2003 4
, 2 22.4%, 3.01%, 2002 4 21 BMI BMI 24 BMI 28 85cm 80cm 2003 3 10 ii
*, iii
1 1 2 1 2.1 2 2.2 3 2.3 3 3 4 3.1 5 3.2 5 4 6 4.1 6 4.2 7 4.2.1 7 4.2.2 8 4.2.3 8 5 9 5.1 9 5.1.1 10 5.1.2 2 11 5.1.3 11 5.1.4 12 5.1.5 12 5.1.6 12 iv
5.1.7 13 5.2 14 6 14 6.1 15 6.2 15 6.3 18 6.4 19 6.4.1 19 6.4.2 21 6.4.3 27 6.4.4 28 6.4.5 30 7 32 7.1 32 7.2 32 7.3 33 8 34 34 34 35 BMI 35 37 38 39 v
1 1948 1999 61% [1] [2] 2 ( %) 1
95% WHO 8:1 2:1 1:1 2.1 (Body Mass Index) BMI (weight for height) (, kg) (, m) BMI= / / ( kg /m 2 ) BMI BMI [3 9] % [3] 2
2.2 (Waist Circumference, WC) ( ) BMI [3,6,9] 2.3 (WHO) 25.0 29.9 30 ( 1 1) [4 7] [8 9] 1 * (cm) kg/m 2 < 85 85 95 95 < 80 80 90 90 ** <18.5...... 18.5 23.9... 24.0 27.9 28 * ** BMI 25 30 1990 13 24 [9] 24( BMI 24 kg/m 2 ) 3
BMI=18.5 23.9 kg/m 2 3 4 2 3 2 2 ( 5 ) 3 4 BMI 28 90% 85 80 3.5 2.5 2 2 4 [9] 10 24,900 35 59 32.0% 30.6% 53.5% [10] 2002 23.0 24.9 25 [11] 2, [12 14] 3 1948 WHO 4
3.1 (BMI 30 ) 20% (NHANES 1988 1994) (20 74 ) 9700 [5] BMI 25 29.9 39.4% 24.7% BMI 30 19.8% 24.9% [11] 1999 34% 27% [1] [12 14] 1992 20 60 BMI 25 14.4%( 24.6% 10.4%) BMI 30 1.5%( 2.9% 1.0%) [15] 20 90 20 70 24 BMI 25 29.9 22.4% BMI 30 3.01% [9] 1995 1997 11 ( ) (BMI 25 29.9 ) 21.51% (BMI 30) 2.92% [16] 3.2 10 10% 40% 2 1976 1993 20 2.4 1.8 5
1980 1990 15 35 59 1990 4 BMI 25 50% 3 BMI 25 50% [16] 4 ( ) ( ) 4.1 70% 80% ( ) 40% 20% 40% [17 ] 20 6
, 4.2 4.2.1 [16] 30% 40% 7
4.2.2 ( ) [3] 4.2.3 ( 8
) ( ) 5 5.1 (LDL) [3,5,12] [4 7] 9
2 * ( 3) ( 2 3) ( 1 2) 2 * 5.1.1 (BMI) 140 / 90 (1 =1 mmhg=0.133kp) 120/90 [18] 24 BM 24 BMI 24 2.5 BMI 28 BMI 24 3.3 85cm 80cm 2.3 [9] [12,17] 10
5.1.2 2 2 24 126 /100 2 200 /100 2 BMI 24 2 BMI 24 2.0 BMI 28 2 BMI 24 3.0 85cm 80cm 2 2.5 [9] 2 18 2 [12] [12] 5.1.3 24 BMI 24 ( 200 /100 ) BMI 24 2.5 BMI 28 BMI 24 3.0 2.5 BMI 24 28 (<35 /100 ) BMI 24 1.8 2.1 11
1.8 [9] 5.1.4 10 ( ) [10] BMI 24 BMI 28 BMI 24 2.2 2.8 2.1 [8] 5.1.5 10 2.2 5.1.6 ( ) ( ) ( ) [3] 12
5.1.7 5.1.7.1 [18] 5.1.7.2 [3] [12] 5.1.7.3 4 [3,12] B 200 BMI 24 41.5% 574 11.3% [19] 13
5.1.7.4 [3,12] 5.2 6 14
[3,5,12] 6.1 6.2 15
6.2.1 5 10 6.2.2 / 16
6.2.3 5% 10% 6.2.4 1 2 3 17
