• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제8권1호
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• pp.49-55
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• 2005

목 적: 검증되지 않는 방법이나 성인비만치료 방법을 성장과 발달을 과정에 있는 소아에게 그대로 적용하게 되면, 건강에 악영향을 주게 된다. 여과 없이 무제한적으로 노출되고, 최근 급격히 이용률이 증가하고 있는 정보전달 매체인 인터넷 웹사이트에 소개된 소아 및 청소년 비만치료의 실태 및 문제점에 대해 알아보고자 한다. 방 법: 2004년 7월1일부터 8월1일까지 1개월 동안 야후 코리아의 검색엔진을 사용하여 '소아비만'이라는 검색어로 검색된 203개의 웹 사이트를 대상으로 하였다. 실제 하이퍼텍스트로 접근할 수 없거나 중복된 경우를 제외한 203개의 웹 사이트를 최종분석 대상으로 선별하였다. 각 분석 대상은 의료기관, 피부미용실, 단식원 및 그 외 사설 정보센터로 분류하여, 현재 실행되고 있는 치료 행태의 종류 및 성인비만과는 구분된 소아비만치료의 특수성을 고려하 고 있는지의 여부에 대해 분류하였다. 결 과: 비만치료에 대한 구체적인 항목을 표방한 경우가 157곳(77.3%)였고, 단순한 정보만 제공한 경우가 46곳(22.7%)이었다. '소아비만' 치료를 표방한 사이트의 구성은 한의원(52.2%), 의원 및 병원(35.0%), 그 외 다이어트식품회사, 피부 관리소 등 기타 순이었다. 의원 및 병원 중, 소아과 의원 및 병원은 35곳(22%)에 불과하였으며, 성형외과 7곳, 가정의학과와 내과가 각각 6곳, 정신과와 신경과 2곳 순이었다. 성인과는 구분된 올바른 소아비만 치료를 하고 있는 사이트의 구성은 한의원 중 19곳(23%), 소아과 병원 및 의원 중 26곳(93%), 내과 및 가정의학 과 등 타과 의원 중 7곳(25%)이었으며, 한의원 63곳 (77%), 소아과 이외의 타과 의원 21곳(75%)에서 성인비만치료를 그대로 여과없이 소아비만에 적응하여 치료하고 있었다. 결 론: 소아 비만에 대한 잘못되거나 부정확한 정보가 인터넷 정보로 무분별하게 제공되고 있으므로 소아과 의사의 더 많은 관심과 인터넷을 통한 홍보 관리 시스템의 적극적인 개발이 필요하다.

• Journal of Preventive Medicine and Public Health
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• 제53권1호
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• pp.45-55
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• 2020

Objectives: This study was conducted to explore recent trends in the prevalence of pediatric elevated blood pressure and hypertension (HTN) in Korea and the United States, applying the new HTN reference values for adolescents. Methods: This study analyzed 17 339 (8755 Korean and 8584 American) adolescents aged 10 to 17 who participated in the Korea National Health and Nutrition Examination Survey and the National Health and Nutrition Examination Survey, respectively, between 2005 and 2016. HTN was defined using percentile-based reference values for non-overweight adolescents from 7 nations, and obesity was defined by body mass index (BMI) based on country-specific growth charts. All analyses were stratified by sex and year-over-year changes were evaluated by calculating the p for trend. Results: Systolic blood pressure showed a statistically meaningful upward trend in Korean boys and girls, while diastolic blood pressure did not show any significant changes. Both systolic and diastolic blood pressure levels declined among United States boys and girls. The prevalence of elevated blood pressure and HTN remained similar in Korean adolescents, but declined in both sexes among United States adolescents. BMI increased in both sexes among Korean adolescents, although the overweight and obesity rates stayed the same. No significant trends were found in any obesity indices among United States adolescents. The prevalence of elevated blood pressure and HTN by obesity level was higher among Korean adolescents than among their United States peers in both sexes, and the gap became higher at more severe levels of obesity. Conclusions: Despite the strong correlation between obesity and HTN, recent trends in the prevalence of HTN and obesity among Korean and United States adolescents were strikingly different. Follow-up studies are necessary to determine why the prevalence of HTN was more than twice as high among Korean adolescents than among their United States counterparts.

• 대한치위생과학회지
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• 제4권1호
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• pp.1-9
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• 2021

The purpose of the present study was to investigate the relationship between obesity and dental caries in children and adolescents. This study was analyzed by searching the following words in Google Scholar (https://scholar.google.co.kr), Kiss (kiss.kstudy.com), KCI (www.kci.go.kr), and RISS (riss.kr): "pediatric," "juvenile," "obesity," and "dental caries." A total of 19 Korean and 10 foreign studies out of 107 studies were selected after excluding the studies based on the exclusion criteria. When evaluating the relationship between childhood and adolescent obesity and dental caries, 16 out of 29 articles (55.2%) indicated a significant relationship, and 2 (6.9%) indicated different results based on sex, while 13 articles (44.8%) showed no significant relationship between obesity and dental caries. Among the significant studies, a total of 10 (34.5%) showed that the number of dental caries increased according to an increase in obesity, i.e., from normal to overweight to obese. A total of 5 studies (17.2%) reported that the number of dental caries increased in underweight individuals compared to those of normal weight, or decreased according to an increase in obesity, while 1 study (3.4%) indicated that the number of dental caries increased in both the underweight and obese groups compared to the normal weight group. Therefore, studies on the relationship between dental caries and the degree of obesity in children and adolescents have not shown a certain trend.

