This study aimed to estimate nationwide prevalence of the metabolic syndrome and to identify its association with cardiovascular diseases. The data on a national representative sample of 6,147 adults from 1998 Korea National Health and Nutrition Survey were analyzed. The syndrome was determined according to two kinds of modified definition from ATP III, in which abdominal obesity was determined by waist circumference (WC) standard for Asians and waist-to-hip ratio (WHR). Based on the former, prevalence was 22.1% in men and 27.8% in women. However, based on the latter, prevalence was 28.6% and 27.8%, respectively. Although age-specific prevalence was higher in men than in women among the younger group, it became higher in women among the older group because of its steeper rise with age. In multiple logistic regression, the syndrome was found to be positively associated with cardiovascular diseases (adjusted odds ratios (ORs)1.97 by WC and 1.48 by WHR in men, and 1.54 and 1.31 in women). Moreover, its effect size exceeded that of total cholesterol (adjusted ORs 1.21 in men, and 1.08 in women) or LDL cholesterol (1.58 in men and 1.22 in women). It is obvious that the metabolic syndrome prevails in Korea, and its importance regarding cardiovascular diseases is considerable. Prevention strategies should be implemented immediately to avoid cardiovascular epidemic in the near future.

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Objective: To examine the prevalence of food insecurity and to identify factors that contribute to it in the Republic of Korea. Design: A cross-sectional study. Setting: Data were selected from a secondary data set, the third Korean Welfare Panel Study. Household food insecurity was measured with a six-item Korean version of the US Household Food Security Survey Module. The differences in proportions or means of household characteristics, householder's characteristics, economic status and social benefits by food insecurity status were tested with the x 2 or t test. The independent associations of food insecurity with each characteristic were assessed with multivariate logistic regression analysis. Subjects: The sample size consisted of 6238 households. Results: The prevalence of food insecurity was 5?3 % among all households and 25?7 % among low-income households. Risk factors that were associated with a higher risk of food insecurity included living alone, unemployment, no job, low household income and living in a leased or rented home. For low-income households, living in a leased or rented home increased the risk of food insecurity. Among food-insecure households, 26?1 % of the full sample of households and 34?3 % of low-income households were participating in food assistance programmes. Conclusions: Food insecurity among the Korean population was related to household type, income, job status and housing. Food assistance programmes were not enough to completely alleviate food insecurity.

SUMMARYDespite a growing body of research regarding the healthpromoting schools (HPS) concept from the World Health Organization (WHO), research on measuring of the HPS is limited. This study aims to develop a scale for assessing the status of the HPS based on the WHO guidelines and to evaluate the reliability and validity of the scale. After completing the translation and back-translation process, the content validity of the 50-item scale for HPS (SHPS) was assessed by an expert committee review and pretested with 17 teachers. A stratified, random sampling design was used. A total of 728 teachers from 94 schools completed a selfadministered questionnaire. The total sample was randomly divided into three groups for exploratory factor analysis (EFA), confirmatory factor analysis (CFA) and cross-validation. The EFA suggested seven factors, including 37 items, and the CFA confirmed these factors. In a second-order factor analysis, the second-order seven-factor model had acceptable fit indices (root mean square error of approximation 0.07, comparative fit index 0.98) with stability over validation sample and whole sample. Thus, the first-order seven factors (school nutrition services [three-item, a ¼ In conclusion, the SHPS is a reliable and valid measurement tool for assessing the states of the HPS in the Korean school context. It will be useful for comprehensively assessing schools' needs and monitoring the progress of school health interventions.

The purpose of this study was to explore psychological distress and examine the relationship between this distress and individual, family, and school factors among adolescents in four low-and middle-income countries (LAMICs) in Asia (i.e., Laos, Mongolia, Nepal, and Sri Lanka). Methods: A total of 4,098 adolescents attending public schools in the four LAMICs were surveyed as part of the Healthy School Development Project, which aimed to develop school capacity for improving (1) health among all school members and (2) the school environment through tailored school health programs. Psychological distress, family factors (i.e., parental understanding and monitoring, and parental tobacco and alcohol use), and school factors (i.e., having close friends, not bullied, school attendance, and health education) were assessed using self-report questionnaires. Data were collected from September to November in 2012 and 2013. Data analysis comprised descriptive statistics, Chi-squared testing, and logistic regression. Results: Over half of the participants were women (53.2%e64.1%), and 33.7% (in Sri Lanka) to 53.8% (in Laos) were aged older than 15 years. Approximately 32.9% reported the presence of psychological distress; moreover, 7.9%e13.2% reported suicidal ideation. Parental monitoring and being bullied were associated with psychological distress in all four countries. Conclusion: One-third of adolescents experience psychological distress across these four LAMICs, which poses a substantial public health issue. Adolescents can benefit from family and school-based approaches for screening, ameliorating, and preventing psychological distress.

25.1% of the households in this study were found to be currently facing catastrophic health expenditure, and it was determined that catastrophic health expenditure is a cause of transition to poverty. This result shows that South Korea's health security system is not an effective social safety net. As such, to prevent catastrophic health expenditure and transition to poverty, the benefit coverage of South Korea's health security system needs to the strengthened.

This study aimed to examine whether a dose-response relationship exists between psychological distress and types of physical activity (total, occupational, and leisuretime). The study subjects (233 men and 313 women) were recruited for a study on cardiovascular disease in the Yangpyeong community located in South Korea. The type and characteristics of physical activity were measured with a modified version of the Stanford 5 city project's questionnaire by well-trained interviewers using a standard protocol. The Psychological Well-being Index-Short Form was used to assess psychological distress. Both the intensity and duration of time in either total physical activity or occupational physical activity (OPA) were not related to the distress score. However, a long duration of time (1 hr/day) in severely intensive (≥ ≥6 metabolic equivalent) OPA was related to a high distress score in men (14.1 for none vs. 19.7, pfor-trend=0.005), even after the adjustment for leisure-time physical activity (LTPA). A long duration in time (1 hr/day) in LTPA was related to a lower distress score in men independent of their OPA (16.7 for none vs. 13.1, p-for-trend=0.02). In conclusion, the dose-response relationship of physical activity on psychological distress appeared to differ among the different types of activities. The type of activity may be an important determinant of whether physical activity produces psychological benefits.

Our finding suggests that social welfare protection can be a pivotal factor for suicide epidemiology, and especially in countries experiencing a social crisis or transition.