Im Huei Son; Young Hee Han; Taisun Hyun

doi:10.4163/jnh.2017.50.4.336

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Son, Han, and Hyun: Changes in weight, waist circumference, prevalence of obesity, and dietary factors associated with weight gain over 8 years in Korean adults: Longitudinal data from the Korean Genome and Epidemiology Study∗

Research Article

J Nutr Health 2017;50(4):336-349.

Published online: 20 January 2017

DOI: https://doi.org/10.4163/jnh.2017.50.4.336

Changes in weight, waist circumference, prevalence of obesity, and dietary factors associated with weight gain over 8 years in Korean adults: Longitudinal data from the Korean Genome and Epidemiology Study^∗

Im Huei Son, Young Hee Han, Taisun Hyun^†

Department of Food and Nutrition, Chungbuk National University, Cheongju 28644, Korea

^†To whom correspondence should be addressed. tel: +82-43-261-2790, E-mail: taisun@chungbuk.ac.kr

^∗ This work was supported by the research grant of the Chungbuk National University in 2014. Data in this study were from the Korean Genome and Epidemiology Study (KoGES; 4851–302).

Received 25 July 2017 Revised 7 August 2017 Accepted 22 August 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purposes of this study were to describe changes in weight, waist circumference (WC), and prevalence of obesity over 8 years as well as investigate demographic and dietary factors associated with weight gain in Korean adults. Methods: The Korean Genome and Epidemiology Study is an ongoing community-based longitudinal study, which was started in 2001∼2002 and repeated every 2 years. Height, weight, and WC were measured, and demographic data and food intake information using the food frequency questionnaire were collected from 10,038 adults aged 40∼69 years at baseline. Among those individuals, 3,506 healthy individuals without chronic diseases completed the 4th follow-up survey in 2009∼2010. Results: Mean weight decreased by 0.35 kg and 0.65 kg in men and women, respectively, whereas mean WC increased by 1.71 cm and 1.85 cm during the 8-year period. Prevalence of obesity based on body mass index (BMI) decreased from 34.5% to 33.5% in men and from 38.0% to 36.7% in women, whereas abdominal obesity increased from 14.8% to 22.2% in men and from 28.8% to 35.4% in women. Weight change was associated with age and smoking status in men, and residence area, age, education, income, and alcohol drinking in women. Approximately 57.5% maintained their BMI over 8 years (< ±1 kg/m², stable weight group), 19.5% showed a BMI increase of ≥ 1 kg/m² (weight gain group), and 23.0% showed a BMI decrease of more than 1 kg/m² (weight loss group). There was no significant difference in energy intake calculated as the percentage of estimated energy requirements among the three weight change groups. Intakes of coffee mix and milk were significantly higher in the weight gain group than in the weight loss group in men after controlling for confounding factors. Conclusion: Our results show that higher consumption of coffee mix and milk was associated with weight gain in Korean healthy men.

Keywords: weight gain, body mass index, obesity, coffee mix, longitudinal study

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Fig. 1.

Flow diagram of participant selection for analysis

Fig. 2.

Changes in the percentages of obesity categories and abdominal obesity over 8 years

Fig. 3.

Changes in mean weight, waist circumference and body mass index by age groups over 8 years

Table 1.

