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서론

Vol.257 C O N T E N T S M O N T H L Y P U B L I C F I N A N C E F O R U M

590호(01-11)

Transcription:

Special Issue Childhood Obesity Dong Hwan Lee, M.D. Department of Pediatrics Soonchunhyang University College of Medicine & Hospital Email : ldh@hosp.sch.ac.kr Abstract Due to economic growth, and as lifestyles got more convenient, the number of calories being spent has decreased for two reasons. One is the lack of physical activities and the other is the increased consumption of westernized food. This outbreak of obesity is the highest among the children and the adolescents. Among primary, middle, and high school students in seoul, the prevalence of obesity has increased from 6.2% in 1988 to 17.9% in 2002 in boys, and from 6.5% to 10.9% during the same period in girls. Thus, during the last 14 years, the obesity frequency increased 2.9 times in boys, and 1.7 times in girls. Increase of child obesity is a worldwide tendency. In United States, 20% of all children, 27% of all adolescents, and 33% of all adults are obese. Childhood obesity is catching much attention, because it has physiological and psychological damages for long term as well as for short term. Some of the psychological damages of an obese children are having difficulties with familial and friend relationships, also having a low selfesteem. Although, physiological damages in short term are not clear, the long term damages would have progressed from an early age up to an adult. Detection and treatment of overweight and obesity in childhood are important not only from the aspect of preventive pediatrics, but also the public health that in which include child's physical, social, and psychological health as well as the negative effect it will have on the adults. Keywords : Childhood obesity; BMI; Obesity index 321

Special Issue (%) 1979 1.7 2.4 1981 1.4 2.3 1988 6.2 6.5 2002 17.9 10.9 322

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Special Issue Alstrom phenothiazines Klinefelter LaurenceMoonBiedle carbamazepine Carpenter Cohen antidepressants glucocorticoids 1 BeckwithWiedemann valproate 324

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Special Issue 42 : 1338-65 15.. 1998, 1998 16. Astrup A, Gotzsche PC, van de Werken K, Ranneries C, Toubro S, Buemann B, et al. Metaanalysis of resting metabolic rate in formerly obese subjects. Am J Clin Nutr 1999 ; 69 : 1117-22 17. Bouchard BM, Despres JP, Tremblay A. Genetics of obesity and human energy metabolism. Proc Nutr Soc 1991 ; 50 : 139-47 18. Behrman RE, Kliegman RM, Arvin AM. Nelson Textbook of Pediatrics. 17th ed. Philadelphia : WB Saunders, 2004 : 173-7 19. Canadian Task Force on the Periodic Health Examination. Periodic health examination, 1994 update : 1. Obesity in chil- Can Med Assoc J 1994 ; 150 : 871 dren. 10. Diet WH, Robinson TN. Assessment and treatment of childhood obesity. Pedatr Rev 1993 ; 14 : 337 11. Dietz WH. Health consequences of obesity in youth : Childhood predictors of adult disease Pediatr 1998 ; 101(Suppl) : 518-25 12. Durnin JGVA, McKillop M. The relationship between body build in infancy and percentage body fat in adolescence. A 14 year followup on 102 infants Proc Nutr Soc 1978 ; 37 : 81A 13. Davies PS, Gregory J, White A. Energy expenditure in children aged 1.5 to 4.5 years. a comparison with current recommendations for energy intake. Eur J Clin Nutr 1995 ; 49 : 360-4 14. Epstein LH, Myers MD, Raynor HA, Saelens BE. Treatment of 11.,,. 18(1976~1996). 1993 ; 30 : 832-9 12... 1996 ; 39 : 1055-65 13... 1999 ; 2 : 8-20 14. 15.. 1999 ; pediatric obesity in The Cause and Health Consequences of Obesity in Children and Adolescents. Pediatr 1998 ; 101 (Suppl) : 554-70 15. Fontvieille AM, Kriska A, Ravussin E. Decreased physical activity in Pima Indian compared with Caucasian children. Int J Obes Relat Metab Disord 1993 ; 17 : 445-52 16. Fontvieille AM, Harper IT, Ferraro RT, Spraul M, Ravussin E. 332

Daily energy expenditure by fiveyearold children, measured by doubly labeled water. J Pediatr 1993 ; 123 : 200-7 17. Goran MI, Carpenter WH, Poehlman ET. Total energy expenditure in 4to 6yrold children. Am J Physiol 1993 ; 264 : 706-11 18. Himes JH, Dietz WH. Guidelines for overweight in adolescent preventive services. recommendations from an expert committee. The Expert Committee on Clinical Guidelines for Overweight in Adolescent Preventive Services. Am J Clin Nutri 1994 ; 59 : 307-16 19. Mossberg HO. 40year followup overweight children. Lancet 1989 ; 2 : 491-3 20. Poskitt EME, Cole TJ. Do fat babies stay fat? Br Med J 1977 ; 1 : 7-9 21. Parsons TJ, Power C, Logan S, Summerbell CD. Childhood predictors of adult obesity. a systematic review. Int J Obes Relat Metab Disord 23 Suppl 1999 ; 8 : 1-107 22. Ravussin E, Bogardus C. Energy balance and weight regulation : genetics versus environment. Br J Nutr 2000 ; 83(Suppl) : 1 17-20 23. Sallade JA. Comparison of the psychological adjustment of obese and nonobese children. J Psychosom Res 1973 ; 17 : 89-96 24. Hintz RL. Management of disorders of size. In Brook CGD, Hindmarsh PC, ed. Clinical Pediatric Endorcrinology, 4th ed, Iowa : Blackwell Science, 2001 : 132-6 25. Wales JK, Wit JM, Rogol AD. Pediatric Endocrinology and Growth, 2nd ed. Philadelphia : WB Saunders, 2003 : 115-30 333