Childhood Obesity and Familial Environmental Factor according to the Developmental Stages: the Korea NHANES Study

고정아 대한가정의학회 2008 Korean Journal of Family Medicine Vol.29 No.12

Background: To investigate the association between childhood obesity and its risk factors according to specific childhood developmental stages. Methods: We performed an analysis of data for 1922 children and adolescents aged 2 to 18 years obtained from the Third Korea National Health and Nutrition Examination Survey conducted in 2005. Weight and height were measured by trained interviewers. Childhood obesity was defined as BMI ≥95th percentile of the BMI cut-off point based on the Korean child growth curve. Data on socioeconomic characteristics such as age, education, occupation, income, physical activity and time spent watching television were collected using a well-established questionnaire and/or interview. Results: The prevalence of obesity defined by using the Korean child growth curve was 4.1% in children aged 2 to 6, 6.3% in children aged 7 to 12, and 8.7% in adolescents aged 13 to 18. In the multiple logistic regression model, parental obesity, and time spent watching television were associated with increased risk of obesity in children aged 2∼6. Parental obesity, family income level, birth weight, and time spent watching television were positively associated with obesity in children aged 7∼12. In adolescents aged 13∼18, participation in vigorous physical activity and attempts to control weight were associated with adolescent obesity. Conclusion: The prevalence and risk factors of childhood obesity vary substantially according to developmental stage. Differential approaches are needed for effective control of childhood obesity. Background: To investigate the association between childhood obesity and its risk factors according to specific childhood developmental stages. Methods: We performed an analysis of data for 1922 children and adolescents aged 2 to 18 years obtained from the Third Korea National Health and Nutrition Examination Survey conducted in 2005. Weight and height were measured by trained interviewers. Childhood obesity was defined as BMI ≥95th percentile of the BMI cut-off point based on the Korean child growth curve. Data on socioeconomic characteristics such as age, education, occupation, income, physical activity and time spent watching television were collected using a well-established questionnaire and/or interview. Results: The prevalence of obesity defined by using the Korean child growth curve was 4.1% in children aged 2 to 6, 6.3% in children aged 7 to 12, and 8.7% in adolescents aged 13 to 18. In the multiple logistic regression model, parental obesity, and time spent watching television were associated with increased risk of obesity in children aged 2∼6. Parental obesity, family income level, birth weight, and time spent watching television were positively associated with obesity in children aged 7∼12. In adolescents aged 13∼18, participation in vigorous physical activity and attempts to control weight were associated with adolescent obesity. Conclusion: The prevalence and risk factors of childhood obesity vary substantially according to developmental stage. Differential approaches are needed for effective control of childhood obesity.

제주 지역 소아, 청소년의 비만의 유병률 및 비만도에 따른 임상적 특성

서정호 대한소아과학회 2004 小兒科 Vol.47 No.4

Review : Effects of Resistance Exercise Training on Childhood Obesity

( Min Suk Oh ),( Yoon Myung Kim ),( Sang Hoon Suh ),( Justin Y Jeon ) 대한비만학회 2014 The Korean journal of obesity Vol.23 No.3

The prevalence of childhood obesity has been steadily increasing worldwide. Low level of physical activity, poor cardiorespiratory fitness, sedentary lifestyle, and increased energy intake are recognized as major culprits in the childhood obesity epidemic. Childhood obesity is closely associated with many chronic comorbidities such as type 2 diabetes mellitus (T2DM), cardiovascular disease (CVD), cancer, and psychological disorders. Studies have suggested that regular exercise is an effective tool for obesity treatment in youth. Aerobic exercise format (either exercise alone or combined with calorie restriction) has been widely and traditionally applied for reducing childhood obesity. A growing body of evidence suggests that resistance exercise training is beneficial in improving body composition, thereby is an alternative tool for the treatment of childhood obesity. However, the effects of resistance exercise training alone in childhood obesity are relatively limited in youth. Thus, the purpose of this review was to provide an update on current findings associated with resistance exercise training as an effective treatment and prevention strategy for childhood obesity reduction.

