Metabolic health is usually judged by five measurements: waist size, blood pressure, fasting blood glucose, triglycerides and HDL cholesterol. In Korea, doctors diagnose metabolic syndrome when a person meets at least three of the five criteria, and the national health screening program already measures most of them. This article explains the Korean thresholds, what lifestyle guidance the Korean and WHO guidelines give, and when to talk to a doctor.
The five measures and the Korean cut-offs
The 2020 Korean Society for the Study of Obesity (KSSO) guidelines define metabolic syndrome in Korean adults as having at least three of these five components:
- Waist circumference of 90 cm or more in men, or 85 cm or more in women.
- Blood pressure of 130/85 mmHg or higher, or use of blood pressure medication.
- Fasting blood glucose of 100 mg/dL or higher, or use of diabetes medication.
- Triglycerides of 150 mg/dL or higher.
- HDL cholesterol below 40 mg/dL in men or below 50 mg/dL in women, or use of medication for lipid problems.
The same guidelines set out body mass index (BMI) bands for Korean adults: 23.0 to 24.9 kg/m2 is pre-obesity, 25.0 to 29.9 is class I obesity, 30.0 to 34.9 is class II, and 35.0 or higher is class III. These are screening tools. A single number does not diagnose anyone, and only a doctor can interpret your results.
Where you can get measured in Korea
A review of the National General Health Screening Program in the journal Public Health and Medicine notes that the program targets adults aged 20 and older. Employees are screened every two years, with manual labourers screened annually, and the self-employed and dependents aged 40 and over are also screened every two years. It measures blood pressure, waist circumference, blood glucose, lipid profiles (triglycerides, HDL and LDL cholesterol), kidney function, and vision and hearing, plus other tests such as liver function and a chest X-ray. Eligibility and the test list can change, so check your own eligibility with the National Health Insurance Service (NHIS).
If you have your results, compare them with the five thresholds above. If you meet one or two, that is a reason to review habits and to ask your doctor how often to re-check, not a diagnosis.
Physical activity: the WHO targets
The World Health Organization's 2020 guidelines say adults should do 150 to 300 minutes of moderate-intensity aerobic activity a week, or 75 to 150 minutes of vigorous activity, or an equivalent mix. They add muscle-strengthening activities involving all major muscle groups on two or more days a week. They also advise limiting sedentary time, and say that replacing sitting with activity of any intensity, including light activity, provides health benefits. For people who are not yet meeting the targets, the WHO says some physical activity is better than none, and that frequency, intensity and duration should be increased gradually.
The KSSO guidelines give similar advice for people with obesity: aerobic exercise of at least 150 minutes a week at moderate intensity, spread over three to five days, plus resistance training two to four times a week using large muscle groups. They report that combining aerobic and resistance training is more effective than either alone.
Eating and weight: what the Korean guideline says
For people who are obese, the KSSO guidelines recommend an individualised reduction in energy intake, with a deficit of 500 to 1,000 kcal a day expected to produce weight loss of 0.5 to 1.0 kg a week. They set a primary goal of losing 5 to 10 percent of body weight within six months of starting treatment, and they describe behavioural therapy methods including self-monitoring, reinforcement, stimulus control, alternative behaviours and cognitive restructuring. Behavioural therapy with a trained therapist is described as needed for more than six months for weight loss and at least a year for maintenance.
These recommendations are for people being treated for obesity under medical supervision. Do not start a large calorie deficit on your own, especially if you have diabetes, take medication, are pregnant or have another condition. Ask your doctor or a registered dietitian what is safe for you.
A practical weekly routine
- Break the WHO minimum into chunks you can keep, such as 30 minutes of brisk walking on five days.
- Add two short strength sessions that use legs, back, chest and arms.
- Stand up and move briefly after long periods of sitting, since the WHO says light activity helps too.
- Write your waist, blood pressure and blood test results in one place each time you are measured, so you can see change over time.
- Book your national screening when it is due, rather than waiting for symptoms.
Common mistakes to verify
- Using cut-offs from another country's guidelines. The Korean guidelines cited here use 90 cm for men and 85 cm for women for waist size.
- Judging health from weight alone, when waist, blood pressure, glucose and lipids all count.
- Trying to meet the exercise target in one weekend session.
- Stopping prescribed medication because a number looks better.
- Treating this checklist as a self-diagnosis.
Rules change: confirm with the official body
This article is general health information and is not medical advice, diagnosis or treatment. Guidelines are revised as evidence changes, and screening eligibility and fees can change. Check current screening details with the National Health Insurance Service, and speak to a qualified doctor about your own results and before changing your diet or exercise routine.
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