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      Recent trends in the prevalence of underweight, overweight, and obesity in Korean adults: The Korean National Health and Nutrition Examination Survey from 1998 to 2014

      research-article
      a , b , c ,
      Journal of Epidemiology
      Elsevier
      Obesity, Overweight, Prevalence, Underweight, Visceral obesity

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          Abstract

          Background

          Recent obesity studies have reported that the rising trend in obesity has stabilized or leveled off. Our study aimed to update estimates of the recent prevalence trend in obesity based on the Korean National Health and Nutrition Examination Survey 1998–2014.

          Methods

          A total of 66,663 subjects were included and defined as being either underweight, overweight, or obese, in accordance with a BMI of 18.5 kg/m 2 or lower, 23 kg/m 2 or higher, and 25 kg/m 2 or higher, respectively.

          Results

          The prevalence of underweight in KNHANES I through VI surveys was 5.4%, 6.1%, 5.8%, 6.5%, 7.6%, and 7.5%, respectively, in men ( p for trend = 0.04, β = 0.003) and 4.7%, 3.3%, 3.4%, 3.3%, 2.7%, and 2.6%, respectively, in women ( p for trend = 0.03, β = −0.002). Also for KNHANES I through VI, the respective prevalence of overweight/obesity was 50.3%, 57.2%, 62.5%, 62.3%, 61.4%, and 61.3% in men ( p for trend<0.01, β = 0.009) and 48.3%, 50.3%, 50.0%, 47.8%, 47.0%, and 45.3% in women ( p for trend<0.01, β = −0.01), respectively.

          Conclusions

          The obesity occurrence in men was trending upward with respect to overweight/obesity and for grade 1 and 2 obesity, but not for abdominal obesity. However, the obesity trends in women were leveling off from overweight/obesity, grade 1 obesity, and abdominal obesity measures. Further studies are required with data on muscle mass and adiposity for effective obesity control policies.

          Highlights

          • We conducted this study using the KNHANES from 1998 to 2014.

          • Male obesity showed upward trends in overweight/obesity and grade 1 and 2 obesity.

          • Overweight/obesity, grade 1, and abdominal obesity were leveling off in females.

          • The prevalence of underweight decreased in men but increased in women.

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          Most cited references11

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          Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013.

          In 2010, overweight and obesity were estimated to cause 3·4 million deaths, 3·9% of years of life lost, and 3·8% of disability-adjusted life-years (DALYs) worldwide. The rise in obesity has led to widespread calls for regular monitoring of changes in overweight and obesity prevalence in all populations. Comparable, up-to-date information about levels and trends is essential to quantify population health effects and to prompt decision makers to prioritise action. We estimate the global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013. We systematically identified surveys, reports, and published studies (n=1769) that included data for height and weight, both through physical measurements and self-reports. We used mixed effects linear regression to correct for bias in self-reports. We obtained data for prevalence of obesity and overweight by age, sex, country, and year (n=19,244) with a spatiotemporal Gaussian process regression model to estimate prevalence with 95% uncertainty intervals (UIs). Worldwide, the proportion of adults with a body-mass index (BMI) of 25 kg/m(2) or greater increased between 1980 and 2013 from 28·8% (95% UI 28·4-29·3) to 36·9% (36·3-37·4) in men, and from 29·8% (29·3-30·2) to 38·0% (37·5-38·5) in women. Prevalence has increased substantially in children and adolescents in developed countries; 23·8% (22·9-24·7) of boys and 22·6% (21·7-23·6) of girls were overweight or obese in 2013. The prevalence of overweight and obesity has also increased in children and adolescents in developing countries, from 8·1% (7·7-8·6) to 12·9% (12·3-13·5) in 2013 for boys and from 8·4% (8·1-8·8) to 13·4% (13·0-13·9) in girls. In adults, estimated prevalence of obesity exceeded 50% in men in Tonga and in women in Kuwait, Kiribati, Federated States of Micronesia, Libya, Qatar, Tonga, and Samoa. Since 2006, the increase in adult obesity in developed countries has slowed down. Because of the established health risks and substantial increases in prevalence, obesity has become a major global health challenge. Not only is obesity increasing, but no national success stories have been reported in the past 33 years. Urgent global action and leadership is needed to help countries to more effectively intervene. Bill & Melinda Gates Foundation. Copyright © 2014 Elsevier Ltd. All rights reserved.
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            Body-mass index and mortality in Korean men and women.