The COVID-19 pandemic: an unprecedented tragedy in the battle against childhood obesity

Storz, Maximilian Andreas The Korean Pediatric Society 2020 Clinical and Experimental Pediatrics (CEP) Vol.63 No.12

The childhood obesity pandemic has emerged as an important public health problem in many countries. Obese children are likely to become obese adults, and adult obesity is associated with an increased risk of morbidity. Therefore, controlling the childhood obesity epidemic has become a top public health priority worldwide. The current coronavirus disease 2019 (COVID-19) pandemic may significantly impede this important mission and constitute an unprecedented tragedy in the global battle against childhood obesity. This manuscript presents evidence that the COVID-19 pandemic will aggravate the childhood obesity epidemic and lead to significant weight gain in school children by creating an unprecedented obesogenic environment. Within the last few months, many countries took uncompromising measures in response to the COVID-19 pandemic, including school closures and quarantine. While these steps are often necessary to ensure infection control, they may have a significant negative effect on children's mental and physical health. Physical, nutritional, and psychosocial factors that promote obesity in children during this special situation complementarily contribute to an unprecedented obesogenic environment. Large-scale quarantine and home confinement will impose new and unfamiliar stressors on children, thereby worsening the childhood obesity epidemic. Most importantly, adverse childhood events resulting from a predicted increase in domestic violence within the next few months will significantly contribute to this concern. The scenario presented in this review is of paramount public health importance and must be considered during future pandemic planning. Involved stakeholders, including governments, schools, and families, must make all possible efforts to minimize the impact of the COVID-19 epidemic on childhood obesity.

한방병원에서 시행 한 소아 비만 관리 프로그램 10예에 대한 평가

정선희,이승연,Jeong, Sun-Hee,Lee, Seung-Yeon 대한한방소아과학회 2004 대한한방소아과학회지 Vol.18 No.2

Objective : There have been many programs to treat childhood obesity, since childhood obesity has shown up as a social problem. The purpose of this study was to find out considerable matters to manage Childhood Obesity Treatment Program (COTP). Methods : This study was made with reference to clinical progress notes of children with obesity, visiting the oriental medicine center, to take COTP from July 30th, 2003 to August 25th, 2004. COTP was consist of abdominal aroma massage, abdominal low frequency acupuncture therapy, auricular acupuncture therapy and behavior modification. Results : 1. Seven children who taken COTP started fat from young age and three started from about ten-year-old ages. 2. Six children have fat fathers, a child has fat parents and three children have no fat family member. 3. The obesity levels of Obesity Index(OI), Body Mass Index(BMI) and Rohler Index(RI) were different, used for evaluating the result of treatment, though they are used for a child. The result of OI reflected more sensitive from changes of weight than those of BMI and RI. 4. We got the better results with numbers of treatment and exercise. Conclusions : More correct standard are needed to estimate degree childhood obesity. And it is necessary to carry out obesity treatment program with behavior modification, for children with obesity. to be healthy adults.

효과적인 브랜딩 전략을 위한 소비자 구매의사 결정 요인 분석: 소아비만 치료제 유통시장을 중심으로

박문서,이상윤,김형준 한국유통과학회 2011 유통과학연구 Vol.9 No.3

This study is important in its focus to find key clues in the marketing strategy, consumer behavior, and communication processes that define the infantile obesity market. The study, the first of its kind, surveyed a target audience, purchasing group, and housewives in their quest to determine purchasing decisions and effective branding strategy planning for the infantile obesity market. Another key component of the study was to focus on the key direct and/or indirect distribution channels for the subject market. Recently, obesity has emerged as a major social concern; some studies show that the onslaught of an adverse eating culture in Korea emanates from the prevalence of fast-food dining establishments. Obesity among children leads to adult obesity, especially if the young people’s parents are overweight; notably, if either one or both of the parents are obese, the percentage of young people eventually being obese is approximately 80 to 85 percent. Because obesity is the cause of many major health concerns later in life, the struggle for a healthy life is considerably adversely affected by parents’ consumer behavior. Infantile obesity, resulting in adult obesity, is also an important national economic and social issue. The sizable direct and indirect economic costs, as well as the tremendous social costs of obesity, cannot be overstated. Effective food branding and advertising centered on food preferences and dietary behaviors, especially to children, creates an effective marketing effort that, ultimately, leads to positive results. Thus, the purpose of this study is to demonstrate that the treatment of childhood obesity in Korea, through the activation of a brand and retail market, can effectively solve social and economic problems that result from infantile and childhood obesity. In this study, obesity markets and distribution channels in the purchase decision-making factors determining factor based on it effective inspection and branding strategies and brand marketing communications strategy proposed measures contribute to the obesity drug market and further enable the childhood obesity problem is intended to assist in solving.

