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u-헬스 케어 (Ubiquitous Healthcare) 서비스를 이용한 영양교육이 직장 남성근로자의 대사증후군에 미치는 영향

Effects of Nutrition Education Using a Ubiquitous Healthcare (u-Health) Service on Metabolic Syndrome in Male Workers

  • 박세윤 (이화여자대학교 임상보건과학대학원 임상영양학) ;
  • 양윤정 (동덕여자대학교 식품영양학과) ;
  • 김유리 (이화여자대학교 임상보건과학대학원 임상영양학)
  • Park, Se-Yun (The Graduate School of Clinical Health Sciences, Ewha Womans University) ;
  • Yang, Yoon-Jung (Department of Food and Nutrition, Dongduk Women's University) ;
  • Kim, Yu-Ri (The Graduate School of Clinical Health Sciences, Ewha Womans University)
  • 투고 : 2011.05.13
  • 심사 : 2011.06.10
  • 발행 : 2011.06.30

초록

본 연구는 u-Health 기반 장비를 활용한 영양교육이 식습관 변화, 영양소 섭취, 대사증후군 위험 인자에 미치는 영향에 대해 알아보고자 하는 목적으로 수행되었다. 1) 연구 대상자는 서울 소재 사업장에 근무하는 직장인 30~50대의 청장년층의 남성으로 구성되었으며, 대부분이 기혼, 대학이상학력의 고학력자이고, 높은 흡연율과 음주율을 나타냈다. 평소 규칙적인 운동 보다는 일상생활에서 활동량이 더 높았다. 2) 영양교육 전 후에 따른 신체계측 및 혈액성분의 결과는 복부둘레, 중성지방, 이완기 혈압, 중성지방과 체지방률, 총 콜레스테롤이 유의적으로 감소하였다. 3) 측정 횟수에 따른 신체계측 및 혈액성분 결과는 측정횟수 12회 이상인 그룹에서 복부둘레와 중성지방이 유의적으로 감소하였고, 체지방률과 총콜레스테롤도 유의적으로 감소하였다. 4) 영양교육 전 후에 따른 영양소섭취 상태 및 식습관 변화는 열량의 섭취가 감소하는 경향에도 불구하고 영양교육 전보다 교육 후 식이섬유, 동물성칼슘, 칼륨, 비타민C, 엽산이 유의적으로 증가하였다. 식습관 변화에서는 '육류, 생선, 달걀, 콩, 두부 등으로 된 음식을 매일 3~4회 먹는다.'와 '김치 이외의 채소를 식사할 때 마다 먹는다.'의 문항이 영양교육 전보다 영양교육 후 유의적으로 증가하여 긍정적인 변화를 보였다. 결론적으로 u-Health 기반 장비를 활용한 영양교육이 대사 증후군 위험요인 뿐만 아니라 식습관에서 또한 긍정적인 영향을 미치는 것으로 나타났다. 또한 교육의 효과에 있어서 대상자 스스로의 동기부여가 건강의 개선에 중요한 영향을 미친다는 것을 확인할 수 있었다. 본 연구 결과 대사증후군 대상자의 식습관 및 생활습관 개선을 위해 영양교육은 필수적이며, 추후 지속적인 동기부여를 위해서는 u-Health 기반 장비를 활용한 다양한 컨텐츠 개발과 이에 맞춘 체계적인 영양교육 프로그램의 연구가 장기적인 의료비의 절감, 삶의 질 향상을 위한 맞춤형 영양관리로 발전하도록 지속적으로 진행되어야 할 것이라고 사료된다.

