Jin-Won Noh

Body Mass Index and Depressive Symptoms in Older Adults: A Cross-Lagged Panel Analysis

Background There are conflicting results about the association between body mass index (BMI) and depressive symptoms in older adults. The present study examined the relationship between weight and depressive symptoms over time in older adults in South Korea. Methods We used data from three waves of the Korean Longitudinal Study of Aging and ran a series of cross-lagged panel models to test the reciprocal relationship between depressive symptoms and obesity in older Korean adults. We assumed a temporally stable relationship between depressive symptoms and obesity and, thus imposed equality constraints over time. Results After controlling for the effect of depressive symptoms two years prior, underweight older adults had a higher depressive symptom score than those of normal weight. When controlling for obesity status from two years prior, older adults with higher levels of depressive symptoms were more likely to be underweight and less likely to be overweight than normal weight. The same patterns were observed in data from 2006 to 2008 and from 2008 to 2010. Conclusions These results show that there is a correlation between depressive symptoms and weight status. In middle-aged and elderly Asian populations, depression can lead to weight loss rather than obesity, and underweight may develop depressive symptoms.

Impact of Parental Socioeconomic Status on Childhood and Adolescent Overweight and Underweight in Korea

Background The prevalence of overweight and underweight is steadily increasing among children and adolescents. To explore the relationship between parental socioeconomic status and body mass index, we examined levels of overweight and underweight among representative samples of children and adolescents in South Korea. Methods We analyzed data from the 2009 Korean Survey on the Obesity of Youth and Children, conducted by the National Youth Policy Institute. The sample response rate for this survey was 93.9%. After excluding 745 subjects who had missing information on age, height, or weight, 9411 subjects were included. To measure parental socioeconomic status, 4 categories were assessed by using a structured questionnaire: subjective economic status, parental education level, parental occupational status, and family structure. We used the chi-squared test in univariable analysis and multinomial logistic regression in multivariable analysis. Results Multinomial logistic regression analysis identified sex, education level, parental interest in weight management, and parental body shapes as statistically significant characteristics affecting overweight in children, and sex, place of residence, parental interest in weight management, and paternal and maternal body shapes as statistically significant characteristics affecting underweight (P < 0.05). Conclusions Underweight and overweight coexist among adolescent Korean males of low socioeconomic status, which indicates that these conditions can coexist in developed countries. Appropriate interventions to address both overweight and underweight in adolescents are required.

Influences of socioeconomic factors on childhood and adolescent overweight by gender in Korea: cross-sectional analysis of nationally representative sample

BackgroundChildhood and adolescent overweight is a recognized public health concern as the prevalence is already high and continues to increase. The purpose of this study was to examine the relationship between socioeconomic status (SES) and overweight status by gender among Korean children and adolescents.MethodsThe data used in this study were taken from the 2009 Korean Survey on the Obesity of Youth and Children. Underweight individuals (n = 1,010) and children and adolescents whose age, height, or weight information was missing (n = 591) were excluded from the data set, resulting in a total of 8,555 subjects who were included in this analysis. Subjective SES, parental education level, parental occupational status, and family structure were used to measure parental SES. Chi-squared tests were used for univariable analysis and multiple logistic regression analysis was conducted for multivariable analysis.ResultsAfter adjusting for subject’s characteristics including gender, age, parental interest in weight management of children, parental body shape, economic status variables that significantly influenced childhood overweight were identified. Low economic status increased the probability of childhood overweight (odds ratio, 1.3; 95% confidence interval, 1.1-1.5).ConclusionsThere is an inverse association between parental SES variables and the overweight status of children and adolescents. Additionally, parental body shape is an important factor that influences childhood and adolescent overweight.

Gender Differences and Socioeconomic Status in Relation to Overweight among Older Korean People

Background The ever-increasing older population and its association with serious overweight problems have garnered much attention. The correlation between being overweight and socioeconomic status factors could be helpful for understanding the inequalities among the overweight population. We examined the correlation between being overweight and some key variables, such as demographics, socioeconomic status, general health status, and health behavior in a large sample of older individuals, by each gender. Methods We used data from the 2008 Korean Longitudinal Study of Aging and it included 8,157 participants who were 45 years or older. To understand the relationship between the overweight participants in accordance to demographic and socioeconomic characteristics, health status, and health behaviors, a weighted chi-square test and logistic regression analysis were conducted by separating variables related to overweight, according to the genders. Results The number of people in the normal group was 6,347 (77.8%), while the people who were considered overweight were 1,810 (22.2%). Women (n = 4,583) constituted 52.7% of the subject, 24.9% of whom were classified as overweight. Meanwhile, 20.6% of the 47.3% (n = 3,574) of the sample who were men were classified as overweight. Participants between the ages of 45 and 64 with chronic diseases were more likely to be overweight. Men in the 4th quartile of household income were more likely to be overweight than those who were in the 1st quartile, in contrast, while unemployed women with lower education levels and urban residents were at greater risk for being overweight. Conclusions Among the men, health status and health behavior appeared to show a correlation with being overweight; however, among women, socioeconomic status factors were strongly related to being overweight. These findings appear to support the association of gender-specifics with the prevalence of being overweight.

