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The objective of the study was to examine the associations between multiple health-promoting behaviors (i.e. current non-smoking, not binge-drinking, aerobic physical activity, healthy dietary behaviors) and obesity and abdominal obesity among adults in South Korea. The study participants were 4,912 (2,085 men and 2,827 women) aged 20 and over in the 2018 Korea National Health and Nutrition Examination Survey. Obesity was defined as a body mass index of ≥25㎏/㎥ and abdominal obesity was defined as a waist circumference of ≥ 85㎝ for females or ≥ 90㎝ for males. 34.7% and 29.7% in the subjects were obesity and abdominal obesity, separately. 31.1%(24.8% of men and 35.7% of women) had three health-promoting behaviors, and 11.0% (6.6% of men and 14.3% of women) had four health-promoting behaviors. Multiple logistic regressions estimated the odds ratio of obesity and abdominal obesity by the number of health-promoting behaviors. The OR of abdominal obesity was lower in individuals meeting three (OR: 0.83, 95% CI: 0.66-1.03; P = 0.085), four (OR: 0.65, 95% CI: 0.49-0.86; P = 0.003) recommendations compared with those meeting zero or one. Especially, for males, the OR of abdominal obesity was statistically significantly lower in those having four health-promoting behaviors(OR: 0.51, 95% CI: 0.31-0.84; P = 0.008). Meanwhile, females practicing four health-promoting behaviors seemed to have a statistically lower OR of obesity(OR: 0.63, 95% CI: 0.41-0.97; P = 0.035). These findings that the OR of obesity was lower in individuals who have healthy diet behavior, never over drunk, not smoked, did an aerobic physical activity support a holistic approach to prevention or controlling abdominal obesity. Besides, the gender differences in the associations between multiple health behaviors and obesity may suggest more research on health promotion strategies specifically designed for each gender be needed.
본 연구는 비만 관리를 위해 건강증진행동을 다수 병행하는 종합적인 접근의 필요성을 검토하기 위해 수행되었다. 2018년 국민건강영양조사 대상자 중 분석변수에 모두 응답한 20세 이상 성인을 대상으로 유산소신체활동 실천 여부, 현재 금연 여부, 문제음주 여부, 영양 관련 건강행동 중 2가지 이상 실천 여부와 비만 유병 간의 상관성을 분석하였다. 비만은 체질량지수(Body Mass Indes, 이하 BMI)와 허리둘레를 이용하여 비만 및 복부비만 여부를 구분하고 각각의 비만과 병행하는 건강증진행동 개수와의 연관성을 살펴보았다. 분석대상자 4,912명(남 2,085명, 여 2,827명) 중 비만(BMI 25㎏/㎥ 이상)은 1,705명(남 873명, 여 832명), 복부비만(남 95㎝이상, 여 80㎝이상)은 1,461명(남 739명, 여 722명)이었으며, 건강행동을 2가지 이상 실천하는 사람은 3,903명(79.5%)이었다. 복합표본 다중로지스틱회귀분석을 실시한 결과, 건강행동을 0개 또는 1개 실천하는 집단에 비해 3개 실천하는 집단의 복부비만 오즈비는 0.83(95% 신뢰구간 0.66-1.03, p=0. 085), 4개 실천하는 집단의 복부비만 오즈비는 0.65(95% 신뢰구간 0.49-0.86, p=0.003)이었다. 한편, 남녀 집단을 구분하여 분석한 결과, 남성집단에서는 복부비만의 오즈비가, 여성 집단에서는 비만의 오즈비가 건강증진행동 4가지를 모두 실천하는 사람에게서 유의하게 낮았다. 이러한 결과는 복부비만 관리에 있어 개인의 다양한 건강행동에 대한 종합적인 접근이 고려될 필요와 함께, 비만 및 복부비만 관리를 위한 중재에서 성별 차이를 고려한 건강생활 실천 전략에 대한 연구가 필요함을 시사한다.
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