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Perspective on Diagnostic Criteria for Obesity and Abdominal Obesity in Korean Adults
Nam, Ga Eun,Park, Hye Soon Korean Society for the Study of Obesity 2018 Journal of obesity & metabolic syndrome Vol.27 No.3
<P>Excessive body weight is associated with increased health risks in humans. In general, the risk of mortality increases with greater obesity. The 2018 guideline for the management of obesity by the Korean Society for the Study of Obesity proposed the body mass index (BMI) cut-off levels of 25 kg/m<SUP>2</SUP> and 23 kg/m<SUP>2</SUP> as diagnostic criteria for obesity and overweight (pre-obese) in Korean adults, respectively. Abdominal obesity has been defined as waist circumference (WC) ≥90 cm in men and WC ≥85 cm in women. In this review, the validity of these criteria for Korean adults was examined based on the evidence regarding the associations of obesity index with mortality and morbidity. The American Association of Clinical Endocrinologists/American College of Endocrinology algorithm and American Diabetes Association guideline for the medical care of obese and overweight patients support a BMI of 25 kg/m<SUP>2</SUP> and 23 kg/m<SUP>2</SUP>, respectively, as the cut-off levels for Asians (and some ethnicities) corresponding to the BMI values of 30 kg/m<SUP>2</SUP> and 25 kg/m<SUP>2</SUP>, respectively, for Caucasians. In the future, the optimal cut-off levels for obesity and abdominal obesity may require adjustment as the demographic characteristics of the Korean population change. In addition, development of more valid indicators that better reflect health risks of obesity is needed.</P>
Seo, Mi Hae,Kim, Yang-Hyun,Han, Kyungdo,Jung, Jin-Hyung,Park, Yong-Gyu,Lee, Seong-Su,Kwon, Hyuk-Sang,Lee, Won-Young,Yoo, Soon Jib Korean Society for the Study of Obesity 2018 Journal of obesity & metabolic syndrome Vol.27 No.1
<P><B>Background</B></P><P>The prevalence of obesity and related comorbidities is increasing worldwide, including in Korea. The Korean Society for the Study of Obesity released the Obesity Fact Sheet 2017 to address this problem in the Korean population.</P><P><B>Methods</B></P><P>Data from the National Health Insurance Service Health Checkup database from 2006 to 2015 were standardized by age and sex using the 2010 Census. The definition of obesity was a body mass index (BMI) ≥25 kg/m<SUP>2</SUP>, and that of abdominal obesity was a waist circumference ≥90 cm in men and ≥85 cm in women. Multivariate adjusted Cox regression analysis was conducted, and hazard ratios (HRs) with 95% confidence intervals were calculated for comorbidities.</P><P><B>Results</B></P><P>From 2009 to 2015, the prevalence of obesity increased from 29.7% to 32.4%, and that of abdominal obesity increased from 18.4% to 20.8%. Obesity with abdominal obesity also increased from 15.1% to 17.7%. Between 2014 and 2015, the prevalence of obesity increased until 30–40 years of age, but decreased from 40–50 years of age in men. In women, it increased until the mid-70s, and decreased thereafter. Abdominal obesity increased from 20–30 years of age to 70–80 years of age, but decreased thereafter. The HRs for type 2 diabetes mellitus, hypertension, dyslipidemia, myocardial infarction, and ischemic stroke were elevated in subjects with abdominal obesity, and their incidence increased as the BMI increased, but slowed down at BMI ≥35 kg/m<SUP>2</SUP>.</P><P><B>Conclusion</B></P><P>Based on the Obesity Fact Sheet 2017, strategies for reducing the prevalence of obesity and abdominal obesity are essential.</P>
Park, Hun-Young,Kim, Jisu,Park, Mi-Young,Chung, Nana,Hwang, Hyejung,Nam, Sang-Seok,Lim, Kiwon Korean Society for the Study of Obesity 2018 Journal of obesity & metabolic syndrome Vol.27 No.2
<P>Obesity is an important health problem caused by positive energy balance. Generally, low calorie dietary intake combined with regular exercise is the most common modality to lose bodily fat in obese people. Although this is the first modality of choice for obesity treatment, it needs to be applied to obese patients for at least 12 weeks or more and it does not provide consistent results because it is difficult to suppress increased appetite due to exercise. Recently, many researchers have been applying hypoxic conditions for the treatment of obesity, as many studies show that people residing in high altitudes have a lower percentage of body fat and fewer obesity-related illnesses than people living at sea level. Hypoxic therapy treatment, including hypoxic exposure or hypoxic exercise training, is recommended as a way to treat and prevent obesity by suppression of appetite, increasing basal metabolic rate and fat oxidation, and minimizing side effects. Hypoxic therapy inhibits energy intake and appetite-related hormones, and enhances various cardiovascular and metabolic function parameters. These observations indicate that hypoxic therapy is a new treatment modality for inducing fat reduction and promoting metabolic and cardiovascular health, which may be an important and necessary strategy for the treatment of obesity. As such, hypoxic therapy is now used as a general medical practice for obesity treatment in many developed countries. Therefore, hypoxic therapy could be a new, practical, and useful therapeutic modality for obesity and obesity-related comorbidities.</P>
Kim, Yang-Hyun,Han, Kyungdo,Son, Jang-Won,Lee, Seong-Su,Oh, Sang Woo,Kwon, Hyuk-Sang,Shin, Soon-Ae,Kim, Yeon-Yong,Lee, Won-Young,Yoo, Soon Jib Korean Society for the Study of Obesity 2017 Journal of obesity & metabolic syndrome Vol.26 No.1
