Evaluation of Eating Behavior and Nutritional Status Using the Nutrition Quotient in Obese Children

Abstract

IntroductionIn Korea, the obesity rate among children and adolescents is 15.3% and is steadily increasing. 1 Twenty-five percent of boys are overweight, which exceeds the Organization for Economic Cooperation and Development average of 23%. 2 These phenomena are largely attributed to westernized dietary habits and insufficient exercise. Particular attention is required because 60% of obese children and adolescents will exhibit adult obesity and because obesity has negative effects such as a psychological loss of self-esteem. 3 In addition, according to the 2012 citizen health statistics data, 7.3% of children aged 6-11 years and 17.0% of adolescents aged 12-18 years suffered from insufficient nutrient intake in Korea, and 8.4% and 7.4% of in-dividuals in the same age groups, respectively, had excessive energy and fat intakes; as a consequence, 15.7% of kindergarteners and younger elementary school students and 24.4% of older elementary school students suffered from defective or excessive nutrient intake. 4 Because obesity in children should not be treated or managed with medication, in contrast to adults, exercise practice, dietary habits, and lifestyles must be changed, and parental interests and efforts are essential to this process. Obese children exhibit characteristic eating behaviors such as irregular meals, overeating, increased intake of processed and instant foods, and rapid eating speeds. 5 During childhood, systematic nutritional management via an accurate eating behavior analysis can promote the acquisition of nutrient-related knowledge and quickly and effectively promote positive attitudes to-Background: The increasing incidence of pediatric obesity has recently emerged as a social problem, and children's eating behaviors and nutritional statuses directly affect health. Obesity prevention and treatment must involve dietary life management. Despite the importance of specialized, accurate eating behavior and nutritional status evaluations of obese children, available study tools in Korea are lack. Methods: Obesity index, blood parameters, and nutrient intake were evaluated in 64 obese children (29 boys, 35 girls) at a university hospital childhood and adolescent obesity clinic; eating behaviors and nutritional statuses were evaluated using a recently developed and validated Korean nutrient quotient (NQ) for children. Results: The subjects' mean age was 9.7 ± 1.8 years, and the mean obesity index was 132.8% ± 17.2%. Moderate or severe obesity (P< 0.001) was significantly more frequent among girls. Nutrient intake analyses revealed insufficient intakes of fiber, calcium, potassium, vitamin A, and folic acid relative to recommendation. Protein and carbohydrate intakes were significantly elevated among boys and girls, respectively (P= 0.001 and 0.004, respectively). The overall mean nutrition quotient score was 59.6 ± 15.3. Diversity and practice scores were below average, and girls had significantly higher scores only in regularity (P = 0.037). Severely obese children had significantly lower moderation (P...