• Nutrition Research and Practice
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• 제11권6호
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• pp.492-499
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• 2017

BACKGROUND/OBJECTIVES: This study aimed to investigate the association of dietary patterns with overweight risk and all-cause mortality in pediatric cancer patients. SUBJECTS/METHODS: Prospective cohort study was undertaken; 83 cancer patients admitted to the pediatric cancer ward at a university hospital in Seoul were included and followed for obesity and death over 24 months. Food consumption data were collected from patients using validated meal order sheets for breakfast, lunch, and dinner at the pediatric cancer ward over 3 days. Using principal component analysis, three dietary patterns were derived from 29 food groups. RESULTS: Eighteen deaths occurred among the patient cohort during the follow-up period. The "spicy & fried meat and fish" dietary pattern was positively associated with overweight risk at both baseline [odds ratio (OR) = 4.396, 95% confidence interval (CI) = 1.111-17.385, P for trend = 0.023] and after 6 months (OR = 4.088, 95% CI = 1.122-14.896, P for trend = 0.025) as well as all-cause mortality (hazard ratios = 5.124, 95% CI = 1.080-24.320, P for trend = 0.042), when comparing the highest and lowest tertiles after adjusting for covariates. The "fish, egg, meat, and fruits & vegetables" dietary pattern was associated with lower overweight risk after 24 months (OR = 0.157, 95% CI = 0.046-0.982, P for trend = 0.084). CONCLUSION: The results imply that dietary patterns might be associated with weight gain and premature death among pediatric cancer patients.

• Journal of Nutrition and Health
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• 제48권3호
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• pp.228-235
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• 2015

본 연구는 만 15~19세 남자 고등학생 902명을 대상으로 식행동, 간식 섭취, 식환경, 생활 습관에 대해 설문 조사를 실시하였고, 비만 판정을 위해 신장과 체중을 측정하여 식행동 패턴에 따른 간식 섭취 및 기타 요인과 비만과의 연관성을 분석하였다. 1) 청소년 식생활 지침의 항목을 이용하여 식행동을 평가한 결과 대상자들은 3가지 패턴으로 분류되었다. 식생활과 생활 습관 모두 건강한 패턴과 식생활과 생활 습관 면에서 건강한 요소와 비건강한 요소가 혼재되어있는 혼합 패턴, 그리고 마지막으로 식생활과 생활 습관이 전반적으로 바람직하지 않은 비건강 패턴이었다. 2) 각 패턴 별로 간식 섭취가 차이를 보였는데, 건강한 패턴은 과일, 우유, 호상요구르트의 섭취 빈도가 높았고, 혼합 패턴은 과일이나 호상요구르트 섭취 빈도가 높은 반면 라면, 아이스크림, 탄산음료, 사탕 섭취 빈도도 같이 높았으며, 비건강 패턴은 과일, 우유, 호상요구르트의 섭취 빈도가 다른 두 패턴에 비해 가장 낮은 반면 라면, 단 간식, 탄산음료 등의 간식 섭취 빈도는 가장 높았다. 3) 식환경을 포함한 생활 습관 요인도 패턴마다 상이했는데, 가정 내 식품 비치율은 각 식품 섭취 빈도와 유사하게 건강한 패턴과 혼합 패턴의 가정 내 과일 비치율이 비건강 패턴에 비해 높았다. 또한 혼합 패턴이 건강기능성 식품이나 식이 보충제 복용 비율이 가장 높았고, 비건강 패턴은 식사 속도, 수면 시간은 짧고 스크린 시간이 하루 2시간 이상인 비율이 가장 높았다. 4) 패턴 별 비만과의 연관성은 건강한 패턴을 기준으로 하였을 때, 혼합 패턴의 교차비는 1.11이었으나 유의하지 않았고, 비건강 패턴의 교차비는 1.88로 유의적이었다. 이상의 결과로부터 청소년의 식행동 패턴에 따라 간식 섭취 뿐 아니라 식습관, 생활 습관 요인이 차이를 보였으며 이러한 요인들이 비만과의 연관성에도 영향을 주었다. 식행동은 식품 섭취나 생활 습관 요인들과 서로 상호작용을 하므로 앞으로 청소년 비만 예방 및 관리를 위한 전략으로 적절한 영양 교육과 함께 식행동과 생활 습관을 함께 개선해 나갈 수 있는 방안을 모색하는 것이 필요하다.

