들을 대상으로 당부하검사, 공복상태의 혈당, 인슐린농도, 총콜레스테롤, LDL-콜레스테롤, HDL-콜레스테롤, 중성지방의 농도, leptin, hs-CRP 및 adiponectin 농도를 측정하였다. 결 과 : 당부하검사를 통한 비만증 소아 및 청소년에서 성별에 따른 인슐린의 농도는 여자에서 인슐린의 농도가 높았다(P<0.05). 비만증 소아에서 4명(4.3%), 비만증 청소년에서 25명(13.3%)에서 내당능 장애로 나타났으며, 당뇨병으로 진단된 경우는 1례도 없었다. 인슐린 저항성은 여자, leptin, adiponectin, 중성지방의 농도와 밀접한 상관관계가 있었다(P<0.05). 결 론 : 비만증에서 인슐린 저항성은 소아보다 청소년에서 컸으며, 남자보다 여자에서 컸다. 또한 leptin 및 중성지방의 농도가 높을수록, adiponectin의 농도가 낮을수록 인슐린 저항성이 컸다. 소아 및 청소년 비만증에서 인슐린 저항성에 미치는 요인들에 관하여 좀 더 많은 연구가 필요하다.

• Journal of Nutrition and Health
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• 제35권1호
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• pp.60-68
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• 2002

Purpose of this study was to compare serum phospholipid fatty acid composition of obese children with that of normal weight children reside in Kangnung area. Subjects were consisted of 56(41 boys and 15 girls) moderately or severely obese elementary school children, and age and sex-matched normal weight children as a control group. Level of serum phospholipid fatty acids was measured by thin layer chromatography(TLC) followed by gas chromatography(GLC). for male subjects, serum triglyceride(121 $\pm$ 4.7mg/dl) and total cholesterol(180 $\pm$ 37.1mg/dl) concentrations were significantly(p < 0.05) higher in obese group than those for control group(81.5 $\pm$ 2.5mg/dl and 161 $\pm$ 32.0mg/dl, respectively). Obese group showed significantly higher percentage of serum phospholipid myristic acid(C14:0) than the value for control group in both male and female subjects. Obese male subjects had significantly higher percentages of palmitoleic acid(16 : 1), oleic acid(18 : 1), dihomo-${\gamma}$-linoleic acid(20 : 3, $\omega$6) and docosatetraenoic acid(22 : 4, $\omega$6), and lower percentages of eicosenoic acid(20 : 1, $\omega$6), docosapentaenoic acid(22 : 5, $\omega$6), EPA(22 : 5, $\omega$3) and DHA (22 : 6, $\omega$3) compared to values for control male subjects. For male subjects, obese group showed significantly higher ratios of 16 : 1($\omega$9)/16 : 0 and 18 : 1($\omega$9)/18 : 0, and significantly lower ratios of 22 : 5($\omega$6)/22 4($\omega$6), and 22 : 6($\omega$3)/22 : 5($\omega$3) compacted to values for the control group. But there was not significant differences in elongation and desaturation indices of serum phospholipids fatty acid metabolism between obese and control group in female subjects. Most of anthropometric measurements related to obesity were negatively correlated with the percentages of PUFA, $\omega$3 fatty acids or DHA(22 : 6, $\omega$3), and positively correlated with the percentage of myristic acid(14 : 0) or $\omega$6/$\omega$3 ratio in serum phospholipids. Serum triglyceride concentration was negatively correlated with the percentage of PUFA or $\omega$3 fatty acids, and positively correlated with $\omega$6/$\omega$3 ratio in serum phospholipids. These results indicate that obesity related changes in blood lipid levels and metabolism are more significant in male subjects than in female subjects. Also changes in serum phospholipid fatty acid composition observed in obese children appear to demonstrate the increased susceptibility of these children to cardiovascular disease and other related chronic diseases.

