Prevalence of general and central obesity and associated factors among north Korean refugees in South Korea by duration after defection from North Korea: A cross-sectional study

Previous studies on obesity status among North Korean refugees (NKRs) have been limited. We investigated mean body mass index (BMI), waist circumference (WC), and general and central obesity prevalence among NKRs in South Korea (SK) by duration after defection from North Korea (NK), using cross-sectional data of the North Korean Refugee Health in South Korea (NORNS) study and compared these data with a sample from the general South Korean population (the fifth Korea National Health and Nutrition Examination Survey). The prevalence of general and central obesity among NKRs with duration after defection from NK of less than five years were lower than among South Koreans, except for central obesity among NKR females (obesity prevalence, 19% (12-27%) vs. 39% (34-44%) for NK vs. SK males (p < 0.001) and 19% (14-24%) vs. 27% (24-29%) for NK vs. SK females (p = 0.076); central obesity prevalence, 13% (6-19%) vs. 24% (20-29%) for NK vs. SK males (p = 0.011) and 22% (17-28%) vs. 20% (18-22%) for NK vs. SK females (p = 0.382)). The prevalence of general and central obesity among NKRs with duration after defection from NK (≥10 years) were comparable to those of South Koreans in both genders (obesity prevalence, 34% (18-50%) vs. 39% (34-44%) for NK vs. SK males (p = 0.690) and 23% (18-29%) vs. 27% (24-29%) for NK vs. SK females (0.794); central obesity prevalence, 21% (7-34%) vs. 24% (20-29%) for NK vs. SK males (p = 0.642); 22% (17-28%) vs. 20% (18-22%) for NK vs. SK females (p = 0.382)). Male sex, age and longer duration after defection from NK (≥10 years) were positively associated with obesity. As for central obesity, age was the only independently associated factor. NKR females with duration after defection from NK of less than five years had comparable central obesity prevalence to South Korean females in spite of a lower BMI, which suggests that we need further monitoring for their metabolic health among NKRs in SK.