18 4 5 6 6.3 BMI 24 BMI <28 BMI 28 5%~10% 5%~10% 5%~10% 5%~10% 1 6
6.4 6.4.1 ( ) ( ) 1 9 1 1 4 1 1 15% 20% 60% 65% 25% 19
( ) 1/3 0.5 1000 1200 / 1200 1600 / 300 500 800 A B 2 B 6 C 1 20
3 ( ) ( ) ( ),, 1100 150 70 40 40 400 100 250 10 54.0 40 149 1300 200 80 50 50 400 100 250 14 64.4 48 187 1500 240 90 50 60 400 100 250 16 72.4 53 217 1700 280 90 50 60 500 100 250 18 77.8 55 250 1900 320 90 50 60 500 100 250 20 82.2 58 280 2000 350 90 50 60 500 100 250 20 85.5 59 302 (1) 50 = 50 = 65 = 120 6.4.2 ( ) / 3% 40% ( 4) 4. ( ) ( ) (VO 2 max) FFM % 21
RMR HDL C (Fat Free Mass, FFM) (Resting Metabolic Rate, RMR) RMR FFM 6.4.2.1 22
1 2 5 6.4.2.2 4.8 7.0 3.3 5.1 /, 1.9 4.6 1.4 3.2 / 100 120 / 80 100 [20 22] 50% 40% 60% 50% 1 4 1 1100 550 2 3 4 1 3 0.75 800 400 1.5 2 2.5 3.5 1 2 0.5 23
550 300 1 1.5 2 3 1 1 0.25 270 150 1 2 35 1.56 64, BMI 26.3, 58, 6 2 2.5, 0.625 670, 350 : 30 ( 100 ) 30 ( 180 ) 15 ( 75 ) 1 355 (315 / ) 1 4, 1100, 1 550 : 30 250 30 150 30 150 ( 5) 24
5. 30 30 30 40 40 70 1609 /1 100 8.5 /1 20 / 120 10 /1 1000 1200 /10 175 150 15 /1, 180 5 0, 200 19 22 200 250 /1 50 / 22 26 /1 300 160 /1 1 150 1 30 40 30 30, 6.4.2.3 ( ) ( ) 1 30 45 100 200 ( ) 25
6.2.2.4, 30 30 60 10,,, 26
6.4.3 30 5000 30 45 60 35% 30% 28% 25% 27
6.4.4 6.4.4.1 BMI 24 BMI 28 3 6 5% 6.4.4.2 5% 10% 6.4.4.3 (Fenfluramine) (Phentermine) 28
(1) 5 5 5 10 / 3 6 10 (2) 1/3 120 3 6 7 10 [18] ( ) 3% 3 6 4 [23] A D E 29
6 (Sibutramine) 10 15 5 5 (Orlistat) 120 120 6 / 2 4 3 6.4.5 BMI>40 30
( A B D ) ( ) 31
7 7.1 ( ) 40% 7.2 ( 65 ) ( 32
) 7.3 33
(WHO) (BMI) BMI BMI (BMI)= ( ) ( ) (kg/m 2 ) ( 1 ) 1 10 ( ) ( ) 30 40 1 ( 34
) 1 (WHO) BMI BMI -1 WHO BMI BMI (kg/m 2 ) ( ) <18.50 ( ) 18.5 24.9 25.0 25.0 29.9 30.0 34.9 35.0 39.9 40.0-2 BMI (kg/m 2 ) <18.5 (cm) <90 <80 (cm) 90 80 ( ) 18.5 22.9 23.0 23.0 24.9 25.0 29.9 30.0 IV BMI ( ) 35
50 52 54 56 58 60 62 64 66 68 70 72 74 76 78 80 82 84 86 88 90 92 94 96 98 100 102 104 1.3 29.6 30.8 32.0 33.1 34.3 35.5 36.7 37.9 39.1 40.2 41.4 42.6 43.8 45.0 46.2 47.3 48.5 49.7 50.9 52.1 53.3 54.4 55.6 56.8 58.0 59.2 60.4 61.5 6 1.32 28.7 29.8 31.0 32.1 33.3 34.4 35.6 36.7 37.9 39.0 40.2 41.3 42.5 43.6 44.8 45.9 47.1 48.2 49.4 50.5 51.7 