A. Satoh et al. / Health 3 (2011) 487-489
Copyright © 2011 SciRes. Openly accessible at http://www.scirp.org/journal/HEALTH/
488
tional balance chart (MNBC) as described previously
and explained briefly here [6]. The MNBC was designed
to outline a 6697 kj intake according to the recommen-
dation by the Japan Obesity Society [7]. The MNBC
demonstrates the ideal dietary distribution of 11 catego-
ries of food: meat, fish, eggs, milk and dairy products
(hereinafter called milk), beans and bean products, such
as bean curd and miso soup (hereinafter called beans),
green and yellow vegetables, light-colored vegetables,
fruit, potatoes and grains (hereinafter called grains), oil,
and sugar. The number of times each food category was
consumed was marked with black dots; the foods eaten
were recorded by category, but not by amount. The child
(and/or mother) filled out a meal chart which consisted
of columns for breakfast, lunch, dinner, and snacks be-
tween meals. The meal chart was to be filled out for 3
days of the last week of one month; Friday, Saturday,
and Sunday. We calculated the nutritional balance, as
follows: (intake ratio of food = the actual food intake
[black dots] ÷ the ideal food intake following the MNBC
[black dots]). Thus the nutritional balance based on the
MNBC was ideally “1”. Ethical approval was obtained
from the Ethical Committee of the University. The
Mann-Whitney’s U test was used for the significance.
Multivariate logistic regression was used to determine
the variations. Values were presented as mean ± SD.
Statistical significance was considered for p < 0.05.
3. RESULTS
Percentage overweight values of obese children and
non-obese ch ildren were 50 ± 21% an d –3 ± 8%, respec-
tively. The numbers of children with exercise habits and
without exercise habits were 9 and 25 in the obesity
group and 8 and 2 in the non-obesity group, resp ectively.
Intake-ratio of food in the obesity group was signifi-
cantly lower than that of the non-o besity group (p < 0.01)
(Table 1). Exercise performance was significantly higher
in non-obese children than obese children (p < 0.01).
Children with exercise showed a significantly lower de-
gree of obesity than children withou t exercise (11 ± 20%
vs. 56 ± 23%) (p < 0.01). Time watching TV was sig-
nificantly lower in non-obese children (2.0 ± 0.9 h) than
obese children (3.0 ± 1.5 h) (p < 0.05). Time playing
games was significantly lower in non-obese children (0.1
± 0.3 h) than obese children (0.4 ± 0.8 h) (p < 0.05). The
children with exercise showed significantly shorter times
of summation of watching TV and playing games than
the children without exercise (2.7 ± 1.2 h vs. 3.2 ± 2.3 h)
(p < 0.01). The relative impact for obesity (where obese
and non-obese ch ildren corresponded to 0 and 1, respec-
tively) verses intake ratio of food, exercise, time watch-
ing TV and time playing games was assessed using mul-
tiple logistic regression wh ere intake ratio of food 1.1 or
more and less than 1.1 corresponded to 0 and 1, exercise
yes and no corresponded to 0 and 1, time watching TV
of 2.6 hours or more and less than 2.6 hours corre-
sponded to 0 and 1, time playing games of 0.3 hours
or more and less than 0.3 hours corresponded to 0 and
1, respectively. Multiple logistic regression of the rela-
tion- ship between obesity and exercise was significant
(odds ratio = 24.8, 95% confidence interval = 1.2 –
500.9, p < 0.05) and not significant for other factors.
4. DISCUSSION
It was an unexpected finding that the non-obesity
group showed a higher intake ratio of food than the obe-
sity group (Table 1). If food-intake is not a primary fac-
tor in determining obesity, there may be other factors.
We observed that exercise was the key factor to deter-
mine obesity. The non-obesity group took less time
watching TV and playing games than that of obesity
groups. The children with exercise show significantly
shorter times of watching TV and playing games. Taking
together these results, obesity might not be brought by
too much food, but might be brought by non-exercise
performance such as watching TV and playing games in
children.
In obese children, the intervention of diet control was
effective using MNBC but limited as the percentage
overweight decreased only from 50% to 40% [6]. Since
the intervention of obesity was limited by the way of
food intake, habitual exercise would determine the obe-
sity. The present non-obese children were volunteer
school children and some selections might cause a dif-
ferent result. Surveillance of Japanese school children
shows approximately 85% of primary school children
performed exercise and 80% of junior high school chil-
dren performed exercise although the percentage of ex-
ercise decreased to 60% in high school students [8]. Of
the present non-obese children, 80% performed exercise
Table 1. Intake-ratio of food in obesity and non-obesity groups.
Meat Fish Egg Milk Beans
Green and yellow
vegetables Light-colored veget a b l e sFruitGrain Oil Sugar Mean ± SD
Obesity group 1.0 0.6 1.4 0.5 0.8 0.3 0.5 0.91.5 1.4 1.4 0.9 ± 0.4
Non-obesity group 1.3 1.1 1.1 1.5 1.1 0.5 0.7 1.11.5 1.8 2.5 1.3 ± 0.4
NS * NS *** NS * * NSNS ** ** **
*(p < 0.05), **(p < 0.01) and ***(p < 0.001) shows dignificances between the obesity group and non obesity group using the two-sided Mann-Whitney’s U test.
NS shows no significance. Values are mean ± SD.