Average Dietary Energy Intake does not Increase as BMI Increased in the National Health and Nutrition Examination Survey Data of Korea

  • Ahn, Younjhin (National Genome Research Institute, National Institute of Health) ;
  • Paik, Hee-Young (Department of Food and Nutrition, Seoul National University) ;
  • Lee, Hong-Kyu (Department of Internal Medicine, Seoul National University)
  • 발행 : 2003.12.01

초록

Although the idea that obese people consume higher calorie diets is widely accepted, many dietary surveys have shown that obese people do NOT consume larger amounts of energy. We had an opportunity to study the relationship between calorie intake and obesity in Korea from the data contained in the '98 National Health and Nutrition Examination Survey of Korea. The survey was executed nationwide for two months - from Nov. 1 to Dec.30 in 1998. The survey included 10,876 (aged >10 years) subjects of whom 9,771 underwent health examinations. Surveyors visited each household and checked health status, measured anthropometry and blood pressures, collected blood and urine samples, and interviewed from the health questionnaires. Well-trained dietitians evaluated the food consumption of 11,525 subjects over the age of 1 year with the 24-hour recall method. The number of subjects from whom a complete health examination and food consumption information was obtained was 8,004. Subjects were classified by BMI (< 20, 20-22, 22-24, 24-26, 26-28, 28 $\leq$) and into newly diagnosed patients with DM (FBS $\geq$ 126 mg/㎗), hypertension (SBP $\geq$ 140 mmHg or DBP $\geq$ 90 mmHg) and hyperlipidemia (Total cholesterol $\geq$ 220 mg/㎗ or TG $\geq$ 200 mg/㎗). Our main results were as following:1) their average energy intake was 2,029.6 $\pm$ 908.5 ㎉ and BMI is 22.6 $\pm$ 3.4 kg/$m^2$;2) a comparison of nutrient intakes by BMI level did not show a significant difference of energy intake even though BMI increased (BMI, < 20: 1,999 ㎉ ∼ 28 $\leq$: 2,028 ㎉);and 3) Even in newly diagnosed patients with diabetes, hypertension or hyperlipidemia, their energy consumption was not significantly increased as BMI increased (from BMI 20). There are several possible explanations for these results:1) Reduced physical activity caused the weight of obese people to increase even with the same energy intake;2) people underreported their energy consumption;or, people intentionally reduced their energy consumption due to self-image regarding their obesity. We might also hypothesize that there is a metabolic problem conceiving obese people, because calorie intake was not higher in obese people than in non-obese people in Korea. Further research is necessary for re-evaluating these current conclusions.

