• Clinical and Experimental Pediatrics
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• v.51 no.6
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• pp.576-583
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• 2008

Purpose : The identification of specific behaviors conducive to overeating or inactivity is the cornerstone of obesity management. The Committee on Nutrition of the Korean Pediatric Society developed parent and self-reporting questionnaires about eating behavior and physical activity in 2006. The aim of this study was to evaluate the usefulness of the questionnaires in assessing modifiable lifestyle factors related to obesity. Methods : A retrospective chart review was performed for 177 children (6-11 years old) and 134 adolescents (12-16 years old) from 10 hospitals between May 2006 and January 2007 who had completed parent or self-reporting questionnaires. Cases were divided into normal and overweight groups at or above the age-gender-specific 85th percentile based on 2007 Korean national growth charts. Results : Compared to children, the adolescents tended to have a significantly more sedentary lifestvle and inappropriate dietary behaviors significantly (P<.05). Overweight mothers were significantly associated with overweight children and adolescents (P<.05). Being overweight was significantly associated with a family history of adult diseases for children and adolescents (P<.05). Inappropriate eating behaviors (strong appetite, eating fast, eating until they were full, binge eating, favoring greasy foods) were associated with being overweight in children and adolescents. Sedentary activity such as TV viewing and using a computer were significantly associated with overweight in children and adolescents (P<.05). Conclusion : Intervention to modify obesity-related lifestyle factors is needed before adolescence. These questionnaires are useful in identifying modifiable lifestyle factors and in individual counseling for overweight children and adolescents in pediatric clinics.

• Clinical and Experimental Pediatrics
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• v.51 no.6
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• pp.597-603
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• 2008

Purpose : Obesity is associated with insulin resistance. Insulin resistance and the presence of pro-inflammatory mediators are thought to cause a state of vascular endothelial dysfunction, an abnormal lipid profile, hypertension, and vascular inflammation. These chronic inflammatory responses, which are characterized by abnormal cytokine production, lead to activation of a pro-inflammatory signaling pathway. Leptin is an important mediator of inflammatory processes and immune-mediated diseases. The purpose of this study was to investigate the relationship between leptin and various cytokines associated with obesity in adolescents. Methods : Sixty-six obese adolescents (between 16-17 years of age, obesity index >130%) and 26 normal controls were included in this study. Obesity index and body mass index (BMI) were calculated. Serum lipid profile, AST and ALT were tested after 10 hours of fasting. Tumor necrosis factor alpha (TNF-${\alpha}$) and Interleukin-6 (IL-6) levels were measured by ELISA. Insulin, adiponectin, and leptin levels were estimated by radioimmunoassay. Results : Leptin was significantly higher in the obese adolescents compared to the control adolescents ($12.0{\pm}6.8ng/mL$ vs $6.3{\pm}1.0ng/mL$). TNF-${\alpha}$, IL-6, and insulin were significantly higher in the obese adolescents. Adiponectin was significantly lower in the obese group than the control group ($3.3{\pm}1.9{\mu}g/mL$ vs $5.0{\pm}1.4{\mu}g/mL$). Leptin had positive correlations with obesity index, BMI, and IL-6. Conclusion : In obese adolescents, leptin, TNF-${\alpha}$, IL-6, and insulin might be important mediators of obesity. Further clinical research is necessary to ascertain leptin as a predictor of cardiovascular diseases and to develop a guideline for clinical intervention.

• Clinical and Experimental Pediatrics
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• v.45 no.12
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• pp.1484-1490
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• 2002

Purpose : The purpose of this study was to look at prevalences of abnormal serum aminotransferase levels and abnormal serum total cholesterol levels among adolescents with obesity in Seoul area. Methods : Body mass index[$BMI(kg/m^2)$], serum aspartate aminotransferase(AST) alanine aminotransferase( ALT), and total cholesterol levels were measured in 26,876 adolescents(male : 13,287, female : 13,589) of first grade of high school in Seoul between the ages of 15 and 16 years, enrolled in a large health examination survey by Seoul School Health Center(SSHC) in 2001. Obesity was defined as BMI more than 95th percentile for age and sex and normal weight was defined as BMI between 25th percentile and 75th percentile for age and sex. Abnormal levels of AST, ALT and total cholesterol were defined as more than 95th percentile for age and sex. Results : The BMI at 95th percentile was 28.7 in males and 26.9 in females. The prevalence of abnormal AST levels was higher in obesity group than in normal weight group. In males, those were 23.7% and 3.7%, respectively(P<0.01, $x^2-value$ : 529.2). In females, those were 11.8% and 4.9 %, respectively(P<0.01, $x^2-value$ : 56.3). The prevalence of abnormal ALT levels was significantly higher in the obesity group compared with the normal weight group. In males, those were 33.9% and 1.7%, respectively(P<0.01, $x^2-value$ : 1,693.4). In females, those were 22.3% and 3.9%, repectively(P<0.01, $x^2-value$ : 397.6). The prevalence of abnormal total cholesterol levels was higher in the obesity group than in the normal weight group. In males, those were 16.8% and 3.5%, respectively(P<0.01, $x^2-value$ : 268.3). In females, those were 9.0% and 5.4%, respectively(P<0.01, $x^2-value$ : 14.2). Conclusion : This study revealed that the prevalences of abnormal AST, ALT and total cholesterol level were higher in the obese group than in the normal weight group.