• Clinical and Experimental Pediatrics
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• 제54권7호
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• pp.282-286
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• 2011

Breastfeeding is the best source of nutrition for every infant, and exclusive breastfeeding for 6 months is usually optimal in the common clinical situation. However, inappropriate complementary feeding could lead to a nutrient-deficient status, such as iron deficiency anemia, vitamin D deficiency, and growth faltering. The recent epidemic outbreak of obesity in Korean children emphasizes the need for us to control children's daily sedentary life style and their intakes of high caloric foods in order to prevent obesity. Recent assessment of breastfeeding in Korea has shown that the rate is between 63% and 89%; thus, up-to-dated evidence-based nutritional management of breastfeeding infants to prevent common nutrient deficiencies or excesses should be taught to all clinicians and health care providers.

• Clinical and Experimental Pediatrics
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• 제49권7호
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• pp.710-717
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• 2006

Type 2 diabetes mellitus in children and adolescents has been increasing for last 10 years. The increase in frequency of type 2 diabetes appears to parallel the increase in prevalence and severity of obesity in children and adolescents. The metabolic syndrome, cluster of potent risk factors for atherosclerotic cardiovascular disease and type 2 diabetes, consists of insulin resistance, obesity, hypertension and hyperlipidemia. The atherosclerotic cardiovascular disease are rarely seen in the young, but the pathologic processes and risk factors are associated its development have been shown to begin during childhood. In pediatrician it is important to recognize early and treat aggressively for prevention of future cardiovascular disease in children and adolescents with metabolic syndrome.

• Clinical and Experimental Pediatrics
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• 제61권12호
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• pp.375-380
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• 2018

With the increase in the prevalence of overweight and obesity worldwide, early adiposity rebound, which is known to have a strong association with obesity, has recently been a focus of research. Early adiposity rebound is conventionally known to have a close relationship with non-communicable diseases. However, novel insights into early adiposity rebound have implied an acceleration of growth and puberty, which is directly reflected in the trends in the timing of adiposity rebound, in the 21st century compared with in the past. Furthermore, the observation that lean mass changes rather than fat mass changes show a more similar pattern to body mass index trajectories is interesting. In this article, the later outcomes and risk factors of early adiposity rebound are briefly summarized, and the current trends in the timing of adiposity rebound and novel insights into its relationship with body composition are reviewed.

• Clinical and Experimental Pediatrics
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• 제61권4호
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• pp.121-128
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• 2018

Purpose: Obesity has been associated with higher total blood mercury levels, based on animal studies; however, studies that focus on children and adolescents are lacking. We aimed to assess the association between total blood mercury levels and the incidence of overweight and abdominal obesity in Korean adolescents. Methods: The study population comprised 1,567 adolescents (793 boys and 774 girls; aged 10-19 years), who participated in the Korea National Health and Nutrition Examination Survey 2010-2013. We analyzed total blood mercury levels according to obesity status in all participants. Results: The geometric mean of total blood mercury levels was $1.93{\mu}g/L$. Participants with overweight ($2.20{\mu}g/L$) and obesity ($2.17{\mu}g/L$) had higher levels than those with normal weight ($1.86{\mu}g/L$, P<0.0001). The prevalence of overweight significantly increased with elevation of the total blood mercury quartile in both sexes. Increased incidence of abdominal obesity corresponding to increased total blood mercury level was observed in boys. After adjusting for covariates, those in the highest total blood mercury quartile were found to be at higher risk of overweight/obesity than those in the lowest quartile in both sexes (odds ratio [95% confidence interval]: boys, 3.27 [1.66-6.41]; girls, 1.90 [1.03-3.49]). The association between total blood mercury quartile and abdominal obesity was significant after controlling for covariates in boys (2.35 [1.05-5.24]). Conclusion: Our results suggest an association between total blood mercury levels and overweight in Korean adolescents.

• Clinical and Experimental Pediatrics
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• 제62권7호
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• pp.261-268
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• 2019

Purpose: This study aimed to evaluate the time trends of waist circumference (WC) and waist-height ratio (WHR), and to present WC and WHR distributions with optimal WHR cutoff for abdominal obesity in Korean children and adolescents. Methods: We performed a retrospective cross-sectional analysis of data from 13,257 children and adolescents (6,987 boys and 6,270 girls) aged 6-18 years who were included in the third to sixth Korea National Health and Nutrition Examination Survey (KNHANES, 2005-2015). Linear regression analyses were used to identify secular changes in WC and WHR by age, sex, and KNHANES waves. A receiver operating characteristic curve analysis was used to determine the optimal WHR cutoff values for abdominal obesity and cardiometabolic risk factors. Results: The mean WC and WHR distributions from 2005 to 2015 showed no significant secular changes between the KNHANES 4 waves (P for trend ${\geq}0.05$ in all ages and both sexes). The mean WCs in the present study were lower than those in the 2007 Korean National Growth Charts. The mean WHR at ages <13 years was statistically higher in the boys than in the girls, but did not significantly differ between the sexes among those aged 13 to 18 years. The optimal WHR cutoff for abdominal obesity was 0.48 (area under the curve, 0.985; 95% confidence interval, 0.985-0.985) in the 13- to 18-year-old adolescents. Conclusion: WC and WHR showed no secular changes over 10 years. The optimal WHR cutoff for abdominal obesity of 0.48 is useful for diagnosing and managing obesity and thus preventing obesity-related cardiometabolic complications in 13- to 18-year-old Korean adolescents.