키워드

참고문헌

  1. Alfieri, M., Pomerleau, J., & Grace, D.M. (1998). A comparison of fat intake of normal weight, moderately obese and severely obese subjects. Obes Surg, 7(1),9-15
  2. Bray, G.A. & Popkin, B.M. (1998). Dietary fat intake does affect obesity. Am J Clin Nutr, 68, 1157-1173
  3. Despres, J.P. (2001). Health consequences of visceral obesity. Ann Med, 33(8), 534-541 https://doi.org/10.3109/07853890108995963
  4. Garaulet, M., Martinez, A., Victoria, E, Perez Llamas, F., Ortega, R.M., & Zamora, S. (2000). Difference in dietary intake and activity level between normal-weight and overweight or obese adolescents. J Pediatr Gastroenterol Nutr; 30(3), 253-258 https://doi.org/10.1097/00005176-200003000-00008
  5. Garrow, J.S. (1998). Obesity and related diseases. Edinburgh; New York: Churchill Livingstone
  6. Gersovitz, M., Madden, J.P., & Smiciklas-Wright, H. (1978). Validity of the 24-hr dietary recall and seven-day record for group comparisons. J Am Diet Assoc, 73(1), 48-55
  7. Gnardellis, C., Boulou, C., & Tricholpoulou, A. (1998). Magnitude, determinants and impact of under-reporting of energy intake in a cohort study in Greece. Public Health Nutr; 1(2),131-137
  8. Guillaume, M.,Lapidus, L., & Lambert, A. (1998). Obesity and nutrition in children. The Belgian Luxembourg Child Study IV. Eur J Clin Nutn 52, 323-328 https://doi.org/10.1038/sj.ejcn.1600532
  9. Haapanen-Nierni, N., Miilunpalo, S., Pasanen, M., Vuori, I., Oja, P., & Malmberg, J. (2000). Body mass index, physical inactivity and low level of physical fitness as determinants of all-cause and cardiovascular disease mortality-16y follow-up of middle-aged and elderly men and women. Int J Obes Relat Metab Disord, 24(11), 1465-1474 https://doi.org/10.1038/sj.ijo.0801426
  10. Jequier, E.& Tappy, L. (1999). Regulation of body weight in human. Physiological reviews, 79(2), 451-480
  11. Kim, E.K. & Moon, H.K. (2001). A comparison of the pastphysical growth, eating habits and dietary intake by obesity index of sixth grade primary school students in Seoul. Korean J Community Nutrition 6(3S), 475-485
  12. Kim, J., & Wee, H.J. (2001). The association of body mass index with dietary intake, serum lipid levels, lipoprotein (a) and PAI-I in middle class Korean adults from 1995 to 1999. Korean J Community Nutrition, 6(1), 51-68
  13. Kim, S.K, Park, YS., & Byoun, KE. (2000). Comparison of the total antioxidant status and usual dietary intake in normal and overweight males. Korean J Community Nutrition, 5(4), 633-641
  14. Kuboonchoo, K. (2001). Energy balance and physical activity. Biomed Environ Sci, 14(1-2), 130-136
  15. Lee, H.K. (2001). Method of proof and evidences for the concept that mitochondrial genome is a thrifty genome. Diabetes Research and Clinical Practice, 54(Suppl 2), S57-S63
  16. Lee, M.S., Sung, C.J., Sung, M.K., Choi, M.K., Lee, v.s., & Cho, K.O. (2000). A comparative study on food habits and nutrient intakes among highschool students with different obesity indexes residing in Seoul and Kyunggi-do. Korean J Community Nutrition, 5(2), 141-151
  17. Lew, E.A, & Garfmkel, L. (1979). Variations in mortality by weight among 750,000 men and women. J Chronic Dis, 32, 563-576 https://doi.org/10.1016/0021-9681(79)90119-X
  18. Lichtman, S.W., Pisarska, K., Berman, E.R., Pestone, M., Dowling, H., Offenbacher, E., Weisel, H., Heshka, S., Mattews, D.E., & Heymsfield, S.B. (1992). Discrepancy between self-reported and actual caloric intake and exercise in obese subjects. New Engl J Med, 327, 1893-1898
  19. Madden, IP. (1980). Flat-slope syndrome. J Am Diet Assoc, 76(2), 172
  20. Miller, W.C., Lindeman, A.K., Wallace, J, & Niederpruem, M.(1990). Dietcomposition, energy intake, and exercise in relation to body fat in men and women. Am J Clin Nutr, 52(3), 426-30
  21. Mokhtar, N., Elati, J, Chabir, R, Bour, A, Elkari, K., Schlossman, N., Caballero, B., & Aguenaou, H. (2001). Diet culture and obesity in northern Africa. J Nutr, 131, 887S-892S
  22. National Rural Living Science Institute. (1996). Food composition table, 5th Ed. Rural Development Administration. Suwon, Korea
  23. Nguyen, T.,Larson, D.E., Johnson, RK., & Goran, M. (1996). Fat intake and adiposity in children of lean and obese. Am J clin Nutr, 63, 507-513
  24. Ortega, RM., Requejo, AM., Andres, P., Lopez Sobaler, AM., Redondo, R, & Gonzalez Fernandez, M. (1995). Relationship between diet composition and body mass index in a group of Spanish adolescents. Br J Nutr, 74(6), 765-773
  25. Romieu, O., Willett, W.C., Stampfer, MJ., Colditz, G.A, Sampson, L., Rosner, B.,Hennekens, CR, & Speize, EE. (1988). Energy intake and other determinants of relative weight. Am J Clin Nutr, 47(3), 406-412
  26. Saltzman, E. & Roberts, S.B.(1995). The role of energy expenditure in energy regulation: Findings from a decade of research. Nutr Rev, 53(8), 209-220
  27. SAS Institute, Inc. (2001). SAS/SAGT users guide, Release 8.01 edition. Cary, NC,USA
  28. Siedell, J.C. (1998). Dietary fat and obesity: An epidemiologic perspective. Am J Clin Nutr, 67(supple), 546S-550S
  29. Waxman, M., & Stunkard,A.J. (1980). Caloric intake and expenditure of obese boys. J Pediatr, 96(2), 187-93 https://doi.org/10.1016/S0022-3476(80)80800-6
  30. WHO. (1997). Report of a WHO consultation on obesity- Obesity: Preventing and managing the global epidemic. Geneve
  31. WHO. (2001). Global database on obesity and body mass index (BMI) in adults. Nutrition data bank (http://www.who.int/nut/db_bmi.htm)
  32. Willett, W.C. (1998). Nutritional epidemiology, 2nd ed Oxford University Press. NewYork
  33. Yim, K.S., Yoon, E.Y., Kim, C.I., Kim, K.T., Kim, C.I., & Choi, H. (1993). Eating behavior, obesity and serum lipid levels in children. Korean J Nutrition 26(1), 56-66
  34. Zhang, J., Temme, E.H.M., Sasaki, S., & Kesteloot, H. (2000). Under-and overreporting of energy intake using urinary cations as biomarkers: Relation to body mass index. AmJ Clin Nutr, 152, 453-462