국내 인터넷 웹사이트에 소개된 소아 및 청소년 비만치료의 실태 및 문제점

신상원,김은영,노영일,양은석,박상기,박영봉,문경래,Shin, Sang Won,Kim, Eun Young,Rho, Young Il,Yang, Eun Seok,Park, Sang Kee,Park, Young Bong,Moon, Kyung Rye 대한소아소화기영양학회 2005 Pediatric gastroenterology, hepatology & nutrition Vol.8 No.1

목 적: 검증되지 않는 방법이나 성인비만치료 방법을 성장과 발달을 과정에 있는 소아에게 그대로 적용하게 되면, 건강에 악영향을 주게 된다. 여과 없이 무제한적으로 노출되고, 최근 급격히 이용률이 증가하고 있는 정보전달 매체인 인터넷 웹사이트에 소개된 소아 및 청소년 비만치료의 실태 및 문제점에 대해 알아보고자 한다. 방 법: 2004년 7월1일부터 8월1일까지 1개월 동안 야후 코리아의 검색엔진을 사용하여 '소아비만'이라는 검색어로 검색된 203개의 웹 사이트를 대상으로 하였다. 실제 하이퍼텍스트로 접근할 수 없거나 중복된 경우를 제외한 203개의 웹 사이트를 최종분석 대상으로 선별하였다. 각 분석 대상은 의료기관, 피부미용실, 단식원 및 그 외 사설 정보센터로 분류하여, 현재 실행되고 있는 치료 행태의 종류 및 성인비만과는 구분된 소아비만치료의 특수성을 고려하 고 있는지의 여부에 대해 분류하였다. 결 과: 비만치료에 대한 구체적인 항목을 표방한 경우가 157곳(77.3%)였고, 단순한 정보만 제공한 경우가 46곳(22.7%)이었다. '소아비만' 치료를 표방한 사이트의 구성은 한의원(52.2%), 의원 및 병원(35.0%), 그 외 다이어트식품회사, 피부 관리소 등 기타 순이었다. 의원 및 병원 중, 소아과 의원 및 병원은 35곳(22%)에 불과하였으며, 성형외과 7곳, 가정의학과와 내과가 각각 6곳, 정신과와 신경과 2곳 순이었다. 성인과는 구분된 올바른 소아비만 치료를 하고 있는 사이트의 구성은 한의원 중 19곳(23%), 소아과 병원 및 의원 중 26곳(93%), 내과 및 가정의학 과 등 타과 의원 중 7곳(25%)이었으며, 한의원 63곳 (77%), 소아과 이외의 타과 의원 21곳(75%)에서 성인비만치료를 그대로 여과없이 소아비만에 적응하여 치료하고 있었다. 결 론: 소아 비만에 대한 잘못되거나 부정확한 정보가 인터넷 정보로 무분별하게 제공되고 있으므로 소아과 의사의 더 많은 관심과 인터넷을 통한 홍보 관리 시스템의 적극적인 개발이 필요하다. Purpose: The purpose of this study was to evaluate the quality and problems of Web sites for management of childhood and adolescent obesity. Methods: We evaluated 203 Web sites identified from the search engine, Korean Yahoo, using the word of 'childhood and adolescent obesity'. 203 Web sites were classified according to medical institutions, health information Web sites, beauty shops. etc. We surveyed whether childhood and adolescent obesity distinguished with adult obesity was considered, or not. and researched the unique managements of childhood and adolescent obesity including the cardinal treatment. Results: Of the 203 Web sites, 157(77.3%) provided detailed information about treatment of obesity, 46(22.7%) provided only simple information about one. The sites providing detailed information were composed of 52.2% of oriental medicine clinics, 35.0% of clinic & hospitals including pediatric hospitals. Distribution of the sites about management of childhood and adolescent obesity distinguished with adult's one was only 23% of oriental medicine clinics, but 93% of childrens hospitals. Conclusion: Without considering the speciality of childhood obesity, inaccurate information are distributing on internet web sites. It is necessary for concern and development of advertizing system on the internet distributing accurate information about treatment of childhood obesity.

