[논문]미국 청소년의 비만에 관한 종단적 분석

김태응; 김종호; 황선환

doi:10.5392/jkca.2016.16.08.743

미국 청소년의 비만에 관한 종단적 분석
Longitudinal Data Analysis for School-aged Adolescents' Obesity Rates across the States 원문보기

한국콘텐츠학회논문지 = The Journal of the Korea Contents Association, v.16 no.8, 2016년, pp.743 - 755

김태응 , 김종호 (서울대학교 체육교육과) , 황선환 (서울시립대학교 스포츠과학과)

초록
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이 연구의 목적은 미국 취학 아동-청소년의 BMI 변화율이 어떻게 달라지고 있는지, 그리고 청소년 발달 상태에 따른 비만을 유발하는 해로운 행동들이 청소년들의 비만 현상에 어떻게 영향을 미치는지 종단적으로 밝히는데 있다. 1999-2011 미국 청소년 위험 행동 조사 데이터를 사용하였으며, 총 연구 대상은 260,293명이다(9-12학년). 미국 취학 청소년들의 비만율에 미치는 종단적 시간의 효과를 검증하기 위해 인구통계학적 특성, 영양 및 신체활동 관련 행위들을 공변량으로 통제한 최소자승법 회귀분석과 위계적 선형 모델링이 활용되었다. 취학 청소년들의 BMI 퍼센티지는 시간과 유의미한 관련이 있는 것으로 나타났으며 특히 종단적 시간은 아이들의 BMI 퍼센티지에 상당히 긍정적인 효과가 있는 것으로 나타났다. 따라서 지난 10년 동안의 미국 아동 비만을 줄이기 위한 신체 활동 및 영양 정책은 미국 아동들의 비만 유지 및 감소를 위한 매우 효과적인 정책이었으며, 향후 청소년의 비만 요인 감소와 장애요소를 극복을 위한 정책을 강화하는데 더욱 많은 관심을 기울여야 할 것이다.

Abstract ▼ AI-Helper

The objectives of this research is to examine: 1) how the rates of adolescents' BMI change over time in terms of the state level; and 2) development difference in the state level of BMI in terms of children's obesogenic behaviors from 1999 to 2011. Data were drawn from the 1999-2011 Youth Risk Behavior Survey in the United States (N=260, 293, grades 9-12, and 27 states). Ordinary least squares regression and hierarchical linear modeling were utilized to capture a longitudinal time effect of school-aged adolescents' obesity rates across the states, controlling for demographics and nutrition- and physical activity-related behaviors. The state's level of children's BMI percentile was significantly associated with longitudinal time. Longitudinal time effect across the states appears to play an important factor associated with children's decrease of BMI percentile. Therefore the states' implementation of physical activity and nutritional policies seems to be effective for preventing and reducing childhood obesity during last decade. More attention should focus on enforcing the policy and overcoming current barriers in order to minimize children's obesogenic factor.

주제어

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문제 정의

The evidence of this study supports the school policies of childhood obesity for how school-based interventional policies affect student’s practice and implementation of obesity prevention behaviors.
The purpose of this research is to explore a longitudinal time effect of school-aged adolescents’ obesity rates across the states.
This study is multi-year cross-section longitudinal study from 1999 to 2011 to explore a longitudinal time effect of school-aged adolescents’ obesity rates across the states.

가설 설정

2) Does the aggregated of consumptions of fruits and vegetables, amounts of physical activity, and the level of sedentary life style predict the state level of BMI percentile?
4) Are there development difference in the state level of BMI percentile that depends on the level of physical activity, consumption of fruits and vegetables and amounts of sedentary life style?

제안 방법

Before the model specification, exploratory analyses were performed on effects of the state level of variables on states’ BMI percentile to exam if the effects of variables (e.g., level of physical activity, the amounts of consumption of fruits and vegetables, and level of amount of sedentary life style controlled the effect of gender, race/ethnicity, and grade) differ states’ BMI percentile over time.
Descriptive statistics were reported to describe study participants’ characteristics such as age, gender, consumptions of fruits and vegetables, a level of physical activity and BMI percentile using mean, standard deviations and percentage.
Firstly, this study utilized self-reported measurements to assess all study variables from students’ one-day recollection which may be inaccurate due to recall bias, respondent bias, or interview bias.
The main purpose of this study is to investigate whether state’s BMI percentile is predicted by level of physical activity, the level of consumption of fruits and vegetables and level of amount of sedentary life style (e.g., watching TV) controlled the effect of age, gender (male), race/ethnicity, and grade over time across states.
This study was a multi-year retrospective longitudinal data analyzing study by utilizing a multi-year retrospective cross-sectional data. The proposed study has a large number of participants with multiple time point of data.

대상 데이터

27 states and 260,293 students were participated (Mage = 16.00 ± 1.22 years, range =12-18, female N=132,311, 51.09%).
This study collected data form the 2012 Youth Risk Behavior Surveillance System (YRBSS)[8], a school-based survey, representing a sample of public and private high school students in the U.S from 1999 to 2011. The CDC conducts this nation-wide survey in both public and private high school students form 9^th grade to 12th including 50 states every other year for to monitor youth’s health-risk behaviors and the prevalence of obesity, level of physical activity and drugs abuse etc.

데이터처리

Descriptive statistics and pairwise correlations were used to report participants’ characteristics and variable correlations, respectively.

성능/효과

Final growth model showed time significantly affect the state’s level of BMI percentile if the effects of all the other predictors are controlled, which as increasing one unit of time, 0.35 of state level of BMI percentile will be increased (p<.0001).
First, behavioral factors (i.e., sedentary lifestyle and physical activity) prove to be significantly associated with adolescents’ obesity.
More specifically, the final growth model showed time significantly increased the state’s level of BMI percentile if the effects of all the other predictors are controlled.
Our study results further supported that increasing the level of sedentary life style affected an increase of state level of BMI percentile. However, consumptions of fruits and vegetables and the level of physical activity were negatively associated with state level of BMI percentile as expected, respectively.
Our study results shows childhood obesity were positively associated with the students’ healthier behaviors (e.g., increased physical activity and nutrition) to potentially decrease adolescent’s obesity.

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