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Original article Body mass index and prevalence of metabolic syndrome among Korean adults before and after the coronavirus disease 2019 outbreak: a retrospective longitudinal study
Joo-Eun Jeong1orcid , Hoon-Ki Park1orcid , Hwan-Sik Hwang1orcid , Kye-Yeung Park1orcid , Myoung-Hye Lee1orcid , Seon-Hi Shin2orcid , Nayeon Choi2orcid
Epidemiol Health 2023;e2023081
DOI: https://doi.org/10.4178/epih.e2023081 [Accepted]
Published online: August 29, 2023
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1Department of Family Medicine, Hanyang University College of Medicine, Seoul, Korea, Seongdong-gu, Korea
2Biostatistical Consulting and Research Lab, Medical Research Collaborating Center, Hanyang University, Seongdong-gu, Korea
Corresponding author:  Hoon-Ki Park,
Email: hoonkp@hanyang.ac.kr
Received: 8 June 2023   • Revised: 16 August 2023   • Accepted: 18 August 2023
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Abstract

Objectives
Studies evaluating weight changes during the coronavirus disease 2019 (COVID-19) pandemic have yielded inconsistent results, and most of those studies were based on self-reported anthropometric measures. We investigated changes in body mass index (BMI), professionally measured waist circumference (WC), and metabolic syndrome components from before to during the pandemic in a sample of the adult population in South Korea.
Methods
This retrospective study included 1,118 men and women (age≥18 years) who underwent health checkups at a university medical center between January 1, 2016, and March 31, 2022. Changes in BMI, lifestyles, and metabolic syndrome components during the pandemic were analyzed using the paired t-test, McNemar test, generalized estimating equations, and repeated-measures analysis of variance.
Results
Changes in body weight, BMI, and body fat percentage during the pandemic were not clinically significant. However, statistically significant results were found for decreased physical activity (p<0.001) and WC (p<0.001), and exacerbation of all metabolic syndrome components (except serum triglyceride levels). Moreover, the metabolic syndrome prevalence increased significantly from 20.2% to 31.2% during the pandemic (p<0.001). The prevalence of abdominal obesity and high fasting blood glucose levels also significantly increased from 2019 to 2021.
Conclusions
Metabolic syndrome, its components, and fat distribution worsened significantly after the implementation of social distancing and lockdowns, despite no clinically significant changes in body weight and BMI. Further studies on the post-pandemic period should investigate the long-term impact of social lockdowns on BMI and the prevalence of metabolic syndrome.

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