도시지역 비만아의 비만도 개선과 관련된 요인

조영규 ( Young Gyu Cho ),강재헌 ( Jae Heon Kang ),전정윤 ( Jung Yoon Chun ),김경아 ( Kyung A Kim ),김옥현 ( Ok Hyun Kim ),송지현 ( Ji Hyun Song ),정명호 ( Myeong Ho Jung ) 대한비만학회 2007 The Korean journal of obesity Vol.16 No.1

연구배경: 최근 우리나라에서도 소아비만의 위험성을 인식하여 소아비만관리 프로그램을 시작하여 진행하고 있지만, 비만아의 비만도 개선과 관련된 요인에 대한 연구는 거의 없는 실정이다. 본 연구는 우리나라 도시지역의 비만아를 대상으로 비만도 개선과 관련된 요인을 알아보고자 하였다. 방법: 과천에서 진행되고 있는 소아 코호트의 1차년도와 2차년도 조사에 모두 참여했던 소아 421명 중 1차년도에 과체중이나 비만으로 진단받은 80명 (과체중: 58명, 비만 22명)을 연구 대상으로 하였다. 연구 대상자들을 남아 과체중군, 남아 비만군, 여아군으로 세 군으로 층화한 후, 각 군을 계산한 비만개선도에 따라 삼분위수로 나누고, 각 군의 최상위 삼분위군을 비만개선군으로 정의하였다. 비만아들에서 비만개선도에 영향을 주는 인자를 알아보기 위하여 카이제곱검정과 로지스틱 회귀 분석 등을 시행하였다. 결과: 가족인자 중 부모의 교육수준이 비만아의 비만도 개선과 관련이 있었다. 아버지의 학력이 대학 졸업 미만이라고 보고한 소아는 한 명도 비만개선군에 포함되지 않았고, 어머니의 학력이 대학 졸업 이상인 소아는 그렇지 못한 소아에 비해 비만개선군에 포함될 가능성이 높았다 (adjusted OR: 4.18) 생활습관 요인 중에서는 채소 섭취 빈도와, 걷는 시간이 비만아의 비만도 개선과 관련이 있었다. 채소를 매일 섭취한 소아 (adjusted OR: 2.88)와 매일 1시간 이상 걷는 소아 (adjusted OR: 3.37)가 그렇지 못한 소아에 비해 비만개선군에 포함될 가능성이 높았다. 결론: 비만아에서 비만도 개선은 부모의 학력, 채소 섭취빈도 걷는 시간과 관련이 있었다. 채소섭취를 증가시키는 것과 걷는 시간을 증가시키는 것은 비만아를 대상으로 하는 소아비만관리 프로그램의 중요한 전략이 될 수 있으며, 부모의 학력이 낮은 가정의 소아는 비만관리 프로그램 시행 시 관심과 이해가 필요한 취약계층이므로 프로그램 진행 시 이에 대한 고려가 필요하다. Background: The increasing prevalence of childhood obesity is one of important public health problems in Korea. Childhood obesity management programs have recently developed and progressed. However, it is not clear which factors are related to improvement of childhood obesity. This study was conducted to investigate the factors related to improving obesity in Korean obese children. Methods: First grade students from elementary schools in Gwacheon City were enrolled in the study in 2005. The study subjects (total 80 students; 52 boys and 28 girls) participated in the investigation of both 2005 and 2006 and were diagnosed as either overweight or obese in 2005, The degree of obesity improvement among the study subjects was estimated for a year. After stratifying study subjects into groups of overweight-boys, obesity-boys and girls, the improvement group was defined as the highest tertile of degree of obesity improvement of each group. Factors related to obesity improvement were analysed. Results: Children of college graduate parents manifested a greater improvement of obesity than children whose parents did not graduate from college. Daily intake of fresh vegetables and daily walking for over an hour were related to improvement of obesity. Adjusted odds ratio of consuming fresh vegetable daily was 2.88 (P-value <0.10) and adjusted odds ratio of walking over 1 hour daily was 3.37 (P-value <0.05). Conclusion: Parental education level, consumption frequency of fresh vegetable and walking hours were related to improvement of obesity in Korean obese children. These results should be considered in practicing childhood obesity management programs in Korea.