<P><B>Background</B></P><P>In Korea, the prevalence of obesity has steadily increased, and the socioeconomic burden of obesity has increased along with it. In 2015, the National Health Insurance Service (NHIS) signed a memorandum of understanding with the Korean Society for the Study of Obesity (KSSO), providing limited open access to its databases so that the status of obesity and obesity management could be investigated.</P><P><B>Methods</B></P><P>Using NHIS databases, we analyzed nationwide population-based studies for obesity using the definition of obesity (body mass index ≥25 kg/m<SUP>2</SUP>) in subjects over the age of 20. Age and sex standardization were used for all data.</P><P><B>Results</B></P><P>The KSSO released the ‘Obesity Fact Sheet 2016’ using the 2006–2015 NHIS Health Checkup database. The prevalence of obesity steadily increased from 28.7% in 2006 to 32.4% in 2015, and the prevalence of abdominal obesity also steadily increased from 18.4% in 2009 to 20.8% in 2015. The prevalence of class II obesity steadily increased from 2006 to 2015, such that the total prevalence was 4.8% in 2015 (5.6% in men and 4.0% in women). The highest prevalence of obesity was found in Jeju Island, while the lowest prevalence was found in Daegu City. The highest prevalence of abdominal obesity was also found in Jeju Island, while the lowest prevalence was found in Gwangju City.</P><P><B>Conclusion</B></P><P>Based on the Obesity Fact Sheet 2016, a strategy for reducing the prevalence of obesity is needed, especially in Korean men.</P>
The Relationship between Depressive Symptoms and Modifiable Lifestyle Risk Factors in Office Workers
Jin, Youngyun,Ha, Changduk,Hong, Hyeryun,Kang, Hyunsik Korean Society for the Study of Obesity 2017 Journal of obesity & metabolic syndrome Vol.26 No.1
<P><B>Background</B></P><P>This study investigated the relationship between depressive symptoms and physical fitness, obesity indices, and vitamin D status in office workers.</P><P><B>Methods</B></P><P>The subjects were 514 adults with more 30 years of experience as office workers in the city of Seoul. Lifestyle risk factors, obesity indices, physical fitness, and serum vitamin D levels were assessed with a standardized protocol. The Beck Depression Inventory (BDI) was used to assess depression status. Vitamin D status was assessed by measuring serum 25-hydroxyvitamin D concentrations. Based on the BDI scores, participants were classified into no depression (ND, BDI ≤9), mild depression (MiD, 10≤BDI≤15), and moderate depression (MoD, 16≤BDI≤23) groups.</P><P><B>Results</B></P><P>Compared with the high cardiorespriatory fitness group, the low cardiorespiratory fitness (men OR=2.618, women OR=1.596) an middle cardiorespiratory fitness group (men OR=1.256, women OR=1.110) had significantly higher odds ratio for having depressive symptoms, even after adjustment for age, hypertension, diabetes, hyperlipidemia, cardiovascular disease, alcohol intake, smoking, body mass index (BMI), percent body fat (%BF), and waist circumference (WC). Compared with the insufficient or deficient vitamin D group, the sufficient vitamin D group had significantly lower odds ratios for having depressive symptoms (men OR=0.121, women OR=0.114), even after adjustment for age, hypertension, diabetes, hyperlipidemia, cardiovascular disease, alcohol intake, smoking, BMI, %BF, and WC.</P><P><B>Conclusion</B></P><P>Vitamin D supplementation and outdoor activities should be key components of a lifestyle intervention against office workers’ depression.</P>
Lee, Dong Hun,Ha, Kyoung Hwa,Kim, Hyeon Chang,Kim, Dae Jung Korean Society for the Study of Obesity 2018 Journal of obesity & metabolic syndrome Vol.27 No.1
<P><B>Background</B></P><P>The relationship between cardiovascular and all-cause mortality and obesity in people with diabetes is still controversial. We investigated the association of body mass index (BMI) with the risk of major adverse cardiovascular events (MACE) and all-cause mortality in people with diabetes.</P><P><B>Methods</B></P><P>In total, 48,438 people with diabetes were enrolled in the Korean National Health Insurance Service-National Health Screening Cohort from 2002 to 2003 and were followed until 2013. Baseline BMI was categorized as underweight (<18.5 kg/m<SUP>2</SUP>), normal-weight (18.5–22.9 kg/m<SUP>2</SUP>), overweight (23.0–24.9 kg/m<SUP>2</SUP>), obese class I (25.0–29.9 kg/m<SUP>2</SUP>), and obese class II (≥30.0 kg/m<SUP>2</SUP>).</P><P><B>Results</B></P><P>During a median of 10.7 years of follow-up (interquartile range, 10.2–11.2 years), there were 7,360 MACE and 5,766 deaths. Compared to those in the normal-weight group, the fully adjusted hazard ratios (HRs) for MACE were 1.09 (95% confidence interval [CI], 0.92–1.29), 0.91 (95% CI, 0.85–0.97), 0.93 (95% CI, 0.88–0.98), and 0.95 (95% CI, 0.84–1.06) for underweight, overweight, obese class I, and obese class II groups, respectively. The HRs for all-cause mortality were 1.75 (95% CI, 1.54–1.99), 0.74 (95% CI, 0.69–0.79), 0.67 (95% CI, 0.63–0.71), and 0.73 (95% CI, 0.63–0.85) for underweight, overweight, obese class I, and obese class II groups, respectively.</P><P><B>Conclusion</B></P><P>In people with diabetes, underweight people had a higher risk for all-cause mortality, whereas overweight or obese people had a lower risk for MACE and all-cause mortality than those with a normal weight.</P>