• Korean Journal of Community Nutrition
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• v.11 no.2
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• pp.180-190
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• 2006

The purpose of this study was to assess several indices of diet quality based on nutrient, food and food group intake of Korean adolescents based on several indices on diet quality according to residence area and body size. Using the data from the 1998 National Health and Nutrition Survey, twenty-four-hour-dietary recalls of a total of 1,110 Korean adolescents aged 13 - 19 years (male 543, female 567) were analyzed for nutrient adequacy ratio (NAR) , index of nutritional quality (INQ) , the number of foods (Dietary Variety Score, DVS) and food group consumed (Dietary Diversity Score, DDS) . In doing that, it was attempted to apply only the minimum amount of solid foods of Kant's without inclusion of liquid foods because of the very limited variety in Korean foods. Based on weight length index, 13.1% of the subjects were categorized as obese, 14.2%, overweight, 44.4%, normal and 28.3%, underweight. Only vitamin B2 intake was higher in the obese group than in the underweight group. There was no meaningful difference in energy, protein and fat intakes according to the grade of the body size. In terms of residence area, intake of fat, niacin, vitamin $B_6$ and folic acid were lower in the rural areas than in the metropolitan city. Only vitamin E intake was higher in the rural areas. Mean value of NARs (MAR) and INQs (mINQ) was also higher in the metropolitan city than in the rural areas, but there was no significant difference of these two values according to body size of the subjects. Mean DVS was 21.02 for total subjects, and has no difference between male and female and between metropolitan city and other medium-small city. But, the rural areas showed the lowest DVS of 19.05. Mean DDS in which five is a maximum score was 3.3 with no significant difference by sex and by residence area in male subjects. However, in female subjects, DDS in the rural areas was the lowest. According to body size of the subjects, there was no meaningful difference in both scores of DVS and DDS. In conclusion, most indices of nutrient intake and food and food group intake were not significantly different by body size of the subjects, while most indices were significantly different by residence areas: higher in the metropolitan city than in the rural area.

• Korean Journal of Health Education and Promotion
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• v.6 no.1
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• pp.22-33
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• 1989

Rapid socio-cultural and economic changes in the country has brought with it changes in the society's value system. For a traditional society that is increasingly being exposed to modernization but where sex norms are still very restrictive, the adolescent sexual mores takes on added significance. Adolescents are caught between two opposing forces, the changing environment that allows for freer and liberal mores and the traditional society that cannot keep pace with the changing environment and therefore demands resistance to changes. This paper focuses on problems of adolescent sexuality in this country and considers the countermeasures for the existing problems. Amongst the problems are: (a) increasingly younger age of the adolescents who start sexual intercourse (b) non-use of contraception, (c) unwanted pregnancies, (d) increase in the number of induced abortion and (e) increase in the number of unwanted children and unmarried mothers. The Korean adolescent's sexual behavior seems to follow that of the developed countries. In other words, many western modes of life and sexual values seem to bave been copied in Korea and yet Korean adolescents lack in their knowledge of sex related matters such as reproductive physiology and contraception. Among middle and high school students, female students are reported to have less knowledge on sex than male students according to a 1988 survey by KIPH. Even among the unmarried famale factory workers, only 42.5 percent replied they know of the condom, and 25.1 percent and 23.1 percent said they had knowledge of spermicide and menstrual regulation respectively. However, 14.9 percent and 13.9 percent reported that they had a knowledge of the loop and female sterilization respectively according to the 1984 study by KIPH. Among the middle school students 0.8 percent said they had experience in sexual intercourse, while 7.3 percent of the high school students reported having had sexual intercourse. The sexual intercourse experience rate among the unmarried female factory workers is 37.8 percent. Among those female factory workers with sexual experience, 46.7 percent had more than one sex partners. Only 39.1 percent of male students and 18.9 percent of female students among those with sexual intercourse experience have used contraceptives. mostly condoms and oral pills 45.1 percent of female factory workers with sexual intercourse experience used contraceptives such as pills, condoms and rhythm methods. The pregnancy experience rate among the female factory workers who had experience in sexual intercourse is 29.5 percent, which is 11.1 percent among the total respondents. Out of the 102 pregnant female workers, 98 workers(96.1 percent) terminated their pregnancy by induced abortion and 2 workders(2 percent) in natural abortion, while 1 worker(1 percent) was in pregnancy and another 1 worker had normal birth that was subsequently sent to orphanage. In order to cope with the problem of adolescent sexuality, a drastic and strong policy measures should be taken by the government. The most effective countermeasure to the adolescent sexual problems appears to the education. The sex and population education in the school is very much in need. In addition, sex education program through mass media and at the job sit-should be promoted for a healthy development of adolescents' sexual behavior. Also, the existing national family planning program, which has focused on the married couples, should be extended to the unmarried people in its scope and contents of the program.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.3
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• pp.309-316
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• 2018