The objective of this study was to investigate the effects of nutrition education based on ubiquitous healthcare (u-health) service on changes in dietary habits, nutrition intake, and risk factors for metabolic syndrome in male workers. In total, 72 male office workers with at least three risk factors of the National Cholesterol Education Program-Adult Treatment Panel III were recruited as subjects. Anthropometric measurements and biochemical analyses were conducted on all subjects. Dietary habits and nutrient intake were determined by a questionnaire using the 24-hour dietary recall method before and after nutrition education. Subjects measured their body composition, blood pressure, and physical activity more than once per week during the 12 weeks using the u-health care equipment and sent these data to a central database system using a personal computer. Individual nutrition counseling was provided four times on the first, fourth, eight, and twelfth weeks. The results showed significant decreases in abdominal circumference, body fat (%), diastolic blood pressure, serum triglycerides, and serum total cholesterol during the 12 weeks. Subjects with more than 12 measurements showed significant reductions in abdominal circumference, body fat (%), serum triglyceride, and serum total cholesterol. Mean intake of dietary fiber, animal calcium, potassium, vitamin C, and folic acid after nutrition education were higher than those before nutrition education. Participants showed significant increases in the frequencies of consuming protein foods (meat, fish, eggs, beans, tofu, etc.) and vegetables. In conclusion, nutrition education through the u-health service resulted in positive effects on the risk factors for metabolic syndrome, nutrient intake, and dietary habits.