52.8 53.9 55.1 56.2 57.4 58.5 59.7 6 1.34 27.8 29.0 30.1 31.2 32.3 33.4 34.5 35.6 36.8 37.9 39.0 40.1 41.2 42.3 43.4 44.6 45.7 46.8 47.9 49.0 50.1 51.2 52.4 53.5 54.6 55.7 56.8 57.9 5 1.36 27.0 28.1 29.2 30.3 31.4 32.4 33.5 34.6 35.7 36.8 37.8 38.9 40.0 41.1 42.2 43.3 44.3 45.4 46.5 47.6 48.7 49.7 50.8 51.9 53.0 54.1 55.1 56.2 5 1.38 26.3 27.3 28.4 29.4 30.5 31.5 32.6 33.6 34.7 35.7 36.8 37.8 38.9 39.9 41.0 42.0 43.1 44.1 45.2 46.2 47.3 48.3 49.4 50.4 51.5 52.5 53.6 54.6 5 1.4 25.5 26.5 27.6 28.6 29.6 30.6 31.6 32.7 33.7 34.7 35.7 36.7 37.8 38.8 39.8 40.8 41.8 42.9 43.9 44.9 45.9 46.9 48.0 49.0 50.0 51.0 52.0 53.1 5 1.42 24.8 25.8 26.8 27.8 28.8 29.8 30.7 31.7 32.7 33.7 34.7 35.7 36.7 37.7 38.7 39.7 40.7 41.7 42.7 43.6 44.6 45.6 46.6 47.6 48.6 49.6 50.6 51.6 5 1.44 24.1 25.1 26.0 27.0 28.0 28.9 29.9 30.9 31.8 32.8 33.8 34.7 35.7 36.7 37.6 38.6 39.5 40.5 41.5 42.4 43.4 44.4 45.3 46.3 47.3 48.2 49.2 50.2 5 1.46 23.5 24.4 25.3 26.3 27.2 28.1 29.1 30.0 31.0 31.9 32.8 33.8 34.7 35.7 36.6 37.5 38.5 39.4 40.3 41.3 42.2 43.2 44.1 45.0 46.0 46.9 47.9 48.8 4 1.48 22.8 23.7 24.7 25.6 26.5 27.4 28.3 29.2 30.1 31.0 32.0 32.9 33.8 34.7 35.6 36.5 37.4 38.3 39.3 40.2 41.1 42.0 42.9 43.8 44.7 45.7 46.6 47.5 4 1.5 22.2 23.1 24.0 24.9 25.8 26.7 27.6 28.4 29.3 30.2 31.1 32.0 32.9 33.8 34.7 35.6 36.4 37.3 38.2 39.1 40.0 40.9 41.8 42.7 43.6 44.4 45.3 46.2 4 1.52 21.6 22.5 23.4 24.2 25.1 26.0 26.8 27.7 28.6 29.4 30.3 31.2 32.0 32.9 33.8 34.6 35.5 36.4 37.2 38.1 39.0 39.8 40.7 41.6 42.4 43.3 44.1 45.0 4 1.54 21.1 21.9 22.8 23.6 24.5 25.3 26.1 27.0 27.8 28.7 29.5 30.4 31.2 32.0 32.9 33.7 34.6 35.4 36.3 37.1 37.9 38.8 39.6 40.5 41.3 42.2 43.0 43.9 4 1.56 20.5 21.4 22.2 23.0 23.8 24.7 25.5 26.3 27.1 27.9 28.8 29.6 30.4 31.2 32.1 32.9 33.7 34.5 35.3 36.2 37.0 37.8 38.6 39.4 40.3 41.1 41.9 42.7 4 1.58 20.0 20.8 21.6 22.4 23.2 24.0 24.8 25.6 26.4 27.2 28.0 28.8 29.6 30.4 31.2 32.0 32.8 33.6 34.4 35.3 36.1 36.9 37.7 38.5 39.3 40.1 40.9 41.7 4 1.6 19.5 20.3 21.1 21.9 22.7 23.4 24.2 25.0 25.8 26.6 27.3 28.1 28.9 29.7 30.5 31.3 32.0 32.8 33.6 34.4 35.2 35.9 36.7 37.5 38.3 39.1 39.8 40.6 4 1.62 19.1 19.8 20.6 21.3 22.1 22.9 23.6 24.4 