Characteristics of the study population at baseline

Characteristics	Total (n = 3,506)	Men (n = 1,804)	Women (n = 1,702)	p-value²⁾
Residence area
Urban (Ansan)	1,892 (54.0)¹⁾	1022 (56.7)	870 (51.1)	< 0.01
Rural (Ansung)	1,614 (46.0)	782 (43.3)	832 (48.9)
Age (yrs)
40 ∼ 49	1,993 (56.9)	1,030 (57.1)	963 (56.6)	NS³⁾
50 ∼ 59	867 (24.7)	439 (24.3)	428 (25.1)
60 ∼ 69	646 (18.4)	335 (18.6)	311 (18.3)
Education
≤ Middle school graduate	1,742 (46.7)	702 (38.9)	1,040 (61.1)	< 0.001
High school graduate	1,236 (35.3)	696 (38.6)	540 (31.7)
≥ College graduate	528 (15.1)	406 (22.5)	122 (7.2)
Monthly income (10,000 won/mo)
< 100	1,031 (29.4)	449 (24.9)	582 (34.2)	< 0.001
100 ∼ 200	1,051 (30.0)	546 (30.3)	505 (29.7)
200 ∼ 300	731 (20.9)	409 (22.7)	322 (18.9)
≥ 300	693 (19.8)	400 (22.2)	293 (17.2)
Job
Farmer	928 (26.5)	574 (31.8)	354 (20.8)	< 0.001
Housewife	897 (25.6)	0 (0.0)	897 (52.7)
Self-employed	570 (16.3)	422 (23.4)	148 (8.7)
Office clerk/Professional	338 (9.6)	283 (15.7)	55 (3.2)
Sales/Manufacturing worker	264 (7.5)	144 (8.0)	120 (7.1)
Other	509 (14.5)	381 (21.1)	128 (7.5)
Alcohol
No	1,727 (49.3)	511 (28.3)	1,216 (71.5)	< 0.001
Yes	1,776 (50.7)	1,293 (71.7)	486 (28.6)
Smoking
No	2,601 (74.2)	943 (52.3)	1,658 (97.4)	< 0.001
Yes	905 (25.8)	861 (47.7)	44 (2.6)
Physical activity
Rarely	1,635 (47.6)	844 (47.2)	809 (48.0)	NS
< 30 min	469 (13.5)	241 (13.5)	228 (13.5)
≥ 30 min	1,350 (38.9)	702 (39.3)	648 (38.5)

¹⁾ N (%) 2) By χ²-test 3) Not significant

Table 2.

Anthropometric measurements and prevalence of obesity at baseline and at 8-year follow-up

	Men (n = 1,804)			Women (n = 1,702)
	Baseline	Follow-up	p-value¹⁾	Baseline	Follow-up	p-value
Age (yrs)	50.4 ± 8.3²⁾	58.2 ± 8.3	< 0.001	50.3 ± 8.3	58.2 ± 8.2	< 0.001
Height (cm)	166.9 ± 5.7	166.6 ± 5.8	NS³⁾	154.5 ± 5.4	154.1 ± 5.7	< 0.001
Weight (kg)	66.7 ± 9.4	66.4 ± 9.6	< 0.001	58.3 ± 8.1	57.6 ± 8.1	< 0.001
WC⁴⁾ (cm)	82.3 ± 7.4	84.0 ± 8.1	< 0.001	79.9 ± 9.1	81.7 ± 9.5	< 0.001
BMI⁵⁾ (kg/m²)	23.9 ± 2.8	23.9 ± 2.9	NS	24.4 ± 3.1	24.2 ± 3.0	< 0.001
BMI categories
Underweight (<18.5 kg/m²)	47 (2.6)⁶⁾	77 (4.3)	< 0.01	25 (1.5)	29 (1.7)	NS
Normal (18.5 ∼ 22.9 kg/m²)	633 (35.1)	586 (32.5)		559 (32.8)	586 (34.4)
Overweight (23 ∼ 24.9 kg/m²)	502 (27.8)	536 (29.7)		472 (27.7)	463 (27.2)
Obese (≥ 25 kg/m²)	622 (34.5)	605 (33.5)		646 (38.0)	624 (36.7)
WC categories
Normal	1,537 (85.2)	1,403 (77.8)	< 0.001	1,212 (71.2)	1,100 (64.6)	< 0.001
Obese (≥ 90 cm for men/85 cm for women)	267 (14.8)	401 (22.2)		490 (28.8)	602 (35.4)

¹⁾ By paired t-test or McNemar's test 2) Mean ± SD 3) Not significant 4) Waist circumference 5) Body mass index 6) N(%)

Table 3.

