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Effect of an abdominal obesity management program on dietary intake, stress index, and waist to hip ratio in abdominally obese women - Focus on comparison of the WHR decrease and WHR increase groups -

복부비만 관리프로그램이 성인 비만여성의 식이섭취, 스트레스지수 및 복부비만율에 미치는 영향 - 복부비만감소군과 복부비만증가군의 비교를 중심으로 -

  • Received : 2011.05.01
  • Accepted : 2012.03.10
  • Published : 2012.04.30

Abstract

This study was conducted to evaluate the effects of an abdominal obesity management program on dietary intake, stress index, and waist to hip ratio (WHR) in abdominally obese women. The subjects were 195 adult abdominally obese women (WHR ${\geq}$ 0.80) who had been participating in a nutrition education (total of nine times) and dietary habits and life style modification programs (total of six times) for 12 weeks. The abdominal obesity management program focused on the nutrition provided by breakfast, lunch, and dinner, proper dietary habits, and practices to improve life style. The subjects were divided into a WHR decrease group and a WHR increase group according to changes in the WHR. Daily nutrient intake was assessed with a 3-day food record, body measurements and blood vessel age, stress index, and a health index that were measured at baseline and after 12 weeks. After the intervention, weight, waist circumference, hip circumference, WHR, and body mass index (BMI) decreased significantly in the WHR decrease group. Energy intake increased from 1486.2 kcal to 1541.4 kcal with a significant improvement in nutrient density for animal protein, total fat, animal fat, fiber, calcium, phosphorus, zinc, vitamin $B_6$, vitamin C, vitamin E, and saturated fatty acids in the WHR decrease group. Additionally, dietary diversity increased significantly in the WHR decrease group compared to that in the WHR increase group. The WHR decrease group showed a significant improvement in the stress and health indices. Changes in WHR were correlated with changes in nutrient intake (animal protein, total fat, animal fat, plant fat, fiber, calcium, iron, potassium, vitamin A, vitamin $B_2$, vitamin $B_6$, vitamin C, and folate) and medical index profiles (stress and indices) adjusted for age, birth status, baseline BMI, and baseline WHR. These results show that an abdominal obesity management program was effective not only for reducing the WHR but also to improve dietary intake and the stress index in abdominally obese women.

본 연구는 비만연구소 복부비만관리 프로그램에 참여한 복부비만율 0.80 이상인 복부비만 여성 195명을 대상으로 12주간 실시하였으며, 프로그램 종료 후 복부비만 감소 여부에 따라 복부비만율 감소군과 복부비만율 증가군으로 나누어 신체계측치의 변화, 식이섭취의 변화, 혈관나이, 스트레스 지수 및 건강지수의 변화를 비교 하였다. 영양소의 섭취량을 살펴본 결과, 체중, 허리둘레, 엉덩이둘레가 유의적으로 감소한 복부비만율 감소군에서 식물성 단백질, 칼륨, 비타민 A, 엽산, 식이섬유, 칼슘, 인, 비타민 $B_2$, 비타민 $B_6$, 비타민 C, 식물성지방, 철분, 나트륨, 나이아신, 비타민 E 및 다가불포화지방산의 영양밀도가 유의적으로 증가하였고, 단백질, 칼슘, 인, 비타민 A, 비타민 $B_1$, 비타민 $B_2$ 그리고 비타민 C의 INQ가 유의적으로 증가하였다. 특히 식이섬유, 칼슘, 인, 아연, 비타민 $B_6$, 비타민 C 그리고 비타민 E의 변화율은 복부비만율 감소군에서 더 컸으며, 두 그룹간의 유의적인 차이를 보였다. 식품섭취 다양성의 변화를 살펴보기 위해 식품군별 섭취 가짓수를 비교해 본 결과, 복부비만율 감소군에서 어패류, 두류, 견과류, 채소류 그리고 버섯류 가짓수가 유의적으로 증가한 것으로 나타났다. 복부비만율 감소군에서는 스트레스 지수와 건강지수가 유의적으로 개선된 반면 복부비만율 증가군에서는 건강지수가 감소하였다. 본 연구에서는 복부비만율 변화와 영양밀도, 혈관나이, 스트레스 지수 및 건강지수 변화간의 상관성을 알아보았다. 그 결과, 복부비만율 감소의 변화율이 높을수록 식물성 단백질, 식물성 지질, 섬유질, 칼슘, 철분, 칼륨, 아연, 비타민 A, 비타민 $B_2$, 비타민 $B_6$, 비타민 C 그리고 엽산의 섭취량이 유의적으로 감소하였고, 복부비만율 증가의 변화율이 높을수록 동물성 단백질과 총 지질의 섭취량이 유의적으로 증가하였다. 스트레스 지수와 건강지수와의 관련성에서는 복부비만율 감소율이 높을수록 스트레스 지수가 유의적으로 감소하는 양의 상관관계를 보인 반면, 건강지수는 증가하는 음의 상관관계를 보였다. 이상을 통해 볼 때, 영양교육과 식습관 및 생활습관 개선 교육으로 구성된 복부비만관리 프로그램은 식이섭취에 긍정적인 영향을 미칠 뿐만 아니라 스트레스도 완화시켜 복부비만율 개선에 도움이 되므로, 후속 연구에서는 이러한 교육을 장기프로그램에 적용시킨 뒤 이러한 복부비만율 개선이 지속적으로 유지되는 지를 살펴보는 것이 필요하다.