25.1 25.9 26.7 27.4 28.2 29.0 29.7 30.5 31.2 32.0 32.8 33.5 34.3 35.1 35.8 36.6 37.3 38.1 38.9 39.6 4 1.64 18.6 19.3 20.1 20.8 21.6 22.3 23.1 23.8 24.5 25.3 26.0 26.8 27.5 28.3 29.0 29.7 30.5 31.2 32.0 32.7 33.5 34.2 34.9 35.7 36.4 37.2 37.9 38.7 3 1.66 18.1 18.9 19.6 20.3 21.0 21.8 22.5 23.2 24.0 24.7 25.4 26.1 26.9 27.6 28.3 29.0 29.8 30.5 31.2 31.9 32.7 33.4 34.1 34.8 35.6 36.3 37.0 37.7 3 1.68 17.7 18.4 19.1 19.8 20.5 21.3 22.0 22.7 23.4 24.1 24.8 25.5 26.2 26.9 27.6 28.3 29.1 29.8 30.5 31.2 31.9 32.6 33.3 34.0 34.7 35.4 36.1 36.8 3 1.7 17.3 18.0 18.7 19.4 20.1 20.8 21.5 22.1 22.8 23.5 24.2 24.9 25.6 26.3 27.0 27.7 28.4 29.1 29.8 30.4 31.1 31.8 32.5 33.2 33.9 34.6 35.3 36.0 3 1.72 16.9 17.6 18.3 18.9 19.6 20.3 21.0 21.6 22.3 23.0 23.7 24.3 25.0 25.7 26.4 27.0 27.7 28.4 29.1 29.7 30.4 31.1 31.8 32.4 33.1 33.8 34.5 35.2 3 1.74 16.5 17.2 17.8 18.5 19.2 19.8 20.5 21.1 21.8 22.5 23.1 23.8 24.4 25.1 25.8 26.4 27.1 27.7 28.4 29.1 29.7 30.4 31.0 31.7 32.4 33.0 33.7 34.4 3 1.76 16.1 16.8 17.4 18.1 18.7 19.4 20.0 20.7 21.3 22.0 22.6 23.2 23.9 24.5 25.2 25.8 26.5 27.1 27.8 28.4 29.1 29.7 30.3 31.0 31.6 32.3 32.9 33.6 3 1.78 15.8 16.4 17.0 17.7 18.3 18.9 19.6 20.2 20.8 21.5 22.1 22.7 23.4 24.0 24.6 25.2 25.9 26.5 27.1 27.8 28.4 29.0 29.7 30.3 30.9 31.6 32.2 32.8 3 1.8 15.4 16.0 16.7 17.3 17.9 18.5 19.1 19.8 20.4 21.0 21.6 22.2 22.8 23.5 24.1 24.7 25.3 25.9 26.5 27.2 27.8 28.4 29.0 29.6 30.2 30.9 31.5 32.1 3 1.82 15.1 15.7 16.3 16.9 17.5 18.1 18.7 19.3 19.9 20.5 21.1 21.7 22.3 22.9 23.5 24.2 24.8 25.4 26.0 26.6 27.2 27.8 28.4 29.0 29.6 30.2 30.8 31.4 3 1.84 14.8 15.4 15.9 16.5 17.1 17.7 18.3 18.9 19.5 20.1 20.7 21.3 21.9 22.4 23.0 23.6 24.2 24.8 25.4 26.0 26.6 27.2 27.8 28.4 28.9 29.5 30.1 30.7 3 1.86 14.5 15.0 15.6 16.2 16.8 17.3 17.9 18.5 19.1 19.7 20.2 20.8 21.4 22.0 22.5 23.1 23.7 24.3 24.9 25.4 26.0 26.6 27.2 27.7 28.3 28.9 29.5 30.1 3 1.88 14.1 14.7 15.3 15.8 16.4 17.0 17.5 18.1 18.7 19.2 19.8 20.4 20.9 21.5 22.1 22.6 23.2 23.8 24.3 24.9 25.5 26.0 26.6 27.2 27.7 28.3 28.9 29.4 3 1.9 13.9 14.4 15.0 15.5 16.1 16.6 17.2 17.7 18.3 18.8 19.4 19.9 20.5 21.1 21.6 22.2 22.7 23.3 23.8 24.4 24.9 25.5 26.0 26.6 27.1 27.7 28.3 28.8 2 BMI 36