소아비만의 치료에 대한 국내 임상연구 동향

김경리,한재경,김윤희,Kim, Kyoung Ri,Han, Jae Kyoung,Kim, Yun Hee 대한한방소아과학회 2016 대한한방소아과학회지 Vol.30 No.3

Objectives The purpose of this study is to investigate Korean clinical studies on treatment of childhood obesity and to propose for better treatment options for childhood obesity. Methods Based on RISS, KISS, OASIS, KMbase with the keyword 'childhood obesity', 'child obesity', 'obese child', 'overweight child', total of 21 randomized controlled trials (RCTs), 11 single clinical studies, 3 chart reviews and 3 case reports have been found, and were analyzed. Results and Conclusion 1. Some study subjects were classified based on their sex - only men or women in a group or sometimes both. Another way of classify the study subjects were based on their age - preschooler, primary school students, middle school students, and high school students. The diagnostic criteria of the subjects were BMI (body mass index), Body fat percentage, Obesity index, Weight and unknown criteria. 2. The treatments used in 38 studies were exercise alone, education alone, both exercise and education or herbal therapy. The 7 studies that used herbal therapy as part of their study intervention had a study group with herbal intervention only and the other 2 study group with herbal treatment in addition to exercise and education. 3. 9 studies included herb medicines, electroacupuncture, auricular acupuncture, cupping, aroma massage, infrared light, and abdomen pad. Herb medications used in 5 studies included Chegameuiin-tang 2 kinds, Sobieum, Biman-tnag, and I-razin. 4. The methods of assessment used in 38 studies were classified by 7 categories and anthropometry parameters which is the basic methods are used in all studies 5. Almost studies (29 studies in all 38 studies) were using anthropometric parameters results on significantly effectiveness of childhood obesity. 6. More studies are needed to prove true effectives from various treatments, especially herbal therapy for childhood obesity.

비만아동 및 청소년의 체중조절 경험과 비만관리 의도에 영향을 미치는 요인

강윤주,손명세,진기남,김한중,오희철,서성제,Kang, Yun-Ju,Sohn, Myong-Sei,Jin, Ki-Nam,Kim, Han-Joong,Oh, Hee-Choul,Suh, Sung-Jae 대한예방의학회 1998 예방의학회지 Vol.31 No.2

This study was undertaken to explain weight control behavior and intention of obese children and adolescents as measured by the elements of the health belief model. A total of 732 obese students from 28 schools in Seoul metropolitan area and their mothers were assessed with a self-administered questionnaire. The analyzed results are as follows; 1. Among obese students, 45.3% of male students and 57.2% of female students, a significantly higher portion than male students, reported that they had tried to lose weight within the recent year. Exercise was the most frequently used method to lose weight followed by diet control, drug use, and specialized clinic visits, in descending order. 2. Male students were more likely to try to lose weight if they perceived a low threat level and their mother had a job, and female students were more likely to try to lose weight if they were younger in age, perceived a low threat level and had strong external motivating factors. 3. Female students showed a significantly higher level of intention to obesity control than male students, and the intention level of their mothers also showed the same trend. 4. In male students, the degree of weight dissatisfaction, weight control experience, the level of obesity related beliefs of students, the educational level of the mother and economic status of the family were significant predictors of intention to obesity control, and in females, age, the level of obesity related beliefs of students and intention of their mothers were significant. In the mothers of male students, obesity index of students, age of the mother and the level of obesity related beliefs of the mother were significant predictors of intention of the mother, and in the mothers of female students, obesity index of students, occupational status of the mother and obesity related beliefs of the mother were significant. 5. According to the path model of intention to obesity control, the degree of weight dissatisfaction had the most powerful effect in male students, and perceived net benefit level was the most important variable in female students. Since the weight control behavior and intention of obese students were more predictable by the degree of weight dissatisfaction than the obesity index, we can conclude that only the students dissatisfied with their weight are well motivated for obesity control. There can be a discrepancy between the mother and her child's beliefs and intention status(especially in male students), so the therapists should also assess the student's opinion as well as the mother's. In female students, the perceived net benefit level wag the most important predictor of intention to obesity control, therefore the intervention program should pay particular attention to the positive benefits of weight control rather than negative aspects(threats) of obesity.