DOI QR코드

DOI QR Code

유산소 트레이닝과 식사조절 병행이 비만아동의 혈중지질과 아포지단백에 미치는 효과

Effects of Aerobic Training Plus Diet on Blood Lipids and Apolipoproteins in Obese Children

  • Park, Tae-Gon (Department of Physical Education, Pusan National University)
  • 발행 : 2008.10.30

초록

비만 남자 초등학생을 대상으로 식사 조절과 병행한 유산 소운동을 HRmax의 60-70% 강도로 1일 100분, 주 5회, 9주간 실시하여 이들의 혈중지질과 아포지단백에 미치는 효과에 대해 알아보았다. 혈중지질의 TC, TG, HDL-C 농도와 TC/ HDL-C비가 개선되었는데 이는 규칙적인 유산소운동과 에너지섭취량 제한(식사제한)이 아닌 1일 영양권장량에 준하는 정상적인 에너지 섭취를 통해 비만아동의 체중감량과 더불어 CHD 위험인자인 혈중지질에 긍정적인 효과를 미칠 수 있음을 확인하였다. 또한 아포지단백의 Apo AII, B, CIII 농도가 감소하였는데 이는 유산소운동과 식사조절 병행이 성인의 경우와 유사하게 비만 남자아동들에게도 동맥경화 질환의 예방에 효과적인 방법이 될 수 있음을 증명하는 결과로 사료된다. 그렇지만 아직 운동에 따른 Apo 반응에 대한 연구들이 미흡하고 특히 Apo CII와 CIII에 대한 연구는 더욱 미흡한 상황이므로 향후 이에 관련된 후속 연구가 진행되어야할 것으로 생각된다.

The purpose of this study was to find out the effects of aerobic training plus diet on blood lipids and apolipoproteins (Apo) in obese children. Sixteen healthy obese boys (ages 10.9; body mass index (BMI) $\geq$95th percentiles for age and sex) participated in this study. The aerobic training program consisted of 40 minutes hiking on a mountain, 60 minute of basketball and football dribbling at an intensity of 60-70% of HRmax, and was performed 5 days a week for 9 weeks. The diet prescription was 2,100 kal/day according to the recommended dietary allowance for 10-12 year old Koreans. All subjects stayed in a training camp for 9 weeks. The results of this study were as follows; Blood lipid profiles including total cholesterol (TC), triglyceride (TG) high density lipoprotein cholesterol (HDL-C) and TC/HDL-C ratio were significantly improved after the 9 week program, but there was no significant change in low density lipoprotein (LDL-C). Apolipoprotein profiles, Apo AI, AII, B, CII and CⅢ were all significantly decreased after the 9 week program, but there were no significant difference in Apo AI/AII ratio and Apo B/AI ratio. These results indicate that aerobic training together with a healthy diet can induce positive changes on blood lipid profiles, Apo AII, B and CII in obese children.

