Predicting the Transition to Metabolically Unhealthy Obesity Among Young Adults With Metabolically Healthy Obesity in South Korea: Nationwide Population-Based Study.

BACKGROUND: Globally, over 39% of individuals are obese. Metabolic syndrome, usually accompanied by obesity, is regarded as a major contributor to noncommunicable diseases. Given this relationship, the concepts of metabolically healthy and unhealthy obesity, considering metabolic status, have been evolving. Attention is being directed to metabolically healthy people with obesity who have relatively low transition rates to noncommunicable diseases. As obesity rates continue to rise and unhealthy behaviors prevail among young adults, there is a growing need for obesity management that considers these metabolic statuses. A nomogram can be used as an effective tool to predict the risk of transitioning to metabolically unhealthy obesity from a metabolically healthy status. OBJECTIVE: The study aimed to identify demographic factors, health behaviors, and 5 metabolic statuses related to the transition from metabolically healthy obesity to unhealthy obesity among people aged between 20 and 44 years and to develop a screening tool to predict this transition. METHODS: This secondary analysis study used national health data from the National Health Insurance System in South Korea. We analyzed the customized data using SAS (SAS Institute Inc) and conducted logistic regression to identify factors related to the transition from metabolically healthy to unhealthy obesity. A nomogram was developed to predict the transition using the identified factors. RESULTS: Among 3,351,989 people, there was a significant association between the transition from metabolically healthy to unhealthy obesity and general characteristics, health behaviors, and metabolic components. Male participants showed a 1.30 higher odds ratio for transitioning to metabolically unhealthy obesity than female participants, and people in the lowest economic status were also at risk for the transition (odds ratio 1.08, 95% CI 1.05-1.1). Smoking status, consuming >30 g of alcohol, and insufficient regular exercise were negatively associated with the transition. Each relevant variable was assigned a point value. When the nomogram total points reached 295, the shift from metabolically healthy to unhealthy obesity had a prediction rate of >50%. CONCLUSIONS: This study identified key factors for young adults transitioning from healthy to unhealthy obesity, creating a predictive nomogram. This nomogram, including triglycerides, waist circumference, high-density lipoprotein-cholesterol, blood pressure, and fasting glucose, allows easy assessment of obesity risk even for the general population. This tool simplifies predictions amid rising obesity rates and interventions.

Association between the transition to metabolically unhealthy obesity and lifestyle behavior: A nationwide cohort study.

OBJECTIVES: To identify the characteristics of individuals transitioning from metabolically healthy obesity (MHO) to unhealthy obesity and the factors influencing the change. DESIGN: This is a nationwide cohort study using data from the National Health Insurance Service in South Korea. SAMPLE: Individuals with obesity but metabolically healthy in 2009 and 2010 and those still obese 4 years later were selected. MEASUREMENTS: Sociodemographic, physical, metabolic, and health behavior variables were collected, and logistic regression was used to find an association with the transition. RESULTS: We analyzed 1,564,467 individuals, observing significant differences in all variables and the transition from MHO to unhealthy obesity. Among males, the transition was associated with smoking and drinking positively and physical activity negatively. Among females, drinking demonstrated a negative correlation. Regardless of age, regular exercise was negatively associated with the transition for all individuals. Except for older adults, all age groups showed a positive correlation with smoking and drinking. CONCLUSIONS: Considering the significant factors in the transition, it is essential to develop and implement interventions varied by gender and age to delay and prevent the change in metabolic status. The necessity of developing interventions enables individuals to engage in regular exercise, regardless of age and gender.

Association of Depression With Precautionary Behavior Compliance, COVID-19 Fear, and Health Behaviors in South Korea: National Cross-sectional Study.

