• Clinical and Experimental Pediatrics
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• v.59 no.5
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• pp.231-238
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• 2016

Purpose: Lipopolysaccharide-binding protein (LBP) is a 65-kDa acute phase protein, derived from the liver, which is present in high concentrations in plasma. Data regarding the association between circulating plasma LBP levels and obesity-related biomarkers in the pediatric population are scarce. We aimed to determine whether there was a difference in plasma LBP levels between overweight/obese and normal-weight adolescents and to assess the correlation of circulating LBP levels with anthropometric measures and obesity-related biomarkers, including insulin resistance, liver enzyme levels, and lipid profiles. Methods: The study included 87 adolescents aged 12-13 years; 44 were overweight/obese and 43 were of normal-weight. We assessed anthropometric and laboratory measures, including body mass index (BMI), blood pressure, insulin resistance, liver enzyme levels, and lipid profiles. Plasma LBP levels were measured using an enzyme-linked immunosorbent assay. Results: The mean age of the participants was $12.9{\pm}0.3$ years. Circulating plasma LBP levels were significantly increased in overweight/obese participants compared with those in normal-weight participants ($7.8{\pm}1.9{\mu}g/mL$ vs. $6.0{\pm}1.6{\mu}g/mL$, P<0.001). LBP levels were significantly and positively associated with BMI, systolic blood pressure, aspartate aminotransferase, alanine aminotransferase, total cholesterol, low density lipoprotein-cholesterol, fasting glucose and insulin, and insulin resistance as indicated by the homeostatic model assessment of insulin resistance (HOMA-IR) (all P<0.05). In multivariate linear regression analysis, BMI and HOMA-IR were independently and positively associated with plasma LBP levels. Conclusion: LBP is an inflammatory biomarker associated with BMI and obesity-related insulin resistance in adolescents. The positive correlation between these parameters suggests a potentially relevant pathophysiological mechanism linking LBP to obesity-related insulin resistance in adolescents.

• Clinical and Experimental Pediatrics
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• v.52 no.12
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• pp.1321-1326
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• 2009

Prevalence of obesity in Korean children and adolescents has dramatically increased since the last 10-20 years. It is important to initiate prevention efforts early in childhood because prevalence of obesity in adolescence is the strongest predictor of its prevalence in adulthood. Intrauterine life, infancy, and preschool years may comprise the critical periods that are essential for the long-term regulation of energy balance therefore, obesity-prevention strategies should be initiated in utero and continued throughout childhood and adolescence. Families with high-risk children should be provided early education about maintaining normal weight. Encouraging physical activity and, especially, avoiding inactivity, are key challenges in the prevention of future obesity. Schools should be primarily involved in educating parents to discourage their children from excessively watching TV or playing computer games and eating unhealthy snacks and food. The involvement of medical practitioners is also important, especially, in the case of obese parents, obesity prevention strategies should be promoted from the first visit of pregnant women to the physicians. Health professionals can also be involved in obesity prevention because they are ideally equipped to identify young children at risk of obesity. Community and nation-wide efforts to increase awareness and promote environments that encourage physical activity and healthy nutrition are required.

• Clinical and Experimental Pediatrics
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• v.49 no.10
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• pp.1037-1041
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• 2006