키워드

참고문헌

  1. Alaupovic, P. 1996. Significance of apolipoproteins for structure, function, and classification of plasma lipoproteins. Methods Enzymol. 263, 32-60. https://doi.org/10.1016/S0076-6879(96)63004-3
  2. Becque, M. D., V. L. Katch, A. P. Rocchini, C. R. Marks and C. Moorehead. 1988. Coronary risk incidence of obese adolescents: reduction by exercise plus diet intervention. Pediatrics 81, 605-612.
  3. Berenson, G. S., S. R. Srinivasan, W. Bao, W. P. Newman, R. E. Tracy and W. A. Wattigney. 1998. Association between multiple cardiovascular risk factors and athrosclerosis in children and young adults. The Bogalusa Heart Study. N. Engl. J. Med. 338, 1650-1656. https://doi.org/10.1056/NEJM199806043382302
  4. Blanco-Vaca, F., J. C. Escola-Gil, J. M. Martin-Campos and J. Julve. 2001. Role of apoA-II in lipid metabolism and atherosclerosis: advances in the study of an enigmatic protein. J. Lipid Res. 42, 1727-1739.
  5. Botton, J., B. Heude, A. Kettaneh, J. M. Borys, A. Lommez, J. L. Bresson, P. Ducimetiere and M. A. Charles. 2007. Cardiovascular risk factor levels and their relationships with overweight and fat distribution in children: the Fleurbaix Laventie Ville Sante II study. Metabolism 56, 614-622. https://doi.org/10.1016/j.metabol.2006.12.006
  6. Brewer, H. B. 1999. Hypertriglyceridemia: changes in the plasma lipoproteins associated with an increased risk of cardiovascular disease. Am. J. Cardiol. 83, 3-12.
  7. Crouse, S. F., B. C. O'Brien, P. W. Grandjean, R. C. Lowe, J. J. Rohack and J. S. Green. 1997. Effects of training and single session of exercise on lipids and apolipoproteins in hypercholesterolemicmen. J. Appl. Physiol. 83, 2019-2028. https://doi.org/10.1152/jappl.1997.83.6.2019
  8. Durstine, J. L., P W. Grandjean, C. A. Cox and P. D. Thompson. 2002. Lipids, lipoproteins, and exercise. J. Cardiopulm. Rehabil. 22, 385-398. https://doi.org/10.1097/00008483-200211000-00002
  9. Eisenberg, S. 1984. High density lipoprotein metabolism. J. Lipid Res. 25, 1017-1058.
  10. Epstein, L. H. and G. S. Goldfield. 1999. Physical activity in the treatment of childhood overweight and obesity: current evidence and research issues. Med. Sci. Sports Exerc. 31, 553-559. https://doi.org/10.1097/00005768-199911001-00011
  11. Ferguson, M. A., B. Gutin, N. A. Le, W. Karp, M. Litaker, M. Humphries, T. Okuyama, S. Riggs and S. Owens. 1999. Effects of exercise training and its cessation on components of the insulin resistance syndrome in obese children. Int. J. Obes. Relat. Metab. Disord. 23, 889-895. https://doi.org/10.1038/sj.ijo.0800968
  12. Freedman, D. S., M. K. Serdula, S. R. Srinivasan and G. S. Berenson. 1999. Relation of circumferences and skinfold thicknesses to lipid and insulin concentrations in children and adolescents: the Bogalusa Heart Study. Am. J. Clin. Nutr. 69, 308-317. https://doi.org/10.1093/ajcn/69.2.308
  13. Freedman, D. S., Z. Mei, Srinivasan, G. S. Berenson and W. H. Dietz. 2007. Cardiovascular risk factors and excess adiposity among overweight children and adolescents: the Bogalusa Heart Study. J. Pediatr. 150, 12-17. https://doi.org/10.1016/j.jpeds.2006.08.042
  14. Gerber, Y., U. Goldbourt, H. Cohen and D. Harats. 2002. Association between serum apolipoprotein C (II) concentration and coronary heart disease. Prev. Med. 35, 42-47. https://doi.org/10.1006/pmed.2002.1045
  15. Gerber, Y., U. Goldbourt, S. Segev and D. Harats. 2003. Indices related to apo CII and CIII serum concentrations and coronary heart disease: a case-control study. Prev. Med. 37, 18-22. https://doi.org/10.1016/S0091-7435(03)00051-3
  16. Janssen, I., A. Fortier, R. Hudson and R. Ross. 2002. Effects of an energy-restrictive diet with or without exercise on abdominal fat, intermuscular fat, and metabolic risk factors in obese women. Diabetes Care 25, 431-438. https://doi.org/10.2337/diacare.25.3.431
  17. Kalopissis, A. D. and J. Chambaz. 2000. Cholesterol homeostatic mechanisms in transgenic mice with altered expression of apoproteins A-I, A-II and A-IV. Int. J. Tissue React. 22, 67-78.
  18. Katzmarzyk, P. T., A. S. Leon, T. Rankinen, J. Gagnon, J. S. Skinner, J. H. Wilmore, D. C. Rao and C. Bouchard. 2001. Changes in blood lipids consequent to aerobic exercise training related to changes in body fatness and aerobic fitness. Metabolism 50, 841-848. https://doi.org/10.1053/meta.2001.24190
  19. Katzmarzyk, P. T., I. Janssen and C. I. Ardern. 2003. Physical inactivity, excess adiposity and premature mortality. Obes. Rev. 4, 257-290. https://doi.org/10.1046/j.1467-789X.2003.00120.x
  20. Kelley, G. A. and K. S. Kelley. 2006. Aerobic exercise and lipids and lipoproteins in men: a meta-analysis of randomized controlled trials. J. Mens Health Gend. 3, 61-70. https://doi.org/10.1016/j.jmhg.2005.09.003
