Suffering from both widespread hunger and poverty, nearly half of North Koreans are undernourished — the highest rate out of all Asia-Pacific countries measured — while nearly a third of adults are considered overweight, according to a new U.N. report.

The U.N. Food and Agriculture Organization stated that more than 45% of North Koreans didn’t have enough food to eat to sustain normal energy levels and health between 2017 and 2019, according to the latest data available under the U.N. umbrella. That’s a significant jump from the second-most malnourished country, Timor-Leste, which is near Indonesia and had a 31% rate of undernourishment. Most of North Korea’s other East Asian neighbors — such as China, Japan and South Korea — had a rate that was under 2.5%.