Purpose: This study was conducted to identify the prevalence and related factors of metabolic syndrome in Korean adolescents. Method: Based on data from the Korea National Health and Nutrition Examination Survey of 2015, 404 adolescents aged 12-18 years were enrolled. We used the adolescent Ford method as the diagnostic criteria for adolescent metabolic syndrome. The data were analyzed using descriptive statistics, t-test, $x^2$-test, and logistic regression with SPSS WINDOW 23.0 program. Results: The prevalence of metabolic syndrome in Korean adolescents was 6.5% (6.5% for boys and 6.4% for girls). Among metabolic syndrome components, the prevalence of elevated blood pressure (28.8%) was the highest, followed by elevated triglycerides (21.3%), increased waist circumference (14.1%), decreased high density lipoprotein-cholesterol (11.5%), and elevated fasting blood sugar (7.8%). The only factor associated with metabolic syndrome in both boys and girls was the Body Mass Index (BMI), and the likelihood of a metabolic syndrome increased by 1.6 to 2.3 times (Adjusted OR=1.552 to 2.313, p=0.001) as the BMI increased. Conclusion: Based on the results of this study, an intervention program should be developed and provided to maintain the BMI in the normal range for the prevention and management of metabolic syndrome in Korean adolescents.

• Clinical and Experimental Pediatrics
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• v.57 no.12
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• pp.520-525
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• 2014

Purpose: Childhood obesity is an increasing public health issue worldwide. We examined dietary patterns among adolescents in a dormitory school, identified obese adolescents and tried to intervene to improve food habits and physical activity. Methods: We conducted an experimental prospective longitudinal study based on 36 obese (body mass index $[BMI]{\geq}95th$ percentile) adolescents (aged 12-18 years) compared with controls (healthy children: normal age-appropriate BMI ($BMI{\leq}85th$ percentile). Six months' intervention included lifestyle-modification counseling (once a week by a clinical dietician), and an exercise regimen twice a week, 60 minutes each time, instructed by a professional pediatric trainer). Both groups underwent baseline measurements at the beginning of the study and 6 months later (arterial stiffness, blood pressure, pulse, weight and height, hemoglobin, creatinine, liver enzymes, highly sensitive C-reactive protein and complete lipid profile). Results: Twenty-one participants completed the study. Low compliance from participants, school staff and parents was observed (participation in planned meetings; 71%-83%). BMI significantly decreased from $32.46{\pm}3.93kg/m^2$ to $30.32{\pm}3.4kg/m^2$ (P=0.002) in the study group. Arterial stiffness was not significantly different between the 2 groups and did not change significantly after 6 months' intervention (P=0.494). No significant changes in CRP and lipid profile were observed after the intervention. Conclusion: Making lifestyle modifications among adolescents in a dormitory school is a complex task. Active intervention indeed ameliorates BMI parameters. However, in order to maximize the beneficial effects, a multidisciplinary well-trained team is needed, with emphasis on integrating parents and the school environment.

• Korean Journal of Community Nutrition
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• v.23 no.4
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• pp.302-318
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• 2018

Objectives: This study examined the differences in dietary life and health related factors, such as drinking behavior, exercise and leisure activities, mental health, and subjective perception for oneself according to obesity in poor urban Peruvian adolescents. Methods: A total of 1,532 Peruvian adolescents were selected from six schools in poor regions using stratified random sampling. The subjects were classified into two groups based on their BMI: 'normal weight group (NW group=980)' or 'overweight and obese group (OWOB group=293)'. The differences in the general characteristics, dietary life, drinking behavior, physical activity and leisure, mental health and subjective perception of oneself in the two groups were compared. ${\chi}^2$ analysis and independent sample t-test were performed using the SPSS program ver. 24. Results: For the total and male students, the frequency of breakfast and dinner were significantly lower in the OWOB group than in the NW group (all p<0.001). For total and female students, the percentage of subjects who received nutrition education was significantly higher in the OWOB group than in the NW group (all p<0.05). For total students, the percentage of subject who exercised more than five days/week was lower in the OWOB group than in the NW group (p<0.05). For the total and female students, the subjective health status was worse in the OWOB group than in the NW group (all p<0.05). The subjective body image was significantly different between the OWOB group and NW group in the total, male and female subjects (all p<0.001). Conclusions: The frequency of meals and exercise, and the subjective perceptions of the health status and body image differed according to obesity in poor urban Peruvian adolescents. Therefore, a school-based intervention program focused on regular meal and exercise, and adequate subjective perceptions for health status and body image need to be developed to prevent adolescent obesity.

