지역아동센터 이용 어린이의 비만관리의 한계점과 모바일폰의 잠재적인 활용 가능성: 어린이와 보호자 대상의 질적 연구

이보영,박미영,김기랑,심재은,황지윤 대한지역사회영양학회 2020 대한지역사회영양학회지 Vol.25 No.3

Objectives: This study was performed to identify the current barriers of obesity management for children using Community Child Care Centers and their caregivers (parents and teachers working in the Centers). Further, this study explored the possibility of utilizing a mobile phone application for tailored obesity prevention and management programs to overcome the current difficulties associated with children's obesity management. Methods: The qualitative data were collected through in-depth interviews with 20 obese and overweight children or children who wanted to participate in this study using Community Child Care Centers, 12 teachers working at the Centers, and a focus group interview with five parents of children using the Centers. Data were analyzed with a thematic approach categorizing themes and sub-themes based on the transcripts. Results: The current barriers of obesity management of obese and overweight children using Community Child Care Centers were lack of self-directed motivation regarding obesity management (chronic obesity-induced lifestyles and reduced self-confidence due to stigma) and lack of support from households and Community Child Care Centers (latchkey child, inconsistency in dietary guidance between the Center and household, repetitive pressure to eat, and absence of regular nutrition education). Mobile phone applications may have potential to overcome the current barriers by providing handy and interesting obesity management based on visual media (real-time tracking of lifestyles using behavior records and social support using gamification), environmental support (supplementation of parental care and network-based education between the Community Child Care Center and household), and individualized intervention (encouragement of tailored and gradual changes in eating habits and tailored goal setting). It is predicted that the real-time mobile phone program will provide information for improving nutritional knowledge and behavioral skills as well as lead to sustainable children’s coping strategies regarding obesity management. In addition, it is expected that environmental factors may be improved by network-based education between the Community Child Care Centers and households using the characteristics of mobile phones, which are free from space and time constraints. Conclusions: The tailored education program for children using Community Child Care Centers based on mobile phones may prevent and reduce childhood obesity by overcoming the current barriers of obesity management for children, providing environmental and individualized support to promote healthy lifestyles and quality of life in the future.

한국 소아청소년의 비만 유병률 추이: 1997년과 2005년 비교

오경원,장명진,이나연,문진수,이종국,유명환,김영택 대한소아청소년과학회 2008 Clinical and Experimental Pediatrics (CEP) Vol.51 No.9

Purpose:The objective of this study was to provide current estimates of the prevalence and examine trends of overweight and obesity in children and adolescents. Methods:Height and weight measurements from 183,159 (112,974 in 1997, 70,185 in 2005) children and adolescents aged 2 to 18 years were obtained via the 1997 and 2005 National Growth Survey. Obesity among children and adolescents was defined as being at or above the 95th percentile of the gender-specific body mass index (BMI) for age in the 2007 Korean National Growth Charts or a BMI of 25 or higher; overweight was defined as being at or above the 85th percentile to less than the 95th percentile BMI. Results:In 2005, 9.7% (11.3% for boys, 8.0% for girls) of South Korean children and adolescents were obese; 19.0% (19.7% for boys, 18.2% for girls) were overweight or obese. The overall prevalence of obesity increased from 5.8% in 1997 to 9.7% in 2005 (from 6.1% in 1997 to 11.3% in 2005 for boys and from 5.5% in 1997 to 8.0% in 2005 for girls); the increasing trend was most evident in boys, especially those aged 13-18 years. Conclusion:The prevalence of obesity among children and adolescents increased significantly during the eight-year period from 1997 to 2005. This study suggests that we need to make a priority of developing strategies to control obesity in children and adolescents; the potential health effects of increases in obesity are of considerable public health importance. (Korean J Pediatr 2008;51:950-955) Purpose:The objective of this study was to provide current estimates of the prevalence and examine trends of overweight and obesity in children and adolescents. Methods:Height and weight measurements from 183,159 (112,974 in 1997, 70,185 in 2005) children and adolescents aged 2 to 18 years were obtained via the 1997 and 2005 National Growth Survey. Obesity among children and adolescents was defined as being at or above the 95th percentile of the gender-specific body mass index (BMI) for age in the 2007 Korean National Growth Charts or a BMI of 25 or higher; overweight was defined as being at or above the 85th percentile to less than the 95th percentile BMI. Results:In 2005, 9.7% (11.3% for boys, 8.0% for girls) of South Korean children and adolescents were obese; 19.0% (19.7% for boys, 18.2% for girls) were overweight or obese. The overall prevalence of obesity increased from 5.8% in 1997 to 9.7% in 2005 (from 6.1% in 1997 to 11.3% in 2005 for boys and from 5.5% in 1997 to 8.0% in 2005 for girls); the increasing trend was most evident in boys, especially those aged 13-18 years. Conclusion:The prevalence of obesity among children and adolescents increased significantly during the eight-year period from 1997 to 2005. This study suggests that we need to make a priority of developing strategies to control obesity in children and adolescents; the potential health effects of increases in obesity are of considerable public health importance. (Korean J Pediatr 2008;51:950-955)