Changes in weight and waist circumference over 8 years by general characteristics at baseline

	Men (n = 1,804)					Women (n = 1,702)
	N	Weight (kg)		WC¹⁾ (cm)		N	Weight (kg)		WC (cm)
Total	1,804	–0.35 ± 3.80²⁾		1.71 ± 5.30		1,702	–0.65 ± 3.51		1.85 ± 6.18
Area
Urban (Ansan)	1,022	–0.34 ± 3.76	NS³⁾	–0.02 ± 5.15	< 0.001⁴⁾	870	–0.46 ± 3.55	< 0.05	0.38 ± 6.49	< 0.001
Rural (Ansung)	782	–0.37 ± 3.85		3.97 ± 4.59		832	–0.84 ± 3.46		3.40 ± 5.43
Age (yrs)
40 ∼ 49	1,030	0.07 ± 3.83	< 0.001	1.25 ± 5.09	< 0.001	963	–0.25 ± 3.57	< 0.001	1.65 ± 6.34	NS
50 ∼ 59	439	–0.79 ± 3.63		1.66 ± 5.62		428	–0.90 ± 3.37		2.23 ± 6.01
60 ∼ 69	335	–1.07 ± 3.76		3.21 ± 5.24		311	–1.52 ± 3.33		1.96 ± 5.87
Education
≤ Middle school graduate	702	–0.23 ± 3.69	NS	2.90 ± 5.21	< 0.001	1,040	–0.92 ± 3.56	< 0.001	2.28 ± 5.95	< 0.01
High school graduate	696	–0.34 ± 3.89		1.35 ± 5.15		540	–0.25 ± 3.45		1.18 ± 6.52
≥ College graduate	406	–0.57 ± 3.83		0.27 ± 5.25		122	–0.08 ± 3.10		1.23 ± 6.28
Monthly income (10,000 won)
< 100	449	–0.63 ± 3.84	NS	3.31 ± 5.04	< 0.001	582	–1.05 ± 3.58	< 0.01	2.62 ± 5.94	< 0.01
100 ∼ 200	546	–0.20 ± 3.86		2.15 ± 5.17		505	–0.61 ± 3.40		1.62 ± 6.09
200 ∼ 300	409	–0.14 ± 3.86		1.02 ± 5.18		322	–0.39 ± 3.79		1.26 ± 6.87
≥ 300	400	–0.45 ± 3.59		0.03 ± 5.28		293	–0.18 ± 3.15		1.37 ± 5.85
Job
Farmer	574	–0.28 ± 3.66	NS	4.03 ± 4.52	< 0.001	354	–1.03 ± 3.47	NS	3.21 ± 5.46	< 0.001
Housewife	0					897	–0.61 ± 3.47		1.50 ± 6.29
Self-employed	422	–0.46 ± 3.76		0.58 ± 5.55		148	–0.73 ± 3.70		1.15 ± 6.39
Office clerk/Professional	283	–0.42 ± 3.76		0.50 ± 4.97		55	0.02 ± 3.18		–0.34 ± 7.48
Sales/Manufacturing worker	144	0.18 ± 3.71		1.12 ± 4.95		120	–0.40 ± 3.59		3.36 ± 5.13
Other	378	–0.48 ± 4.09		0.60 ± 5.35		128	–0.21 ± 3.66		0.96 ± 6.45
Alcohol
No	511	–0.49 ± 3.56	NS	1.72 ± 5.24	NS	1,216	–0.77 ± 3.43	< 0.05	1.77 ± 6.15	NS
Yes	1,293	–0.29 ± 3.89		1.71 ± 5.32		486	–0.34 ± 3.70		2.05 ± 6.24
Smoking
No	943	–0.73 ± 3.54	< 0.001	1.07 ± 5.22	< 0.001	1,658	–0.67 ± 3.49	NS	1.78 ± 6.17	< 0.01
Yes	861	0.06 ± 4.02		2.41 ± 5.30		44	0.15 ± 4.11		4.46 ± 6.06
Smoking at follow-up
No	1214	–0.19 ± 3.84	< 0.05	1.73 ± 5.44	NS	1676	–0.63 ± 3.52	NS	1.84 ± 6.19	NS
Yes	590	–0.67 ± 3.69		1.67 ± 4.99		26	–1.45 ± 3.11		2.49 ± 5.31
Physical activity
Rarely	844	–0.40 ± 3.80	NS	1.60 ± 5.25	NS	809	–0.76 ± 3.62	NS	1.99 ± 6.13	NS
< 30 min	241	–0.66 ± 3.85		1.58 ± 5.44		228	–0.85 ± 3.24		1.51 ± 5.56
≥ 30 min	702	–0.19 ± 3.80		1.86 ± 5.31		648	–0.42 ± 3.47		1.77 ± 6.47

