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Analysis of the Relationship Between Obesity Factors and Health-Related Physical Fitness Factors Among People with Intellectual Disabilities in South Korea

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Analysis of the Relationship Between Obesity Factors and Health-Related Physical Fitness Factors Among People with Intellectual Disabilities in South Korea International Journal of Environmental Research and Public Health Article Analysis of the Relationship between Obesity Factors and Health-Related Physical Fitness Factors among People with Intellectual Disabilities in South Korea Guyeol Jeong 1 and Buongo Chun 2,* 1 Department of Social Physical Education, College of Humanities and Arts, Sunchon National University, Sunchon 57922, Korea; [email protected] 2 Graduate School of Physical Education, College of Arts and Physical Education, Myongji University, Yongin 17058, Korea * Correspondence: [email protected]; Tel.: +82-(31)-330-6302 Abstract: Little is known about the relationship between health-related physical fitness factors and obesity-related factors in individuals with intellectual disabilities. We investigated the prevalence of obesity and the relationship between obesity-related factors and health-related physical fitness factors among people with intellectual disabilities in South Korea to identify the physical fitness factors that influence the degree of obesity. For obesity-related factors, we measured body composition (height, weight, body mass index—BMI, and body fat percentage) of 108 subjects with intellectual disabilities (mean ± standard deviation; age = 24.4 ± 8.45 years). For health-related physical fitness factors, we measured muscular strength, muscular endurance, and flexibility. There was a significant negative correlation between muscular endurance and obesity factors (BMI, r = −0.306, p < 0.01; body fat Citation: Jeong, G.; Chun, B. percentage, r = −0.402, p < 0.01). Further, the prevalence of obesity (34.3%) and being overweight Analysis of the Relationship between (17.6%) among people with intellectual disabilities was high in South Korea. In addition, muscular Obesity Factors and Health-Related endurance was found to have a significant effect on the obesity level (β = −0.239, p < 0.000). This Physical Fitness Factors among suggests that a program that considers muscular endurance should be prioritized when implementing People with Intellectual Disabilities in an exercise intervention strategy for the treatment of overweight and obesity among people with South Korea. Int. J. Environ. Res. intellectual disabilities. Public Health 2021, 18, 6533. https://doi.org/10.3390/ Keywords: people with intellectual disability; overweight; obesity; health-related physical fitness ijerph18126533 factor; muscular endurance; relationship Academic Editor: Sylvia Kirchengast Received: 16 April 2021 Accepted: 14 June 2021 1. Introduction Published: 17 June 2021 Obesity is a complex chronic disease characterized by excessive accumulation of body fat. It has been declared a global pandemic by the World Health Organization (WHO) [1]. Publisher’s Note: MDPI stays neutral Its prevalence is high among children, adolescents, and adults in developed countries [2]. with regard to jurisdictional claims in Obesity is considered a dangerous disease because it causes or worsens many health published maps and institutional affil- problems independently or in connection with other diseases. The WHO defines obesity iations. as body mass index (weight—kg divided by the square of height—m2; body mass index— BMI) of over 30 kg/m2 [3,4]. Among Asians, obesity is defined as a BMI of ≥25 kg/m2 [5]. BMI is a person’s weight in kilograms divided by the square of height in meters. BMI is an inexpensive and easy screening method for weight categories, such as underweight, Copyright: © 2021 by the authors. healthy weight, overweight, and obesity. Obesity has negative effects on health, such as Licensee MDPI, Basel, Switzerland. type 2 diabetes, hypertension, cardiovascular disease, and premature death. It is also highly This article is an open access article related to social and psychological problems as well as a social and economic burden [6–9]. distributed under the terms and Since such obesity-related costs impose a large economic burden on society [10], rapid conditions of the Creative Commons intervention and treatment for obesity are required. Attribution (CC BY) license (https:// In particular, it has been reported that the prevalence of obesity is higher among creativecommons.org/licenses/by/ people with intellectual disabilities than among the general population [11–13]. According 4.0/). Int. J. Environ. Res. Public Health 2021, 18, 6533. https://doi.org/10.3390/ijerph18126533 https://www.mdpi.com/journal/ijerph Int. J. Environ. Res. Public Health 2021, 18, 6533 2 of 11 to a study on people with intellectual disabilities in Australia, the prevalence of obesity (23.8%) and being overweight (22.5%) was higher in this population than that in the general population [12]. In the UK, the prevalence of obesity and being overweight among adults with intellectual disabilities is 20.7% and 28%, respectively [11]. This indicates that obesity is a more serious problem among people with intellectual disabilities than among the general population [14,15]. On the other hand, it has been reported that the number of people with intellectual disabilities is the highest in low- and middle-income countries [16]. Currently, there are 2.59 million people with disabilities in South Korea, accounting for 5% of the total population, of which 212,936 have intellectual disabilities. The proportion of people with intellectual disabilities among the population with disabilities consistently increased from 6.9% in 2009 to 8.2% in 2015, to 9.0% in 2018 [17]. Although it may seem that the prevalence of being overweight and obese among people with intellectual disabilities is higher in South Korea than in Western countries due to social and environmental problems, studies examining such prevalence are limited. Obesity is caused by a variety of factors, including environmental and genetic fac- tors [18]. In particular, it has been reported that decreased physical activity, decreased physical fitness, inadequate nutritional intake, and a sedentary lifestyle are risk factors of obesity [19]. In this regard, people with intellectual disabilities are limited in their physical activities due to limitations in language development, cognitive function, and cognitive impairment [20]. It has also been reported that many of them lead a sedentary lifestyle [21]. In addition, as they have a stronger desire for food intake than the general population, the prevalence of obesity is also higher [22]. Their lack of physical activity leads to a decline in their fitness level, which, in turn, causes various diseases such as obesity, hypertension, type 2 diabetes, and cardiovascular disease, thereby decreasing the health of people with intellectual disabilities [23]. Previous studies have shown that people with low fitness levels have a higher risk of becoming overweight or obese than those with high fitness levels [24,25]. Other studies have also shown that obese or overweight individuals have lower physical fitness levels than do people with a normal weight [26], and that physical fitness and body fat are negatively correlated [27]. It can be assumed that higher physical fitness levels among people with intellectual disabilities are associated with better body composition. However, little is known about the relationship between health-related physical fitness factors and obesity-related factors in this population. In addition, while the prevalence of intellectual disabilities and obesity is increasing in middle-income countries such as South Korea, no survey data have been reported on the obesity rates of teenagers to adults in their 40 s or the relationship between obesity and health-related physical fitness factors. Therefore, we aimed to investigate the prevalence of obesity among people with intellectual disabilities in South Korea and examine the relationship between health-related physical fitness and obesity-related fac- tors. Elucidating the physical factors associated with obesity in people with intellectual disabilities could lead to the development of new intervention programs to promote a healthier lifestyle in this population. Our results can help researchers, clinical experts, and trainers develop intervention strategies for the treatment of obesity and further motivate policymakers and decision makers to prioritize the treatment of people with intellectual disabilities. 2. Materials and Methods 2.1. Subjects In total, 108 individuals with intellectual disabilities (75 men and 33 women) residing in City G in South Korea were included in this study. They were selected from people with intellectual disabilities who visited the Physical Fitness Certification Center for the Disabled in City G (https://nfa.koreanpc.kr/front/centerpop/bs/boardList.do?center_cd=002& board_seq=14&type=popup, accessed on 23 January 2019). The inclusion criteria for subjects in this study are as follows: (1) participants, parents, and/or legal guardians have Int. J. Environ. Res. Public Health 2021, 18, 6533 3 of 11 signed prior consent before participation; (2) people who can walk without help; (3) people without motor impairment. The exclusion criteria for the subjects in this study are as follows: (1) people who are prohibited from exercising; (2) persons with a physical disability who are unable to perform physical activities. After we provided a thorough explanation of the purpose of our study and the measurement method to the visitors and their guardians in accordance with the Ethical Principles of the Declaration of Helsinki, we selected subjects among those who gave consent. In addition, for the sake of consistency, measurement and evaluation
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