General and abdominal obesity in South Korea, 1998–2007: Gender and socioeconomic differences
Research Highlights
►For the recent 10 years in Korea, obesity has significantly increased in men, not in women. ►Low socioeconomic position was associated with obesity among women while high socioeconomic position was so in men. ►Socioeconomic inequalities in obesity increased in women during the past 10 years.
Introduction
An alarming increase in the prevalence of overweight and obesity has been reported worldwide (World Health Organization, 2000). Obesity may affect men and women with different socioeconomic position (SEP) in a different degree. A landmark review by Sobal and Stunkard on studies published prior to 1989 demonstrated a predominance of low SEP–obesity associations among women not among men in developed countries (Sobal and Stunkard, 1989). This gender difference has been confirmed in a recent study reviewing literatures between 1988 and 2004 (McLaren, 2007). The socioeconomic differentials in obesity measures are known to vary with SEP (Ball and Crawford, 2005, McLaren, 2007, Monteiro et al., 2004). Because each SEP indicator has a distinct influence in promoting or damaging an individual's health (Geyer et al., 2006, Khang and Kim, 2005), trends in obesity by multiple SEP measures are worth investigating. However, there has been a limited report from Korea as well as other countries to examine more recent trends in the prevalence of both general and abdominal obesity according to various SEP indicators. Questions still remain as to whether the magnitude of socioeconomic inequalities in obesity has increased, whether the patterns of socioeconomic inequalities in obesity and their time trends varied with SEP measures, and whether the trends of socioeconomic inequalities are similar in both general obesity and abdominal obesity and among men and women. In this context, we examined recent national trends in prevalence of and socioeconomic inequalities in both general and abdominal obesity by gender and SEP indicators using four waves of national health survey of Korea between 1998 and 2007.
Section snippets
Data source and study subjects
Data were derived from Korean National Health and Nutrition Examination Survey (KNHANES). Four rounds of publicly available KNHANES data (1998, 2001, 2005, and 2007) were used. The subjects were selected from non-institutionalized civilians by a stratified multistage probability sampling design. The response rates were 86.5% in 1998, 77.3% in 2001, 70.2% in 2005, and 65.8% in 2007. Additional details regarding study design and methods are provided elsewhere (KCDC, 2010). Considering
Characteristics of study population by year and SEP indicators
We presented the number and percentage of study subjects by year and socioeconomic position in Supplementary Table 1. A total of 7794 men and 9518 women participated in the four surveys. Supplementary Table 1 shows increases in educational levels as well as the proportion of non-manual occupation and non-standard employment in both genders.
Trends in overweight by year and SEP indicators
Table 1, Table 2 show age-adjusted prevalence of overweight measured by BMI (≥ 25 kg/m2) among men and women and indicate widening gender differences in
Discussion
Result of this study shows gender differences in (1) time trends of overweight (based on BMI) and abdominal obesity (based on waist circumference), (2) relationships between obesity measures and various SEP indicators, and (3) linear time trends of socioeconomic differentials in obesity. Analysis results using different cutoffs for general (BMI ≥ 27.5 kg/m2) and abdominal obesity (men ≥ 94 cm, women ≥ 88 cm) showed similar patterns (Supplementary Tables 5–8). Men showed significant increases in both
Conclusion
Overweight and abdominal obesity has increased recently in Korean men, not in women. Low SEP was associated with overweight and abdominal obesity in women while high SEP was so in men. Inequality in education and income for abdominal obesity increased among women during the last 10 years. Public actions should be implemented to prevent obesity among socio-economically deprived people considering the gender differences.
Conflict of interest statement
The authors declare no conflict of interest.
Acknowledgments
We thank the Korea Centers for Disease Control and Prevention for providing the data.
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