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.
The purpose of this study was to compare the validity of obese index among body mass index (BMI), waist to hip ratio (WHR), and waist circumference (WC) and to determine which is the best in relation to cardiovascular disease (CVD) risk in Korean elderly more than 65 ages. Data from the 1998 Korean Health and Nutrition Survey were used (n=1017). Anthropometric indices and CVD risk factors were measured, and chi-square test, analysis of variance following duncan's multiple range test, partial correlation analysis, and Receiver Operator Characteristic (ROC) curves were used in the analysis. Anthropometric values were decreased in both male and female when ages were goes up. In female elderly, it specially showed the characteristics of upper body fat and systolic blood pressure risk (p<0.05). Among life style factors the current smokers were prevalent in obese male (p<0.05), but not prevalent in female having obese or upper body fat. Also, person with upper body obesity have more exercise than that of normal group (p<0.01). Mean BMI values of the current smoker was lower than that of normal group in both sexes (p<0.01). Mean BMI value of person with other risk factors were higher than that of normal groups (p<0.05). Among 7 CVD risk factors in partial correlation analysis, WC had the highest correlation coefficient in 5 in male, whereas BMI in 4 in female. In ROC analyses of 12 risk factors and health conditions, the largest area under curve of obese indices for risk factors were WC>WHR>BMI in male and BMI>WHR>WC in female. The optimal cutoff values of each index (BMI : WHR : WC) for one or more risk factors were 19.02 : 0.84 : 71.3 in male and 19.04 : 0.88 : 85.6 in female. In conclusion, Most Korean elderly showed non-obese and abdominal obesity likewise other Asians. Also CVD risk factors were prevalent in Korean elderly within normal limits of obese indices. Therefore the upper body fat indices reflected in the aged whose muscle mass is replaced by fat must be used as an indicator of CVD risk together with BMI. Although WHR was the worst index based on partial correlation analysis and so located between BMI and WC in ROC curve analysis in both sexes, it need to be use with WC to screen the cardiovascular risk group.
Proper nutrient intakes and physical fitness focus one's attention on health promotion. This study was conducted to investigate nutrient intakes and physical fitness by BMI in middle school students. Health-related questionnaire, dietary intakes, food frequency questionnaire and physical fitness were studied. There were no significant differences in health-related questionnaire, food frequency questionnaire and physical fitness by BMI, but several nutrition intakes, preference of salty tastes and the proportion of iron deficiency of female students were significantly different by BMI. Although the female obese group (BMI 85 - 100 percentile) had decreased the proportion of iron deficiency and increased fish intake frequency than other groups, obese females did not show better physical fitmess than other groups. And the average Ca intake was below $75\%$ of Korean RDA in both male and female students. Significantly positive correlation was found between calorie intake and push-up of normal (BMI 15 - 84 percentile) male students (r = 0.29), also significantly negative correlation was found between protein intake and 50m dash of normal female students (r = 0.22). And significantly positive correlation was found between beans and bent knee sit-up of normal male students (r = 0.25), and significantly positive correlations were found between beans, meat, eggs, green & yellow vegetable and sit and reach (r = 0.20, r = 0.28, r = 0.21, r = 0.19) and significantly negative correlation was found between beans and long distance race of normal female students. Therefore, this study suggests that proper nutrition and non-obese states should be achieved for health promotion in middle school students.
The purpose of this study were to examine how people categorize obese individuals and if they have stereotyping about obese individuals. Twenty-five female volunteer subjects participated in this study. Subjects were undergraduate students in Textiles and Clothing courses at a midwestern university, US. Subjects were asked to give their one-word responses to four statements or questions regarding their impressions of six stimuli. The six stimuli consisted of magazine photographs of women; the magazines were general interest and fashion publications. Subjects then recorded their answers in the boxes for each of the six pictures. As the results, the relevant question as to whether or not more negative attributes would be assigned to the obese model's photographs was confirmed for the Description of Model variable, but not for the Personality of Model or for the Liking the Model variables. There was significant difference in means between the positive and negative descriptions of the Description of Model variable in the direction of negativity toward the obese group seems to confirm that, not only do people categorize others based on appearance, but there was a tendency to favor the average-size group and to view as negative the obese group.
