• Clinical and Experimental Pediatrics
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• v.48 no.6
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• pp.588-593
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• 2005

Purpose : Obesity is associated with disturbances of ventilatory functions in adults. But few studies have evaluated the pulmonary complications of obesity in the pediatric population. The purpose of this study is to clarify the effects of obesity on pulmonary function and body composition in obese children. Methods : Forty seven obese children whose ages ranged from nine to twelve years were evaluated for their body composition(intracellular fluid, extracellular fluid, protein mass, mineral mass, soft lean mass, fat mass, percent body fat, fat distribution) by bioelectrical impedance analysis. Hemoglobin, serum glucose, aspartate aminotransferase(AST), alanine aminotransferase(ALT), total cholesterol and triglycerides were measured. Pulmonary function test was performed by spirometer. Results : Intracellular fluid, protein mass, fat mass, percent body fat and fat distribution were significantly higher in severely obese children with an obesity index of more than 150 percent compared with those with an index of less than 150 percent. Peak expiratory flow rate(PEFR) was significantly lower in severely obese children with obesity index of more than 150 percent compared with those with less than 150 percent($241.7{\pm}14.6L/sec$ vs $276.8{\pm}64.3L/sec$). PEFR, forced expiratory flow 25 percent($FEF_{25}$), mid expiratory flow rate(MEFR), forced expiratory flow 50 percent($FEF_{50}$), forced expiratory volume in 1st second($FEV_1$) and forced vital capacity(FVC) were decreased in 37.0 percent, 14.8 percent, 14.8 percent, 11.1 percent, 3.7 percent and 3.7 percent of obese children, respectively. Conclusion : PEFR was significantly decreased in obese children. Pulmonary function test must be performed in severely obese children and more extended study is needed in other age groups.

• Tuberculosis and Respiratory Diseases
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• v.54 no.2
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• pp.210-218
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• 2003

Background : Sex specific cross sectional reference values for the lung function indices usually employ a linear model with a term for age and height. The purpose of this study was to determine the effects of the body mass index (BMI), the fat percentage of the body mass and the fat-free mass index (FFMI) on the forced expiratory volume curve. Methods : Between January 2000 and December 2001, a total of 300 subjects, 150 men and 150 women (mean age : $45{\pm}13$ years), with a normal lung function were enrolled in the study sample. This study measured the $FEV_1$, FVC and $FEF_{25-75%}$ from the forced expiratory volume curve by a spirometer and the body composition by a bioelectrical impedance method in all subjects. Multiple regression analysis was used in order to examine the effects of the body composition on the parameters derived from the forced expiratory volume curve. Results : After adjusting for age, the BMI and Fat percentage improved the descriptions of the FVC (p<0.05, $r^2=0.491$) and $FEV_1$ (p<0.05, $r^2=0.654$) in women. In contrast, the FFMI contributed significantly to the FVC (p<0.05, $r^2=0.432$) and $FEV_1$ (p<0.05, $r^2=0.567$) in men. The $FEF_{25-75%}$ correlated with the fat percentage in women (p<0.05, $r^2=0.337$). Conclusion : These results suggest that the BMI, the fat percentage and the FFMI are significant determinants of the forced expiratory volume curve. The plmonary function test, when considering the BMI, the fat percentage and the FFMI, might be useful in clinical applications.

• Tuberculosis and Respiratory Diseases
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• v.52 no.4
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• pp.346-354
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• 2002

Background : Dyspnea and a limitation in exercise performance are important cause of disability in patients with chronic obstructive pulmonary disease(COPD). A depleted nutritional state is a common problem in patients with a severe degree of chronic airflow limitation. This study was carried out to assess the factors determining the maximum exercise capacity in patients with COPD. Methods : The resting pulmonary function, nutritional status, and maximum exercise performance was assessed in 83 stable patients with moderate to severe COPD. The nutritional status was evaluated by bioelectrical impedance analysis. Maximum exercise performance was evaluated by maximum oxygen uptake($VO_2max$). Results : Among the 83 patients, 59% were characterized by nutritional depletion. In the depleted group, a significantly lower peak expiratory flow rate(p<0.05), Kco(p<0.01) and maximum inspiratory pressure(p<0.05), but a significantly higher airway resistance(p<0.05) was observed. The maximum oxygen uptake and the peak oxygen pulse were lower in the depleted group. The $VO_2max$ correlated with some of the measures of the body composition : fat-free mass(FFM), fat mass(FM), body mass index(BMI), intracellular water index(ICW index), and pulmonary function : forced vital capacity(FVC), forced inspiratory vital capacity(FIVC), diffusion capacity(DLCO) : or maximum respiratory pressure : maximum inspiratory pressure(PImax), maximum expiratory pressure(PEmax). Stepwise regression analysis demonstrated that the FFM, DLCO and FIVC accounted for 68.8% of the variation in the $VO_2max$. Conclusion : The depletion of the FFM is significant factor for predicting the maximum exercise performance in patients with moderate to severe COPD.