¹⁾ Waist circumference 2) Mean ± SD 3) Not significant 4) p-value by t-test or ANOVA

Table 4.

Anthropomeric changes over 8 years in the three groups classified based on weight changes

		Men (n = 1,804)				Women (n = 1,702)
		Weight loss	Stable weight	Weight gain	p-value¹⁾	Weight loss	Stable weight	Weight gain	p-value
		(n = 390)	(n = 1,061)	(n = 353)	p-value¹⁾	(n = 417)	(n = 955)	(n = 330)	p-value
Height (cm)	Baseline	166.7 ± 5.7	166.8 ± 5.8	167.3 ± 5.7	NS	154.4 ± 5.3	154.6 ± 5.4	154.5 ± 5.5	NS
	Follow-up	166.5 ± 5.8	166.5 ± 5.8	167.1 ± 5.7	NS	154.1 ± 5.5	154.2 ± 5.7	153.9 ± 5.9	NS
	8-year change	–0.2 ± 0.9	–0.2 ± 0.8	–0.2 ± 0.8	NS	–0.3 ± 1.0^a	–0.4 ± 1.0^a	–0.5 ± 1.6^b	< 0.01
Weight (kg)	Baseline	69.3 ± 10.4^a ²⁾	66.2 ± 9.1^b	65.5 ± 8.8^b	< 0.001	61.5 ± 8.3^a	57.5 ± 7.7^b	56.5 ± 7.8^b	< 0.001
	Follow-up	64.0 ± 10.2^c	65.9 ± 9.1^b	70.4 ± 9.2^a	< 0.001	56.5 ± 8.0^b	57.2 ± 7.8^b	60.4 ± 8.2^a	< 0.001
	8-year change	–5.3 ± 2.4^c	–0.3 ± 1.6^b	4.9 ± 2.3^a	< 0.001	–5.0 ± 2.4^c	–0.3 ± 1.5^b	4.0 ± 2.1^a	< 0.001
WC³⁾ (cm)	Baseline	84.5 ± 7.9^a	81.9 ± 7.2^b	81.1 ± 7.0^b	< 0.001	82.9 ± 8.6^a	79.3 ± 9.0^b	77.6 ± 8.8^b	< 0.001
	Follow-up	81.8 ± 8.3^c	83.6 ± 7.9^b	87.6 ± 7.5^a	< 0.001	80.8 ± 9.1^b	81.3 ± 9.5^b	84.1 ± 9.4^a	< 0.001
	8-year change	–2.7 ± 4.8^c	1.7 ± 4.3^b	6.5 ± 4.4^a	< 0.001	–2.1 ± 5.5^c	2.0 ± 5.4^b	6.4 ± 5.7^a	< 0.001
BMI⁴⁾ (kg/m²)	Baseline	24.9 ± 3.1^a	23.7 ± 2.7^b	23.4 ± 2.6^b	< 0.001	25.8 ± 3.1^a	24.1 ± 2.9^b	23.7 ± 3.0^b	< 0.001
	Follow-up	23.0 ± 3.1^c	23.7 ± 2.7^b	25.2 ± 2.7^a	< 0.001	23.8 ± 3.0^b	24.0 ± 2.9^b	25.5 ± 3.1^a	< 0.001
	8-year change	–1.8 ± 0.8^c	–0.0 ± 0.6^b	1.8 ± 0.8^a	< 0.001	–2.0 ± 1.0^c	–0.0 ± 0.6^b	1.8 ± 0.8^a	< 0.001
Prevalence of	Baseline	191 (49.0)⁶⁾	340 (32.5)	91 (25.8)	< 0.001	231 (55.4)	315 (33.0)	100 (30.3)	< 0.001
obesiy⁵⁾	Follow-up	97 (24.9)	332 (31.3)	176 (49.9)	< 0.001	138 (33.1)	311 (32.6)	175 (53.1)	< 0.001
Prevalence of	Baseline	95 (24.4)	134 (12.6)	38 (10.8)	< 0.001	163 (39.1)	258 (27.0)	69 (20.9)	< 0.001
abdominal obesity⁷⁾	Follow-up	64 (16.4)	209 (19.7)	128 (36.3)	< 0.001	131 (31.4)	325 (34.0)	146 (44.2)	< 0.001