  21. Kelley, G. A. and K. S. Kelley. 2007. Aerobic exercise and lipids and lipoproteins in children and adolescents: a metaanalysis of randomized controlled trials. Atherosclerosis 191, 447-453. https://doi.org/10.1016/j.atherosclerosis.2006.04.019
  22. Klish, W. J. 1995. Childhood obesity: pathophysiology and treatment. Acta. Paediatr. Jpn. 37, 1-6. https://doi.org/10.1111/j.1442-200X.1995.tb03675.x
  23. Leon, A. S. and O. A. Sanchez. 2001. Response of blood lipids and lipoproteins to exercise training alone or combined with dietary intervention. Med. Sci. Sports Exerc. 33, 502-515. https://doi.org/10.1097/00005768-200106001-00021
  24. Onat, A., G. Hergenc, V. Sansoy, M. Fobker, K. Ceyhan, S. Toprak and G. Assmann. 2003. Apolipoprotein C-III, a strong discriminant of coronary risk in men and a determinant of the metabolic syndrome in both genders. Atherosclerosis 168, 81-89. https://doi.org/10.1016/S0021-9150(03)00025-X
  25. Ooi, E. M., G. F. Watts, M. S. Farvid, D. C. Chan, M. C. Allen, S. R. Zilko and P. H. Barrett. 2005. High-density lipoprotein apolipoprotein A-I kinetics in obesity. Obes. Res. 13, 1008-1016. https://doi.org/10.1038/oby.2005.118
  26. Sacks, F. M., P. Alaupovic, Moye, L. A., Cole, T. G., B. Sussex, Stampfer, M. J., M. A. Pfeffer and E. Braunwald. 2000. VLDL, apolipoproteins B, CIII, and E, and risk of recurrent coronary events in the Cholesterol and Recurrent Events (CARE) trial. Circulation 102, 1886-1892.
  27. Sasaki, J., M. Shindo, H. Tanaka, M. Ando and K. Arakawa. 1987. A long-term aerobic exercise program decreases the obesity index and increases the high density lipoprotein cholesterol concentration in obese children. Int. J. Obes. 11, 339-345.
  28. Schwartz, R. S. 1987. The independent effects of dietary weight loss and aerobic training on high density lip oproteins and apolipoprotein A-I concentrations in obese men. Metabolism 36, 165-171. https://doi.org/10.1016/0026-0495(87)90012-6
  29. Schwartz, M. W. and J. D. Brunzell. 1997. Regulation of Body Adiposity and the Problem of Obesity. Arteriosclerosis, Thrombosis and Vascular Biology 17, 233-238. https://doi.org/10.1161/01.ATV.17.2.233
  30. Seip, R. L., P. Moulin, T. Cocke, A. Tall, W. M. Kohrt, K. Mankowitz, C. F. Semenkovich, R. Ostlund and G. Schonfeld. 1993. Exercise training decreases plasma cholesteryl ester transfer protein. Arterioscler. Thromb. 13, 1359-1367. https://doi.org/10.1161/01.ATV.13.9.1359
  31. Stefanick, M. L., S. Mackey, M. Sheehan, N. Ellsworth, W. L. Haskell and P. D. Wood. 1998. Effects of diet and exercise in men and postmenopausal women with low levels of HDL cholesterol and high levels of LDL cholesterol. N. Engl. J. Med. 339, 12-20. https://doi.org/10.1056/NEJM199807023390103
  32. Thomas, N. E., S. M. Cooper, S. P. Williams, J. S. Baker and B. Davies. 2007. Relationship of fitness, fatness, and coronary-heart-disease risk factors in 12- to 13-year-olds. Pediatr. Exerc. Sci. 19, 93-101. https://doi.org/10.1123/pes.19.1.93
  33. Thompson, P. D., E. M. Cullinane, S. P. Sady, M. M. Flynn, D. N. Bernier, M. A. Kantor, A. L. Saritelli and P. N. Herbert. 1988. Modest changes in high-density lipoprotein concentration and metabolism with prolonged exercise training. Circulation 78, 25-34. https://doi.org/10.1161/01.CIR.78.1.25
  34. Tolfrey, K., A. M. Jones and I. G. Campbell. 2000. The effect of aerobic exercise training on the lipid-lipoprotein profile of children and adolescents. Sports Med. 29, 99-112. https://doi.org/10.2165/00007256-200029020-00003
  35. Tolfrey, K., A. M. Jones and I. G. Campbell. 2004. Lipid-lipoproteins in children: anexercise dose-response study. Med. Sci. Sports Exerc. 36, 418-427. https://doi.org/10.1249/01.MSS.0000117132.70711.2B
  36. Walldius, G. and I. Jungner. 2004. Rationale for using apolipoprotein B and apolipoprotein A-I as indicators of cardiac risk and as targets for lipid-lowering therapy. J. Intern. Med. 255, 188-205. https://doi.org/10.1046/j.1365-2796.2003.01276.x
  37. Williams, P. T., R. M. Krauss, K. M. Vranizan, J. J. Albers and P. D. Wood. 1992. Effects of weight-loss by exercise and by diet on apolipoproteins A-I and A-II and the particle- size distribution of high-density lipoproteins in men. Metabolism 41, 441-449. https://doi.org/10.1016/0026-0495(92)90082-L
  38. Woolf-May, K., E. M. Kearney, A. Owen, D. W. Jones, R. C. Davison and S. R. Bird. 1999. The efficacy of accumulated short bouts versus single daily bouts of brisk walking in improving aerobic fitness and blood lipid profiles. Health Educ. Res. 14, 803-815. https://doi.org/10.1093/her/14.6.803
  39. Ziogas, G. G., T. R. Thomas and W. S. Harris. 1997. Exercise training, postprandial hypertriglyceridemia, and LDL subfraction distribution. Med. Sci. Sports Exerc. 29, 986-991. https://doi.org/10.1097/00005768-199708000-00002