한국 성인과 노인을 대상으로 이중표식수법을 이용한 신체활동분류표 타당도 평가

Purpose: This study evaluated the validity of a physical activity classification table (PACT) based on total energy expenditure (TEE) and physical activity level (PAL) measured using the doubly labeled water (DLW) method in Korean adults and the elderly. Methods: A total of 141 (male 70, female 71) adults and elderly were included. The reference standards TEEDLW, PALDLW were measured over a 14-day period using DLW. A 24-hour physical activity diary was kept for three days (two days during the week and one day on the weekend). PALPACT was calculated by classifying the activity type and intensity using the PACT. PALPACT was multiplied by resting energy expenditure measured by indirect calorimetry to estimate TEEPACT. Results: The mean age of the study participants was 50.5 ± 18.8 years, and the mean body mass index was 23.4 ± 3.3 kg/m2. A comparison of TEEDLW and TEEPACT by sex and age showed no significant differences. The bias, the difference between TEEDLW and TEEPACT, was male 17.3 kcal/day and female -4.5 kcal/day. The percentage of accurate predictions (values within ± 10% of the TEEDLW) of TEEPACT was 58.6% in males and 54.9% in females, with the highest prediction values in the age group 40-64 years (70.9%) in males and over 65 years (73.9%) in females. The spearman correlation coefficient (r) between TEEPACT and TEEDLW was 0.769, indicating a significant positive correlation (p < 0.001). Conclusion: In this study, the use of a new PACT for calculating TEE and PAL was evaluated as valid. A web version of the software program and a smartphone application need to be developed using PACT to make it easier to apply for research purposes. 그동안 국내 연구에서 PAL을 산출하기 위해 사용해온 18단계 신체활동분류표로 신체활동을 평가하는 데 한계가 있었기에 새롭게 한국인을 위한 신체활동분류표가 보고되었다. 이에 본 연구에서 총에너지소비량을 측정하는 gold standard인 이중표식수법을 이용하여 새로 보고된 신체활동분류표의 타당도를 평가한 결과, TEEDLW와 TEEPACT 간의 유의한 차이가 없었으며 TEEDLW와 TEEPACT 간의 스피어만 상관관계 (r = 0.769)는 유의한 높은 양의 상관성을 보였다. 즉, 본 연구에서 TEE 및 PAL 산출을 위해 새로운 신체활동분류표의 사용이 타당한 것으로 평가되었으며, 앞으로 이와 관련된 연구 결과는 2025 한국인 영양소 섭취기준에서 에너지필요추정량 산출식에 필요한 신체활동단계별 계수 (PA)를 결정하는데 유용한 자료가 될 것으로 기대된다. 또한 개인별 및 연구 목적으로도 쉽게 사용하기 위해서, 신체활동분류표를 이용한 웹 버전의 소프트웨어 프로그램 및 스마트폰 어플리케이션의 개발이 필요하다.