The purpose of this study is to analyze the effects of exercise therapy on serum lipid levels and antioxidants of obese and normal college female students. The subject group composed of ten normal-weight students(below 30% body fat ratio) and ten obese students(above 30% body fat ratio). After a pilot test, the subjects were given an eight-weeks exercise program. Before and after the exercise program, the subjects were given test for serum lipid and antioxidants were analyzed. The SAS program was used in the data analysis. The statistical measurements employed here were T-test, Wilcoxon signed rank test, and Wilcoxon rank sum test. The results of this research are as follows. 1) The effects of exercise therapy on serum lipid levels : Before the exercise therapy, the levels of Total-cholesterol, Triglyceride and LDL-cholesterol of the obese group were highier than those of the normal-weight group. However, the HDL-cholesterol levels were highier in the normal-weight group than in the obese group, but these differences were not significant. With the exercise therapy, the levels of Total-cholesterol increased gradually. The HDL-cholesterol increased gradually, the LDL-cholesterol level decreased in both groups, However, the Triglyceride level decreased in the obese group and increased in normal group, but the difference was not significant. 2) The effects of the exercise therapy on serum antioxidants ; Before exercise therapy, the serum FR and GSSG levels of the obese group were significantly highier than those of the normal-weight group(p=0.00, p=0.04). The serum GSH level of the normal-weight group was highier than that of the obese group, and the serum MDA level of the obese group was highier than that of the normal-weight group. Again these differences were not significant. With exercise therapy, serum FR level was reduced and serum GSSG level significantly increased in both group(obese group p=0.01, normal-weight group p=0.01), The serum GSH level of the obese group significantly increased (p=0.01), and serum MDA level significantly increased in the obese group(p=0.01), but the difference in the normal-weight group was not significant. These results show that regular exercise therapy reduces serum FR levels and activation of antioxidant systems, and suppress oxidative stress. These effects were slightly highier in the obese group than in the normal-weight group. The regular exercise therapy decreased the serum Triglyceride levels more in the obese group than in the normal-weight group. However the improvement of the serum lipid profile may require a longer exercise period than eight weeks. The results show that the exercise therapy was overall more effective in the obese group than the normal-weight group.
Adipose tissue has now been recognized as a rich source of metabolically active molecules that include leptin and angiotensinogen (AGT), the precursor of angiotensin II (Ang II). Both of which have been implicated in the pathogenesis of metabolic alteration and hypertension associated with obesity. In this study, we examined the relationship between body mass index (BMI), adipocyte size, leptin, Ang II secretion and mRNA expression in human adipose tissue obtained from female subjects. Leptin and Ang II were analyzed using specific radioimmunoassay kits following a 48hour tissue culture. Leptin and Ang II secretion varied from 1.4 - 72.1ng/g and 0.8 - 57.3pg/g of tissue respectively. These large individual variations limit significant correlation between BMI, leptin and Ang II secretion. Ang II secretion was significantly higher in the obese than the non-obese (p < 0.05) and positively correlated with BMI. However, no difference in leptin secretion between the obese and the non-obese was observed and leptin secretion showed negative correlation with BMI. No difference in leptin and AGT mRNA expression in adipose tissue between the obese and the non-obese was observed. Although several limitations of this study, we found increased Ang II secretion in obese patients compared with non-obese patients, and positive correlation between AGT and BMI. Observed difference in AGT expression between the obese and the non-obese in this study might be of importance in relation with obesity related hypertension. (J Community Nutrition 8(2): 69-75, 2006)
This study researches an obesity index and the realities of physical activity of elementary school children and provide basic data to instruct correct physical activity for low weight and obese children. The subject was 813 Elementary School Children of grade 4-6 in Kyungju and data were collected with a Physical Activity Questionnaire from YHS, USA. The collected data were analyzed with real number, percentage, average and standard deviation techniques. The range was by SPSS WIN. Both of them were in the normal range, between -38.3 and 77.7, between low weight and obesity. The results are as follows : 1. An Obesity index according to grade and sex: the average obesity index of 423 boys was $7.56{\pm}15.7$, for girls it was $2.56{\pm}14.3$. Both of them were in the normal range, between -38.3 and 77.7. There were low weight($-38.85{\pm}0.9$) students as well as obese, including extremely low weight children ($-38.85{\pm}0.9$) and extremely obese children. 2. On the whole, in the Frequency of the 25 item physical activities breakdown, children reported to watch TV 1. ($2.7{\pm}0.6$), or do homework($2.1{\pm}0.9$), more than three-fourths of the week, male children, however, played more football($2.0{\pm}0.9$). As male obese children do less MET5, MET8(highly active activity) than male normal children, it was also discovered that low weight children do more severe activity in MET8(high activity). In female cases, it was revealed that neither do highly intense activity. 3. In physical activity, male children received higher points than female children with $92.94{\pm}37.95$ to $74.46{\pm}29.50$. On the whole, male and female obese children had lower score than normal children. 4. As for attitude toward physical activity, male children($31.96{\pm}4.37$) had a positive attitude than female children ($29.57{\pm}3.89$), but obese male children had a negative attitude regarding activity viewed as normal. Therefore, in preventing obesity in elementary school children the treating of under-weight children should be included in the obesity program so as to prevent mal-nutrition or deficiency. It is needed to instruct obese children to carry out intensive work-outs at least 3 times a week through systematic programs. It is also needed that parents and teachers educate elementary school children from an early age with information on the frequency and intensity of work-outs to prevent obesity. It is also desirable that children be educated to carry out physical activities that address their specific needs. As a result of this study, obesity management must be started from elementary school and children should be instructed to act in high-intensity actirities when they spend leisure time.