• Journal of Nutrition and Health
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• v.41 no.2
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• pp.156-164
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• 2008

The purpose of this study was to investigate factors related to bone mineral contents (BMC) at os calcis of adolescents. The subjects were 604 students (327 boys and 277 girls) between 7th and 9th grade in Seoul, Korea. The mean age was 14.2 ${\pm}$ 0.9 years. General characteristics were collected by a questionnaire, bone mineral contents (BMC) were measured in os calcis by Duel Energy X-ray Absorptiometry (PIXI, General Electronics, USA) and height and weight were measured by bioelectrical impedance analysis method (Inbody 4.0, Biospace Co. Ltd, Seoul, Korea). Mean BMC of os calsis were 2.241 g. Height (p <.0001), weight (p <.0001I), BMC (p <.0001I) ofboys were higher than those of girls. Percent body fat of girls, however, was higher than that of boys (p <.0001). Anthropometric measurement, pocket money, sibling, experience of fracture, pubertal stage, intake of supplements, physical or outdoors activity, and eating habit had significant influence on BMC of boys. Anthropometric measurement, physical or outdoors activity, and eating habit had significant influence on BMC of girls. Multivariate regression with adjustment for sex and age showed that BMC was associated positively with height, BMI, frequency of regular activity, and intake of spinach or radish leaves (all p <0.05), and negatively with percent body fat (p <.0000 and Korean traditional diet pattern (p = 0.01). On the basis of these results, it is recommended to develop nutrition education and physical activity program for adolescents to improve BMC and prevent osteoporosis.

• Clinical and Experimental Pediatrics
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• v.53 no.3
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• pp.335-340
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• 2010

Purpose : This study was designed to determine the effects of a school-based obesity-management program on obese primary school children. Methods : A total of 995 children (6-2 years old) in a primary school were screened in March 2008, and of those, 101 obese students (44 boys and 57 girls, body mass index (BMI) ${\geq}95$ percentile) were enrolled for a study group. The schoo-lbased, obesity management program, which includes physical exercise and nutritional education, was conducted as part of an extracurricular program for 12 weeks. The measurement of height, weight, waist circumference, blood pressure (BP), and bioelectrical impedance analysis (BIA) was performed before and after the program.Results : Height and weight increased significantly (P <0.05). The BMI and obesity index decreased significantly (P <0.01). Systolic and diastolic BP decreased significantly (P <0.01). BMI decreased in 61.4% of boys and 66.7% of girls. Protein and basal metabolic rate (BMR) increased significantly on the BIA (P <0.01). Fat decreased significantly (P <0.05). The total body water (TBW) and percent body fat (PBF) decreased significantly (P <0.01). The changes in protein, fat, TBW, PBF, and BMR significantly correlated to the change in BMI (P <0.05). In a multiple logistic regression analysis, BMI change was significantly correlated to the changes in protein and fat content (P <0.01). Conclusion : The school-based obesity management program is a very effective way to manage obesity for obese primary school children.

• Tuberculosis and Respiratory Diseases
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• v.51 no.6
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• pp.570-578
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• 2001

Background: With cases of chronic obstructive pulmonary disease(COPD), weight loss and low body weight have been found to correlate with increased mortality and poor prognosis. Therefore, nutritional aspects are an important part of the treatment in cases of COPD. In Korea, there is only limited data available for the changes of resting pulmonary function in relation to nutritional status. This study was carried out to investigate the differences of resting pulmonary function in relation to the nutritional status of patients with COPD. Method : 83 stable patients, with moderate to severe COPD, were clinically assessed for their nutritional status and resting pulmonary function. The patients' nutritional status was evaluated by body weight and fat-free mass (FFM), which was assessed by bioelectrical impedance analysis. According to their nutritional status, the 83 patients were divided into two groups, designated as the depleted, and non-depleted, groups. Result : Of the 83 patients, 31% were characterized by body weight loss and depletion of FFM, whereas 28% had either weight loss or depleted FFM. In the depleted group, significantly lower peak expiratory flow rate(p<0.05) and Kco(p<0.01), but significantly higher airway resistance(Raw, p<0.05) were noted. There was no difference for the non-depleted group in forced expiratory volume at one second, residual volume, inspiratory vital capacity, or total lung capacity. Maximal inspiratory pressure($P_{Imax}$) was also significantly lower in the depleted group(p<0.05). Conclusion : We conclude, from our clinical studies, that nutritional depletion is significantly associated with the change in resting pulmonary function for patients with moderate to severe COPD.