제주시 지역 일부 초등학교 비만아동의 간식 섭취 실태

Abstract

본 연구는 제주시 지역 일부 초등학교 4·5학년 비만아동 117명(남자 70명, 여 자 47명)과 정상체중아동 117명(남자 70명, 여자 47명)을 대상으로 설문지를 이 용하여 일반사항, 체중감량 관련 식행동, 간식 식습관을 조사하였으며 24시간 회 상법을 이용하여 식이섭취실태를 조사한 결과는 다음과 같다. 조사대상자의 평균 신장, 체중 및 비만도는 각각 정상체중아동은 143.8cm, 38.5kg, -0.42%이며 비만아동은 147.5cm, 56.6kg, 35.4%로 신장, 체중, 비만도 모두 체중군에 따라 유의한 차이가 있었다. 조사대상자의 체중감량 관련 식행동에서 식사량 감소 경험이 '있다'라고 응답한 정 상체중군은 26.3%이고, 비만군은 77.6%로 유의적인 차이를 보였다(p<0.001). 살찌는 음식임을 고려하며 먹는 비율로 정상체중군은 20.2%, 비만군은 31.8%로 비만아동이 더 높았다(p<0.001). 식사량을 감소하는 끼니에서 정상체중군의 경우 '주로 간식만 줄 인다'는 비율이 48.8%이고, 비만군에서는 '저녁 식사를 줄인다'고 응답한 비율이 54. 2%로 가장 높았다(p<0.01). 체중 감량을 위해 섭취량을 줄인 음식의 종류는 과자류, 사탕․초콜릿류, 햄버거 등의 패스트푸드류, 튀김류, 빵․케익류, 아이스크림류, 육류, 음료류, 밥류, 기타의 순이었다. 섭취량을 줄인 비만아동이 정상체중아동에 비해 이들 음식의 섭취량을 더 줄이고 있으며, 그 차이는 유의적이었다. 조사대상자의 간식 섭취 이유로는 '배가 고파서'가 64.1%, '심심해서'는 12% 순으로 나타났으며, 성별과 체중군별 유의적인 차이는 없었다. 간식 섭취 횟수에서 일반 간 식의 경우 정상체중군은 일주일에 2.1회, 비만군은 일주일에 1.6회 섭취하는 것으로 나타났으며, 체중군간에 유의한 차이를 보였다(p<0.01). 학교나 학원 주변 간식의 경 우는 정상체중군과 비만군 모두 일주일에 1.0회 먹는다고 응답하였다. 일반 간식과 학교나 학원 주변 간식을 합하여 분석할 경우 정상체중군은 일주일에 3.1회이나, 비 만군은 일주일에 2.6회 먹는다고 응답하였다. 일반 간식에서 자주 먹는 간식 음식은 과일·과일주스가 41.9%, 과자·사탕·초콜릿이 38.9%, 우유·요구르트가 35.9% 순으로 높게 나타났다. 학교나 학원 주변 간식에서는 김밥·삼각김밥·떡볶이·순대 45.3%, 아이스크림 44.9%, 과자·사탕·초콜릿 32.5% 순으 로 높게 나타났으며, 체중군별 간식 선택 음식의 종류에는 유의적 차이가 없었다. 간식음식을 저열량고영양 간식과 고열량저영양 간식으로 구분하고, 간식 음식 선택 여부와 섭취 횟수를 고려한 섭취 수준을 비교하였을 때, 저열량고영양 간식은 정상 체중군 6.0±8.0, 비만군은 4.0±7.2로, 비만군이 정상체중군보다 유의적으로 낮은 섭취량을 보였으나(p<0.05), 고열량저영양 간식에서는 정상체중군 11.8±13.8, 비만 군 10±12.7로 체중군간 유의적인 차이는 없었다. 이는 비만아동들이 간식을 적게 먹는다고 응답하였으나 간식 음식 선택에서 저열량고영양 간식음식 선택 수준이 낮은 것을 보여주고 있다. 조사대상자의 열량 섭취량은 정상체중군 1653.4kcal, 비만군 1712.8kcal로 에너지 필요추정량의 83.7%, 86.8%에 해당하였고, 체중군별 유의적인 차이를 보이지 않았다. 조사대상자의 총 열량에 대한 아침, 점심, 저녁, 간식의 열량은 289.8kcal, 569kcal, 499.2kcal, 325.1kcal였으며, 끼니별 열량 섭취 비율은 17.2%, 33.8%, 29.7%, 19.3%로 나타났다. 끼니별 영양소 섭취 비율 중 다른 끼니에 비해 간식으로 섭취하는 비율이 높은 영양소는 칼슘이 42.9%, 비타민B2가 27.3%이었다. 이는 학교에서 제공되는 우 유급식과 관련이 있는 것으로 보여졌다. 간식으로 섭취하는 열량 비율이 높은 식품군은 식물성 식품에서는 음료류(60.5%), 당류(52.1%)순으로 나타났으며, 동물성 식품에서는 우유 및 유제품류(86.4%)로 나타 났다. 간식의 섭취 열량은 정상체중군이 330.3kcal, 비만군은 319.9kcal이며 유의한 차 이는 없었다. 특정 간식 음식을 섭취한 아동만 대상으로 분석하였을 때, 사탕․초콜 릿류에서 정상체중군이 84.6kcal, 비만군이 182.9kcal로 비만군이 유의적으로 더 많이 섭취하고 있었다(p<0.01). 이상의 결과를 종합해 볼 때 체중 감량 식행동에서 비만군이 정상체중군에 비해 체중 감량을 위해 노력하는 것으로 나타났다. 간식의 섭취 빈도에서는 아동의 비만도 와 관련이 없는 것으로 나타났으나, 간식의 선택 부분에서 비만군이 정상체중군보다 저열량고영양 간식을 유의적으로 낮게 섭취하는 것으로 나타났다. 반면 고열량저영양 간식은 유의적인 차이를 보이지 않은 것으로 나타나 비만군의 경우, 체중 감량을 위 해 무조건 식품 섭취의 양을 줄이는 것이 아니라 올바른 식품 선택을 할 수 있도록 영양교육이 필요하다고 생각된다.