Purpose : The prevalence of obesity and nonalcoholic steatohepatitis(NASH) was increased in adolescents. This study was performed to observe the prevalence of elevated aminotransferase levels in adolescents and to assess the correlations between aminotransferase levels and obesity related parameters(body mass index, waist circumference, hip circumference, waist to hip ratio and insulin level). Methods : We obtained weight, height, waist circumference and hip circumference from 2,417 male and 1,219 female adolescents. Mean age was $15.7{\pm}0.7$ years old. We measured fasting insulin, aspartate aminotransferase(AST) and alanine aminotransferase(ALT). Obese and overweight were defined as body mass indices(BMI) of more than the 95th, and 85th-94th percentiles, respectively, for age and sex. Results : The number of adolescents with obesity is 324(8.9 percent). 414(11.4 percent) subjects belonged to the overweight group. The average ALT level of obese, overweight and control groups were significantly different(obese : $32.1{\pm}34.3U/L$, overweight : $19.6{\pm}13.6U/L$, control : $12.7{\pm}6.7U/L$, P<0.001). The average AST level was also different according to group(obese : $27.8{\pm}16.5U/L$, overweight : $22.8{\pm}8.6U/L$, control : $20.8{\pm}8.5U/L$, P<0.001). AST and ALT were correlated with anthropometric parameters and insulin level. After multiple regression analysis, waist circumference was the significant predictive value for AST(r=0.234, P<0.001). Waist circumference, BMI and insulin levels were significant predictive values for ALT(r=0.435, P<0.001). Conclusion : The prevalence of abnormal aminotransferase was higher in the obese and overweight groups than control group. Waist circumference was useful to predict abnormal aminotransferase levels.

• Clinical and Experimental Pediatrics
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• v.51 no.6
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• pp.604-609
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• 2008

Purpose : Obesity in children and adolescence is highly correlated with adult obesity, which can provoke hypertension. Therefore, it is important to evaluate the blood pressure of obese children regularly. In this study, the results of ambulatory blood pressure monitoring (ABPM) in obese children and adolescents were evaluated. Methods : ABPM was conducted for selected patients who visited Handong University Sunlin Hospital from Feb. 1, 2006 to Dec. 1, 2007. The patients were classified into 3 groups: group 1 was normal, group 2 had normal casual blood pressure and a body mass index over the 95th percentile, and group 3 had high casual blood pressure over 120/80 mm Hg and a body mass index over the 95th percentile. Systolic and diastolic 24-hour blood pressure was measured, including both day and night. Results : There were 49 patients in the study. The results showed a significant difference for average systolic blood pressure between the three groups ($105.1{\pm}4.7$, $111.0{\pm}7.1$, $117.8{\pm}6.6mmHg$, P<0.001), but for average diastolic blood pressure only between groups 1 and 3 ($69.1{\pm}5.3$, $77.9{\pm}6.3mmHg$, P=0.001). In the daytime, only groups 1 and 3 showed a statistically significant difference for systolic and diastolic blood pressure. During the night the systolic pressure of group 3 was significantly higher than the other groups, but the diastolic pressure of group 3 was only higher than that group 1. No statistical difference was found in night dips among the groups. Conclusion : Ambulatory blood pressure monitoring in children and adolescents showed statistically higher blood pressure in obese patients with high casual blood pressure.

• Clinical and Experimental Pediatrics
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• v.50 no.8
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• pp.767-773
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• 2007

Purpose : Obesity has become a pandemic and especially the prevalence of childhood obesity has increased remarkably over the past years. Childhood obesity is often accompanied by the expected morbidities such as hyperlipidemia, fatty liver and glucose intolerance. We evaluated the pattern of alteration in the body mass index (BMI), serum adiponectin concentration, insulin resistance (HOMA-IR), and complication rates after one year follow-up. Methods : Forty two obese children (age: 8-15 years, 95th percentile of BMI for age and sex) were examined twice annually on June, 2004 and July, 2005. The body mass index (BMI) and sexual maturityrating (SMR) were determined annually by the same examiner and serum fasting glucose, liver enzyme, lipid profiles, adiponectin, insulin and HOMA-IR were measured and annual results were compared. Upper abdominal sonography was performed to detect fatty liver. Results : BMI ($25.3{\pm}2.9kg/m^2$ vs. $26.0{\pm}2.9kg/m^2$) and HOMA-IR ($3.6{\pm}1.8$ vs. $4.7{\pm}1.9$) have increased significantly after one-year follow-up. The serum adiponectin concentration ($17.2{\pm}5.2g/mL$ vs. $12.6{\pm}5.2g/mL$) has decreased after one year. The prevalence of hyperlipidemia and fatty liver were not changed significantly but that of hyperinsulinemia increased after one-year. HOMA-IR showed a positive correlation with BMI and SMR, but was negatively correlated with serum adiponectin concentration. Conclusion : Obese children in our study showed significant increment of insulin resistance during one year. These results suggest that well-organized and continuous obesity control is required especially for obese adolescent to prevent complication of obesity.