Keywords

References

  1. Azadbakht L, Esmaillzadeh A. Dietary diversity score is related to obesity and abdominal adiposity among Iranian female youth. Public Health Nutr 2011; 14(1): 62-69 https://doi.org/10.1017/S1368980010000522
  2. Al-Rethaiaa AS, Fahmy AE, Al-Shwaiyat NM. Obesity and eating habits among college students in Saudi Arabia: a cross sectional study. Nutr J 2010; 9: 39 https://doi.org/10.1186/1475-2891-9-39
  3. Baek YA, Kim KN, Lee YA, Chang N. The effect of nutrition education on visceral fat reduction and diet quality in postmenopausal women. Korean J Nutr 2008; 41(7): 634-644
  4. Kim HR, Kang YH, Kwak NS, Kang EJ, Kim EJN. Trends in obesity and comprehensive policy strategy to prevent obesity in Korea. Seoul: Korea Institute for Health and Social Affairs; 2009
  5. Yang SW. The effects of combined exercise program on blood lipids, laptin, and cortisol stress hormone concentration in obesity middle-aged women. J Sport Leis Stud 2008; 33(2): 795-802
  6. Garrow JS. Obesity and related diseases. Edinburgh: Churchill Livingstone; 1988. p.12-14
  7. Nam JH. Effect of weight control program on obesity degree and blood lipid levels among middle-aged obese women. Korean J Food Nutr 2006; 19(1): 70-78
  8. Lee KS, Lee J. Effect of the Dietary Approaches to Stop Hypertension diet with aerobic exercise on body composition and blood lipid profiles in obese individuals. Korean J Exerc Nutr 2010; 14 (1): 17-21
  9. Jacobs EJ, Newton CC, Wang Y, Patel AV, McCullough ML, Campbell PT, Thun MJ, Gapstur SM. Waist circumference and all-cause mortality in a large US cohort. Arch Intern Med 2010; 170(15): 1293-1301 https://doi.org/10.1001/archinternmed.2010.201
  10. Klein S, Allison DB, Heymsfield SB, Kelley DE, Leibel RL, Nonas C, Kahn R. Waist circumference and cardiometabolic risk: a consensus statement from shaping America's health: Association for Weight Management and Obesity Prevention; NAASO, the Obesity Society; the American Society for Nutrition; and the American Diabetes Association. Diabetes Care 2007; 30 (6): 1647-1652 https://doi.org/10.2337/dc07-9921
  11. Heo YH, Kim EJ, Seo HS, Kim SM, Choi KM, Hwang TG, Cho GJ, Park Y. The effect of 16 week exercise program on abdominal fat, serum lipids, blood glucose, and blood pressure in obese women. Korean J Obes 2010; 19(1): 16-23
  12. Oh IS, Ahn GS, Kang BH. Women's diet practice by their lifestyles. Rev Ind Manage 2005; 17(2): 87-111
  13. Neovius M, Johansson K, Rössner S. Head-to-head studies evaluating efficacy of pharmaco-therapy for obesity: a systematic review and meta-analysis. Obes Rev 2008; 9(5): 420-427 https://doi.org/10.1111/j.1467-789X.2008.00463.x
  14. Choi MS. Effects of nutrition education and exercise intervention on health and diet quality of middle-aged women. Korean J Nutr 2009; 42(1): 48-58