• 대한영양사협회학술지
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• 제6권1호
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• pp.44-52
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• 2000

Two hundred sixty six children were retrospectively surveyed from first to fifth grade to find out the status of obesity during four years. The obesity index was gained by height and weight data from student's health file and the data about eating behaviors and weight control behaviors, etc. were collected by questionnaires. Children assigned to one of the following groups : underweight, normal, overweight and obese. The results were as follows ; 1. Obese children were 18.6%(n=27) of boys and 10.8%(n=13) of girls at fifth grade. 2. Twenty eight children among forty obese children at fifth grade were also overweight or obese at first grade, and the other twelve was normal. 3. Breakfast skipping rate was significantly high among underweight and obese group of boys(p<0.01).The most children(87.6%) had prejudice for special foods. 4. The rate of agreement between obesity index and self recognition of body image was 60.7% in boys and 63.6% in girls. 5. Forty two point five percent of children have ever tried weight control as exercise(35.7%), reducing sugars and snacks(27%), fasting(23.8%), avoiding fatty foods(12.7%), taking diet food or drug(0.8%). In conclusion, the prevalence of children obesity is gradually increasing and children tried weight control without right guidances. In order to prevent progress into adulthood obesity, nutrition education should be followed with school foodservice including the right perception for obesity, proper weight control and eating behavior modification.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제21권2호
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• pp.111-117
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• 2018

Purpose: The prevalence of obesity has significantly increased among children and adolescents worldwide and is becoming an important health care problem in parallel with the increased prevalence of obesity pediatric non-alcoholic fatty liver disease. Betatrophin is a newly define hormone that is commonly secreted by liver and plays role in glucose tolerance. This study aimed to investigate the relationship between serum betatrophin levels and non-alcoholic fatty liver disease in obese children. Methods: The study included 40 obese children with a body mass index (BMI) above 95th centile, and 35 non-obese subjects with a BMI 3-85th centile, whose age and gender were similar to those of the patient group. For the evaluation of metabolic parameters fasting serum glucose, insulin, alanine aminotransferase, aspartate aminotransferase, lipid profile and serum betatrophin levels were measured. Total cholesterol: high-density lipoprotein cholesterol and low-density lipoprotein cholesterol: high-density lipoprotein cholesterol ratios were calculated as "atherogenic indices." Results: Serum betatrophin levels of the obese subjects were similar to that of non-obese subjects (p=0.90). Betatrophin levels were not correlated with the metabolic parameters. Conclusion: In the present study, levels of betatrophin are not different between obese and insulin resistant children and non-obese subjects, and they are not correlated with atherogenic indices. To elucidate the exact role of betatrophin in obesity, further studies are required to identify the betatrophin receptor and/or other possible cofactors.

• 아동학회지
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• 제26권6호
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• pp.393-409
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• 2005

This study examined effects of self-perceived obesity, peer victimization, stress, and maternal child rearing behaviors on self-esteem in an obese group(OG) and a normal weight group(NWG) of elementary school children. Subjects were 1,501 elementary school children in the 4th to the 6th grades in Seoul, Busan, Daegu, Gwangju, and Andong and their mothers. Major findings were that maternal child rearing behaviors and stress related to parents and home environments influenced children's self esteem only in the NWG; school-related stress was an influential variable on children's self esteem in both the NWG and OG. Peer victimization influenced children's self-esteem in both NWG and OG. Self-perceived obesity influenced some domains of children's self-esteem, especially in girls.

• 정신신체의학
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• 제7권2호
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• pp.213-225
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• 1999

