국민 건강증진을 위한 신체활동 지침

Health-enhancing Physical Activity Guidelines for Koreans: the Status and Directions for Revision

  • 김완수 (대구대학교 운동처방학과)
  • 투고 : 2009.04.24
  • 심사 : 2009.06.13
  • 발행 : 2009.06.30

초록

Objectives: There have been no specific as well as evidence-based physical activity guidelines issued on the governmental level. There just have been physical activity recommendations and guidelines released from governmental agencies or organizations as well as individual researchers and these are not consistent, thereby giving the public and even some professionals quite a confusion. As such, this study was aimed to suggest key factors to include when issuing national physical activity recommendations for Koreans. Methods: Since chronological evolution of modern physical activity recommendations reflects key factors to consider when establishing those recommendations and guidelines, that released for several decades was reviewed. Results: The evolution was found to be based on the basis of strong evidence from both epidemiological and exercise physiology studies and the key concepts of such evolution were feasibility, efficacy, and safety. Conclusion: On the basis of three key factors found in the review process, this study concluded that the upcoming national physical activity guidelines should include the following to maximize the outcomes of the efforts which have long been put by the division of physical activity under the 'New Health Plan 2010'. First, guidelines for achieving health benefits (ie, preventing chronic diseases such as cardiovascular disease, diabetes, and cancers or weight management) as well as improving cardiorespiratory fitness should be included to enhance efficacy. Second, safety measures should be included to enhance safety. Third, various alternative forms of physical activity should be included to enhance feasibility.

