DOI QR코드

DOI QR Code

제주 지역주민기반 대사성질환 개선 프로그램 중재 효과

The Effect of Community-based Health Intervention Program to Improve Metabolic Disease in Jeju Island

  • 김우진 (제주한라병원 진단검사의학과) ;
  • 김상훈 (제주한라병원 대외협력처) ;
  • 박신영 (제주한라대학교 임상병리과)
  • Kim, Woo Jin (Department of Laboratory Medicine, Cheju Halla General Hospital) ;
  • Kim, Sang Hoon (Office of External Affairs, Cheju Halla General Hospital) ;
  • Park, Shin Young (Department of Clinical Laboratory Science, Jeju Halla University)
  • 투고 : 2018.08.07
  • 심사 : 2018.08.22
  • 발행 : 2018.09.30

초록

본 연구는 대사성질환 관련 위험 인자를 가지고 있는 제주 지역주민을 대상으로 마을 기반 건강프로그램의 효과성을 입증하기 위해 수행되었다. 50명의 실험군은 BMI가 25 이상인 지역주민으로 3주 동안 고유수용성신경근촉진(PNF) 트레이닝과 스트레칭을 포함한 운동요법 7회, 영양관리 식습관 개선을 위한 쿠킹테라피 프로그램 4회 그리고 대체의학활용 프로그램인 힐링터치 마사지 프로그램 3회의 건강중재프로그램에 참여하였다. 건강프로그램 중재의 효과성 평가를 위해 프로그램 중재 전과 후에 체 성분, 혈액의 지질 프로파일, 혈당 및 허리둘레를 측정하여 비교하였다. 건강프로그램 중재 후에는 중재 전에 비해 TC, HbA1C, 이완기혈압, 체지방 그리고 허리둘레가 크게 감소하여 거의 정상수치가 되었고 특히 HbA1C, 체지방 그리고 허리둘레는 유의한 수준으로 감소 (P<0.001)되었다. 그러나 반대로 건강프로그램 중재를 받지 않은 대상군의 경우 HbA1C, 체지방 및 허리둘레가 유의한 수준으로 증가 (P<0.001)하는 부정적 결과를 보였다. 이상의 결과로부터 대사성질환 관련 인자들은 건강프로그램의 중재로 개선되어 호전될 수 있음을 알 수 있었다. 본 연구에서는 건강중재프로그램인 운동과 쿠킹테라피 효과를 구분하여 조사하지는 않았지만 3주간의 단기간에 보여진 효과가 두 가지를 병행해서 수행함으로써 나타난 결과임을 암시하며 식사조절과 운동을 병행하는 것이 대사성질환 개선에 보다 효과적임을 제시하고자 한다.

This study investigated the effect of community-based health intervention program to improve metabolic disease in Jeju island. There were 50 obese local residents in the experimental group (body mass index, $BMI{\geq}25kg/m^2$). They participated in cooking therapy with nutrition education (4 times), exercise program with proprioceptive neuromuscular facilitation (PNF) and stretching training (9 times), and alternative medicine program with healing touch massage (3 times) during a 3-week period. To evaluate the effectiveness of the program, body composition, blood lipid profiles, blood glucose, and waist circumference were assessed before and after the intervention program. After the program, the value of total cholesterol (TC), glycosylated hemoglobin (HbA1C), diastolic blood pressure, percent body fat, and waist circumference were decreased, and became the normal value. Especially, HbA1C, percent body fat, and waist circumference were significantly decreased (P<0.001) in the experimental group, while HbA1C, percent body fat, and waist circumference were significantly increased (P<0.001) in the control group (N=50), who had no intervention. Our results suggest that metabolic syndrome associated markers need intervention program for improving them. In conclusion, although this study did not analyze the effect of the health intervention program and cooking therapy separately, considering the result of this 3-week, short term program, the effect will be more profuse if cooking therapy and exercise program were performed concurrently.