Factors associated with the frequency of physician visits among North Korean defectors residing in South Korea: a cross-sectional study

BackgroundSince the mid-1990s, a growing number of North Korean defectors have been arriving in South Korea, many of whom have various somatic and mental disorders. The health status of defectors is an important predictor of their successful resettlement. Therefore, this study examined the frequency of physician visits among North Korean defectors residing in South Korea, as well as the factors associated with this frequency.MethodsThe data used in this study were collected through survey questionnaires and interviews conducted from April 6 to May 20, 2009, and involving 500 North Korean defectors who entered South Korea in 2007. This study used three domains of independent variables: ‘health-related factors,’ ‘special characteristics of North Korean defectors,’ and ‘demographic and socio-economic factors’. Nested multivariable linear regression analysis was conducted in order to determine the factors related to the frequency of physician visits between January 1 and December 31, 2008.ResultsThe average number of physician visits made by the participants during 2008 was 15.3; 14.5% of participants did not have physician visits. The number of physician visits was largely associated with health-related variables including disability, chronic disease and self-rated health status. The frequency of physician visits was higher among those with a disability, chronic disease, lower self-rated health score, a greater number of traumatic experiences during their escape, lower annual family income, and among females.ConclusionsThis study confirmed that the number of defectors’ physician visits was related with objective and subjective health status, traumatic experiences during their migration, economic, and demographic variables. The results serve useful understanding of medical utilization characteristics among North Korean defectors in South Korea.

Independent association between glycated hemoglobin and arterial stiffness in healthy men

Many studies have reported that high levels of glycated hemoglobin (HbA1c) are strongly associated with an increased risk of cardiovascular disease. Many researchers have not studied the association of HbA1c with various subclinical atherosclerosis phenotypes. We evaluated the impact of HbA1c on arterial stiffness and atherosclerosis in healthy Korean healthy men.

Gender Difference in Relationship between Health-Related Quality of Life and Work Status

This study investigated the association of employment status with health-related quality of life in adult Koreans, as well as the gender difference in the relationship, using a large, nationally representative sample. Using data from the Korea Health Panel survey, we examined the relationship between quality of life measured by EQ-5D and work status among Korean adults. We also tested whether and how the relationship between quality of life and work status differed by gender. Quality of life among working adults was better than among non-working adults. The gap between the two groups was larger among male than female participants. Further, the gender differential effect was larger in the 41–60-year-old age group than in the 18–40-year-old and 61-or-older groups. Being employed has a positive relation to quality of life among adults. Work status plays a more important role in quality of life for men than for women, especially for the working elderly men than working elderly women.

Factors associated with self-rated health among North Korean defectors residing in South Korea

BackgroundThe number of North Korean refugees entering South Korea has increased recently. The health status of refugees is a significant factor in determining their success in resettlement; therefore, this study examined both the self-rated health status of North Korean defectors who have settled in South Korea and the factors associated with their self-rated health status.MethodsThis study utilized data gained from face-to-face interviews with 500 North Korean defectors who arrived in South Korea in 2007. The interviews were structured and conducted by ‘Yonsei University Research Team for North Korean defectors’. A stepwise multivariable linear regression was performed to determine the factors associated with their self-rated health status.ResultsNorth Korean defectors who were female, elderly, or had low annual household income, disability or chronic diseases reported lower health status. However, self-rated health status was higher among those who had settled in South Korea for 18 months or more, who were satisfied with government support or their current life, and who had experienced more traumatic events in North Korea.ConclusionsGovernment policies and refugee assistance programs should consider and reflect the factors relevant to the health status of North Korean defectors.

A Study of Predictive Factors Affecting Health: Promoting Behaviors of North Korean Adolescent Refugees

Objectives: The present study aimed to analyze the factors that could affect the health-promoting behaviors of North Korean adolescent refugees residing in South Korea. Methods: Questions about their sociodemographic variables, subjective health status, healthy living habits, and health-promoting behaviors were asked. Results: Statistically significant differences were found in religion (t=2.30, p<0.05), having family members in South Korea (t=2.02, p<0.05), and subjective health status (t=4.96, p<0.01). Scores on health-responsible behaviors were higher with higher age (t=2.90, p<0.01) and for subjects without family or friends (t=2.43, p<0.05). Higher physical-activity behaviors were observed in males (t=3.32, p<0.01), in those with better subjective health status (t=3.46, p<0.05) and lower body mas index (t=3.48, p<0.05), and in smokers (t=3.17, p<0.01). Nutritional behaviors were higher in those who followed a religion (t=2.17, p<0.05). Spiritual growth behaviors were higher in those who followed a religion (t=4.21, p<0.001), had no family in South Korea (t=2.04, p<0.05), and had higher subjective health status (t=5.74, p<0.01). Scores on interpersonal relationships and stress-management behaviors were higher for those with higher subjective health status. A multiple regression analysis showed greater effects on health-promoting behaviors when subjective health status was better. Older people and non-smokers exhibited more health-responsible behaviors, while more physical-activity behaviors and spiritual growth activities were observed when subjective health status was better. Interpersonal relationship behaviors had positive effects on those with good subjective heath status and on non-smokers. Conclusions: Based on the results of the current study, an alternative was suggested for promoting health in North Korean adolescent refugees.

Relationship between the intensity of physical activity and depressive symptoms among Korean adults: analysis of Korea Health Panel data

[Purpose] The aim of this study was to examine the relationship between the intensity of physical activity and symptoms of depression. [Subjects and Methods] We analyzed the influence of different intensities of physical activity on depressive symptoms using the data of 12,350 adults over the age of 20 years who had completed the 2011 Korea Health Panel. After controlling for confounding variables, a multivariable logistic regression analysis was conducted to identify the association between the intensity of physical activity and depressive symptoms. [Results] The results showed that vigorous physical activity had a significant effect on depressive symptoms. The incidence of depressive symptoms was 1.487 (95% CI 1.137, 1.943) OR higher among people who did not participate in regular activity than it was among those who took part in regular intense physical activity. [Conclusion] It appears that physical activity affects depressive symptoms, a result which is in agreement with previous studies. However, we also showed a difference in influence according to activity intensity. Thus, the intensity of physical activity should be considered when developing physical activity programs for improving depressive symptoms.