키워드

참고문헌

  1. 김완수. 임상운동생리학개론. 대구대학교 출판부, 2009
  2. 김완수, 이미라. 국민건강증진을 위한 생애주기별 신체활동 지침 : 현황 및 개선 방향. 2007년 한국보건교육.건 증진학회 추계학술대회 연제집, 서울대학교 보건대학원, 2007
  3. 김완수, 주기찬, 강현주. 고령화 사회에 대비한 노인 운동지도 인력에 관한 연구. 건양대학교.건강증진사업지원단. 2006
  4. 건강길라잡이. http://www.hp.go.kr/ 보건복지부.한국보건사회연구원. 2008년 접속
  5. 보건복지가족부.질병관리본부. 2007년도 국민건강.영양조사 중간결과 발표. 보도자료 2008년 11월 18일자
  6. 보건복지부. 2007년도 건강생활실천사업 안내서. 서울: 보건복지부, 2007
  7. 보건복지부(보건정책팀). 30세 이상 인구 1/3이 심․뇌혈관질환의 고위험군 - 에너지 섭취는 늘고, 비만은 증가하고, 고혈압, 당뇨병 유병률은 높다. 보건복지부 보도자료. 2006년 6월
  8. 보건복지부. 건강증진을 위한 신체활동 활성화 방안. 서울: 보건복지부, 2005
  9. 보건복지부. 2001 국민건강.영양조사. 보건복지부. 서울: 보건복지부, 2002
  10. 이미라. 운동을 통한 중년여성의 건강증진을 위한 연구: 운동행위 측정, 운동 장애성 분석, 개인적 특성에 따른 운동의 TG 및 HDL-C 개선효과 분석〔석사학위논문〕. 논산: 건양대학교 보건복지대학원. 2006
  11. 일본 국립 건강.영양연구소. 건강증진을 위한 운동기준 2006, 보고서 : 신체활동.운동.체력. 운동소요량.운동지침의 책정 검토회, 2006. 7
  12. 정호영 등. 우리나라 국민의 건강결정요인 분석. 한국보건사회연구원. 2006
  13. ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Survey_Questionnaires/NHIS/2004/english/QADULT.pdf. 2008년 접속
  14. http:/www.cdc.gov/nchs/data/nhanes/nhanes_03_04/sp_paq_c.pdf.2008년 접속
  15. http:/www.cdc.gov/brfss/questionnaires/pdf-ques/2005brfss.pdf. 2008년 접속
  16. http://www.cdc.gov/nccdphp/dnpa/physical/terms/index.htm. 2008년접속
  17. www.healthypeople.gov/Document/pdf/Volume2/22physical.pdf. 2008년 접속
  18. www.ipaq.ki.se/ipaq.htm. 2008년 접속
  19. http://www.who.int/chp/steps/GPAQ%20Instrument%20and%20Analysis%20Guide%20vs.pdf. 2008년 접속
  20. American College of Sports Medicine. Guidelines for graded exercise testing and exercise prescription. Philadelphia: Lea & Febiger. 1975
  21. American College of Sports Medicine. ACSM position statement on the recommended quantity and quality of exercise for developing and maintaining fitness in healthy adults. Medicine and Science in Sports Exercise 1978; 10: 7-10
  22. American College of Sports Medicine position statement. The recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness in healthy adults. Medicine and Science in Sports Exercise 1990; 22: 265-274
  23. American College of Sports Medicine position stand. Exercise and physical activity for older adults. Medicine and Science in Sports Exercise 1998; 30(6): 975-991 https://doi.org/10.1097/00005768-199806000-00032
  24. American College of Sports Medicine. ACSM's guidelines for exercise testing and prescription, sixth edition. Philadelphia : Lippincott Williams & Wilkins. 2000
  25. American College of Sports Medicine. ACSM's guidelines for exercise testing and prescription, seventh edition. Philadelphia : Lippincott Williams & Wilkins. 2006
  26. American College of Sports Medicine. ACSM's guidelines for exercise testing and prescription, eighth edition. Philadelphia : Lippincott Williams & Wilkins. 2010
  27. American Heart Association. Medical/scientific statement on exercise: benefits and recommendations for physical activity for all Americans. Circulation 1992; 85(1): 2726-2730
  28. Bouchard C, Blair N, Haskell WL. Physical Activity and Health. Human Kinetics. 2007
  29. Braith RW, Stewart KJ. Resistance exercise training: its role in the prevention of cardiovascular disease. Circulation 2006; 113:2642-2650 https://doi.org/10.1161/CIRCULATIONAHA.105.584060
  30. Burke AP, Farb A, Malcom Y-h, Liang JES, Virman R. Plaque rupture and sudden death related to exercise in men with coronary artery disease. Journal of the American Medical Association 1999; 281: 921-956 https://doi.org/10.1001/jama.281.10.921
  31. Carpinelli, RN, Otto, RM, Winett, RA. A critical analysis of the ACSM position stand in resistance training: insufficient evidence to support recommended training protocols. Journal of Exercise Physiology 2004; online: 7(3)
  32. Donnelly JE, Jacobsen DJ, Heelan Snyder KS, Seip R, Smith S. The effects of 18 months of intermittent vs continuous exercise on aerobic capacity, body weight and composition, and metabolic fitness in previously sedentary, moderately obese female. International Journal of Obesity and Related Metabolic Disorders 2000; 24: 566-572 https://doi.org/10.1038/sj.ijo.0801198
  33. Duscha, BD, Slentz, CA, Johnson, JL, Houmard, JA. et al. Effects of exercise training amount and intensity on peak oxygen consumption in middle-age men and women at risk for cardiovascular disease. CHEST 2005; 128: 2788-2793 https://doi.org/10.1378/chest.128.4.2788
  34. Haskell WL, Lee I-M, Pate RR, Powell KE, Blair SN, Franklin BA, Macera CA, Heath GW, Thompson PD, Bauman A. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Circulation 2007; 116:1081-1093 https://doi.org/10.1161/CIRCULATIONAHA.107.185649