서론 : 본 연구는 아동의 놀이 습관, 기질, 부모 및 가족 환경적 요인이 아동의 비만에 미치는 영향을 체계적으로 연구하여, 임상에서 비만아동 및 비만 성인을 치료할 때 활용하며 정확한 부모교육의 지침을 마련하고, 소아비만을 예방하는 대책을 강구해 보고자 하였다. 대상 및 방법 : 연구 대상은 서울과 천안 소재의 유치원에 다니는 만 4세에서 6세 아동 중 본 연구를 위해 고안한 설문지, 가정환경척도, 부모용 기질평가척도를 모두 답하고 신장, 체중 및 체지방율 측정이 가능했으며 특별한 과거력이 없는 260명이었다. 대상 아동들의 비만도는 한국소아의 신장별 체중 백분위의 50 퍼센타일을 이용하여 비만도(obesity index, 이하 OBI)를 계산하여 비만도가 20% 이상을 비만으로 정의하였고, 체지방 측정기기인 Bioelectrical Impedance Fatness Analyzer로 측정한 체지방율이 30% 이상인 경우를 비만으로 정의하였다. 결과 : 총 대상 아동 260명중 비만으로 측정된 25명을 비만군으로 나머지 235명을 정상체중군으로 평가하였고, 비만군의 평균 체지방율은 $32.0{\pm}2.4%$이었고, 정상체중군은 $22.4{\pm}2.9$ 이었으며, 비만도는 유의한 차이를 보였다(p<0.01). 비만아와 정상체중아의 부모의 BMI, 학력, 직업, 월평균소득을 비교한 결과 비만아의 아버지와 어머니가 모두 유의하게 높은 교육 수준을 보였고(p<0.05). 비만아의 어머니가 직업을 가진 경우가 유의하게 많았다(p<0.05). 비만아의 어머니가 유의하게 높은 BMI를 보였다(p<0.05). 월 평균 소득은 비만아동의 가정에서 높았으나, 통계적으로 유의한 차이를 보이지는 않았다. 대상 아동들의 놀이 형태를 관찰한 결과 비만아에서 TV나 비디오 시청 시간이 유의하게 길었으나(p<0.05). TV나 컴퓨터를 이용한 오락시간, 독서시간 및 장난감 가지고 노는 시간은 유의한 차이가 없었다. 정상체중군에서 실외놀이 시간이 긴 경향을 보였다(p<0.1). 부모용 기질 평가 설문지의 결과 활동성에서 비만아동이 정상체중아에 비해 유의하게 적은 활동성을 나타내었고(p<0.05), 비만아와 정상체중아에서 가정환경척도의 각 소척도를 비교해 본 결과 비만아의 가정에서 성취지향성, 지적-문화적 지향성, 도덕적-종교적 강조 소척도들의 점수가 유의하게 높았다(p<0.05). 부모의 BMI, 부모의 학력, 월평균 소득, 비만 아동의 놀이 습관, 기질의 각 소척도 및 가정 환경척도의 각 소척도들과 비만 아동의 체지방율의 상관 관계를 살펴본 결과, TV 시청 시간이 길수록, 아동의 활동성이 적을수록, 가정환경 척도 중 성취지향적이고 지적 문화적 지향적일수록, 아버지의 학력이 높을수록, 어머니의 학력이 높을수록, 아동의 체지방율이 높았다(p<0.05). 어머니의 BMI가 클수록, 가정의 평균 월수입이 높을수록, 아버지의 BMI가 클수록, 비만 아동의 체지방이 증가하는 경향을 나타내었다(p<0.1). 결론 : 결론적으로 비만한 아동은 기질특성상 저 활동성이며. TV 시청 시간이 길었다. 비만아동의 부모들은 높은 교육 수준을 보였으며 비만 아동의 어머니는 BMI가 높았고, 직업을 가진 경우가 많았다. 비만아의 가정에서 성취지향성, 지적-문화적 지향성, 도덕적-종교적 강조 소척도들의 점수가 유의하게 높았다. 가정 요인이 아동의 비만에 미치는 것은 단순한 것이 아니고 유전적 요인과 동시에 행동적 요인, 심리적 요인의 복합적인 영향을 준다고 볼 수 있다. 따라서 비만 아동을 치료시 아동 뿐 아니라 가족 모두의 참여와 변화가 중요하다고 볼 수 있다.

