DOI QR코드

DOI QR Code

Validation of the physical activity classification table for Korean youth and assessment of total energy expenditure, estimated energy requirement and physical activity in Korean children and adolescents

한국 소아청소년을 위한 신체활동분류표의 타당도 평가 및 이를 이용한 일일 총에너지소비량, 에너지필요추정량과 신체활동 평가

  • Ji-Yeon, Gwak (Department of Food and Nutrition, Gangneung-Wonju National University) ;
  • Myung-Hee, Kim (Department of Food and Nutrition, Gangneung-Wonju National University) ;
  • Jonghoon, Park (Department of Physical Education, Korea University) ;
  • Kazuko, Ishikawa-Takata (Faculty of Applied Bioscience, Tokyo University of Agriculture) ;
  • Eun-Kyung, Kim (Department of Food and Nutrition, Gangneung-Wonju National University)
  • 곽지연 (강릉원주대학교 식품영양학과) ;
  • 김명희 (강릉원주대학교 식품영양학과) ;
  • 박종훈 (고려대학교 체육교육학과) ;
  • ;
  • 김은경 (강릉원주대학교 식품영양학과)
  • Received : 2023.01.12
  • Accepted : 2023.02.13
  • Published : 2023.02.28

Abstract

Purpose: The purpose of the first part of this study was to evaluate the validity of the physical activity classification table for youth (Youth-PACT). The second part of this study was aimed at comparing the estimated energy requirement (EER) with the total energy expenditure (TEE) and evaluating the physical activity patterns of Korean children and adolescents. Methods: The subjects of the first part of the study were 17 children aged 10 to 12 years, and their total energy expenditure (TEEDLW) was measured using the double labeled water (DLW) method. A total of 166 children and adolescents aged 6-18 years participated in the second part of this study. Their resting energy expenditure (REE) was measured using indirect calorimetry and the TEEYouth-PACT and physical activity level were calculated by applying the Youth-PACT to the physical activity diary prepared by the subjects. Results: In the first part of this study, there were no significant differences between the TEEDLW and the TEEYouth-PACT. The TEEYouth-PACT accurately predicted TEEDLW in 37.5% of the subjects. In the second part of the study, the rates at which EER accurately predicted TEE YouthPACT and overestimated TEE Youth-PACT were 29.6% and 47.3%, respectively. The time spent based on intensity of physical activity and the physical activity categories which were obtained using Youth-PACT showed different patterns according to sex and age group. Age showed significant positive correlations with REE, TEE, and the time spent in sedentary behavior, but age was significantly negatively correlated with REE/body weight, TEE/body weight, and the time spent in low-intensity and high-intensity activities. Conclusion: The results of this study showed that the Youth-PACT can be used to evaluate the TEE and PAL of children and adolescents. However, further studies are needed to validate the TEEYouth-PACT and to set the EER for children and adolescents.

소아청소년은 성인과는 다른 신체적, 생리적 특성이 있으므로 동일한 신체활동을 할지라도 에너지소비량이 다름이 보고된 바 있다. 그러나 지금까지 국내에서 수행된 소아청소년 대상 연구에서 이들의 에너지소비량을 평가 시, 성인 대상으로 측정한 에너지소비량 또는 성인대상 18단계 신체활동분류표가 이용되어왔다. 최근 소아청소년을 대상으로 한 미국의 자료와 국내의 일부 자료를 토대로 4단계 연령대 (6-9세, 10-12세, 13-15세 및 16-18세)에 따라 서로 다른 에너지당량 (METs)을 제시하는 한국 소아청소년을 위한 신체활동분류표가 보고되었다. 이에 본 연구의 1부에서 에너지소비량 측정방법의 gold standard로 알려져 있는 이중표식수법을 이용하여 소아청소년을 위한 신체활동분류표의 타당도를 평가한 결과, 이의 활용 가능성을 확인하였다. 2부에서는 세계보건기구에서 제안한 방법 (TEE = REE × PAL), 즉 간접열량계로 측정한 REE과 소아청소년 신체활동분류표로 측정한 PAL을 이용하여 166명의 소아청소년 (초·중·고등학생)의 일일 총에너지소비량을 산출하였다. 이를 기준으로 한국인 영양소 섭취기준에서 제시한 공식을 이용한 EER을 비교한 결과, 과대평가 비율이 47.3%로 나타났다. 또한 소아청소년 신체활동분류표를 이용하여 산출된 신체활동 강도별 및 신체활동 유형별 소비시간이 성별 및 연령대별로 차이가 있음을 알 수 있었다. 앞으로 중학생 및 고등학생을 포함하는 다수의 소아청소년을 대상으로 이중표식수법을 이용하여 일일 총에너지소비량을 측정하는 연구가 수행되어, 소아청소년을 위한 신체활동분류표의 타당도가 폭넓게 평가되어야 한다. 또한 이와 같은 이중표식수법 연구를 통하여 우리나라 소아청소년을 위한 에너지필요추정량 산출 공식의 타당도 평가와 함께 한국의 소아청소년을 위한 에너지필요추정량공식이 개발되어야 할 것이다. 또한 학업부담이 많은 고등학생 뿐만 아니라, 중학생 및 초등학생에서도 강도있는 신체활동의 소비시간이 매우 낮은 것으로 나타났으므로 우리나라 소아청소년의 건강 및 비만의 예방 및 관리를 위하여 이들의 에너지소비량을 증진시킬 수 있는 프로그램의 개발 및 적용이 요구된다

