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The prevalence of childhood obesity in South Korea has increased owing to economic improvement and the prevailing Westernized dietary pattern. As the incidence of chronic diseases caused by obesity is also expected to increase, effective interventions to prevent childhood obesity are needed. Therefore, we conducted a Delphi study to determine the priorities of a potential intervention research on childhood obesity prevention and its adequacy and feasibility.
The two-round Delphi technique was used with a panel of 10 childhood obesity experts. The panelists were asked to rate “priority populations,” “methods of intervention,” “measurement of outcomes,” “future intervention settings,” and “duration of intervention” by using a structured questionnaire. Finally, a portfolio analysis was performed with the adequacy and feasibility indexes as the two axes.
For priority populations, the panel favored “elementary,” “preschool,” and “middle and high school” students in this order. Regarding intervention settings, the panelists assigned high adequacy and feasibility to “childcare centers” and “home” for preschool children, “school” and “home” for elementary school children, and “school” for adolescents in middle and high school. As the age of the target population increased, the panelists scored increasing numbers of anthropometric, clinical, and intermediate outcomes as highly adequate and feasible for assessing the effectiveness of the intervention.
According to the results of the Delphi survey, the highest-priority population for the research on childhood obesity prevention was that of elementary school students. Various settings, methods, outcome measures, and durations for the different age groups were also suggested.
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In the 1990s the primary focus of medicine was shifted to disease prevention. Accordingly, it became the responsibility of primary-care physicians to educate and counsel the general population not only on disease prevention specifically but health promotion generally as well. Moreover, it was, and is still today, considered important that physicians provide positive examples of health-promotion behaviors to patients. The purpose of this study was to investigate physicians' health-promotion behaviors and to identify the factors that influence them.
We conducted a postal and e-mail survey of the 371 members of the Physician Association of Cheonan City between May 16th and June 25th, 2011. The questionnaire consisted of 18 items, including questions relating to sociodemographic factors, screening tests for adult diseases and cancer, and health habits.
There were 127 respondents. The gender breakdown was 112 men (88.2%) and 15 women (11.8%), and the mean age was 47.8 years. Fifty-nine (46.4%) were family physicians or interns, and 68 (53.6%) were surgeons. Twenty-six percent (26%) were smokers, and 74.8% were drinkers; 53.5% did exercise; 37% had chronic diseases; 44.9% took periodic cancer screening tests, and 72.4% took periodic screening tests for adult diseases.
It was found that general characteristics and other health-promotion behaviors of physicians do not affect physicians' practice of undergoing periodic health examination.
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To compare the prevalence and metabolic characteristics of metabolically healthy but obese (MHO) individuals according to different criteria.
We examined 186 MHO middle-aged men (age, 37.2 years; body mass index [BMI], 27.2 kg/m2). The following methods were used to determine MHO: the National Cholesterol Education Program (NCEP) Adult Treatment Panel III criteria, 0-2 cardiometabolic abnormalities; the Wildman criteria, 0-1 cardiometabolic abnormalities; the Karelis criteria, 0-1 cardiometabolic abnormalities; the homeostasis model assessment [HOMA] criteria (lowest quartile of HOMA). After dividing the overall subjects into two age groups, we compared the prevalence and clinical characteristics between MHO and at-risk groups according to four different criteria.
The prevalence of MHO using the NCEP, Wildman, Kaleris, and HOMA criteria were 70.4%, 59.7%, 28.5%, and 24.2%, respectively. The agreement between the groups according to the NCEP and Wildman criteria was substantial (kappa = 0.8, P < 0.001). Among individuals 35 years or younger, and regardless of method, the MHO subjects had significantly lower weight, waist circumference, BMI, body fat percentage, insulin, HOMA, alanine aminotransferase, triglyceride (TG), and TG/high density lipoprotein cholesterol (HDL-C) ratio than the at-risk subjects (P < 0.05); However, among individuals older than 35 years old, and regardless of method, the MHO subjects had different insulin, HOMA, HDL-C, and TG/HDL-C levels than the at-risk subjects (P < 0.05).
The differences in metabolic profile between MHO and at-risk groups varied according to age. MHO prevalence varies considerably according to the criteria employed. Expert consensus is needed in order to define a standardized protocol for determining MHO.
Citations
Association Metabolic Obesity Phenotypes with Cardiometabolic Index, Atherogenic Index of Plasma and Novel Anthropometric Indices: A Link of FTO-rs9939609 Polymorphism
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