V 7 37
9 4 ( 100 ) ( ) ( ) ( ) 341 9.3 1.2 73 338 7.4 0.8 75 34 11.2 1.5 71 126 19.1 5.2 0.8 143 20.3 6.2 1.5 106 20.2 2.3 1.2 118 20.5 3.9 0.2 109 17.6 4.1 0.5 167 19.3 9.4 1.3 146 12.7 10 1.4 (1) 121 16.2 3.6 6 23 1.4 0.5 3 20 1.2 0.2 3 23 1.8 0.5 3 27 0.5 1.2 4 44 0.4 0.1 10 50 0.2 0.1 12 39 0.7 0.1 9 55 3 3.2 3 (1) 50 = 50 = 65 = 120 ( ) 38
/ / 65 55 1 30 30 / / / 0.018 0.075 35 30 <80 0.025 0.105 49 41 <80 0.034 0.142 66 56 <80 0.045 0.188 88 74 80 100 0.048 0.201 94 79 80 100 0.056 0.234 109 92 80 100 0.062 0.259 121 102 80 100 0.040 0.167 78 66 80 100 0.060 0.251 119 99 80 100 0.088 0.368 172 145 80 100 0.054 0.071 0.112 0.129 105 150 90 127 80 100 0.226 0.322 0.469 0.540 219 252 186 213 120 140 39
/ 65 55 1 30 30 / / / 0.027 0.113 53 45 <80 0.048 0.201 94 79 80 100 50 55 / 0.052 0.218 101 86 80 100 110 120 / 0.076 0.318 148 125 80 100 120 / 0.097 0.406 189 160 100 120 0.057 0.239 111 94 80 100 : 0.061 0.225 119 101 80 100 0.083 0.347 162 137 100 120 0.088 0.368 172 145 100 120 0.115 0.481 224 190 100 120 0.130 0.544 254 215 120 140 0.062 0.259 121 102 80 100 0.030 0.126 59 50 <80 0.032 0.134 62 53 <80 0.040 0.167 78 66 80 100 0.060 0.251 117 99 80 100 0.067 0.280 131 111 80 100 40
/ 65 55 1 30 30 / / / 0.053 0.066 0.222 0.276 103 129 88 109 80 100 0.078 0.130 0.326 0.544 152 254 129 215 80 120 0.086 0.360 168 142 100 120 0.121 0.506 236 200 120 140 <10 0.098 0.411 192 162 100 120 0.115 0.481 224 190 100 120 200 / 0.150 0.628 293 248 120 140 0121 0.506 236 200 120 140 0.060 0.251 117 99 80 100 0.058 0.243 113 96 80 100 0.075 0.091 0.314 0.381 146 178 124 150 80 100 0.042 0.176 82 69 80 100 0.068 0.285 133 112 80 100 0.069 0.083 0.289 0.347 135 162 114 137 80 110 0.052 0.076 0.218 0.318 101 148 86 125 80 100 0.098 0.138 0.410 0.577 191 269 162 228 120 140 0.109 0.456 213 180 100 120 0.132 0.552 260 218 120 140 0.084 0.115 0.352 0.481 164 224 139 190 100 120 0.115 0.481 224 190 110 120 41
