Obesity in South Korea

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1 Obesity in South Korea Nah-Mee Shin, Ph.D, Assistant Professor, APRN, BC (Nurse Practitioner) Korea University, College of Nursing 1 To get to know South Korea Geography: area: 98,477 sq.km. (38,022 sq.mi.); the size of Indiana. Population (2006): million, Korea has one of the world s highest population densities (1,288/sq.mi). Capital--Seoul (10.3 million); increased urban population: 1/5 of total population in Seoul. Ethnically & linguistically homogenous population 2

2 Health Report of Korea Infant mortality rate (2006): 6.2/1,000. Life expectancy (2006) 79.2yrs (men 75.7yrs.; women 82.4yrs) Labor force (2005): 23.5 million. Rapidly aging population: major health problems of elders--htn, CVA, CHD; CA (stomach, liver); DM; Dementia (Korea National Statistics Office) Population annual growth rate (2006): 0.4%. 3 Life Expectancy (Year) All Female Male Gap (Female-Male) Source: KOSIS (Korean Statistical Information Service) 4

3 Obesity in Korea Low Risk of Obesity: only 8% had BMI >30 kg/m² (in 1996) 47% of African American women & 37% of Latino women in Detroit area ( ) were overweight (BMI ) or obese (BMI 30). BMI Categories (National Heart Lung and Blood Institute) Underweight = <18.5 Normal weight = Overweight = Obesity = BMI of 30 or greater 5 Year 1996 Total Total Prevalence of Obesity (Age 15) Over Normal Underweight Overweight Subtotal Obesity City Rural Male Female Age 15~ Age 20~ Age 30~ Age 40~ Age 50~ Age

4 Then, No Worries about Obesity? In 05, obesity rate in Korea was 3.5 (ot 27) Koreans may need a different interpretation of BMI for clinical use: BMI 25 regarded as obesity BMI as overweight; BMI normal; BMI <18.5 as underweight (WHO Asian-Pacific region) Waist circumference 90cm (36 ) for men & 85cm (34 ) for female Obesity rate in Canada is 18 (ot 32); 23 (ot 37) in England; 32.2 (ot 34) in US BMI categories (NHLBI) Obesity: 30 Overwt: Nl wt: Underwt <18.5 Waist C: 40 ( ), 35 ( ) 7 % Prevalence of Obesity in Population (age 15): {(lbs x 705)/inches} /inches Korea Japan Overweight (OT) Obesity (OB) OT+ OB OT OB OT + OB OT OB OT + OB OT OB OT + OB Canada USA Italy England England

5 Why Do We Care? While prevalence of obesity (BMI 30) among Koreans remains low, prevalence of metabolic disorder, hypertension (HTN), hyperlipidemia ( total cholesterol, HDL, LDL, TG), and DM have been increasing. In 2006, stroke is the 2 nd cause of death; heart disease is the 3 rd, DM is 4 th. With the modified BMI categories, obesity rate for men increased to 35.2%, 28.3% for women. 9 Cause of Death (per 100,000) Rank 1996 Total Female Male Ratio (M/F) 1 Cancer Stroke Accident/Trauma Heart Disease 1) Liver Disease DM Suicide Chronic Lower Respiratory Illness Hypertension Tuberculosis Rank 2006 Total Female Male Ratio (M/F) 1 Cancer Stroke Heart Disease 1) DM Suicide Accident/Trauma Liver Disease Chronic Lower Respiratory Illness Hypertension ) Pneumonia Source : Korean Statistical Information Service (Kosis) 1) ischemic heart disease and other heart dz are included 10

6 Age & BMI As we get older, BMI (kg/m²) increases. Male: 23.7 (40-49y/o: 24.3) Female: 23.4 (50-59y/o: 24.7; 60-69y/o: 24.9) In 2005, prevalence of obesity was high in 40s and 50s in men; 50s & 60s in women 11 Educational Background (2001) Overall, the more educated, the less BMI For female, the influence of educational background on the BMI is clear. Distribution of BMI ( 20y/o) Whole Male Female Elementary School Junior High School High School year College

7 Influence of Household Income (2001) for female, the less they In 2005, this pattern make, the more is the BMI. was repeated (Korea National Health & Nutrition for male, the more they Examination Survey: make, the more is the BMI KNHNES). Monthly household Income Whole Female Male <$1,000/month $ 1,001-2, $ 2,001-3, >$3, Environmental Influence (KNHNES, 2005) Both men and women live in cities showed higher prevalence of obesity than people reside in rural areas in 1996 and this pattern was repeated in Year 1996 Tota l Prevalence of Obesity (Age 15) Over Overweight Subtotal Obesit y Normal Underweight Total City Rural

8 Korean Immigrants to U.S. Korea has experienced one of the largest rates of emigration; primarily, China (1.9 million), U.S. (>1.5 million), Japan, & the countries of the former Soviet Union. Korean-Americans (KA) are the fastest growing subgroup of Asian-Americans. Since 1975, Koreans have ranked in the top 5 of immigrants to the U.S. Over 1 million U.S. residents identified their race as Korean (US Census, 2000). The number of KA is expected to continue to increase. 15 Health Risk in KA As Koreans move away from their home country, their health risks are subject to change. In 1999, the most KA lived in metropolitan areas of the western U.S. (53%), and the South (20%). Depression: associated w/the process of acculturation (Choi et al., 2005; Miller et al., 2006) Nutrition: Korean diet is high in salt; high fat d/t westernized food intake (high fat), 44-66% of KA in Michigan were found to have borderline ( ) or undesirable total cholesterol (>240). 16

9 Leading Cause-Specific Rates: 2000 Michigan Residents & 1999 US Residents (Source: 2000 Michigan Resident Death File; National Vital Statistics Reports, vol 49, no. 3) Rates are per 100,000 population. Cause of Death MI US Heart Disease Cancer Stroke Chronic Lower Respiratory Disease Unintentional Injuries DM U21 Health Sciences

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