小児肥満児に対する食事＋運動療法が
腹腔内脂肪蓄積に及ぼす影響について

The Effects of Dietary Treatment and Physical Training
on Body Fat Distribution in Obese Children

by

Kenji Togashi
Department of Physical Education, Faculty of Education, Mie University
Hidenari Masuda, Takao Fujisawa
Department of Pediatrics, Mie National Hospital

ABSTRACT

The purpose of this study was to investigate the combined efect of dietary treatment and physical training on body fat distribution, the risk factors of chronic disease, and aerobic work capacity in obese children. The subjects were 9 obese children (6 boys, 3 girls; 11.4 yrs; %fat, 33.6%). The areas of subcutaneous and visceral fat were measured using in CT images at the level of the umbilicus. Early in the morning, blood samples were taken to measure risk factors of chronic disease such as TG, HDL-C, LDL-C and uric acid, and their relationship with the areas of subcutaneous and visceral fat was examined. Supervised physical training at 50% Vo2max for 30min/day using a bicycle ergometer was performed 2 or 4 days/week for 10 weeks. The dietary treatment was varied with daily calorie intake between 1400 and 1900 kcal depending on the degree of obesity. After dietary treatment combined with physical training, the areas of subcutaneous and visceral fat decreased significantly (from 249.5 to 158.9c? , from 46.0 to 28.5 c? : p＜0.001, respectively), and such risk factors as TG, HDL-C, LDL-C and uric acid were noticeably redu-ced. Maximum oxygen uptake increased significantly from 28.9 to 32.9 ml /kg/min (p＜0.05). These data suggest that dietary trearment com-bined with physical training in obese children reduced the risk factors of chronic disease and the distribution of body fat, while improving aerobic work capacity. Moreover, such treatment would be effective for the early treatment of obesity and prevention of chronic disease.

　要　旨

　本研究の目的は個人ごとに設定した食事＋運動療法の併用が、小児肥満児の体脂肪分布、生活習慣病危険因子、有気的作業能の及ぼす影響について検討することである。対象は単純性肥満児童９名であり、臍高部ＣＴ画像より皮下脂肪面積、内蔵脂肪面積を定量した。早朝空腹時に採血を行ない、ＴＧ、ＨＤＬ−Ｃ、ＬＤＬ−Ｃ、尿酸などの生活習慣病危険因子と皮下・内蔵脂肪面積との関連を検討した。運動療法は毎日の日課としての運動（ジョギング、なわ跳び、肥満体操、エアロビクス等）１９週間と、そのうち１０週間は自転車エルゴメータを用いた５０％Ｖｏ２ｍａｘ強度の有酸素的運動を１日３０分、週２〜４回付加的に行なった。食事療法は肥満の程度に応じて１日１４００〜１９００ｋｃａｌの間で行なった。
　食事＋運動療法後、皮下脂肪面積、内蔵脂肪面積とも有意に減少（それぞれ、２４９．５から１５８．９ｃ?へ、４６．０から２８．５ｃ?へ）し、それに伴い、生活習慣病危険因子も改善した。また、有気的作業能力の指標である最大酸素摂取量は２８．９から３２．９ｍｌ／ｋｇ／ｍｉｎへと有意に増加し、体力面での向上も認められた。
　以上の結果より、小児肥満児における適切な食事療法と有気的な運動療法の併用は体脂肪分布を変化させるとともに生活習慣病危険因子や有気的作業能を改善させ、肥満の早期治療、将来の生活習慣病予防の点で有効であることが示唆された。