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1 26 1 ( ) J Korean Oriental Med 2005;26(1): ) 2) 1) 2) The Effect of Education Program on Weight Control in Taeumin Childhood Obesity Jung-Hee Yoo, Il-Byung Song, Eui-Ju Lee, Sang-Ryong Back 1), Byung-Hee Koh, Hyang-Yeon Lee 2) Department of Sasang Constitutional Medicine, College of Oriental Medicine, Kyunghee University Maenangukjuk oriental clinic 1) Department of Nursing Science, Kyunghee University 2) Objective : Childhood obesity has become one of the most common health problems facing children in the world. Although a number of regimens have been developed and distributed for the treatment of adult obesity, few studies have focused on therapeutic programs for obese children. The objective of this study was to develop and measure the effects of Taeumin childhood obesity by a sasang constitutionbased education program. Methods : A total of 14 (%RBW 20) among 18 taeumin with childhood obesity from June to August 2003 participated in the constitution-based education program. It was designed to examine the effects of a constitution-based education program through anthropometric measurements, body composition indicates, biochemical indicates and serum level of taeumin childhood obesity. Results : The results of this study were as follows: 1. The anthropometric measurement of subscapular skinfold thickness was reduced after 4 weeks of the constitution-based education program. 2. The body composition indicates reduction in degree of obesity, percent body fat, and fat distribution. The other side increased in height, total body water, soft lean mass, and lean body mass. 3. For biochemical indicates, HDL-cholesterol was increased significantly after 4 weeks of the constitution-based education program. The other side decreased in AST and ALT. 4. There was a significant reduction in BMI and %RBW after the constitution-based education program. Conclusion : A constitution-based education program for weight control results in reduced degree of obesity among taeumin children. Key Words: childhood obesity, sasang constitution, obesity control program : : : : (Tel; , Fax; , ; 1-3)., 4). 103

2 (104) 26 1 ( ) 5-8). 9-12).,..,,.,,,,,,,,,... 13,14).,, 15-16). 17),,,. 18) 70.2%,, ). K ( ). (Fig. 1). K Fig. 1. Design of study 104

3 (105) 18., ,, : : :, metal tape.. : Skinfold Caliper. Caliper 10g/ rpm 15.. :, HDL-,, LDL- Friedwald formular. LDL = (HDL - /5). : leptin leptin kit(human Leptin RIA kit, LINCO Research, INC) radioimmuno assay(ria). Hexokinase, G6PD, UV, Leptin -conter (COBRA Quantum. USA) radioimmuno assay(ria). aspartate aminotransferase(ast), alanine aminotransferase(alt). 4,,,,, BIA ( ) Inbody (%RBW) 1998, ). Body Mass Index(BMI: / ). 20%, 20-30%, 31-50%, 50%. X-ray /, QSCC ( 105

4 (106) 26 1 ( ) ),.,.. 5. (,,, )....,.,...,, 3. 40, 50-70% 4.,. ( 1). SPSS for window Version 11.0.,,,, (,,, ),, (Wilcoxon signed rank statistic). p<0.05.,,,,,,.,, 57% 43%. 11, 135, % %, 31-50%, 50% 37% (Table 1)., (Table 2). Skinfold Caliper. 106

5 (107) Table 1. General Caracteristics of the Taeumin Childhood Obesity Characteristcs Group(n=14) No(%) Mean SD Gender female 8(57.1) - male 6(42.9) - 9 2(14.3) 10 2(14.3) Age(year) 11 5(35.7) (28.6) 13 1(7.1) (7.1) (14.3) Height( ) (35.7) (14.3) (14.3) 156-2(14.3) -40 1(7.14) (21.4) Weight( ) (50.0) (7.14) (7.14) -79 1(7.14) overweight(%rbw 20) 2(14.3) Distribution of obese slight-obese(21 %RBW 30) 2(14.3) medium-obese(31 %RBW 50) 8(57.1) high-obese(%rbw 51) 2(14.3) Table 2. Comparison of Anthropometry Pre-post Scores on Program(n=14) Pre-program Post-program 4 wks sig. Circumference( ) Chest Upper arm Abdominal Buttock Mid-thigh Skinfold Thickness( ) Subscapular Triceps Biceps Supra-iliac * p<0.05; p<0.01,,,,,,, BMR BCM 4., BMR BCM.(Table 3, Fig. 2), (1.3%) (3.3%),, (BMR) 2.6%, (BCM) 3.3%, (5.3%) (2.2%). 4,,.,.. 107

