Abstract
Objective. To investigate adolescent eating, activity, and behavioral patterns, and attitudes and their associations with obesity in selected communities in Indonesia. Design. A cross-sectional questionnaire and physical measurement-based study in three communities of varying modernization levels in Indonesia (Yogyakarta, Kuta, and Jakarta). Subjects. 1758 middle school students (aged 12–15 years) recruited at six different schools: one public and one private school in each of the three target communities. Measurements. The questionnaire collected data on demographic characteristics (age, gender, ethnicity, estimated household income); fast food eating habits (frequency, types of food/restaurant, general beliefs about fast foods); television, computer, and Play Station usage; physical activity (hrs/wk of participation in physical activity, transportation means for attending school); and eating habits (frequency of consuming selected foods and beverages). Student's height and weights were obtained, body mass index (BMI: weight [kg]/height [m2]) was calculated, and obesity was defined as ≥95%, using the BMI-for-age cut-offs from the Centers for Disease Control and Prevention (CDC) charts. Results. Chi-square analysis revealed associations between obesity and community setting, family income, use of a computer or Play Station, type of transportation to school, and beliefs about fast foods (P<0.01). According to the logistic regression analysis, adolescents from families with incomes over Rp 2 mil were three times as likely to be obese (95% CI 1.9, 4.9) and boys were 2.6 times more likely to be obese (95% CI 1.5, 4.5). Conclusion. Greater likelihood of obesity among Indonesian adolescents who spend greater amounts of time using a computer or Play Station suggests that such sedentary activities may be replacing physical activity, promoting an energy imbalance, and subsequently, an increased risk for obesity.
Acknowledgements
This study was funded by a Fulbright grant for 2002–2003 and approved by the Indonesian government research board (LIPI research permit #6177/SU/KS/2002).
We thank all of the following people who helped conduct the project, as well as the Fulbright Foundation for sponsoring this research. For their efforts in the preparation for the study, we thank Dr. Robin Kanarek, Dr. Donna Mumme, and Dr. Christina Economos from Tufts University. For their efforts in the data collection phase, we thank Dr. Endy Prawirohartono, Indria Gamayanti, and Dr. Djauhar Ismail from Universitas Gadjah Mada in Yogyakarta, as well as research assistants Tri Sulistyowati and Dwi Susilowati, and Fransisca Primawarhani; Dr. Supriyadi M.P. from Universitas Indonesia Denpasar Bali, as well as research assistants Dita and Christina Lindstrom; and Yasmine Widyawati, Tesiana Gastina, Nathanael Sumampouw, M. Faisal, and Tusriyono Fajar in Jakarta.