/ 65 55 1 30 30 / / / 0.158 0.661 308 261 140 160 0.058 0.101 0.243 0.423 113 197 96 167 80 110 0.101 0.142 0.423 0.594 197 277 167 234 120 140 10 / 0.050 0.209 98 83 80 100 20 / 0.070 0.293 137 116 80 100 30 / 0.170 0.711 332 278 140 160 0.037 0.155 72 61 <80 0.054 0.226 105 89 80 100 0.023 0.096 45 38 <80 0.075 0.314 146 124 80 100 0.085 0.356 166 140 80 100 0.115 0.481 224 190 100 120 0.091 0.381 178 150 100 120 0.092 0.178 0.385 0.745 179 347 152 294 110 150 0.108 0.452 211 178 100 120 0.145 0.607 283 239 120 140 0.297 1.243 579 490 180 Nutrition in Sport (the Encyclopaedia of Sports Medicine, R.J. Maughan, 2000) [20 22] 42
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2002, 360:9328 7 20 12 National Institutes of Health, National Heart Lung, and Blood Institute in cooperation with the National Institute of Diabetes and Digestive and Kidney Diseases: Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults. The evidence report. NIH Publication, no. 98 4083, September 1998 13 National Health and Medical Research Council: Acting on Australia s weight: a strategic plan for the prevention of overweight and obesity. 1998 14 Scottish Intercollegiate Guidelines Network: Obesity in Scotland. integrating prevention with weight management. A national clinical guideline recommended for use in Scotland. Pilot edition, November 1996. 15 2001 30(6) 339 342 16 1998 2000 29(5) 329 17 Bray GA Contemporary diagnosis and management of obesity, Handook in Health Care Co., Newton, Pennsylvania, USA. 1998 pp 41 44 18 2001 19,, 2000 28 2 97 98 20 Hill JO, Commerford R. Physical activity, fat balance, and energy balance. Int J Sport Nutr 1996; 6:80 92. 21 Kleges RC, Kleges LM, Haddock CK, et al. A longitudinal analysis of the impact of dietary intake and physical activity on weight change in adults. Am J Clin Nutr 1992; 55: 818. 22 Montoye H.J., Eergy Costs of exercise and Sport, in Maughan R.J. (Ed) Nutrition in 44
Sport, vol VII of The Encyclopaedia of Sports Medicine, An IOC Commission Publication, In Collaboration with the International federation of Sports Medicine, Blackwell Science, 2000; pp53 72. 23 Sjostrom L, Torgerson JS, Houptman J and Boldrin M, Xenical in prevention of diabetes in obese subjects, poster presentation at 9 th International Obesity Conference, 2002, Sao Paulo 45