Physical activity and sedentary lifestyle towards teenagers' overweight/obesity status

Abstract

Background: The prevalence of obesity and overweight that caused by genetic factor and environment factors, like physical activity and sedentary lifestyle, increased continually, not only in children and teenagers who live in developed countries, but also in developing countries. Aim of this research was to understand the relation of physical activity and sedentary lifestyle towards teenagers’ overweight/obesity status of State Senior High School in Yogyakarta City, Indonesia. Methods: This research was an observational research using cross-sectional method. Samples in this research were 184 State Senior High School students in Yogyakarta between July-August 2015 with proportional stratified random sampling method. Data was analyzed using chi-square test and multiple logistic regressions. Results: There was relation between physical activity and overweight/obesity (p<0.001), also between sedentary lifestyle and overweight/obesity (p<0.001). Analysis result of multiple logistic regressions showed that dominant factors in this research were family income, parents’ overweight history, physical activity, and sedentary lifestyle with p<0.001 and R square 0.539. Conclusions: Overweight/obesity in teenagers could be caused by the decreased physical activity and the increased sedentary lifestyle, and aggravated by family income and parents’ overweight history. Follow up research must be done using cohort study design with bigger samples.

Full text

International Journal of Community Medicine and Public Health | March 2016 | Vol 3 | Issue 3 Page 630
International Journal of Community Medicine and Public Health
Kurdaningsih SV et al. Int J Community Med Public Health. 2016 Mar;3(3):630-635
http://www.ijcmph.com
pISSN 2394-6032 | eISSN 2394-6040
Research Article
Physical activity and sedentary lifestyle towards teenagers’
overweight/obesity status
Septi Viantri Kurdaningsih, Toto Sudargo, Lely Lusmilasari*
INTRODUCTION
The increasing prevalence of obesity and overweight in
children and teenagers became one of global epidemic
health problems, especially in developed and developing
countries. WHO (World Health Organization) in 2014
reported that more than 1.9 billion of adults and teenagers
in the world experienced overweight, and 600 million of
them got obesity.1 Obesity became a serious disease
because it could cause other disease complications such
as diabetes mellitus, hypertension, sleep apnea syndrome,
metabolic changes, intracranial hypertension, and
precocious puberty.2
Overweight and obesity in teenagers could be caused by
several factors. Factors that contributed to overweight
and obesity were genetic factor and environment factors
(sedentary lifestyle, physical activity, socioeconomic
status, nutritional status).3 This finding was parallel to
research from Hadi in 2004 which explained that factor
importantly contributed to increased bodyweight and the
incidence of overweight and obesity in teenagers was
decreased physical activity.4
The continued development of today's technology, people
are increasingly experiencing a decrease in physical
activity.5 Based on research Ortega et al that the child and
ABSTRACT
Background:
The prevalence of obesity and overweight that caused by genetic factor and environment factors, like
physical activity and sedentary lifestyle, increased continually, not only in children and teenagers who live in
developed countries, but also in developing countries. Aim of this research was to understand the relation of physical
activity and sedentary lifestyle towards teenagers’ overweight/obesity status of State Senior High School in
Yogyakarta City, Indonesia.
Methods:
This research was an observational research using cross-sectional method. Samples in this research were
184 State Senior High School students in Yogyakarta between July-August 2015 with proportional stratified random
sampling method. Data was analyzed using chi-square test and multiple logistic regressions.
Results:
There was relation between physical activity and overweight/obesity (p<0.001), also between sedentary
lifestyle and overweight/obesity (p<0.001). Analysis result of multiple logistic regressions showed that dominant
factors in this research were family income, parents’ overweight history, physical activity, and sedentary lifestyle with
p<0.001 and R square 0.539.
Conclusions:
Overweight/obesity in teenagers could be caused by the decreased physical activity and the increased
sedentary lifestyle, and aggravated by family income and parents’ overweight history. Follow up research must be
done using cohort study design with bigger samples.
Keywords: Overweight, Physical activity, Sedentary lifestyle
School of Nursing, Faculty of Medicine, Universitas Gadjah Mada, Indonesia
Received: 20 December 2015
Revised: 20 December 2015
Accepted: 11 January 2016
*Correspondence:
Dr. Lely Lusmilasari,
E-mail: lely_psik@ugm.ac.id
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20160623

