Diets of obese and non-obese children

doi:10.4236/health.2011.38080

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Vol.3, No.8, 487-489 (2011)

doi:10.4236/health.2011.38080

Health

Diets of obese and non-obese children

Atsuko Satoh1*, Seiko Fujita2, Kazuko Menzawa3, Sangun Lee4, Masao Miyamoto1, Hidatada Sasaki5

1Akita University of Nursing and Welfare, Odate, Japan; *Corresponding Author: [email protected]

2Hiroaki Kensei Hospital, Hirosaki, Japan;

3Faculty of Education, Hirosaki University, Hirosaki, Japan;

4Department of P hysical Therapy, Aomori University of Health and Welfare, Aomori, Japan;

5Sendai Tomisawa Hospital, Sendai , Ja pan.

Received 23 March 2011; revised 8 May 2011; accepted 20 July 2011.

ABSTRACT

Aim: To compare diets betw een obese and non-

obese in children. Methods: Thirty-four obese

and ten non-obese school children were re-

cruited and their habitual factors of obesity

were asked. Intakes of food in the obesity and

non-obesity groups were checked using a

model nutriti onal balance cha rt (M NBC). Resul ts:

Average intake ratio of food relative to ideal

food intake was significantly higher in the

non-obesity group than the obesity group. The

relationship between obesity and exercise was

significant but not significant for intake ratio of

food, times watching TV and playing games.

Conclusion: Food intake is not a primary factor

of obesity but exercise is a key factor for obe-

sity in school children. Since the effect of diet

intervention in obese children was slight, exer-

cise habit would be a more import ant strategy to

reduce obesity than diet in school children.

Keywords: Food Intake; Exercise; Sedentary

Times; Children; Obesity

1. INTRODUCTION

In the last 20 years, the prevalence of obesity in-

creased two-fold (from 5% to 10%) in school children in

Japan [1]. Childhood obesity is an urgent issue to sub-

side increasing metabolic syndrome in adulthood be-

cause obesity in children tends to persist into adulthood.

Interventions to prevent childhood obesity resulted in

not consistent or limited effects of dietary habits and

physical activity [2]. Physical activity in children above

the government-recommended intensity was not associ-

ated with a change in obesity [3]. Cro ss-sectional studies

showed that children’s weights were associated with

food consumption [4] and sedentary activities [5]. How-

ever, it has not been reported which is the key factor to

contribute obesity. In the present report, we studied diets

between obese and non-obese children and compared

diets with physical activity, time watching TV and play-

ing games.

2. METHODS

The subjects were recruited from primary school chil-

dren and a junior high school in Odate City, Akita pre-

fecture, Japan, where the authors had school health as-

signments as nurses. A child was considered to be obese

when the body weight exceeded 120% of the standard

body weight, which is defined as the mean body weight

corresponding to the he ight for that age and sex obtained

from national statistics for Japanese school children in

2009 [1]. The criteria for inclusion as non-obese children

are body weight less than 120% of the standard body

weight. The subjects of the present study had no endo-

crine, metabolic or kidney disease. Among 43 obese

children, 9 children refused to participate in the study,

leaving 34 children female/male, 20/14, average age

11.9 ± 1.5 years, and ranging from 8 - 14 years. Fifteen

children were randomly chosen for the non-obese group.

Five children in the non-obese group refused to partici-

pate in the study leaving 10 children (female/male, 5/5,

average 11.7 ± 2.3 years, ranging from 7 to 14 years) in

the non-obese group. Among the 10 non-obese children,

5 were in primary school and 5 were in junior high

school. It took one year of serial participation by the

subjects, from August 2003 to July 2004.

All the participants, including their parents, completed

a questionnaire about physical characteristics, health

assessment, life styles, such as exercise habits and time

watching television an d playing games, family composi-

tion, and eating habits. Exercise habits were defined as

participating in sporting clubs such as football, basket-

ball, baseball and so on associated with the school or

outside school and practiced exercise at least twice a

week. Food intakes were asked using the model nutri-

A. Satoh et al. / Health 3 (2011) 487-489

488

tional balance chart (MNBC) as described previously

and explained briefly here [6]. The MNBC was designed

to outline a 6697 kj intake according to the recommen-

dation by the Japan Obesity Society [7]. The MNBC

demonstrates the ideal dietary distribution of 11 catego-

ries of food: meat, fish, eggs, milk and dairy products

(hereinafter called milk), beans and bean products, such

as bean curd and miso soup (hereinafter called beans),

green and yellow vegetables, light-colored vegetables,

fruit, potatoes and grains (hereinafter called grains), oil,

and sugar. The number of times each food category was

consumed was marked with black dots; the foods eaten

were recorded by category, but not by amount. The child

(and/or mother) filled out a meal chart which consisted

of columns for breakfast, lunch, dinner, and snacks be-

tween meals. The meal chart was to be filled out for 3

days of the last week of one month; Friday, Saturday,

and Sunday. We calculated the nutritional balance, as

follows: (intake ratio of food = the actual food intake

[black dots] ÷ the ideal food intake following the MNBC

[black dots]). Thus the nutritional balance based on the

MNBC was ideally “1”. Ethical approval was obtained

from the Ethical Committee of the University. The

Mann-Whitney’s U test was used for the significance.