• Journal of Life Science
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• v.21 no.2
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• pp.322-327
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• 2011

The effects of green tea consumption and/or exercise for 12weeks on body weight and select biochemical markers in plasma were evaluated in obese adolescents with a fat ratio of greater than 25%. The subjects were randomly divided into a control group (n=9), green tea consumption group (n=9), exercise group (n=9) and green tea consumption with exercise group (n=9). Subjects in both green tea consumption group and green tea consumption with exercise group were given more than five cups of green tea extract in hot water ($90^{\circ}C$) daily, equivalent to 1.5-1.7 g dry green tea, for 12 weeks. Subjects in both the exercise group and green tea consumption with exercise group participated in a training program (HRmax 60-70%, 60 min/day) for 12 weeks. Control subjects were only given water equal to the quantity of green tea being given to the subjects of green tea consumption. No significant changes body weights were seen in any of these treatments, but the waist to hip ratio was reduced with treatments of both green tea and exercise. The control group showed no significant changes in TNF-$\alpha$, IL-6 and leptin levels. Green tea consumption reduced leptin (p<0.05), TNF-$\alpha$, and leptin levels. Exercise lowered TNF-$\alpha$ (p<0.05), IL-6 (p<0.01), and leptin (p<0.05) concentrations. Meanwhile, a combination of green tea consumption and exercise lowered TNF-$\alpha$, IL-6 (p<0.05) and leptin (p<0.05) levels. These results indicate that green tea consumption and exercise both had a positive effect on the reduction of inflammatory cytokines, TNF-$\alpha$, IL-6 and leptin, in obese adolescents, but no synergistic effect on the reduction of these cytokines.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.15
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• pp.6273-6278
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• 2015

Objective: This study assessed the association between subjective body image or objective body mass index (BMI) and the risk of daily smoking in Korean adolescents, with a purpose of identifying the most suitable models. Materials and Methods: Using the 2013 9th Korea Youth Risk Behavior Web-based Survey data for 72,435 students, odds ratios were calculated for daily smoking in the past month, according to the subjective body image and calculated BMI using a respective multiple logistic regression model. The combined effect of these two factors was also analyzed by pairing a BMI category with a subjective body image category, using odds ratios for the same event within each sex group. Results: Among the surveyed students, 7.2% of boys and 1.8% of girls were classified as daily smokers. Students who perceived themselves as being very obese tended to be at lower risk of daily smoking (OR=0.61 in boys with 95% CI=0.47 to 0.79; OR=0.66 in women with 95% CI=0.47 to 0.93). In addition, boys within the obese or overweight BMI category showed a lower risk of daily smoking (OR=0.86, 95% CI: 0.77-0.96). Lean BMI was significantly associated with higher odds ratios for daily smoking only in female students (OR=1.24, 95% CI: 1.02-1.52). When pairing these two objective and subjective factors, results suggested that subjective body image has a greater effect on daily smoking than BMI in both boys and girls. Conclusions: In both male and female students, subjective body image had a greater effect on daily smoking than body mass index. A model using the combination of BMI and subjective body image was the best fit in girls, in contrast to the model using subjective body image only best suitable in boys, for the prediction of daily smoking. These results including several factors associated with daily smoking in Korean students, provide useful data for the development and implementation of smoking intervention and cessation programs for adolescents.