6 (108) 26 1 ( ) Table 3. Comparison of Body Composition Pre-post Scores on Program(n=14) contents Pre-program Post-program 4 wks sig. Height( ) Weight( ) Obesity degree(%) Total body water Intracellular fluid( ) Soft lean mass Extracellular fluid( ) Protein mass( ) Lean body Mineral mass( ) Weight Soft lean mass( ) Fat mass( ) Percent body fat(%) * Fat distribution(whr) * BMR( ) BCM( ) BMR;Basal metabolic rate; BCM;Body cell mass; WHR(%);waist hip ratio * p<0.05; p<0.01; p<0.001 Heigt( ) Obesity degree(%) Intracellular fluid( ) Extracellular fluid( ) Protein mass( ) Mineral mass( ) 108

7 (109) Soft lean mass( ) Percent body fat(%) Fat distribution BMR( ) BCM( ) Fig. 2. Comparison of body composition pre-post scores on program 4., HDL-,, LDL- Friedwald formular, HDL Cholesterol 10.2%., AST ALT 13.2% 33.74%. (Table 4, Fig. 3) Leptin. 109

8 (110) 26 1 ( ) Table 4. Comparison of Blood Chemistry Pre-post Scores on Program(n=14) Pre-program Post-program 4 wks sig. HDL Cholesterol( ) * LDL Cholesterol( ) TG( ) Glucose( ) AST(GOT)(IU/L) ALT(GPT)(IU/L) Insulin(uIU/ ) Leptin(ng/ml) TSH(uIU/ ) Free T4(ng/dL) HDL;high density lipoprotein; LDL; low density lipoprotein; TG; triglyceride TSH; Thyroid stimulating hormone * p<0.05; p<0.01; p<0.001 Table 5. Comparison of BMI & %RBW Pre-post Scores on Program(n=14) Pre-program Post-program 4 wks sig. BMI %RBW BMI: body mass index= body weight(kg)/height(m 2 ) %RBW: relaive weight= body weight 100/standard weight * p<0.05; p<0.01; p< (BMI) 1.9% (%RBW) 14.5% (Table 5, Fig. 4.),,,,,,,,,. 20).. Goodrick et al(1991),. 8 21).,,. 6.,..,,,,,. 110

9 (111) HDL Cholesterol( ) AST(IU/L) ALT(IU/L) Fig. 3. Comparison of blood chemistry pre-post scores on program BMI( ) %RBW Fig. 4. Comparison of BMI & %RBW pre-post scores on program,. 70%. 22) total protein, total cholesterol, triglyceride, phospholipid, LDL-cholesterol, 23). ( ),.,, 111

10 (112) 26 1 ( )., 24) ) ( ) (, ),.,.,.,..,,,., (BMI) (%RBW)... K 14 4,,. 1. Skinfold Caliper % (1.3%) (3.1%), (3.9%), (3.4%), (2.4%), (3.3%), (2.6%), (3.3%), (2.8%), (5.3%) (2.2%). 3. HDL- (10.2%), GOT(13.2%) GPT(33.74%). 4. BMI(1.9%) %RBW(14.5%). 112

11 (113) 1.,,,,, ;27(1): ,,,, ;46(4): ,,,, ;21(7): ,, ;31(6): Leng AC. Robson WM. Childhood obesity. Postgraduate Medicine. 1989;87(4); Styne DM. Childhood obesity. Time for action not complacency. Am Fam Physician. 1999;59; Blackburn GL, Kanders BS(eds). Obesitypathophysiology, psychology and treatment. Chapman & Hall. 1994: Epstein LH, Wing DR, Valoski A. Childhood Obesity. Pediatric Clin North Am. 1985;35(2): ,, ;23(12): , ;29(3): ,, ;19(10): ; 39(8): :. 2001: :. 2003: : , ;11(1): ,,,,, ;15(6): , ;8(1): ;Supplement ( 7 ): ;21(2): Skender ML, Goodrick GK, Deljunco DJ. et al. Comparision of 2-year weight loss trends in behavioral treatment of obesity: Diet, exercise and combination intervention. J Am Diet Assoc. 1996;96(4): ;5(1): ;3(1): ,,.,. 1996;8(2): :. 1999:

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