BACKGROUND: As of January 2022, the number of people infected with COVID-19 worldwide has exceeded 350 million. As the COVID-19 pandemic continues, people are affected in a wide range of areas of life, which in turn causes numerous psychological problems. Depression is a serious problem for people who have suffered from COVID-19. Depression can worsen COVID-19 precautionary behavior compliance or the health behavior itself. In addition, these depressive symptoms may have different characteristics depending on the individual's gender. OBJECTIVE: The aim of this study was to determine whether depression is a factor that may affect COVID-19 fear, precautionary behavior compliance, and health behavior, and how these characteristic trends differ by gender. METHODS: This was a secondary analysis of data from the 2020 Korea Community Health Survey (KCHS), a national cross-sectional survey conducted with complex sampling analysis. In 2020, the KCHS included COVID-19-related questions. For this study, we used the KCHS data from both the COVID-19-related questions and the Patient Health Questionnaire-9 scale. After weighting the data according to the KCHS guidelines, we calculated the distribution of men and women according to depression level. The data were collected using multiple-choice questions related to precautionary behavior compliance, COVID-19-related fears, and health behavior changes. RESULTS: Of the 204,787 participants, those who were clinically depressed had a greater tendency to not comply with precautionary behaviors. Regarding COVID-19, "fear" showed a decreasing trend in both men (adjusted odds ratio [AOR] 0.72, 95% CI 0.61-0.83) and women (AOR 0.74, 95% CI 0.63-0.86) with clinically relevant depression. Moreover, for both men and women, health behaviors deteriorated as depression intensified; the AOR for sleep duration changes was 2.28 (95% CI 2.00-2.59) in men and was 2.15 (95% CI 1.96-2.36) in women. Notably, the responses of clinically depressed women revealed a doubled increase in both their drinking (AOR 2.25, 95% CI 1.88-2.70) and smoking (AOR 2.71, 95% CI 1.95-3.77) habits compared with those of nondepressed women. CONCLUSIONS: Both men and women with more severe depression were more likely to violate precautionary health behaviors as their depression worsened. Health behaviors also deteriorated for both genders, but women tended to show a greater change. Therefore, additional studies and interventions for vulnerable groups such as severely depressed people are needed. More research is also necessary to develop interventions based on statistical comparisons of men and women.

Nurses' duty to care during the COVID-19 pandemic: a cross-sectional survey.

BACKGROUND: Despite the increased demand for nurses worldwide, discussion of nurses' duty to care is lacking. This study aimed to examine nurses' duty to care during the coronavirus disease 2019 (COVID-19) pandemic and to identify the influencing factors. METHODS: This was a cross-sectional descriptive research study that used a structured online questionnaire. Registered Korean nurses answered a demographic questionnaire and the Nash Duty to Care Scale. RESULTS: Age and employment at tertiary hospitals increased nurses' duty to care. Male sex, a highly educated status, and employment at tertiary hospitals increased the perceived risk. Male sex and employment at tertiary or general hospitals increased confidence in the employer, while a high level of education and a longer total clinical career decreased the same. Age and a higher monthly wage increased perceived obligation. Age, lack of religious beliefs, and clinical experience of 3-7 years increased professional preparedness. CONCLUSION: Without enough nursing manpower, the disaster response system could prove to be inefficient. Considering that adequate nurse staffing is essential in disaster management, it is crucial to ensure that nurses have a will to provide care in the case of disaster. In the future, a more active discussion on nurses' duty to care and additional research on factors that may hinder and facilitate the same are needed.

Adolescent Employment, Mental Health, and Suicidal Behavior: A Propensity Score Matching Approach.

This study aimed to confirm the relationships between part-time work experience, mental health, and suicidal behavior in adolescents. The impact of part-time work in this population is a controversial topic, perhaps because of the sociocultural background-related inconsistencies in previous results. In this cross-sectional study, which involved a secondary analysis of data from the 11th-13th Korea Youth Risk Behavior Web-Based Surveys, conducted among 800 middle and high schools by the Korean government, we used propensity score matching analysis to minimize the impact of individual backgrounds on the findings concerning the relationships in question. Overall, part-time experience was significantly related to mental health problems and suicidal behavior even after eliminating background differences. Adolescents with part-time work experience had higher overall stress levels (odds ratio = 1.148; 95% confidence interval = 1.094, 1.205) than those without such experience, and more suicidal thoughts (odds ratio = 1.355; 95% confidence interval = 1.266, 1.450), suicide planning (odds ratio = 1.717; 95% confidence interval = 1.527, 1.929), and suicide attempts (odds ratio = 1.852; 95% confidence interval = 1.595, 2.151). Thus, it is important to pay increased attention to mental health and suicide-related issues in South Korean adolescents with part-time jobs.