• Journal of Korean Home Economics Education Association
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• v.28 no.2
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• pp.41-50
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• 2016

Fast foods are very popular to adolescent and the sales are increasing due to the convenience, low price, and a broad scale advertisement through mass media. Fast foods are often named as junk foods because of high calorie and fat, low vitamins and minerals contents. This study investigated the intake frequency of hamburger, pizza and fried chicken, the 3 representative fast foods, in 306 male and female high school students living in Daejeon. Data were collected by food frequency questionnaire, and analyzed by SPSS(ver. 18.0). Intake frequency of hamburger, pizza and fried chicken were 33, 29, 17 times per year, respectively. Intake frequency of these 3 fast foods were not sig. different by BMI obesity, breakfast and supper meal frequency, and first time of fast foods intake. But intake frequency of fast foods were different by the allowance, intake frequence of pizza and fried chicken are higher in students with higher allowance. Restrain score of fast foods intake were higher in underweight and obese than normal weight students. There were no sig. difference of intake restrain score by preferable future body figure. As conclusion, the most effective way of reducing the fast food intake frequency in adolescent were cutting down the allowance. Besides that education based on analysis about what are the specific nutritional defects in each fast food may help to change the behavior of fast foods intake.

• Korean Journal of Community Nutrition
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• v.23 no.4
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• pp.302-318
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• 2018

Objectives: This study examined the differences in dietary life and health related factors, such as drinking behavior, exercise and leisure activities, mental health, and subjective perception for oneself according to obesity in poor urban Peruvian adolescents. Methods: A total of 1,532 Peruvian adolescents were selected from six schools in poor regions using stratified random sampling. The subjects were classified into two groups based on their BMI: 'normal weight group (NW group=980)' or 'overweight and obese group (OWOB group=293)'. The differences in the general characteristics, dietary life, drinking behavior, physical activity and leisure, mental health and subjective perception of oneself in the two groups were compared. ${\chi}^2$ analysis and independent sample t-test were performed using the SPSS program ver. 24. Results: For the total and male students, the frequency of breakfast and dinner were significantly lower in the OWOB group than in the NW group (all p<0.001). For total and female students, the percentage of subjects who received nutrition education was significantly higher in the OWOB group than in the NW group (all p<0.05). For total students, the percentage of subject who exercised more than five days/week was lower in the OWOB group than in the NW group (p<0.05). For the total and female students, the subjective health status was worse in the OWOB group than in the NW group (all p<0.05). The subjective body image was significantly different between the OWOB group and NW group in the total, male and female subjects (all p<0.001). Conclusions: The frequency of meals and exercise, and the subjective perceptions of the health status and body image differed according to obesity in poor urban Peruvian adolescents. Therefore, a school-based intervention program focused on regular meal and exercise, and adequate subjective perceptions for health status and body image need to be developed to prevent adolescent obesity.

• Korean Journal of Community Nutrition
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• v.22 no.3
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• pp.191-206
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• 2017

Objectives: The present study systematically reviewed previous studies published in Korea regarding obesity status of children and adolescents in order to provide valid directions for future research and to help establish evidence-based prevention strategies. Methods: The articles were selected by searching the primary keyword 'obesity' and the secondary keywords 'children', 'young children', 'adolescents' or 'kids' on the KISS (Korean Studies Information Service System). Out of 503 articles excluding the overlap, 308 articles were selected with inclusion and exclusion criteria. Secular trends of obesity research, distribution of subjects, potential risk factors for obesity, and intervention method for obesity management were documented. The associations between obesity and dietary factors were summarized. Results: The overall number of research studies has increased since 2000 but obesity management studies have decreased in recent years. Most of the studies used a cross-sectional design. Research on preschool children were extremely limited. Intervention studies targeting males were prevalent. The most significant variables relevant to dietary habits were speed of eating, regular breakfast and snacking. The most significant food and nutrient intake factors were thiamin and iron. Intakes of cereals and animal foods were significantly higher in obese children than the counterparts. Conclusions: The present review of locally published articles on the obesity status in children and adolescents suggested the need for well-designed further studies focused on risk factors of obesity and on a range of intervention methods conducive to the development of obesity prevention and management programs.