¹⁾ By ANOVA or χ²-test 2) Mean ± SD, Different letters within the same row are significantly different at 0.05 by Tukey's test. 3) Wais circumference 4) Body mass index 5) BMI ≥ 25 kg/m²⁾ N (%) 7) WC ≥ 90 cm for men, ≥ 85 cm for women

Table 5.

Mean energy intake and nutrient adequacy ratio (NAR) of selected nutrients at baseline

Men (n = 1,804)				Women (n = 1,702)				p-value
	Weight loss	Stable weight	Weight gain	p-value¹⁾	Weight loss	Stable weight	Weight gain
	(n = 390)	(n = 1,061)	(n = 353)		(n = 417)	(n = 955)	(n = 330)
Energy (kcal/day)	1,966 ± 587²⁾	2,026 ± 665	2,023 ± 641	NS³⁾	1,845 ± 683	1,949 ± 761	1,902 ± 667	< 0.05
	(86.8)⁴⁾	(88.1)	(87.7)	NS	(100.8)	(105.9)	(103.0)	NS
Protein	0.89^b5)	0.92^a	0.92^a	< 0.01	0.92^b	0.94^ab	0.94^a	< 0.05
Vitamin A	0.59^b	0.64^a	0.65^a	< 0.01	0.66	0.67	0.67	NS
Thiamine	0.86^b	0.89^a	0.89^a	< 0.01	0.85	0.88	0.88	< 0.05
Riboflavin	0.63^b	0.66^a	0.67^a	< 0.05	0.72	0.74	0.75	NS
Vitamin C	0.80	0.84	0.83	< 0.05	0.83	0.85	0.84	NS
Calcium	0.54^b	0.59^a	0.58^a	< 0.01	0.59	0.61	0.62	NS
Iron	0.85^b	0.88^a	0.87^a	< 0.01	0.80	0.81	0.80	NS
MAR⁶⁾	0.74^b	0.77^a	0.77^a	< 0.01	0.77	0.79	0.79	NS

¹⁾ By ANOVA 2) Mean ± SD 3) Not significant 4) Percentage of estimated energy requirements 5) NAR, Different letters within the same row are significantly different at 0.05 by Tukey's test. 6) Mean adequacy ratio

Table 6.