  15. Wu H, Pan A, Yu Z, Qi Q, Lu L, Zhang G, Yu D, Zong G, Zhou Y, Chen X, Tang L, Feng Y, Zhou H, Li H, Demark-Wahnefried W, Hu FB, Lin X. Lifestyle counseling and supplementation with flaxseed or walnuts influence the management of metabolic syndrome. J Nutr 2010; 140(11): 1937-1942 https://doi.org/10.3945/jn.110.126300
  16. Keränen AM, Savolainen MJ, Reponen AH, Kujari ML, Linde man SM, Bloigu RS, Laitinen JH. The effect of eating behavior on weight loss and maintenance during a lifestyle intervention. Prev Med 2009; 49(1): 32-38 https://doi.org/10.1016/j.ypmed.2009.04.011
  17. Kim YH, Yoo JY, Lee EG, Kim KB, Jo DH, Hwang JY. Effects of a dietary supplement consisting of Phaseolus vulgaris and Garcinia cambogia (HCA) on the lipid level and body weight. J Korean Soc Food Sci Nutr 2004; 33(3): 518-522 https://doi.org/10.3746/jkfn.2004.33.3.518
  18. Lee SH, Chang N. Effectiveness of nutrition education on dietary habits and diet quality in the weight loss and weight gain groups in college women. Korean J Nutr 2007; 40(5): 463-474
  19. Jin HM, Kwon JS. The change of physical fitness, percent body fat and waist hip ratio on the elderly people using exercise program in leisure-welfare facility. J Korean Phys Edu Assoc Girls Women 2010; 24(1): 107-118
  20. Friedenreich CM, Woolcott CG, McTiernan A, Terry T, Brant R, Ballard-Barbash R, Irwin ML, Jones CA, Boyd NF, Yaffe MJ, Campbell KL, McNeely ML, Karvinen KH, Courneya KS. Adiposity changes after a 1-year aerobic exercise intervention among postmenopausal women: a randomized controlled trial. Int J Obes (Lond) 2011; 35(3): 427-435 https://doi.org/10.1038/ijo.2010.147
  21. Ahn HJ, Cho YO, Kwon HR, Ku YH, Koo BK, Han KA, Min KW. The effects of low-calorie diets on abdominal visceral fat, muscle mass, and dietary quality in obese type 2 diabetic subjects. Korean Diabetes J 2009; 33(6): 526-536 https://doi.org/10.4093/kdj.2009.33.6.526
  22. Baker S, Jerums G, Proietto J. Effects and clinical potential of very-low-calorie diets (VLCDs) in type 2 diabetes. Diabetes Res Clin Pract 2009; 85(3): 235-242 https://doi.org/10.1016/j.diabres.2009.06.002
  23. Zwiauer KF, Mueller T, Widhalm K. Resting metabolic rate in obese children before, during and after weight loss. Int J Obes Relat Metab Disord 1992; 16(1): 11-16
  24. Tounian P, Frelut ML, Parlier G, Abounaufal C, Aymard N, Veinberg F, Fontaine JL, Girardet JP. Weight loss and changes in energy metabolism in massively obese adolescents. Int J Obes Relat Metab Disord 1999; 23(8): 830-837 https://doi.org/10.1038/sj.ijo.0800959
  25. Lissner L, Odell PM, D'Agostino RB, Stokes J 3rd, Kreger BE, Belanger AJ, Brownell KD. Variability of body weight and health outcomes in the Framingham population. N Engl J Med 1991; 324(26): 1839-1844 https://doi.org/10.1056/NEJM199106273242602
  26. Chang UJ, Lim KA, Han YB. Effect of nutrition education on weight control program. Korean J Food Nutr 1999; 12(2): 177- 183
