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Effects of a 12-week, school-based obesity management program on obese primary school children

12주간의 학교 비만 관리 프로그램이 초등학교 비만 아동에 미치는 효과

  • Kim, Han Gyu (Department of Pediatrics, Ewha Womans University, School of Medicine) ;
  • Lim, Goh-woon (Department of Pediatrics, Ewha Womans University, School of Medicine) ;
  • Kim, Hae Soon (Department of Pediatrics, Ewha Womans University, School of Medicine) ;
  • Hong, Young Mi (Department of Pediatrics, Ewha Womans University, School of Medicine)
  • 김한규 (이화여자대학교 의과대학 소아과학교실) ;
  • 임고운 (이화여자대학교 의과대학 소아과학교실) ;
  • 김혜순 (이화여자대학교 의과대학 소아과학교실) ;
  • 홍영미 (이화여자대학교 의과대학 소아과학교실)
  • Received : 2010.01.08
  • Accepted : 2010.02.10
  • Published : 2010.03.15

Abstract

Purpose : This study was designed to determine the effects of a school-based obesity-management program on obese primary school children. Methods : A total of 995 children (6-2 years old) in a primary school were screened in March 2008, and of those, 101 obese students (44 boys and 57 girls, body mass index (BMI) ${\geq}95$ percentile) were enrolled for a study group. The schoo-lbased, obesity management program, which includes physical exercise and nutritional education, was conducted as part of an extracurricular program for 12 weeks. The measurement of height, weight, waist circumference, blood pressure (BP), and bioelectrical impedance analysis (BIA) was performed before and after the program.Results : Height and weight increased significantly (P <0.05). The BMI and obesity index decreased significantly (P <0.01). Systolic and diastolic BP decreased significantly (P <0.01). BMI decreased in 61.4% of boys and 66.7% of girls. Protein and basal metabolic rate (BMR) increased significantly on the BIA (P <0.01). Fat decreased significantly (P <0.05). The total body water (TBW) and percent body fat (PBF) decreased significantly (P <0.01). The changes in protein, fat, TBW, PBF, and BMR significantly correlated to the change in BMI (P <0.05). In a multiple logistic regression analysis, BMI change was significantly correlated to the changes in protein and fat content (P <0.01). Conclusion : The school-based obesity management program is a very effective way to manage obesity for obese primary school children.

목 적 : 최근 우리나라는 과영양과 운동부족으로 인하여 소아 비만이 급등하고 있는 추세이나 소아의 체중 조절은 성인에 비하여 어려운 점이 많고 성인 비만으로 지속될 가능성이 많아서 보건 건강의 당면한 문제가 되었다. 연구자들은 초등학교 비만 소아를 대상으로 학교 비만 관리 프로그램의 효과를 알아보고자 하였다. 방 법 : 2008년 3월에 경기도에 위치한 1개 초등학교 학생(6-12세) 995명에 대해 신체 검진을 시행하였고 그 중 체질량지수가 95백분위수 이상인 비만 아동 101명을 대상으로 학교 특별활동수업에 12주간 영양 교육 프로그램과 운동 교육 프로그램을 실시하였다. 학교 비만 관리 프로그램 전에 키, 몸무게, 허리둘레, 혈압을 측정하였고 생체전기저항법에 의한 체성분 분석을 실시하였다. 비만 프로그램 후 신체계측, 혈압 측정 및 체성분 분석을 추적 검사하였고 비만 프로그램 전과 비교 분석하였다. 결 과 : 12주간의 학교 비만 관리 프로그램 후 남녀 모두 체중과 신장이 유의하게 증가하였다(P <0.05). 남녀 모두 체질량지수와 비만도, 수축기 혈압과 이완기 혈압이 유의하게 감소되었다(P<0.01). 남아의 경우 61.4%, 여아의 경우 66.7%에서 체질량지수가 감소되었다. 비만 프로그램 후 체성분 분석 결과, 남녀 모두에서 단백질이 증가하였고(P <0.01), 체지방이 유의하게 감소하였다(P <0.05). 남녀 모두에서 총체수분량과 체지방률이 유의하게 감소되었고(P <0.01), 기초대사량은 유의하게 증가되었다(P<0.01). 학교 비만 관리 프로그램 전 후의 단백질, 체지방, 총체수분량, 체지방률 및 기초대사량의 변화량과 체질량지수의 변화량과 유의한 양의 상관관계가 있었고(P <0.05), 다중회귀분석결과 단백질과 체지방의 변화량이 체질량지수 변화량에 유의한 영향을 주었다(P <0.01). 결 론 : 초등학교 비만아를 대상으로 12주 동안 영양 교육 프로그램과 운동 교육 프로그램을 포함하는 학교 비만 관리 프로그램을 시행한 결과, 체질량지수와 함께 비만도, 혈압이 감소되었고, 체지방률이 감소되었기 때문에 학교 비만 관리 프로그램은 소아비만의 치료에 매우 중요하다고 생각된다.

Keywords

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