Multivariate logistic regression was used to determine

the variations. Values were presented as mean ± SD.

Statistical significance was considered for p < 0.05.

3. RESULTS

Percentage overweight values of obese children and

non-obese ch ildren were 50 ± 21% an d –3 ± 8%, respec-

tively. The numbers of children with exercise habits and

without exercise habits were 9 and 25 in the obesity

group and 8 and 2 in the non-obesity group, resp ectively.

Intake-ratio of food in the obesity group was signifi-

cantly lower than that of the non-o besity group (p < 0.01)

(Table 1). Exercise performance was significantly higher

in non-obese children than obese children (p < 0.01).

Children with exercise showed a significantly lower de-

gree of obesity than children withou t exercise (11 ± 20%

vs. 56 ± 23%) (p < 0.01). Time watching TV was sig-

nificantly lower in non-obese children (2.0 ± 0.9 h) than

obese children (3.0 ± 1.5 h) (p < 0.05). Time playing

games was significantly lower in non-obese children (0.1

± 0.3 h) than obese children (0.4 ± 0.8 h) (p < 0.05). The

children with exercise showed significantly shorter times

of summation of watching TV and playing games than

the children without exercise (2.7 ± 1.2 h vs. 3.2 ± 2.3 h)

(p < 0.01). The relative impact for obesity (where obese

and non-obese ch ildren corresponded to 0 and 1, respec-

tively) verses intake ratio of food, exercise, time watch-

ing TV and time playing games was assessed using mul-

tiple logistic regression wh ere intake ratio of food 1.1 or

more and less than 1.1 corresponded to 0 and 1, exercise

yes and no corresponded to 0 and 1, time watching TV

of 2.6 hours or more and less than 2.6 hours corre-

sponded to 0 and 1, time playing games of 0.3 hours

or more and less than 0.3 hours corresponded to 0 and

1, respectively. Multiple logistic regression of the rela-

tion- ship between obesity and exercise was significant

(odds ratio = 24.8, 95% confidence interval = 1.2 –

500.9, p < 0.05) and not significant for other factors.

4. DISCUSSION

It was an unexpected finding that the non-obesity

group showed a higher intake ratio of food than the obe-

sity group (Table 1). If food-intake is not a primary fac-

tor in determining obesity, there may be other factors.

We observed that exercise was the key factor to deter-

mine obesity. The non-obesity group took less time

watching TV and playing games than that of obesity

groups. The children with exercise show significantly

shorter times of watching TV and playing games. Taking

together these results, obesity might not be brought by

too much food, but might be brought by non-exercise

performance such as watching TV and playing games in

children.

In obese children, the intervention of diet control was

effective using MNBC but limited as the percentage

overweight decreased only from 50% to 40% [6]. Since

the intervention of obesity was limited by the way of

food intake, habitual exercise would determine the obe-

sity. The present non-obese children were volunteer

school children and some selections might cause a dif-

ferent result. Surveillance of Japanese school children

shows approximately 85% of primary school children

performed exercise and 80% of junior high school chil-

dren performed exercise although the percentage of ex-

ercise decreased to 60% in high school students [8]. Of

the present non-obese children, 80% performed exercise

Table 1. Intake-ratio of food in obesity and non-obesity groups.

Meat Fish Egg Milk Beans

Green and yellow

vegetables Light-colored veget a b l e sFruitGrain Oil Sugar Mean ± SD

Obesity group 1.0 0.6 1.4 0.5 0.8 0.3 0.5 0.91.5 1.4 1.4 0.9 ± 0.4

Non-obesity group 1.3 1.1 1.1 1.5 1.1 0.5 0.7 1.11.5 1.8 2.5 1.3 ± 0.4

NS * NS *** NS * * NSNS ** ** **

*(p < 0.05), **(p < 0.01) and ***(p < 0.001) shows dignificances between the obesity group and non obesity group using the two-sided Mann-Whitney’s U test.

NS shows no significance. Values are mean ± SD.

A. Satoh et al. / Health 3 (2011) 487-489

489

which seems to be an average percentage for exercise.

The present study suggests that in school children, if

they exercised, obesity would not be a problem irrespec-

tive of the amount of food they took. The present MNBC

was proved to be useful for self-care dependent older

patients with diabetes mellitus [9]. The subjects were

responsible for reporting their own food intake by cate-

gory but not by the amount of food, which precludes any

quantitative estimate of their actual food intake [6]. In

adults and older patients with diabetes mellitus, since

exercise performance is limited due to social and physi-

cal reasons, diet control might be more important in re-

ducing obesity as well as for controlling diabetes melli-

tus.

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