Kurdaningsih SV et al. Int J Community Med Public Health. 2016 Mar;3(3):630-635
International Journal of Community Medicine and Public Health | March 2016 | Vol 3 | Issue 3 Page 631
teenagers who do more physical activity lower risk of
becoming overweight and obesity. Teenagers today to
spend more time at home than to be walking and cycling.6
Changes in lifestyle with eating disorders and decreased
physical activity showed changes become sedentary
lifestyle.7 Sedentary lifestyle is a lifestyle lazing or less
mobile.8 This causes the incoming energy intake only
slightly used that is stored as body fat. This lifestyle has a
greater likelihood to become obesity in teenagers.9
METHODS
This study was an observational research with cross-
sectional method. Samples in this research were 184
teenagers aged 16-18 years old that studied in State
Senior High School in Yogyakarta City, Indonesia
between July-August 2015 using proportional stratified
random sampling method. IPAQ (International Physical
Activity Questionnaire) was used to assess respondent’s
physical activity. Sedentary lifestyle questionnaire
constructed based on literature searching and some
modifications adopted from ASAQ (Adolescents Activity
Sedentary Questionnaire).10
Data was analyzed using chi square test and multiple
logistic regressions to identify which variable that was
really dominant related to overweight/obesity in research
subjects
RESULTS
Results of the study are the result of data analysis of
univariate, bivariate and multivariate analyzes that have
been done.
Table 1: Participants’ background.
Variable
Nutritional status
OR
95% CI
p-value
Normal (n=92)
Overweight/obesity
(n=92)
N
%
n
%
Age
Mid adolescence
Late adolescence
77
15
53.1
38.5
68
24
46.9
61.5
1.812
0.879-3.733
0.104
Sex
Man
Female
52
40
60.5
40.8
34
58
39.5
59.2
2.218
1.228-4.004
0.008*
Father’s education
Low
High
2
90
28.6
50.8
5
87
71.4
88.5
0.387
0.073-2.046
0.444
Mother’s education
Low
High
2
90
66.7
49.7
1
91
33.3
50.3
2.022
0.180-22.698
1.000
Father’s occupation
Does not work
Work
4
88
40
50.6
6
86
60
49.4
0.652
0.178-2.390
0.747
Mother’s occupation
Does not work
Work
41
51
47.1
52.6
46
46
52.9
47.4
0.804
0.450-1.435
0.460
Family income
Low
High
28
64
30.4
69.6
9
83
9.8
90.2
4.035
1.779-9.149
<0.001*
Family outcome
Low
High
15
77
48.4
50.3
16
76
51.6
49.7
0.925
0.427-2.003
0.844
History of overweight
parents
Yes
No
29
63
29.9
72.4
68
24
70.1
27.6
0.162
0.086-0.308
<0.001*
*Significant at p<0.05