• 대한지역사회영양학회지
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• 제9권5호
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• pp.566-577
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• 2004

The present study was conducted to investigate the effect of nutrition education program on anthropometric values and boichemical index in obese children who live in Gumi city. The subjects were 16 obese boys, 20 obese girls with obesity index over 130 and 36 of their parents. The nutrition education was carried out by the professional personnel such as doctors, professors, and dietitians. The children were provided with well-balanced lunch meals and had 40min-lectures on the reasonable weight management, 40 min-games and also had regular exercises (stretching, swimming) for 90 mins everyday during 2weeks of the program. The parents had 90 min-lectures on childhood obesity, diet therapy, behavior modification, and exercise for 6times. After the program, obesity index, BMI, % body fat were significantly decreased (p < 0.05) in boys and obese index, BMI, % body fat and WHR were significantly decreased (p < 0.05) in girls. Blood cholesterol and TG levels of girls were significantly decreased (p < 0.05). These findings show that the well-designed nutrition education program for obese children can be an effective approach to help them to improve their anthropometric values and biochemical index.

• Child Health Nursing Research
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• 제12권4호
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• pp.451-461
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• 2006

Purpose: The purpose of this study was to identify the effects of a obesity management program on BMI, body composition, knowledge, perception and attitudes, mood and exercise habits in obese elementary school children with the goal of developing nursing interventions to promote a healthy lifestyle. Method: The study used a pre-experimental design with a one-group pre-post test. The content of the 8-week obesity management program included obesity education, diet control education, behavioral modification education, counseling, hand-reflexo massage, and exercise. Participants were 36 obese children who were students in elementary schools in K city. Data collection was done from October $4^{th}$ to November $28^{th}$, 2005. The data was analyzed using descriptive statistics and paired t-test. Results: After the students received the obesity management program, their BMI scores were significantly lowered, and scores for mood and excercise habits were significantly improved. Conclusion: The results show this obesity management program is effective in changing the BMI, mood, and behavioral modifications in obese students. The results suggest that this program be utilized to manage obesity in obese children, and that this study be replicated to compare an experimental group with a control group in order to verify the effects of the obesity management program.

• 대한영양사협회학술지
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• 제6권2호
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• pp.171-178
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• 2000

The purpose of this study was to obtain basic data of nutrition education for obese children in Seoul and to examine dietary habits, dietary behaviors, and body image recognition before and after nutrition education. A convenience sample of 69(male : 54, female : 15) obese children was selected from "98 Children Nutrition Camp" in Seoul. The survey design employed a structured questionnaires. The results of this study were summarized as follows ; 1. Anthropometric parameters such as height, weight were measured in 69 obese subjects of age 10~12. 2. Effects of nutrition knowledge were gained by dietary habits, dietary behaviors and body image recognition. 3. Comparison of nutrition knowledge scores for obese children was to obtain basic data of effects for nutrition education.

• 대한지역사회영양학회지
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• 제7권6호
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• pp.803-813
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• 2002

The purpose of this study was to investigate the anthropometric and blood biochemical characteristics, the dietary behaviors and health-related lifestyles of obese children in Incheon. A cross-sectional survey was conducted using anthropometric measurements, biochemical assessments and questionnaire analysis. The subjects included 7,055 obese children residing in the Incheon area (from 106 elementary schools). The degree of obesity was classified using the Obesity Index (OI) as light 20% ＜ OI ＜ 30% ; Medium 30% ＜ OI ＜ 50% ; Severe 50% ＞ OI. The statistical analysis was conducted using SPSS 10.0 program. Most subjects fell within the medium range of obesity. Most subjects had dietary problems such as overeating, unbalanced meals and skipping breakfast. The ratio of boy subjects eating green and yellow vegetables was lowe. when compared to that of the girl subjects. The boy subjects exercised more frequently and longer than the girls. As the Obesity Index increased, hypercholesterolemia significantly increased. The blood cholesterol levels of the subjects were positively correlated with body fat, waist/hip ratio and BMI; HDL cholesterol levels of the subjects were negatively correlated with the anthropometric data and the LDL cholesterol levels of the subjects were positively correlated with body fat. The blood triglycerides levels of the subjects were positively correlated with body weight, body fat, waist/hip ratio and BMI. Therefore, proper nutritional education and intervention are required for an improvement of obese children＇s dietary behavior, heath-related factors and blood lipid profiles.