Journal of Nutrition and Health

The Korean Nutrition Society (한국영양학회)
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Development of an Eating Habit Checklist for Screening Elementary School Children at High Risk of Energy Overintake

초등학생의 에너지 과잉섭취 위험 진단을 위한 식습관평가표 개발

  • Yon, Mi-Yong (Department of Food and Nutrition, Chungbuk National University) ;
  • Hyun, Tai-Sun (Department of Food and Nutrition, Chungbuk National University)
  • Published : 2008.07.30
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Abstract

The purpose of the study was to develop an eating habit checklist for screening elementary school children at high risk of energy overintake. Dietary habits, food intake, anthropometric data were collected from 142 children (80 boys and 62 girls) in the 4th to 6th grades of elementary schools. Energy intake, fat intake, and percentage of Estimated Energy Requirement (%EER) were used as indices to detect the risk of energy overintake of the children. Pearson correlation coefficients were calculated between dietary habit scores and energy overintake indices in order to select questions included in the checklist. TV watching during the meal, meal speed, meal amount, overintake frequency, eatingout frequency, snack frequency, frequency of eating Ramyun or fast foods showed significant correlations with energy overintake indices. Stepwise regression analysis was performed to give each item a different weight by prediction strength. To determine the cut-off point of the test score, sensitivity, specificity, and positive predictive values were calculated. The 7-item checklist with test results from 0 to 13 points was developed, and those with equal or higher than 5 points were diagnosed as a risk group of energy overintake. Among our subjects 13.4% was diagnosed as the risk group. Mean energy intake of the subjects in the risk group and the normal group were 2,650 kcal and 1,640 kcal, respectively. However, there were no significant differences of Index of Nutritional Quality (INQ) of the other nutrients except eating fiber between the risk group and the normal group. This checklist will provide a useful screening tool to identify children at high risk of energy overintake.

초등학교 $4{\sim}6$학년 어린이 142명 (남 80명, 여 62명)을 대상으로 식습관과 식이섭취조사를 실시하여 에너지를 과잉으로 섭취할 위험이 있는 어린이를 선별할 수 있는 간단한 식습관평가표를 개발한 결과는 다음과 같다. 에너지 과잉섭취 위험이 있는 어린이를 선별하기 위해서는 과잉섭취의 위험을 나타낼 수 있는 지표가 필요하므로 에너지 섭취량, 지방 섭취량, 에너지필요추정량에 대한 에너지 섭취량 비율 (%EER)의 세가지 지표를 임의로 선정하였고, 식습관 각 문항의 응답 보기에서 가장 좋은 식습관에 대하여 0점, 가장 좋지 않은 식습관에 대하여 2점을 부여하고, 이 두가지 식습관 사이에 중간 정도의 보기가 있는 경우 1점을 부여하였다. 부여된 점수로 계산한 각 문항의 식습관 점수와 에너지 과잉섭취 위험 평가지표와의 Pearson상관계수를 계산한 결과 유의적인 양의 상관관계를 나타낸 식습관 문항은 식사 중 TV 시청 여부, 식사속도, 식사량, 과식횟수, 외식횟수, 간식횟수, 라면과 패스트푸드 섭취 횟수에 관한 7개 문항으로 나타나 이들을 평가표에 포함시킬 문항으로 선정하였다. 선정된 문항 중에서 에너지 과잉섭취 위험을 더 잘 가려낼 수 있는 문항에 대한 가중치를 부여하기 위하여 선정된 문항과 에너지 과잉섭취 위험 평가지표와의 단계적 회귀분석을 실시하였고, 단계적 회귀분석 결과에 따라 세가지 지표 모두와 유의수준이 0.1 미만인 식사량에 관한 문항의 배점을 1점으로 낮추었다. 진단기준 점수를 결정하기 위해서 %EER$\geq$125%를 에너지 과잉섭취군, %EER < 125%를 비과잉섭취군으로 분류하고, 두 집단의 식습관평가표 점수 분포를 살펴본 후, 임의의 진단기준 점수에 대한 민감도, 특이도, 양성예측도를 구한 결과 5점을 진단기준 점수로 결정하였다. 본 조사대상자를 식습관평가표로 진단하여 5점 이상을 위험군으로 분류하였을 때, 13.4%가 위험군으로 분류되었고, 이들의 영양소 섭취량을 비위험군과 비교한 결과 위험군의 에너지 섭취량 평균은 2,156 kcal, 비위험군은 1,708 kcal로 유의적 차이가 있었으며, 대부분의 영양소 섭취량에도 유의적 차이를 볼 수 있었다. 그러나 에너지 섭취량으로 보정해 주어 INQ로 계산한 결과 모든 영양소에서 차이를 볼 수 없었다. 따라서 본 연구에서 개발된 에너지 과잉섭취 위험 진단을 위한 식습관평가표는 에너지 과잉을 잘 나타내 준다고할 수 있겠다. 본 연구에서 개발된 7문항의 식습관평가표는 복잡한 식이섭취조사를 실시하지 않고도 에너지 과잉섭취의 위험이 있는 어린이를 선별할 수 있으리라고 생각되며, 초등학생이 쉽고 간편하게 사용할 수 있으므로 이들을 대상으로 영양판정이나 영양교육을 실시할 때 활용할 수 있을 것이다. 다만 본 연구에서는 중소도시, 군 지역 어린이를 대상으로 조사한 결과를 이용하여 에너지 과잉섭취 위험을 평가할 수 있는 식습관평가표를 개발하였으므로 대도시를 포함한 다양한 지역의 어린이에게 활용하여 타당성을 검토하는 것이 필요하겠다. 개인의 식습관을 평가하여 진단하는 것은 영양교육이나 영양사업을 계획하고 실시하기 위하여 가장 먼저 해야 하는 단계로 이를 위한 간단하고 효율적인 평가도구가 절실히 필요하다. 따라서 앞으로 다양한 인구집단을 대상으로 다양한 영양적 위험을 평가하고 진단할 수 있는 식습관평가표가 지속적으로 개발되어야 할 것이다.

Keywords

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