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International Journal of Community Medicine and Public Health | March 2016 | Vol 3 | Issue 3 Page 632
Table 1 shows that the distribution characteristics of the
respondents in teenagers’ normal nutritional status and
the nutritional status of teenagers with
overweight/obesity. There is no significant relationship
(p>0.05) based on the distribution of age, father's
education, mother's education, father's occupation,
mother's occupation, and family expenses. This means
that the distribution of age, father's education, mother's
education, father's occupation, mother's occupation,
family spending on group of teenagers’ normal
nutritional status and teenagers’ nutritional status
overweight/obesity is the same. Distribution
characteristics of the respondents showed a significant
relationship between the two groups, namely gender,
family income and parental history of obesity (p<0.05).
The respondents who have a heavy physical activity but
normal nutritional status of 70 people (79.5%) and who
have physically strenuous activity but the nutritional
status of overweight/obesity as many as 18 people
(20.5%). Results of statistical test showed that there is a
relationship between physical activity with
overweight/obesity with p-value <0.05. More results are
shown in Table 2.
Table 2: Analyses of the relationship of physical activity with overweight/obesity (n=184).
Variable
Nutritional Status
OR
95% CI
p-value
Normal
Overweight/obesity
n
%
n
%
Physical Activity
Vigorous
Moderate
70
22
79.5
22.9
18
74
20.5
77.1
0.076
0.038-0.154
<0.001*
*Significant at p<0.05
Table 3: Analyses of the relationship dimension sedentary lifestyle with overweight/obesity (n=184).
*Significant at p<0.05
Based on analysis of data obtained strenuous physical
activity are mostly done in teenagers as rapid cycling and
riding climbs, jogging, playing basketball, and
swimming. In addition, regular physical activity is being
done is cleaning the bathroom, washing clothes, washing
of vehicles (car/motorcycle), the ironing clothes,
gardening, playing drums, sweeping and mopping floors.
The analysis showed there is a significant relationship
between the dimensions of sedentary lifestyle with
overweight / obesity with p <0.05. Results can be seen in
Table 3.
Multivariate analysis using multiple logistic regression
data analysis to determine which variables are dominant
with regard to overweight / obesity in teenagers. From the
test results obtained by several bivariate variables eligible
to continue in the multivariate analysis, the variables that
have a fairly high level of significance (p <0.25). These
variables were sex, family income, parental history of
obesity, physical activity, and sedentary lifestyle
Dimension sedentary lifestyle
Nutritional Status
OR
95%CI
p-value
Normal
Overweight/obesity
n
%
n
%
Small screen-based recreation
Low (≤ 2 hours/day)
High (>2 hours/day)
60
32
74.1
31.1
21
71
25.9
68.9
6.339
3.313-12.130
<0.001*
Education
Low (≤ 2 hours/day)
High (>2 hours/day)
35
57
66
43.5
18
74
34
56.5
2.524
1.298-4.910
0.006*
Travel
Low (≤ 2 hours/day)
High (>2 hours/day)
27
65
71.1
45.5
11
81
28.9
55.5
0.327
0.151-0.708
0.004*
Cultural Activity
Low (≤ 2 hours/day)
High (>2 hours/day)
62
30
73.8
30
22
70
26.2
70
6.576
3.441-12.567
<0.001*
Social Activity
Low (≤ 2 hours/day)
High (>2 hours/day)
55
37
70.5
34.9
23
69
29.5
65.1
4.459
2.376-8.370
<0.001*

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International Journal of Community Medicine and Public Health | March 2016 | Vol 3 | Issue 3 Page 633
variables subsequently analyzed using logistic regression
to determine which variables are the dominant influences
on overweight/obesity. While age, mother's education,
father's education, father's occupation, mother's
occupation, family expenses / month, are not included in
the multivariate analysis.
Table 4: Multivariate analyses.
Variable
OR
CI (95%)
p-
value
Lower
Upper
Step 2
Family income/month
Low
High
0.080
0.022
0.290
0.001*
History of overweight parents
Yes
No
6.883
2.650
17.880
0.001*
Physical activity
Vigorous
Moderate
Mild
21.038
7.356
60.168
0.001*
Sedentary lifestyle
Low (≤8
hours/day)
High (>8
hours/day)
0.086
0.028
0.259
0.001*
R2
0.690
*Significant at p<0.05
Table 5: Multivariate analysis relation physical
activity and sedentary lifestyle with
overweight/obesity (n=184).
Variable
OR
CI (95%)
p-value
Lower
Upper
Step 1
Physical activity
Vigorous
Moderate
Mild
10.948
4.980
24.065
<0.001*
Sedentary lifestyle
Low (≤8
hours/day)
High (>8
hours/day)
0.086
0.034
0.220
<0.001*
R2
0.539
Based on Table 4, the final results of multivariate logistic
regression analysis in step 2 shows that the variables that
influence overweight/obesity is a history of parental
obesity, physical activity and sedentary lifestyle has an
effect of 69% of the overweight/obesity. This means that
these variables are the dominant factors for
overweight/obesity in teenagers.
Based on Table 5, the final results of the multivariate
analysis with logistic regression obtained R value Square
of 0.539, which means that physical activity and
sedentary lifestyle have an influence for 53.9% of the
overweight/obesity, while 46.1% are influenced by other
factors.
DISCUSSION
The research result described that sex factor influenced
overweight/obesity in teenagers, especially for female
teenagers. Writer assumed that female teenagers tended
to do snacking more than male teenagers. This unhealthy
meal pattern could cause fat depositions in the body.
Therefore, the consumption of high-calories food without
accompanied by enough physical activity could cause the
body fat minimally got burned. This condition could
cause overweight/obesity in teenagers.
Overweight/obesity was not only related to sex factor.
Parents factor could also supported the incidence of
overweight/obesity in teenagers. Some variables from
parents’ factor in this research could support
overweight/obesity in teenagers. Based on the
researchers’ analysis, some factors such as family income
and parents’ overweight history had significant relation
toward overweight/obesity in teenagers.
The results are consistent with Muktiarti et al, declares
that income parents have a relationship with overweight /
obesity. Good family economic conditions make it easier
to meet the nutritional needs of the family and socio-
economic factors are important in determining the
amount and kinds of food available in the household.
However, income is a factor not directly affects food
consumption and a major determinant of the nutritional
status of a person in a state of good or bad.11
In this study also found a significant association between
physical activities with overweight/obesity. The authors
assume that the overweight/obesity in teenagers due to
lack of physical activity undertaken by teenagers in
Senior High School Yogyakarta. Senior high school
teenagers prefer to use motorcycles than cycling or
walking to get to school. Besides the many activities
outside of school such as extra classes and tutoring to
make the activity to be low. This is supported by
research Herini stated that the lack of physical activity
causes a lot of energy stored as fat, so it tends to people
who lack the activity to be obese.12
Another study conducted by Mustelin showed that there
was a significant relationship between physical activity
and obesity in children. Children and adolescents who
rarely exercise have an increased risk of obesity by 1:35
times compared with respondents who regularly
exercise.13 In addition, children who did not exercise
regularly tend to have a higher energy intake than those
who regularly exercise. Food and physical activity may
affect the incidence obesity both collectively and
respectively. Students who have low physical activity
have a risk of 1.7 times to become obesity.14 This is in
line with research Muktiharti et al, Which showed that

