한국 남자 소아비만의 환경 및 영양상태 분석

Abstract

Recently, the morbidity in child obesity has shown a higher increase than in any other age groups, and also, child obesity may seriously affect the outbreak of cardiovascular disease and metabolic disorder as it proceeds to the teenage period and to the adult period. Therefore, obesity during childhood should be corrected at the earliest possible opportunity. In addition, an obesity determination index needs to be established in order to prevent child obesity by making an appropriate decision about obesity. This study determined the obesity of each of 535 third grade male children in 8 elementary schools in Seoul, by using the Broca Obesity Index (OI), the Rӧhrer Index (RI), the Child Growth Curve Index (GCI), and the Body Mass Index (BMI), which are child obesity determination indexes. And then, the study conducted a comparative analysis of general characteristics, biochemical characteristics, and nutritional intake in those children according to obesity determination methods, and the results include the following.

1. Concerning general characteristics, the average height and weight of those children in the physical characteristics of the children were 132.85.7cm and 32.07.1kg, respectively. In terms of physical characteristics of their parents, the parents' BMI showed a significant difference when determined by OI, RI, GCI, and BMI (p<0.05).

2. In the item of relevance between the parents' jobs and educational backgrounds, the mother's job was mostly a professional managerial position in the obesity group, constituting 43.8%, and it displayed a significant difference when determined by OI (p<0.05). The higher the mother's educational background was, the more obese the children were.

3. In the item of family history research, most of the parents of obese children in the obese groups according to RI and GCI had high blood pressure (55.5% and 50.0%, each), and this was demonstrated at a significant difference (p<0.05). As regards cancer in the family history, when it was determined by RI, it was placed at 12.7%, which showed a significant difference (p<0.05).

4. With regard to others, the ratio of less than 1 hour of pastime a day' was the lowest in the obesity group (39.5%), and this displayed a significant difference (p<0.05).

5. In the item related to eating habits, the skipping rate of breakfast was high in obese children (100%), and the main reason for skipping a meal was found to be because 'they had no time'. Concerning the snack type the obese children often ate, it was 'cookies' in most cases, whereas the intake of fruits was small. This presented a significant difference (p<0.05). The number of dining out and eating fried foods according to OI, appeared to show a significant difference in the obesity group (p<0.05).

6. In the item of biochemical characteristics, serum total cholesterol (TC), LDL-cholesterol, and triglyceride (TG) were significantly higher in the obesity group by OI, RI, and GCI (p<0.05), whereas HDL-cholesterol was found to be significantly lower (p<0.001). Insulin, HOMA-IR, and GPT were discovered to be significantly higher in obese children according to OI, RI, GCI, and BMI (p<0.001).

7. In the item concerning their nutritional intake, the intake of carbohydrates was significantly smaller in the obesity group when determined by OI, RI, and GCI (p<0.05), but the intake of fat was significantly higher in the obesity group when determined by RI and GCI (p<0.05). When determined by RI, obese children were taking significantly higher total fat, saturated fatty acid, and monounsaturated fatty acid (p<0.05). In the obesity group according to determination by OI, they were taking significantly lower vitamin C, folate, and vitamin E (p<0.05).

8. The result of comparing the average intake of nutrition in the research subjects and the KDRIs, the dietary reference intakes for Koreans, discovered that the intake of iron, folate, calcium, fiber, and potassium were insufficient when compared to the required intakes. Specifically, obese children according to OI, RI, GCI, and BMI were taking below-estimated average requirements (EAR) of vitamin C; thus, the probability of their nutritional deficiency was significantly high (p<0.05).

9. Regarding the correlation between nutritional intake and the obesity index, carbohydrate (p<0.01), vitamin C (p<0.01), folate (p<0.05), and vitamin E (p<0.05) had a significantly negative correlation with OI, RI, and BMI, whereas animal protein (p<0.05), animal fat (p<0.01), cholesterol (p<0.01), saturated fatty acid (p<0.05), and monounsaturated fatty acid (p<0.05) had a significantly positive correlation with them.

In conclusion, the analyzed results of physical characteristics, eating habits, biochemical characteristics, and nutritional conditions were shown to be very different according to the 4 types of obesity classification methods. This explains the reason why it is difficult to propose standard values for nutritional determination that may be used in clinical situations because the standard for obesity determination is inappropriate for the research subjects, 10 year-old children who are in a rapid growth period. Therefore, in order to offer data that can be easily used in the clinical fields for highly reliable and valid standard values for child obesity determination, by age and region, it would be necessary to continue broad research in the future.