Prevalence of General and Central Obesity and Associated Factors among North Korean Refugees in South Korea by Duration after Defection from North Korea: A Cross-Sectional Study

Abstract

Previous studies on obesity status among North Korean refugees (NKRs) have been limited. We investigated mean body mass index (BMI), waist circumference (WC), and general and central obesity prevalence among NKRs in South Korea (SK) by duration after defection from North Korea (NK), using cross-sectional data of the North Korean Refugee Health in South Korea (NORNS) study and compared these data with a sample from the general South Korean population (the fifth Korea National Health and Nutrition Examination Survey). The prevalence of general and central obesity among NKRs with duration after defection from NK of less than five years were lower than among South Koreans, except for central obesity among NKR females (obesity prevalence, 19% (12–27%) vs. 39% (34–44%) for NK vs. SK males (p < 0.001) and 19% (14–24%) vs. 27% (24–29%) for NK vs. SK females (p = 0.076); central obesity prevalence, 13% (6–19%) vs. 24% (20–29%) for NK vs. SK males (p = 0.011) and 22% (17–28%) vs. 20% (18–22%) for NK vs. SK females (p = 0.382)). The prevalence of general and central obesity among NKRs with duration after defection from NK (≥10 years) were comparable to those of South Koreans in both genders (obesity prevalence, 34% (18–50%) vs. 39% (34–44%) for NK vs. SK males (p = 0.690) and 23% (18–29%) vs. 27% (24–29%) for NK vs. SK females (0.794); central obesity prevalence, 21% (7–34%) vs. 24% (20–29%) for NK vs. SK males (p = 0.642); 22% (17–28%) vs. 20% (18–22%) for NK vs. SK females (p = 0.382)). Male sex, age and longer duration after defection from NK (≥10 years) were positively associated with obesity. As for central obesity, age was the only independently associated factor. NKR females with duration after defection from NK of less than five years had comparable central obesity prevalence to South Korean females in spite of a lower BMI, which suggests that we need further monitoring for their metabolic health among NKRs in SK.

Promoting health behaviors for preventing and controlling noncommunicable disease among North Korean defectors: A systematic review

“…Three studies reported the prevalence of obesity and metabolic diseases. In comparison with South Korean natives (SKN), one study showed that the obesity and central obesity prevalence rate in North Korean refugee (NKR) men increased by duration after defection, and all the prevalence rates were comparable to those of SKN for both the genders after >10 years of defection (obesity prevalence NKR vs. SKN: men, 34% vs. 39%, p = 0.690; women, 23% vs. 27%, p = 0.794; central obesity, 21% vs. 24%, p = 0.642; and women, 22% vs. 20%, p = 0.382, respectively) [13]. Our results are similar with another study wherein the excess weight gain after defection was associated with metabolic syndrome with similar prevalence rate of metabolic syndrome between NKR and SKN (men, 19.7% vs. 26.2%, p = 0.134; and women, 17.2% vs. 16.6%, p = 0.757, respectively) [11].…”

“…The summary of the characteristics of selected studies is presented in Table 1. It includes 18 quantitative studies [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] and 4 qualitative studies [28][29][30][31]; among the quantitative studies, 5 studies report comparisons with South Korean people [11,[13][14][15]22]. The number of participants in these studies varied from 8 to 932 participants, and 54.6%-100% of them were women.…”

“…The survey using questionnaires was the most popular research method. Data from objective measurement such as body weight, waist circumference, blood test, and urine analysis were used in a few studies [12][13][14]19] Table 2 shows the variables that were investigated in the selected studies by classifying them into 4 categories: non-communicable disease, health promotional lifestyle, self-rated health status, and others. was related w women (p < 0.00 elderly (p < 0.00 or had low ann household inco (p = 0.017), a chronic diseases < 0.001).…”

“…The rate of current smokers among NKRs was 11.9% [14], 26.2% [19], and 84.2% [23]. The rate of current smokers in men was 48.0% [13] and 44.6% [11]. One study reported that 21.3% of the smokers were nicotine dependent [19], and the other study demonstrated low to moderate dependent status on nicotine with a score of 3.35 out of 10 (Fagerström test for nicotine dependence) [23].…”

“…The current drinkers comprised of 72.1% [14] and 37.7% [19].Two studies reported that the current drinkers among men were 70.8% [13] and 87% [11].The rate of alcohol consumption more than once a month was 56.8% [17]. The score of health behavior for reducing alcohol consumption was 2.8 (HPLP, range 1-4) [21].…”