J Nutr Health.  2019 Oct;52(5):449-464. 10.4163/jnh.2019.52.5.449.

Dietary behaviors and nutritional status according to the bone mineral density status among adult female North Korean refugees in South Korea

Affiliations
  • 1Department of Food and Nutrition, Inha University, Incheon 22212, Korea. skleenutrition@inha.ac.kr
  • 2Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul 02841, Korea.

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.

Keyword

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

MeSH Terms

Adult*
Animals
Bone Density*
Calcium
Cohort Studies
Cross-Sectional Studies
Democratic People's Republic of Korea
Diet
Female*
Food Supply
Health Behavior
Humans
Korea*
Menopause
Nutrition Policy
Nutritional Status*
Obesity, Abdominal
Refugees*
Seoul
Starvation
Calcium

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