키워드

참고문헌

  1. Statistics Korea. The cause of death statistics in 2008; 2009
  2. Ministry of Health and Welfare. Major chronic disease management program guide 2009; 2009
  3. Ministry of Health and Welfare. 2009 Korean national health and nutrition examination survey report; 2010
  4. Wilson PW, Kannel WB, Silbershatz H, D'Agostino RB. Clustering of metabolic factors and coronary heart disease. Arch Intern Med 1999; 159(10): 1104-1109 https://doi.org/10.1001/archinte.159.10.1104
  5. Lim S, Lee EJ, Koo BK, Cho SI, Park KS, Jang HC, Kim SY, Lee HK. Increasing trends of metabolic syndrome in Korea: based on Korean national health and nutrition examination surveys. J Korean Diabetes Assoc 2005; 29(5): 432-439
  6. Ministry of Health and Welfare. 2005 Korean national health and nutrition examination survey report; 20006
  7. Lee JY. Domestic u-Health demonstration project progress status and implications. Inf Commun Policy 2008; 20(21): 25-44
  8. Kim JH, Park JS, Jung EY, Park DK, Lee YH. A diet prescription system for U-healthcare personalized services. J Korea Contents Assoc 2009; 10(10): 111-119 https://doi.org/10.5392/JKCA.10.10.111
  9. Philips. [cited 2011 Apr 25]. Available from: http://www.healthcare.philips.com/kr_ko/about/company/whatwedo.wpdion/xa
  10. Newsis. MKE, 'u-Health' fostering industry... Speeding up medical power. [cited 2011 Apr 25]. Available from: http://www.newsis.com/article/view.htm?cID=article&ar_id=NISX20100511_0005152731.ms
  11. Kwak HS, Ryu S, Youn KI. Internet health information and health promotion behavior of employees. J Korean Soc Health Inf Health Stat 2008; 33(1): 105-118
  12. Kim JS, Han JS. Effects of a web-based nutrition counseling on food intake and serum lipids in hyperlipidemic patients. J Korean Soc Food Sci Nutr 2004; 33(8): 1302-1310 https://doi.org/10.3746/jkfn.2004.33.8.1302
  13. No JH. Symposium for activating nutrition education program for health promotion of workers. J Korean Diet Assoc 2004; 10(1): 69-76
  14. Suh I, Shaten BJ, Cutler JA, Kuller LH. Alcohol use and mortality from coronary heart disease: the role of high-density lipoprotein cholesterol. The Multiple Risk Factor Intervention Trial Research Group. Ann Intern Med 1992; 116(11): 881-887 https://doi.org/10.7326/0003-4819-116-11-881
  15. Mjos OD. Lipid effects of smoking. Am Heart J 1988; 115(1 Pt 2): 272-275 https://doi.org/10.1016/0002-8703(88)90649-7
  16. Lee KS, Park CY, Meng KH, Bush A, Lee SH, Lee WC, Koo JW, Chung CK. The association of cigarette smoking and alcohol consumption with other cardiovascular risk factors in men from Seoul, Korea. Ann Epidemiol 1998; 8(1): 31-38 https://doi.org/10.1016/S1047-2797(97)00113-0
  17. Kim JH, Lee KM, Kim HY, Song CH, Jung SP. The effects of cigarette smoking on abdominal fatness. J Korean Acad Fam Med 2000; 21(9): 1172-1179
  18. Yun HK, Kim H, Chang N. Diet quality index-international score is correlated with weight loss in female college students on a weight management program. Korean J Nutr 2009; 42(5): 453-463 https://doi.org/10.4163/kjn.2009.42.5.453
  19. Moore TJ, Alsabeeh N, Apovian CM, Murphy MC, Coffman GA, Cullum-Dugan D, Jenkins M, Cabral H. Weight, blood pressure, and dietary benefits after 12 months of a Web-based Nutrition Education Program (DASH for health): longitudinal observational study. J Med Internet Res 2008; 10(4): e52 https://doi.org/10.2196/jmir.1114
  20. Park JE, Kwon HC. Cardiovascular risk factors of Koreans. Korean J Lipidol 1995; 5(1): 97-102
  21. Muto T, Yamauchi K. Evaluation of a multicomponent workplace health promotion program conducted in Japan for improving employees' cardiovascular disease risk factors. Prev Med 2001; 33(6): 571-577 https://doi.org/10.1006/pmed.2001.0923
  22. Shimizu T, Horiguchi I, Kato T, Nagata S. Relationship between an interview-based health promotion program and cardiovascular risk factors at Japanese companies. J Occup Health 2004; 46(3): 205-212 https://doi.org/10.1539/joh.46.205
  23. Lee MS, Kang HJ, Oh HS, Paek YM, Choue RW, Park YK, Choi TI. Effects of worksite nutrition counseling for health promotion; Twelve-weeks of nutrition counseling has positive effect on metabolic syndrome risk factors in male workers. Korean J Community Nutr 2008; 13(1): 46-61
  24. Kang JY, Cho SW, Lee JY, Sung SH, Park YK, Paek YM, Choi TI. The effects of a worksite on-line health education program on metabolic syndrome risk factors and nutrient intakes of male workers. Korean J Nutr 2010; 43(1): 57-68 https://doi.org/10.4163/kjn.2010.43.1.57
  25. Plotnikoff RC, McCargar LJ, Wilson PM, Loucaides CA. Efficacy of an E-mail intervention for the promotion of physical activity and nutrition behavior in the workplace context. Am J Health Promot 2005; 19(6): 422-429 https://doi.org/10.4278/0890-1171-19.6.422
  26. Oh JY, Kim SB. Development and effects' analysis of nutrition education program for diabetes mellitus at community health center: focused on individual daily energy requirements and food exchange units. Korean J Community Nutr 2010; 15(4): 485-497
  27. Woo YJ, Lee HS, Kim WY. Individual diabetes nutrition education can help management for type II diabetes. Korean J Nutr 2006; 39(7): 641-648
  28. Kim EJ, Hwang HJ. Effects of a nutrition education and exercise program of overweight or obese female adults on nutritional and health status. J Korean Soc Food Sci Nutr 2010; 39(1): 78-84 https://doi.org/10.3746/jkfn.2010.39.1.078
  29. Hung HC, Joshipura KJ, Jiang R, Hu FB, Hunter D, Smith-Warner SA, Colditz GA, Rosner B, Spiegelman D, Willett WC. Fruit and vegetable intake and risk of major chronic disease. J Natl Cancer Inst 2004; 96(21): 1577-1584 https://doi.org/10.1093/jnci/djh296
  30. He K, Hu FB, Colditz GA, Manson JE, Willett WC, Liu S. Changes in intake of fruits and vegetables in relation to risk of obesity and weight gain among middle-aged women. Int J Obes Relat Metab Disord 2004; 28(12): 1569-1574 https://doi.org/10.1038/sj.ijo.0802795
  31. Ford ES, Mokdad AH, Giles WH, Brown DW. The metabolic syndrome and antioxidant concentrations: findings from the Third National Health and Nutrition Examination Survey. Diabetes 2003; 52(9): 2346-2352 https://doi.org/10.2337/diabetes.52.9.2346
  32. McCarron DA, Morris CD, Henry HJ, Stanton JL. Blood pressure and nutrient intake in the United States. Science 1984; 224(4656): 1392-1398 https://doi.org/10.1126/science.6729459
  33. van Mierlo LA, Arends LR, Streppel MT, Zeegers MP, Kok FJ, Grobbee DE, Geleijnse JM. Blood pressure response to calcium supplementation: a meta-analysis of randomized controlled trials. J Hum Hypertens 2006; 20:(8) 571-580 https://doi.org/10.1038/sj.jhh.1002038
  34. Shim JE, Paik HY, Moon HK, Kim YO. Comparative analysis and evaluation of dietary intakes of Koreans by age groups: (1) nutrient intakes. Korean J Nutr 2001; 34(5): 554-567
  35. Shim JE, Paik HY, Moon HK, Kim YO. Comparative analysis and evaluation of dietary intakes of Koreans by age groups: (2) food and food group intakes. Korean J Nutr 2001; 34(5): 568-579
  36. Shim JE, Kim JH, Nam GY, Paik HY, Moon HK, Kim YO. Comparative analysis and evaluation of dietary intakes of Koreans by age groups: (3) risk factors for chronic degenerative diseases. Korean J Nutr 2002; 35(1): 78-89
  37. Azadbakht L, Mirmiran P, Esmaillzadeh A, Azizi F. Dairy consumption is inversely associated with the prevalence of the metabolic syndrome in Tehranian adults. Am J Clin Nutr 2005; 82(3): 523-530 https://doi.org/10.1093/ajcn/82.3.523
  38. Lin YC, Lyle RM, McCabe LD, McCabe GP, Weaver CM, Teegarden D. Dairy calcium is related to changes in body composition during a two-year exercise intervention in young women. J Am Coll Nutr 2000; 19(6): 754-760 https://doi.org/10.1080/07315724.2000.10718075
  39. Trichopoulou A, Gnardellis C, Benetou V, Lagiou P, Bamia C, Trichopoulos D. Lipid, protein and carbohydrate intake in relation to body mass index. Eur J Clin Nutr 2002; 56(1): 37-43 https://doi.org/10.1038/sj.ejcn.1601286