• Journal of the Korean Society of School Health
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• v.14 no.1
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• pp.115-130
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• 2001

Dieting behaviors prevail among most women and are highly increasing among female adolescents who don't have to lose weight. The dieting behaviors of normal or low weight groups are highly related to the negative impact of health risk behaviors. We need a strategy for intervening in the dieting behaviors of relevant groups. With this background, a study was conducted to examine the current situation of dieting behaviors and related factors in middle school girls, and to provide guidelines for the relevant dieting group. This survey was carried out by self-questionnaires passed out to 901 middle school girls from 3 middle schools in Seoul. Data were collected from April 10th, 2000 to April 17th, 2000 and 794 respondents' data were finally selected for analysis. The instruments of this study were Shin's scale for effects of mass-media, Birleson's depression self-rating scale translated by shim, Rosenberg's self-esteem scale, Smilkstein's Family APGAR score translated by Yoon, Kim's school-related adjustment scale. The credibility of instruments was 0.41~0.83 in the pilot study and 0.70~0.86 in the main study. The summary of results was as follows: 1. The general characteristics of respondents were analyzed. In comparison of grade and dieting behaviors, the subjects of the group perceived that their body image was obeser than their real body image and their ideal body image was slenderer than their current body image. A dieter's body image was seriously distorted. 2. The dieting behaviors were analyzed. The Subjects' BMI was within the normal to low range -- they didn't have to lose weight. But actually 47.3% of the respondents were dieters. Their main dieting methods were exercise(71.8%), computer games(64.9%) such as DDR and pump, and intake reduction(64.1%). Most dieters were using desirable methods such as exercise and intake control. But unhealthy methods such as saunax, smoking and harmful drug-use were also used by a few dieters. The main reason for dieting was attractiveness. The chief resources of dieting methods were mass-media(67.8%), friends(64.3%), and parents & relatives(35.1%). Only a few subjects obtained the information from health professionals. While they were trying to lose weight, 42.1% of the subjects experienced side effects such as dizziness(45.0%), apathy(20.5%), appetite loss(18.5%), amenorrhea and the irregularity of the menstrual cycle(16.6%). 3. The relationship between dieting behaviors and factors was analyzed. Dieting behaviors were significantly related to the experience of menarche, the experience of dating with heterosexuals, perceived body image, self-esteem, depression, family's relationship, school instruction-related adjustment, school life-related adjustment, and the effect of mass-media. After that, the multiple logistic regression was used. The analysis revealed that dating, perceived body image, the experience of menarche and the effect of mass media were significant factors. In conclusion, strategies for preventing irrelevant dieting behaviors are urgently required to enhance female adolescents' ability to choose the right information from countless others and to recognize their optimum body image.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.5 no.1
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• pp.162-171
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• 1994

Objects : This study was carried out to develop the Korean form of Leyton Obsessional Inventory-Child Version(LOI-CV) designed to assess the obsessive compulsive symptoms in children and adolescents. The LOI-CV was modified into a paper-and-pencil form in order to administer it to group. Methods : We applied the Korean form LOI-CV to 127 elementary, middle and high school children, and retest it to 82 children with 3 weeks interval. Together with LOI-CV, Korean form of SCL-90-R which had been proved its reliability and validity, were administered to the all subjects for examining of concurrent validity. And then we examined whether this scale discriminates between obsessive patients, psychiatric controls and normal controls in the level of obsessive symptoms. Results : Test-retest reliability, internal consistency were very satisfactory. Concurrent validity with SCL-90-R was moderate level. And obsessive patients was scored significantly higher than psychiatric and normal controls in the level of obsessive symptoms. In factor analysis, items are clustered to 5 factors. In the global obsessive symptom, obsessive scores of female elimentary school students were higher than that of male students. Conclusions : These results indicate that the Korean form of LOI-CV is reliable and valid self-rating scale to assess the obsessive-compulsive symptoms in Korean children and adolescents. Author suggests that future research is needed for Korean version standardization study in normal and clinic-refered population.