An Ontology-Based Content Provision System to Advance Child Obesity Management Platforms

Hyunmo Koo,Heon Jeong,Ungu Kang,Byungmun Lee,Youngho Lee 보안공학연구지원센터 2016 International Journal of Multimedia and Ubiquitous Vol.11 No.5

The 2014 National Health and Nutrition Survey of Korea reported that child/teenager obesity rates are 11.5% in 6-18 year olds, 5.9% in 6-11 year olds, and 15.5% in 12-18 year olds. Child obesity is a disease caused by changes in social environment structure and may become a chronic disease that leads to adult obesity; thus, prevention and management are becoming increasingly critical. Education and policies for obesity prevention are in place in Korea, but their effects are limited and temporary because no personalized education is provided. Therefore, this study proposes a service using data to set up obesity-related guidelines by using an ontology-based JENA engine to provide content tailored for child obesity. The goal of this study is to aid in obesity prevention and management by providing customized obesity-related content as contextual information for obese children and teenagers through ontology-based guidelines.

Global relationship between parent and child obesity: a systematic review and meta-analysis

Lee, Ju Suk,Jin, Mi Hyeon,Lee, Hae Jeong The Korean Pediatric Society 2022 Clinical and Experimental Pediatrics (CEP) Vol.65 No.1

Background: The growing prevalence of overweight and/or obese children is an important public health problem in both developed and developing countries. Although the association of obesity between parents and their children is well known, its underlying mechanisms are not well established. Purpose: This meta-analysis examined parent-child (PC) relationships in obesity and identified factors such as world region and country income level that may influence this relationship. Methods: We identified all related studies published between January 1, 2015 and May 31, 2020 by conducting a literature search using the MeSH terms "obesity," "overweight," "body mass index," "parent," "child," "associate," and "relate" in the PubMed database in English. Results: The meta-analysis of 23 studies that reported an odds ratio (OR) for parent and child obesity associations found a significant association between parents and children who were overweight or obese (pooled OR, 1.97; 95% confidence interval, 1.85-2.10). A meta-regression analysis was used to examine the sources of interstudy heterogeneity. The association between parent and child obesity was higher in Asia than in Europe and the Middle East and higher in high-income countries than in middle-or low-income countries. In addition, a higher association between parent and child obesity was found when both parents were obese than when only the father or mother was obese. This study from multiple countries indicates a significant PC relationship in weight status that varies according to PC pair type, parent and child weight statuses, world region, and country income level. Conclusion: These results demonstrate that the risk of childhood obesity is greatly influenced by parental weight status and indicate that parents could play an important role in preventing child obesity.

학령전기 소아비만에 영향을 주는 영유아기 인자

박선주,문재원,김현지,조민정 대한소아청소년과학회 2008 Clinical and Experimental Pediatrics (CEP) Vol.51 No.8

Purpose:Childhood obesity is a problem that places a child at great risk for becoming an obese adult. To prevent obesity, it is important to focus on early life risk factors that may contribute to childhood obesity. The aim of this study is to find obesity-causing infantile risk factors in preschool children. Methods:A total of 223 children aged 3 to 5 years old from Busan were the subjects of this study. We calculated their body mass index (BMI) and classified them into two groups (normal weight and overweight/obese children). Information regarding parental weight and height, mother's educational level and employment status, birth weight, feeding patterns, start time of weaning, duration of night feeding, and fosterer was obtained by using questionnaires. Results:There were 68 (30.5%) overweight/obese children and 155 (69.5%) normal weight children. Overweight/obese children were significantly associated with formula milk feeding, rapid weight gain during the first 6 months, and maternal obesity (P<0.05). There were no statistical differences in paternal obesity, mothers educational level and employment status, birth weight, start time of weaning, duration of night feeding, and fosterer between the normal and overweight/obese children. Conclusion:Although healthy diet and regular exercise will remain the cornerstones of weight management in obese children, our data supports the view that education about maintaining a normal weight could be introduced much earlier in families with high-risk children. (Korean J Pediatr 2008;51:804-811) Purpose:Childhood obesity is a problem that places a child at great risk for becoming an obese adult. To prevent obesity, it is important to focus on early life risk factors that may contribute to childhood obesity. The aim of this study is to find obesity-causing infantile risk factors in preschool children. Methods:A total of 223 children aged 3 to 5 years old from Busan were the subjects of this study. We calculated their body mass index (BMI) and classified them into two groups (normal weight and overweight/obese children). Information regarding parental weight and height, mother's educational level and employment status, birth weight, feeding patterns, start time of weaning, duration of night feeding, and fosterer was obtained by using questionnaires. Results:There were 68 (30.5%) overweight/obese children and 155 (69.5%) normal weight children. Overweight/obese children were significantly associated with formula milk feeding, rapid weight gain during the first 6 months, and maternal obesity (P<0.05). There were no statistical differences in paternal obesity, mothers educational level and employment status, birth weight, start time of weaning, duration of night feeding, and fosterer between the normal and overweight/obese children. Conclusion:Although healthy diet and regular exercise will remain the cornerstones of weight management in obese children, our data supports the view that education about maintaining a normal weight could be introduced much earlier in families with high-risk children. (Korean J Pediatr 2008;51:804-811)