피인용 문헌

  1. Prevalence of Metabolic Syndrome and Assessment of Food·Nutrient Intakes among Adult Visitors of a Public Health Center in Korea vol.41, pp.2, 2012, https://doi.org/10.3746/jkfn.2012.41.2.205
  2. Effect of the Telephone-Delivered Nutrition Education on Dietary Intake and Biochemical Parameters in Subjects with Metabolic Syndrome vol.2, pp.2, 2013, https://doi.org/10.7762/cnr.2013.2.2.115
  3. Comparison of Dietary Status and Health Behaviors according to the Obesity in Male Workers vol.24, pp.3, 2013, https://doi.org/10.7856/kjcls.2013.24.3.411
  4. Effects of Health Education using Short Messaging Service of Cellular Phone vol.25, pp.3, 2013, https://doi.org/10.7475/kjan.2013.25.3.241
  5. Comparison of health outcomes according to intervention compliance in male Korean workers with metabolic syndrome vol.46, pp.2, 2013, https://doi.org/10.4163/kjn.2013.46.2.156
  6. Development of Web-based u-Health Self-nutrition Management Program for Diabetic Patients vol.19, pp.4, 2014, https://doi.org/10.5720/kjcn.2014.19.4.372
  7. Effect of a Worksite-based Dietary Intervention Program for the Management of Metabolic Syndrome vol.21, pp.3, 2016, https://doi.org/10.5720/kjcn.2016.21.3.237
  8. The Effect of Computer-Assisted Instruction for Elementary School Students in Food Safety and Sanitation Knowledge vol.62, pp.2261-236X, 2016, https://doi.org/10.1051/matecconf/20166202001
  9. Needs for Development of IT-based Nutritional Management Program for Women with Gestational Diabetes Mellitus vol.22, pp.3, 2017, https://doi.org/10.5720/kjcn.2017.22.3.207
  10. Factors Affecting Health Promotion Behavior among Workers with High Risk of Metabolic Syndrome: Based on Theory of Planned Behavior vol.26, pp.2, 2015, https://doi.org/10.12799/jkachn.2015.26.2.128
  11. 건강포인트제도가 건강관련 생활습관에 미치는 영향 vol.18, pp.1, 2011, https://doi.org/10.14370/jewnr.2012.18.1.025