This research was carried out using a survey with 117 obese children (70 boys and 47 girls) and 117 normal weight children (70 boys and 47 girls) in 4th to 5th grade in some of the elementary students located in Jeju as targets on their general details, dietary habits related to weight reduction, and snack intake habits. The dietary intake results that were found out using the 24 hour retrospection method are as follows. The normal weight children's average height, weight and degree of obesity were 143.8cm, 38.5kg, and -0.42% respectively while the overweight children's figures were 147.5cm, 56.6kg, and 35.4% respectively, demonstrating a significant difference in all weight groups of height, weight and degree of obesity. The normal weight group who answered 'yes' to the question as to whether they have experienced a reduction in the food intake related to weight loss amounted to 26.3% while the overweight group amounted to 77.6% showing another significant difference (p<0.001). The rate of children who considered about the issue of fatty foods amongst the normal weight group was 20.2% while the overweight group showed 31.8% showing a higher rate awareness amongst the overweight children (p<0.001). In the questions that showed the highest rate related to efforts in reducing food intake, among the normal weight group, 48.8% reported that 'they mainly reduce the snack intake' while 54.2% of the overweight group reported that 'they reduce the dinner amount' (p<0.01). The types of food that they chose to pass up on for weight loss included cookies, sweets, chocolate, fast foods such as hamburgers, fried foods, breads & cakes, ice creams, meats, beverages, rice and so on. The overweight children were found to be choosing to reduce their food intake more compared to the normal weight children and that difference was of special significance. The reason behind the snack intake among the investigation subjects included 'because I'm hungry' 64.1%, followed by 'because I'm bored' 12%. There was no special difference between gender or weight groups. In terms of the frequency of snack intakes, the normal weight group indicated 3.5 times a week in snack intake at home while the overweight group indicated 2.5 times a week and thus showed a significant difference between the two weight groups (p<0.01). In the case of eating snacks at school or around their separate after school classes, both the weight groups replied that they chose to eat snacks 1.5 times a week. An analysis was made by aggregating the home snacks as well as the school and the separate after school class snacks data, and the normal weight group answered that they ate snacks once a day but the overweight group answered that they ate snacks 5.5 times a week. The snacks they consumed frequently at home was shown to be quite high in the hierarchical order of fruits or fruit juice 41.9%, cookies, sweets, chocolate 38.9%, and milk, yogurt 35.9%. As for snacks around their school or the separate after school classes, types of kimbab (rolled rice with several ingredients), samgak kimbab (triangular shaped rice balls), tteokbokki (spicy rice cakes), soondae (Korean blood sausages) were the most popular with 45.3%, followed by ice cream 44.9%, and finally cookies, sweets, chocolate 32.5%. There was no significant difference between the types of snack food choices amongst the weight groups. The snack foods were then categorized into low calorie & high nutrition snacks and high calorie & low nutrition snacks. When comparing the intake level considering the snack food choices and the intake frequency, the low calorie & high nutrition snacks showed a rate of 6.0±8.0 for the normal weight group while the overweight group showed a rate of 4.0±7.2. This meant that the overweight group showed a lower intake level compared to the normal weight group (p<0.05) but in the choice of high calorie & low nutrition snack, the normal weight group showed 11.8±13.8, while the overweight group showed 10±12.7 also showing no particular significant difference. Although the overweight group answered that they ate less snacks but in the choice of snacks, the above results show that they have a lower level of preference for low calorie & high nutrition snacks. The calorie intake for the investigated subjects was 1653.4kcal for the normal weight group and 1712.8kcal for the overweight group. This would fall under 83.7% and 86.8% of the necessary energy amount and there was no particular significant difference between the weight groups. The total calorie amount of the subjects regarding breakfast, lunch, dinner and snacks amounted to 289.8kcal, 569kcal, 499.2kcal, and 325.1kcal respectively while the intake level rate per meal were 17.2%, 33.8%, 29.7%, and 19.3%. Among the nutritional intake rate per meal, the higher rate of nutrient for snacks compared to other meals were calcium 42.9% and vitamin B2 27.3%. This appears to be closely related to the milk provision in schools. The food group that had high calories in their snack intake were beverages 60.5% followed by sugars 52.1% in the vegetable food category while the milk and dairy products amounted to 86.4% in the animal foods category. The calorie intake of snacks was 330.3kcal for the normal weight group while the overweight group had 319.9kcal showing no significant difference. When analyzing just the children who consumed a certain specific type of snacks, it was found that the overweight group was consuming more sweets and chocolates with 182.9kcal compared to the 84.6kcal for the normal weight group showing a significant difference (p<0.01). After consolidating all the above results, it can be concluded that the overweight group put in more effort to lose weight compared to the normal weight group in the weight reduction dietary process. It appeared that the snack intake frequency had no relation with the degree of obesity in children but the overweight group showed a significant difference in choosing to eat less low calorie & high nutrition snacks compared to the normal weight group in snack choices. On the other hand, the high calorie and low nutrition snacks didn't show any significant difference and in the case of the overweight group, it is deemed necessary to carry out a nutritionary education so that they can make the right food choices and not just choosing to blindly reduce the food amount for their weight loss.