            Obesity is associated with diverse health risks, but the role of body weight as a risk factor for death remains controversial. We examined the association between body weight and the risk of death in a 12-year prospective cohort study of 1,213,829 Koreans between the ages of 30 and 95 years. We examined 82,372 deaths from any cause and 48,731 deaths from specific diseases (including 29,123 from cancer, 16,426 from atherosclerotic cardiovascular disease, and 3362 from respiratory disease) in relation to the body-mass index (BMI) (the weight in kilograms divided by the square of the height in meters). In both sexes, the average baseline BMI was 23.2, and the rate of death from any cause had a J-shaped association with the BMI, regardless of cigarette-smoking history. The risk of death from any cause was lowest among patients with a BMI of 23.0 to 24.9. In all groups, the risk of death from respiratory causes was higher among subjects with a lower BMI, and the risk of death from atherosclerotic cardiovascular disease or cancer was higher among subjects with a higher BMI. The relative risk of death associated with BMI declined with increasing age. Underweight, overweight, and obese men and women had higher rates of death than men and women of normal weight. The association of BMI with death varied according to the cause of death and was modified by age, sex, and smoking history. Copyright 2006 Massachusetts Medical Society.
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              How useful is body mass index for comparison of body fatness across age, sex, and ethnic groups?

              This study tested the hypothesis that body mass index (BMI) is representative of body fatness independent of age, sex, and ethnicity. Between 1986 and 1992, the authors studied a total of 202 black and 504 white men and women who resided in or near New York City, were ages 20-94 years, and had BMIs of 18-35 kg/m2. Total body fat, expressed as a percentage of body weight (BF%), was assessed using a four-compartment body composition model that does not rely on assumptions known to be age, sex, or ethnicity dependent. Statistically significant age dependencies were observed in the BF%-BMI relations in all four sex and ethnic groups (p values < 0.05-0.001) with older persons showing a higher BF% compared with younger persons with comparable BMIs. Statistically significant sex effects were also observed in BF%-BMI relations within each ethnic group (p values < 0.001) after controlling first for age. For an equivalent BMI, women have significantly greater amounts of total body fat than do men throughout the entire adult life span. Ethnicity did not significantly influence the BF%-BMI relation after controlling first for age and sex even though both black women and men had longer appendicular bone lengths relative to stature (p values < 0.001 and 0.02, respectively) compared with white women and men. Body mass index alone accounted for 25% of between-individual differences in body fat percentage for the 706 total subjects; adding age and sex as independent variables to the regression model increased the variance (r2) to 67%. These results suggest that BMI is age and sex dependent when used as an indicator of body fatness, but that it is ethnicity independent in black and white adults.
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                Author and article information

                Contributors
                Journal
                J Epidemiol
                J Epidemiol
                Journal of Epidemiology
                Elsevier
                0917-5040
                1349-9092
                15 April 2017
                September 2017
                15 April 2017
                : 27
                : 9
                : 413-419
                Affiliations
                [a ]Department of Family Medicine, Myongji Hospital, Seonam University, College of Medicine, Gyeonggi-do, Republic of Korea
                [b ]Department of Epidemiology and Health Promotion and Institute for Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea
                [c ]Department of Family Medicine, School of Medicine, Chungbuk National University, Cheongju-city, Republic of Korea
                Author notes
                []Corresponding author. Department of Family Medicine, School of Medicine, Chungbuk National University, Chungdae-ro, Seowon-gu, Cheongju, Chungbuk, 28644, Republic of Korea.Department of Family MedicineSchool of MedicineChungbuk National UniversityChungdae-ro, Seowon-guCheongjuChungbuk28644Republic of Korea KANGHT0818@ 123456gmail.com
                Article
                S0917-5040(17)30102-8
                10.1016/j.je.2016.08.014
                5565760
                28420559
                d3cfd061-8086-4ff6-8de4-cbd126db864e
                © 2017 The Authors

                This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

                History
                : 25 May 2016
                : 22 August 2016
                Categories
                Original Article

                obesity,overweight,prevalence,underweight,visceral obesity
                obesity, overweight, prevalence, underweight, visceral obesity

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