Associations among the Degree of Nonalcoholic Fatty Liver Disease, Metabolic Syndrome, Degree of Obesity in Children, and Parental Obesity

Min-Su Oh,Sorina Kim,Joon-Hyuck Jang,Jong Yoon Park,Hyun-Sik Kang,Mu Sook Lee,Ki Soo Kang 대한소아소화기영양학회 2016 Pediatric gastroenterology, hepatology & nutrition Vol.19 No.3

Purpose: To analyze the associations among the degrees of nonalcoholic fatty liver disease (NAFLD) by ultra-sonography and metabolic syndrome, degrees of obesity in children, and degrees of parental obesity. Methods: A total of 198 children with obesity who visited a pediatric obesity clinic were prospectively enrolled in this study. The severity of NAFLD based on ultrasonography was classified into no, mild, moderate, or severe NAFLD group. The degree of obesity based on the percentage over standard weight for height per sex was classified into mild, moderate, or severe. Results: Of 132 patients evaluated for the degree of NAFLD and metabolic syndrome, the p-value of correlation between the two factors was 0.009. Therefore, metabolic syndrome might significantly affect the degree of NAFLD. Of 158 patients evaluated for the degree of NAFLD and the degree of obesity, the p-value of correlation between the two factors was 0.122. Of 154 patients evaluated for the degree of obesity and father’s obesity, the p-value was 0.076. Of 159 patients evaluated for the degree of obesity and mother’s obesity, the p-value was 0.000, indicating that mother’s obesity could significantly affect the degree of obesity in children. Of 142 patients evaluated for the degree of obesity and metabolic syndrome, the p-value was 0.288. Conclusion: Metabolic syndrome might significantly affect the degree of nonalcoholic fatty liver in children. In addition, mother’s obesity might be a significant factor that affects the degree of obesity in children.

The Effects of a Weight Loss Program Focusing on Maternal Education on Childhood Obesity

Hyun-Sook Kang,Sunhee Park,Myoung-Hae Ryu 한국간호과학회 2008 Asian Nursing Research Vol.2 No.3

Purpose Childhood obesity is a matter of great concern because of its negative health and social consequences. We examined the effect of a weight control program focusing on maternal education on childhood obesity, given that the incidence of obesity is greatly affected by parents. Methods A two-group pre-test/post-test design was used. Participants consisted of 65 obese children and their mothers. The children were fourth- to sixth-grade elementary students who did not currently receive any therapy for weight loss. The children and their mothers were randomly assigned to either an experimental (n = 32) or a control group (n = 33). The 8-week intervention for mothers included one-time group education, three-time phone counseling, and four-time fliers regarding obesity management. Four outcomes (self-control, obesity index, abdominal circumference, and body fat percentage) were measured before and after the intervention. Chi-squared test or t test was used to test homogeneity between the two groups. Analysis of covariance was used to test the intervention effects. Results After the intervention was completed, the level of self-control was significantly heightened and obesity levels in the other three outcomes were greatly lowered in the experimental group when compared with the control group. Conclusion Due to strong maternal effects on children’s weight control, mothers’ active participation must be encouraged in order to resolve childhood obesity. [Asian Nursing Research 2008;2(3):150–158] Purpose Childhood obesity is a matter of great concern because of its negative health and social consequences. We examined the effect of a weight control program focusing on maternal education on childhood obesity, given that the incidence of obesity is greatly affected by parents. Methods A two-group pre-test/post-test design was used. Participants consisted of 65 obese children and their mothers. The children were fourth- to sixth-grade elementary students who did not currently receive any therapy for weight loss. The children and their mothers were randomly assigned to either an experimental (n = 32) or a control group (n = 33). The 8-week intervention for mothers included one-time group education, three-time phone counseling, and four-time fliers regarding obesity management. Four outcomes (self-control, obesity index, abdominal circumference, and body fat percentage) were measured before and after the intervention. Chi-squared test or t test was used to test homogeneity between the two groups. Analysis of covariance was used to test the intervention effects. Results After the intervention was completed, the level of self-control was significantly heightened and obesity levels in the other three outcomes were greatly lowered in the experimental group when compared with the control group. Conclusion Due to strong maternal effects on children’s weight control, mothers’ active participation must be encouraged in order to resolve childhood obesity. [Asian Nursing Research 2008;2(3):150–158]