Kurdaningsih SV et al. Int J Community Med Public Health. 2016 Mar;3(3):630-635
International Journal of Community Medicine and Public Health | March 2016 | Vol 3 | Issue 3 Page 634
physical activity has a relationship with
overweight/obesity.11
Low physical activity in teenagers resulting in sedentary
behavior. This behavior is called sedentary lifestyle
which is one of the causes overweigh/obesity in
teenagers. Sedentary lifestyle is quite relaxed lifestyle,
among others, sitting, lying down, etc. in every day at
work (working at the computer, reading, etc.), at home
(watching TV, playing games, etc.), travel/transport
(buses, trains, motor), but not including bedtime.15
Sedentary lifestyle is grouped into five categories based
display, education, travel, cultural activities and social
events. Screen-based lifestyle includes watching
TV/video, use a computer or laptop for fun, and playing
mobile phone. The results showed that all of the
dimensions of a sedentary lifestyle have a significant
association with overweight/obesity.
Results of this study was supported by research Lowry et
al, declares that watching television more than two (2)
hours per day at risk of overweight/obesity.16 The same
study presented by Gomes et al stating that watching
television more than two (2) hours of 1:44 times the risk
of overweight / obesity.17
Muktiarti states that teenagers after school activities more
repeat lessons at school. They spend their spare time with
tutoring at school and outside of school. This leads to
more passive teenagers in the move because it just sitting
and writes as well as pay attention to the teacher's
explanation who caused the occurrence of
overweight/obesity.11
Gordon et al also mentioned that teenagers and the adult
who go to school and to work by walking or cycling is
not at risk of becoming overweight/obesity. However,
teenagers and adults who went by car, motorcycle, and
buses can be overweight/obesity. The study also states
that only a few people who use bicycles or walk to school
or to the office.18 Walking is good for health because it
improves cardiovascular function and reduces the risk of
death. Walking can be a means to an active lifestyle that
can increase physical activity and reduce the impact
obesity.19
CONCLUSION
Overweight/obesity in teenagers could be caused by the
decreased physical activity and the increased sedentary
lifestyle, and also aggravated by family income and
parents’ overweight history.
Recommendations
This research explained that the low physical activity and
high sedentary lifestyle could increase the risk of
overweight/obesity in teenagers. The need of follow up
research using better study design, which used cohort
study with bigger samples and gold standard
(accelerometer) to assess physical activity and sedentary
lifestyle complexly, must be accommodated for better
research result.
ACKNOWLEDGEMENTS
I would like to thank the student of state senior high
school in Yogyakarta city who participated in this study
for their willingness to give their time to complete the
questionnaire.
Funding: No funding sources
Conflict of interest: None declared
Ethical approval: The study was approved by the
Institutional Ethics Committee
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Cite this article as: Kurdaningsih SV, Sudargo T,
Lusmilasari L. Physical activity and sedentary lifestyle
towards teenagers’ overweight/obesity status. Int J
Community Med Public Health 2016;3:630-5.