Keywords

Acknowledgement

This work was supported by grants from the National Research Foundation of Korea (2019R1F1A1057685).

References

  1. Ministry of Health and Welfare (KR). Korea Health Statistics 2020: Korea National Health and Nutrition Examination Survey (KNHANES VIII-2). Cheongju: Korea Disease Control and Prevention Agency; 2022.
  2. Lee SH, Hwang JS, Park HS. Prediction of adolescence overweight from childhood body mass index 7 year retrospective study of suburban school children. J Korean Acad Fam Med 2003; 24(7): 642-647.
  3. Kim JH, Son HR, Choi JS, Kim EK. Energy expenditure measurement of various physical activity and correlation analysis of body weight and energy expenditure in elementary school children. J Nutr Health 2015; 48(2): 180-191.  https://doi.org/10.4163/jnh.2015.48.2.180
  4. Kang YK. An effect of adolescent's participation in exercise programs on their physiological and physical functions: a meta-analysis. Korean J Growth Dev 2013; 21(4): 265-272.
  5. Kim JH, Jung CW. Relation between mental health and academic achievement of Korean teenagers in accordance with physical education and physical activity. Korean J Sports Sci 2012; 21(6): 553-570.
  6. Park BS, An GH. Evaluation of physical activity and level in normal weight and overweight or obese children and adolescents by accelerometer. Korean J Phys Educ 2014; 53(6): 458-493.
  7. Lee YS, Jeon HJ, Kim HJ. Assessment of physical activity on weekdays and weekend for obesity children in elementary school. Korean J Elementary Phys Educ 2015; 21(3): 75-83.
  8. Son NR, Suh SH. An analysis of research trend and effects of physical activities among Korean adolescents through systematic review. J Legis Stud 2017; 15(1): 111-129.
  9. Lee HM, Kim EK. Assessment of daily steps, physical activity and activity coefficient of the elementary school children in the rural area. Korean J Community Nutr 2007; 12(3): 361-371.
  10. Kim Y, Na HJ. The estimation of the daily energy expenditure of Korean adolescents. Korean J Community Nutr 2003; 8(3): 270-279.
  11. Yoon JS, Kim GJ, Kim JH, Park YS, Gu JO. A Study to Determine the Recommended Dietary Allowance of Energy and to Develop Practical Dietary Education Program for Korean Adults. Sejong: Ministry of Health and Welfare; 2002.
  12. Ridley K, Olds TS. Assigning energy costs to activities in children: a review and synthesis. Med Sci Sports Exerc 2008; 40(8): 1439-1446.  https://doi.org/10.1249/MSS.0b013e31817279ef
  13. Kim EK, Gwak JY, Jun HY. Physical activity classification table for Korean youth: using the Youth Compendium of Physical Activities in the United States. J Nutr Health 2022; 55(5): 533-542.  https://doi.org/10.4163/jnh.2022.55.5.533
  14. Weir JB. New methods for calculating metabolic rate with special reference to protein metabolism. J Physiol 1949; 109(1-2): 1-9.  https://doi.org/10.1113/jphysiol.1949.sp004363
  15. Park J, Kazuko IT, Kim E, Kim J, Yoon J. Estimating free-living human energy expenditure: practical aspects of the doubly labeled water method and its applications. Nutr Res Pract 2014; 8(3): 241-248.  https://doi.org/10.4162/nrp.2014.8.3.241
  16. Kim EK, Kim OY, Park J, Kim E, Kim J. Establishment and future tasks of estimated energy requirement in 2020 dietary reference intakes for Koreans. J Nutr Health 2021; 54(6): 573-583.  https://doi.org/10.4163/jnh.2021.54.6.573
  17. Molnar D, Jeges S, Erhardt E, Schutz Y. Measured and predicted resting metabolic rate in obese and nonobese adolescents. J Pediatr 1995; 127(4): 571-577.  https://doi.org/10.1016/S0022-3476(95)70114-1