  27. Kim MS, Choi MS, Kim KN. Effect of nutritional education and exercise intervention on reducing and maintaining weight in obese women. Korean J Community Nutr 2007; 12(1): 80-89
  28. Kang YH, Yi KO, Ha EH, Kim JY, Kim WY. Evaluation of short term weight control program for female college students. Korean J Nutr 2004; 37(6): 493-501
  29. Park BN, Lee HJ, Park JS. The effects of health management program on BMI, obesity stress, self-esteem and depression in female college students. J Korean Soc Health Inf Health Stat 2007; 32(2): 1-12
  30. Bray GA. Is dietary fat important? Am J Clin Nutr 2011; 93(3): 481-482 https://doi.org/10.3945/ajcn.110.011114
  31. Brehm BJ, Seeley RJ, Daniels SR, D'Alessio DA. A randomized trial comparing a very low carbohydrate diet and a calorie-restricted low fat diet on body weight and cardiovascular risk factors in healthy women. J Clin Endocrinol Metab 2003; 88(4): 1617-1623 https://doi.org/10.1210/jc.2002-021480
  32. Yoo JS, Kim EJ, Lee SJ. The effects of a comprehensive life style modification program on glycemic control and stress response in type 2 diabetes. J Korean Acad Nurs 2006; 36(5): 751-760 https://doi.org/10.4040/jkan.2006.36.5.751
  33. Oh HJ. Obesity and trace mineral. Med Postgrad 2007; 35(1): 25-27
  34. Lim MR, Kang SM. The effect of functional foods on the abdominal obesity. J Cosmetol Sci 2010; 6(2): 95-104
  35. Papakonstantinou E, Flatt WP, Huth PJ, Harris RB. High dietary calcium reduces body fat content, digestibility of fat, and serum vitamin D in rats. Obes Res 2003; 11(3): 387-394 https://doi.org/10.1038/oby.2003.52
  36. Ock SM, Ju SY, Choi WS, Park HM, Jung KI, Song CJ. Association of sleep hours with obesity in adult women. Korean J Obes 2008; 17(3): 110-116
  37. Tuomilehto H, Peltonen M, Partinen M, Lavigne G, Eriksson JG, Herder C, Aunola S, Keinänen-Kiukaanniemi S, Ilanne-Parikka P, Uusitupa M, Tuomilehto J, Lindström J; Finnish Diabetes Prevention Study Group. Sleep duration, lifestyle intervention, and incidence of type 2 diabetes in impaired glucose tolerance: The Finnish Diabetes Prevention Study. Diabetes Care 2009; 32(11): 1965-1971 https://doi.org/10.2337/dc08-1980
  38. The Korean Nutrition Society. Dietary reference intakes for Koreans, 1st revision. Seoul; 2010
  39. Lee HS, Lee JW, Chang N, Kim JM. The effect of nutrition education and excercise program on body composition and dietary intakes, blood lipid and physical fitness in obese women. Korean J Nutr 2009; 42(8): 759-769 https://doi.org/10.4163/kjn.2009.42.8.759
  40. Moon SJ, Kim HS, Kim JH, Park GS, You YH. The effect of weight control on obese women. Korean J Nutr 1995; 28(8): 759-770
  41. Hong HR, Kang HS, An EN. Relationship of obesity indices with daily physical activity and dietary intake in high school women. Korean J Exerc Nutr 2007; 11(3): 189-197

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