키워드

참고문헌

  1. Kim SE. Impacts of ageing society on local administration and its preparation for the future. Local administration study. 2017;31:3-034.
  2. National Health Insurance Service. Obesity white paper. 2017. p41-127.
  3. Lim HK, Sull JW, Park JY, Hong MH, Lee YR, et al. Relationship of metabolic diseases with physical activity depending on age. Korean J Clin Lab Sci. 2018;50:144-154. https://doi.org/10.15324/kjcls.2018.50.2.144.
  4. Oja P, Vuori I, Paronen O. Daily walking and cycling to work: their utility as health-enhancing physical activity. Patient Educ Couns. 1998;33(Suppl 1):87-94. https://doi.org/10.1016/S0738-3991(98)00013-5
  5. Kim HJ, Choi IJ, Kim WG, Asano K, Hong JM, Cho YM, et al. Effect of a worksite-based dietary intervention program for the management of metabolic syndrome. KJCN. 2016;21:237-246. https://doi.org/10.5720/kjcn.2016.21.3.237.
  6. Choi MS. Effects of nutrition education and exercise intervention on health and diet quality of middle-aged women. Korean J Nutr. 2009;42:48-58. https://doi.org/10.1186/1471-2458-9-45.
  7. Lee HS, Lee JW, Chang NS, Kim JM. The effect of nutrition education and exercise program on body composition and dietary intakes, blood lipid obese women. Korean J Nutr. 2009;42: 759-769. https://doi.org/10.5720/kjn.2009.42.8.759.
  8. Mottillo S, Filion KB, Genest J, Joseph L, Pilote L, Poirier P, et al. The metabolic syndrome and cardivascular risk a systematic review and mata-analysis. J Am Coll Cardiol. 2010;56:1113-1132. https://doi.org/10.1016/j.jacc.2010.05.034.
  9. Jekal Y, Yun JE, Park SW, Jee SH. Jeon JY. The relationship between the level of fatness and fitness during adolescence and the risk factors of metabolic disorders in adulthood. Korean diabetes J. 2010;34:126-134. https://doi.org/10.4093/kdj.2010.34.2.126.
  10. Ko SH, Park CH, Jekal US. Effects of exercise intervention program on the level of obesity, physical fitness level and metabolic related risk factors among hypertensive and diabetic patients. Korea Society for Wellness. 2017;12:645-655. https://doi.org/10.21097/ksw.2017.02.12.1.645.
  11. Williams PT. Physical fitness and activity as separate heart disease risk factors: a meta-analysis. Med Sci Sports Exerc. 2001;33:754-761.
  12. Park CH, Jekal Y. The effect of family-based health promotion programm on the level of obesity, physical fitness and metabolic related risk factors among children and adolescents. Korea Society for Wellness. 2017;12:565-578. https://doi.org/ 10.21097/ksw.2017.08.12.3.565.
  13. Wang Y, Xie B, Tao Y, Ma Y, Zang K. Impact of community-based integrated traditional chinese and Western medicine metabolic symdrome intervention technology in rural residents in Southern Jiangsu, China. Clini Res. 2015;2163-2169. https://doi.org/10.12659/MSM.893972.
  14. Kim MJ, Park EO. The prevalence and the related factors of metabolic syndrome in urban and rural community. Korean J of Adult Nurs. 2014;26:67-77. https://doi.org/10.7475/kjan.2014.26.1.67
  15. Weng X, Liu Y, Ma J, Wang W, Yang G, Caballero B. An urban-rural comparison of the prevalence of the metabolic syndrome in Eastern China. Public Health Nutrition. 2007;10:131-136. https://doi.org/10.1017/S1368980007226023.
  16. Zyl S, Merwe LJ, Walsh CM, Groenewald AJ, Rooyen FC. Risk-factor profiles for chronic diseases of lifestyle and metabolic syndrome in an urban and rural setting in South Africa. Afr J Prm Health Care Fam Med. 2012;4:1-10. https://doi.org/10.4102/phcfm.v4i1.346.
  17. Rossi AM, Davies E, Lavoie KL, Arsenault A, Gordon JL, Meloche B, et al. The impact of metabolic syndrome and endothelial dysfunction on exercise-induced cardiovascular changes. Obesity. 2013;21:143-148. https://doi.org/10.1002/oby.20258.
  18. Shin KA. Optimal cutoff points of rate pressure product in each stage of treadmmill exercise test according to the degree of metabolic syndrome in Korean adults. Korean J Clin Lab Sci. 2018;50:136-143. https://doi.org/10.15324/kjcls.2018.50.2.136.
  19. Grundy SM, Cleeman JI, Merz CN, Brewer HB, Clark LT, Hunninghake DB, et al. Implication of recent clinical trials for the national cholesterol education program adult treatment panel III guideline. Circulation. 2004;110:227-239. https://doi.org/ 10.1161/01.ATV.0000133317.49796.0E.
  20. Rabe K, Lerke M, Parhofer KG, Bredl UC. Adipokines and insulin resistance. Mol Med. 2008;14:741-751. https://doi.org/10.2119/2008-00058.Rabe.
  21. Lindsay RS, Funahashi T, Hanson RI, MatsuzawaY, Tanaka S, Tataranni PA, et al. Adiponectin and development of type 2 diabetes in the Pima Indian population. Lancet. 2002;360:57-58. https://doi.org/10.1016/S0140-6736.
  22. Wijesekara N, krishnamurthy M, Bhattacharjee A, Suhail A, Sweeney G, Wheeler MB. Adiponectin-induced ERK and Akt phosphorylation protects against pancreatic beta cell apoptosis and increases insulin gene expression secretion. J Biol Chem 2010;285:33623-33631. https://doi.org/10.1074/jbc.M109.085084.
  23. Hans JS, Zhoh CK, Lee EJ. The effect of obesity management program on blood lipid profile and adiponectin in obese women. Korean J Obes. 2013;22:231-236. http://dx.doi.org/10.7570/kjo.2013.22.4.2311.