Mean intake of selected sugar containing foods and beverages at baseline

	Men (n = 1,804)					Women (n = 1,702)
	Weight loss	Stable weight	Weight gain	p-value ¹⁾	p-value ²⁾	Weight loss	Stable weight	Weight gain	p-value	p-value
	(n = 390)	(n = 1,061)	(n = 353)			(n = 417)	(n = 955)	(n = 330)
Bread
Loaf bread	4.0 ± 9.7³⁾	4.4 ± 12.1	4.8 ± 10.2	NS⁴⁾	NS	4.4 ± 9.8	5.0 ± 11.1	5.5 ± 10.3	NS	NS
Bread with red bean paste	3.5 ± 8.6	4.4 ± 16.2	3.5 ± 9.4	NS	NS	3.5 ± 9.5	3.5 ± 8.8	3.9 ± 7.9	NS	NS
Choco pie/cake	2.1 ± 6.8	2.8 ± 8.3	3.0 ± 16.7	NS	NS	2.1 ± 8.7	2.4 ± 7.2	1.9 ± 5.0	NS	NS
Other (bread with cream, castella)	4.2 ± 9.7	4.9 ± 13.9	4.6 ± 11.1	NS	NS	4.0 ± 15.2	4.2 ± 10.1	4.4 ± 8.3	NS	NS
Confectionery
Cookies	4.6 ± 9.0	5.4 ± 10.4	5.0 ± 9.5	NS	NS	3.9 ± 8.6	5.5 ± 11.7	5.7 ± 10.6	< 0.05	NS
Candy/Chocolate	2.0 ± 5.6	1.7 ± 5.0	1.6 ± 5.0	NS	NS	1.7 ± 5.1	1.8 ± 3.9	1.3 ± 3.3	NS	NS
Ice cream	7.1 ± 15.8	9.1 ± 19.5	9.8 ± 26.3	NS	NS	7.4 ± 19.7	9.5 ± 22.6	9.9 ± 19.2	NS	NS
Beverages
Carbonated beverages	25.3 ± 44.3^b5)	31.2 ± 54.8^ab	38.1 ± 59.0^a	< 0.01	NS	19.9 ± 76.1	16.7 ± 38.4	16.8 ± 39.0	NS	NS
Coffee (mix)	12.0 ± 13.1^b	12.9 ± 13.0^ab	14.5 ± 13.8^a	< 0.05	< 0.05	8.6 ± 9.8	7.9 ± 9.6	8.7 ± 9.6	NS	NS
Green tea	38.1 ± 72.9	39.3 ± 74.2	40.2 ± 68.3	NS	NS	40.1 ± 89.0	37.1 ± 73.3	35.6 ± 72.3	NS	NS
Soy milk	10.3 ± 29.2	11.7 ± 36.7	10.0 ± 29.4	NS	NS	6.5 ± 26.1	9.1 ± 42.5	8.6 ± 28.9	NS	NS
Other beverages (Sikhye, Yuja-cha)	13.7 ± 31.0	17.5 ± 43.6	14.6 ± 33.0	NS	NS	10.9 ± 27.6	11.3 ± 27.6	9.6 ± 22.0	NS	NS
Dairy products
Milk	53.5 ± 95.7^b	67.0 ± 104.7^ab	72.0 ± 127.3^a	< 0.05	< 0.05	84.1 ± 132.5	82.3 ± 117.6	89.0 ± 117.3	NS	NS
Yogurt	27.4 ± 52.1	28.6 ± 55.9	28.1 ± 57.8	NS	NS	35.3 ± 67.2	33.6 ± 64.3	31.9 ± 59.3	NS	NS
Total⁶⁾	116.0 ± 104.8^b	134.6 ± 134.6^a	137.6 ± 135.8^a	< 0.05	NS	108.2 ± 137.5	110.6 ± 121.7	108.1 ± 99.3	NS	NS

¹⁾ By ANOVA 2) Adjusted for area, age, education, income, alcohol at baseline, and smoking at follow-up 3) Mean ± SD (g/day) 4) Not significant 5) Different letters within the same row are significantly different by Tukey's test. 6) Sum of the intakes of 12 items among 14 items except green tea and milk

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