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.
This study attempted to identify obese students' stress and coping method in middle and high schools. The data were collected from the total of 600 obese students from middle and high schools in Pusan. The author used a convenience sampling method. The data collection was done from March 2 to April 30. 2001. The analysis of the data was done with SPSS Win(10.0) for descriptive statistics. t-test. and ANOVA. The instrument used for the obese students' stress and coping method was a questionnaire developed by Kim. Yi-Soon and Kim. Young-Hae(200l). The tool was composed of 65 items (33stress items: 32coping method items) with the five-point Likert scale. The results were as follow: 1. The average score of stress was 2.49 (SD = .86) points in the male students. and 2.83(SD= .86) points in the female students. The subcategories were: (outward appearance), (boyfriend/girlfriend), (occurrence of an outbreak of a disease), (relationship within the family), (an obese appearance), (difficulty in exercise). The highest degree of stress came from 'an obese appearance' for the male students (mean=2.64. SD=0.87) and (mean=2.64. SD=0.87) for the female students. 2. The subcategories of the coping method were: (be concerned about other matters), (recreation activities), (self-violence), (relaxation), (hobby activities), (avoid a situation), (communication), (music), (negative behavior), (positive thinking). The highest degree of coping method were (recreation activities) in the male students (mean=3.07. SD=0.86) and (music) in the female students (mean=3.47. SD=1.01). 3. The results comparing stress with demographic variables were significant for gender (t=7.010. p=0.000). grades at school (F=2.918. p=0.02l), degree of obesity (F=5.205. p=0.006). grades (F=2.550. p=0.027). standard of living(F=8.277. p=0.000). the state of health (F=2.882, p=0.022), relationship with the father (F=4.790, p=0.001), relationship with the mother (F=6.080, p=0.000), and the educational level of the father (F=3.192, p=0.013). 4. The results comparing the coping method with demographic variables were significant for gender (t=4.597. p=0.000). These findings contribute to the understanding of the degree of stress and the type of coping methods of obese students in middle and high schools. Therefore, the result of this study aids in an effective nursing intervention to improve the mental health program for the obese.
Purpose: To examine the effect of the exercise behavior modification therapy one the obesity control and self-esteem of the obese female college students. Method: Data was collected from March 10, 2006 to June 10, 2006. The research design was adopted randomized control group (EG=exercise group) pretest-posttest experimental ($E{\cdot}BG$=exercise${\cdot}$behavior modification therapy group) design. The subjects were nursing students at T college. A total of 37 obese female college students (BMI: over $27mg/m^2$) were selected for this research. The exercise program was executed for 12 weeks and 4 days a week, and the behavior modification was therapy performed for 12 weeks and 60 minutes per week. The data were analyzed with the SPSS Win 12.0 program through the Mann-Whitney test. Result: BMI (Z=-3.049, p=.002) of the $E{\cdot}BG$ was significantly different from the EG. The Total Cholesterol(Z=-1.162, p= .250) of the $E{\cdot}BG$ was not significantly different from the EG. The self-esteem(Z=-3.196, p= .001) of the $E{\cdot}BG$ was significantly different from the EG. Conclusion: The exercise behavior modification therapy was more effective than the exercise therapy in improving the obesity and self-esteem of the obese female college students.
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