  35. Hill JO, Wyatt HR. Role of physical activity in preventing and treating obesity. Journal of Applied Physiology, 2005; 99(2):765-770 https://doi.org/10.1152/japplphysiol.00137.2005
  36. Institute of Medicine of the National Academies of Science. Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein, and amino acids (macronutrients). Washington, DC: National Academy Press. 2002
  37. Lalonde. A new perspective on the health of canadians : a working document. Ottawa, Government. 1974
  38. Lee IM, Sesso HD, Oguma Y, Paffenbarger RS. Relative intensity of physical activity and risk of coronary heart disease. Circulation 2003; 107: 1110-1116 https://doi.org/10.1161/01.CIR.0000052626.63602.58
  39. Miller WC, Wallace JP, Eggert KE. Predicting max HR and the HR-$VO_2$relationship for exercise prescription of obesity. Medicine and Science in Sports Exercise 1993; 25:1077-1081
  40. Morris JN, Heady JA, Raffle PA, Roberts CG, Parks JW. Coronary heart-disease and physical activity of work. Lancet 1953; 265:1111-1120
  41. National Institutes of Health. Physical activity and cardiovascular health. NIH consensus statement. December 18-20; 13(3), 1-33. 1995
  42. Nishida Y, Suzuki H, Wang DH, Kira S. Psychological determinants of physical activity in Japanese female employees. Journal of Occupational Health 2003; 45(1): 15-22 https://doi.org/10.1539/joh.45.15
  43. Pate RR, Pratt, MP, Blair SN, Haskell WL, Macera CA, Bouchard, Buchner D, Ettinger W, Health GW, King AC. et al. Physical activity and public health: a recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. Journal of American Medical Association 1995; 273(5): 402-407 https://doi.org/10.1001/jama.273.5.402
  44. Pollock ML, Franklin BA, Balady GJ, Chaitman BL, Fleg JL, Fletcher B, Limacher M, Pina IL, Stein RA, Williams M, Bazzarre T. Resistance exercise in individuals with and without cardiovascular disease : benefits, rationale, safety, and prescription. An advisory from the committee on exercise, rehabilitation, and prevention, council on clinical cardiology, American Heart Association. Circulation 2000; 101: 828-833 https://doi.org/10.1161/01.CIR.101.7.828
  45. Sallis JF, Patrick K, Long BJ. International consensus conference on physical activity guidelines for adolescents. Pediatric Exercise Science 1994; 6(4): 299-301
  46. Saris WH, Blair SN, van Baak MA, Eaton SB, Davies PS, Pietro L, Fogelholm M, Rissanen A, Schoeller D, Swinburn B, Tremblay A, Westerterp KR, Wyatt H. How much physical activity is enough to prevent unhealthy weight gain? Outcome of the IASO 1st Stock Conference and consensus statement. Obesity Review 2003; 4: 101-114 https://doi.org/10.1046/j.1467-789X.2003.00101.x
  47. Schoeller DA, Shay K, Kushner RF. How much physical activity is needed to minimize weight gain in previously obese women? American Journal of Clinical Nutrition 1997;. 66: 551-556
  48. Sigal RJ, Wasserman DH, Kenny GP, Castaneda-Sceppa C. Physical activity/exercise and type 2 diabetes. Diabetes Care 2004;27(10): 2518-2539 https://doi.org/10.2337/diacare.27.10.2518
  49. Siscovick DS, Weiss NS, Fletcher RH, Lasky T. The incidence of primary cardiac arrest during vigorous exercise. New England Journal of Medicine 1984; 311: 874-877 https://doi.org/10.1056/NEJM198410043111402
  50. Swain DP, Franklin BA. Comparison of cardioprotective benefits of vigorous versus moderate intensity aerobic exercise. American Journal of Cardiology 2006; 97: 141-147 https://doi.org/10.1016/j.amjcard.2005.07.130
  51. Tudor-Locke C, Williams JE, Reis JP, Pluto D. Utility of pedometers for assessing physical activity: convergent validity. Sports Medicine 2002; 32: 795–808
  52. US Department of Health and Human Services. Physical activity and health: a report of the Surgeon General. Atlanta, GA: US Department Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion. 1996
  53. US Department of Health and Human Services and US Department of Agriculture. Dietary guidelines for Americans, 2005. 6th ed., Washington, DC : US Government Printing Office. 2005
  54. US Department of Health and Human Services. 2008 Physical Activity Guidelines for Americans. 2008
  55. Votruba SB, Horvitz MA, Schoeller DA. The role of exercise in the treatment of obesity. Nutrition 2000; 16: 179-188 https://doi.org/10.1016/S0899-9007(99)00264-6
  56. World Health Organization. Health and development through physical activity and sport. Noncommunicable Diseases and Mental Health, Noncommunicable Diseases and Health Promotion, 2003; p3