  18. Butte NF, Wong WW, Adoph AL, Puyau MR, Vohra FA, Zakeri IF. Validation of cross-sectional time series and multivariate adaptive regression splines models for the prediction of energy expenditure in children and adolescents using doubly labeled water. J Nutr 2010; 140(8): 1516-1523.  https://doi.org/10.3945/jn.109.120162
  19. Kim EK, Kim EK, Song JM, Choi HJ, Lee GH. Assessment of activity coefficient, resting energy expenditure and daily energy expenditure in elementary school children. J Korean Diet Assoc 2006; 12(1): 44-54.
  20. Kim MH, Kim EK. Physical activity level, total daily energy expenditure, and estimated energy expenditure in normal weight and overweight or obese children and adolescents. Korean J Nutr 2012; 45(6): 511-521.  https://doi.org/10.4163/kjn.2012.45.6.511
  21. Arvidsson D, Slinde F, Hulthen L. Physical activity questionnaire for adolescents validated against doubly labelled water. Eur J Clin Nutr 2005; 59(3): 376-383.  https://doi.org/10.1038/sj.ejcn.1602084
  22. Ramirez-Marrero FA, Smith BA, Sherman WM, Kirby TE. Comparison of methods to estimate physical activity and energy expenditure in African American children. Int J Sports Med 2005; 26(5): 367-371.  https://doi.org/10.1055/s-2004-821011
  23. Rodriguez G, Moreno LA, Sarria A, Fleta J, Bueno M. Resting energy expenditure in children and adolescents: agreement between calorimetry and prediction equations. Clin Nutr 2002; 21(3): 255-260. https://doi.org/10.1054/clnu.2001.0531
  24. Liu HY, Lu YF, Chen WJ. Predictive equations for basal metabolic rate in Chinese adults: a cross-validation study. J Am Diet Assoc 1995; 95(12): 1403-1408.  https://doi.org/10.1016/S0002-8223(95)00369-X
  25. Case KO, Brahler JC, Heiss C. Resting energy expenditure in Asian women measured by indirect calorimetry are lower than expenditures calculated from prediction equations. J Am Diet Assoc 1997; 97(11): 1288-1292.  https://doi.org/10.1016/S0002-8223(97)00308-8
  26. Shin HM, Jeon JH, Kim EK. Assessment of pedometer counts, physical activity level, energy expenditure, and energy balance of weekdays and weekend in male high school students. J Korean Diet Assoc 2016; 22(2): 131-142.  https://doi.org/10.14373/JKDA.2016.22.2.131
  27. Kim MJ, Na HJ, Kim Y. Total energy expenditure difference by the class hours in 5th & 6th grade primary school students. Korean J Teach Educ 2010; 26(6): 55-73. 
  28. Kim EK, Nidahimana D, Takata KI, Lee SJ, Kim JR, Lim KW, et al. Validation of Dietary Reference Intakes for predicting energy requirements in elementary school-age children. Nutr Res Pract 2018; 12(4): 336-341.  https://doi.org/10.4162/nrp.2018.12.4.336
  29. Ministry of Education (KR). Korean Student Health Examination Sample Statistics 2021. Sejong: Ministry of Education; 2021.
  30. Stamatakis E, Ahmadi MN, Gill JM, Ntoumani CT, Gibala MJ, Doherty A, et al. Association of wearable device-measured vigorous intermittent lifestyle physical activity with mortality. Nat Med 2022; 28(12): 2521-2529.  https://doi.org/10.1038/s41591-022-02100-x
  31. Ministry of Culture, Sports and Tourism (KR). National Sport Survey in Korea 2021. Sejong: Ministry of Culture, Sports and Tourism; 2021.
  32. Driskell MM, Dyment S, Mauriello L, Castle P, Sherman K. Relationships among multiple behaviors for childhood and adolescent obesity prevention. Prev Med 2008; 46(3): 209-215.  https://doi.org/10.1016/j.ypmed.2007.07.028
  33. Dietz WH Jr, Gortmaker SL. Do we fatten our children at the television set? Obesity and television viewing in children and adolescents. Pediatrics 1985; 75(5): 807-812.  https://doi.org/10.1542/peds.75.5.807
  34. Astrup A, Gotzsche PC, van de Werken K, Ranneries C, Toubro S, Raben A, et al. Meta-analysis of resting metabolic rate in formerly obese subjects. Am J Clin Nutr 1999; 69(6): 1117-1122. https://doi.org/10.1093/ajcn/69.6.1117