Journal List > J Nutr Health > v.52(5) > 1136452

J Nutr Health. 2019 Oct;52(5):449-464. Korean.
Published online Oct 30, 2019.  https://doi.org/10.4163/jnh.2019.52.5.449
© 2019 The Korean Nutrition Society
Dietary behaviors and nutritional status according to the bone mineral density status among adult female North Korean refugees in South Korea
Su-Hyeon Kim,1 Soo-Kyung Lee,1 and Sin-Gon Kim2
1Department of Food and Nutrition, Inha University, Incheon 22212, Korea.
2Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul 02841, Korea.

To whom correspondence should be addressed. tel: +82-32-860-8121, Email: skleenutrition@inha.ac.kr
Received Dec 26, 2018; Revised Jul 09, 2019; Accepted Aug 18, 2019.

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

North Koreans could be at higher risk for their bone health because of previous periods of severe famine and the continuing low availability of food. This study determined the bone mineral density (BMD) status and its relationship with dietary behaviors and nutrient intake of North Korean refugees (NKR) in South Korea (SK).

Methods

This cross-sectional study analyzed 110 female NKR from a NORNS cohort of a non-probability sample of adult NKR in Seoul. BMD examined by DEXA was used to divide participants into the normal group (NG) and the non-normal group (NNG) according to the WHO guideline. A self-administered questionnaire included questions on age, the socioeconomic situation in North Korea (NK) and SK, the food security in NK and SK, and the health behaviors, dietary behaviors, and food frequency questionnaire administered in SK. A one-day 24-hr recall was conducted and the results were analyzed by using CanPro. SPSS was used to analyze whether BMD and related dietary behaviors and nutrient intakes differed according to the groups.

Results

NG (62.7%) was significantly younger and had a lower abdominal obesity score than NNG (p < 0.001). While 14.5% of NG reported experiencing menopause, all of NNG reported experiencing menopause. The NG more frequently consumed the dairy group of foods (9.6 times a week) than did the NNG (4.8 times a week) after the statistics were adjusted for age (p < 0.007). The NG consumed significantly more animal protein and animal calcium than did the NNG (p = 0.01, p = 0.009, respectively). Calcium intake was low with 49.3% of NG, and 78.0% of the NNG reported consuming calcium lower than the estimated average requirement. Only calcium showed an index of nutrient quality lower than one in both groups.

Conclusion

These results showed that NKR women and possibly all North Korean women are at high risk for bone health and they consumed low levels of bone-related nutrients, and this should be considered for the nutrition policy for NKR and North Korea.

Keywords: North Korea; bone density; women; diet; nutritional status

Tables


Table 1
Bone mineral density and general characteristics of adult female North Korean refugees in South Korea
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Table 2
Health and health behaviors of adult female North Korean refugees in South Korea
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Table 3
Food security in South and North Korea experienced by adult female North Korean refugees in South Korea
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Table 4
Dietary behaviors in South Korea of adult female North Korean refugees in South Korea
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Table 5
Weekly consumption frequency of adult female North Korean refugees in South Korea1)
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Table 6
Energy and nutrient intake of adult female North Korean refugees in South Korea
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Table 7
Comparison of energy and nutrient intake against KDRI1) among adult female North Korean refugees in South Korea
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Table 8
Index of Nutrient Quality1) of adult female North Korean refugees in South Korea
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Notes

The authors thank all those who participated in this study and Dr. SY Nam for her assistance on additional statistical analyses.

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