The longitudinal influence of child maltreatment on child obesity in South Korea: The mediating effects of low self-esteem and depressive symptoms

Park, Aely,Kim, Youngmi Elsevier 2018 CHILDREN AND YOUTH SERVICES REVIEW - Vol.87 No.-

<P><B>Abstract</B></P> <P>Research finds that children who have experienced parental neglect and abuse in their childhood are more likely to engage in unhealthy behaviors or experience obesity. The relationship between child maltreatment and obesity is supported in previous studies, but the mechanism of how child maltreatment leads to obesity has not yet been adequately examined. We aim to investigate the mediating roles of children's self-esteem and depressive symptoms in the longitudinal influences of child maltreatment on child obesity. We employ national longitudinal data from the Korean Children and Youth Panel Study collected annually in South Korea. The sample consists of 1796 elementary school students. Child maltreatment was measured by the child's report of parental neglect and physical abuse in wave 2 when the sample was the second grade. Child obesity was assessed using Body Mass Index (BMI) in wave 5. Self-esteem was measured in wave 3, and depressive symptoms in wave 4. The Structural Equation Modeling analysis shows that children's self-esteem significantly mediates the association between parental neglect and child obesity as well as that between physical abuse and child obesity. However, children's depressive symptoms do not demonstrate statistically significant mediating effects. This study discusses implications for research and practice to advance current knowledge and intervention efforts.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Self-esteem buffers the negative effects of child maltreatment on child obesity. </LI> <LI> Depressive symptoms do not demonstrate mediating effects. </LI> <LI> Both parental neglect and abuse have detrimental effects as child maltreatment. </LI> <LI> Self-esteem should be considered a target area in child obesity interventions. </LI> <LI> New evidence is provided from a cross-cultural context outside of Western countries. </LI> </UL> </P>

소아청소년 비만상담에서 설문지를 이용한 중재 가능한 행동요인 탐색

서정완,정지아,박혜숙,고재성,김용주,김재영,류일,배선환,심재건,양혜란,최병호,조기영 대한소아청소년과학회 2008 Clinical and Experimental Pediatrics (CEP) Vol.51 No.6

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. (Korean J Pediatr 2008;51:576-583) 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. (Korean J Pediatr 2008;51:576-583)

Changes in the Prevalences of Obesity, Abdominal Obesity, and Non-Alcoholic Fatty Liver Disease among Korean Children during the COVID-19 Outbreak

송경철,양주연,이혜선,김수진,이명섭,서정환,권아름,김호성,채현욱 연세대학교의과대학 2023 Yonsei medical journal Vol.64 No.4

Purpose: We aimed to investigate the prevalences of obesity, abdominal obesity, and non-alcoholic fatty liver disease (NAFLD) among children and adolescents during the coronavirus disease 2019 (COVID-19) outbreak. Materials and Methods: This population-based study investigated the prevalences of obesity, abdominal obesity, and NAFLD among 1428 children and adolescents between 2018–2019 and 2020. We assessed the prevalences of obesity, abdominal obesity, and NAFLD according to body mass index, age, sex, and residential district. Logistic regression analyses were performed to deter mine the relationships among obesity, abdominal obesity, and NAFLD. Results: In the obese group, the prevalence of abdominal obesity increased from 75.55% to 92.68%, and that of NAFLD increased from 40.68% to 57.82%. In age-specific analysis, the prevalence of abdominal obesity increased from 8.25% to 14.11% among par ticipants aged 10–12 years and from 11.70% to 19.88% among children aged 13–15 years. In residential district-specific analysis, the prevalence of both abdominal obesity and NAFLD increased from 6.96% to 15.74% in rural areas. In logistic regression analy sis, the odds ratio of abdominal obesity for NAFLD was 11.82. Conclusion: Our results demonstrated that the prevalences of abdominal obesity and NAFLD increased among obese Korean chil dren and adolescents and in rural areas during the COVID-19 outbreak. Additionally, the prevalence of abdominal obesity in creased among young children. These findings suggest the importance of closely monitoring abdominal obesity and NAFLD among children during COVID-19, focusing particularly on obese young children and individuals in rural areas.