Abstract
The prevalence of overweight and obesity in adult groups in Indonesia experience a surge compared to the previous year. The obesity determinants are classified as complex, and they can differ between regions. Appropriate policies, in accordance with determinants, play an important role in efforts to reduce the prevalence of obesity. This study aimed to identify the determinant factors for overweight and obesity in Indonesia and policies that supported a decrease in the prevalence of overweight and obesity based on the significant determinant factors found. The data sources were from the Ministry of Health, Statistics Indonesia, and the Ministry of Agriculture for 33 provinces in Indonesia. The literature regarding policy analysis was sought on Google, the IPB University repositories, related ministry websites, PubMed, ScienceDirect, and MEDLINE. The multiple regression analysis was performed to identify the determinants of overweight and obesity while the Five-E approach was used to analyze related policies. The simple regression analysis showed that the consumption of animal source foods (p=0.001), oil and fat consumption (p=0.006), the proportion of the population with low physical activity (p=0.01), the average study duration (p=0.001), total per capita expenditure (p=0.000), food (p=0.001) and non-food expenditure (p=0.000), and share of food expenditure (p=0.005) had significant effects on the proportion of adulthood overweight and obesity. Only oil and fat consumption (p=0.02) still had a significant positive effect on the proportion of overweight and obesity after performing the multiple regression analysis. Vegetable consumption (p=0.03) also had a significant negative effect on the proportion of overweight and obesity after being included in the multiple regression model. The Healthy Community Movement (HMC or known as GERMAS in Indonesia) policy and the inclusion of fat content into food labels are policies for preventing and managing overweight, which are conducted related to consumption of vegetables, fat, and oil. The effectiveness of the policy is still not optimal even though the policy is efficient. An improvement of the policy implementation needs to be conducted by optimizing the implementation of follow-up monitoring and evaluation of the implementation of program policies.
Highlights
Obesity is a global health problem, and its prevalence is increasing from year to year throughout the world
The data used in the analysis consisted of the consumption of grains, tubers, animal source foods, oils and fats, oily fruits and seeds, legumes, sugar, vegetables, fruits, and energy,[16] food and non-food expenditure,[17] the average study duration,[18] poor population,[19] the proportion of people with low physical activity, and the proportion of overweight and obese people,[3] The data used were the 2018 data in 33 provinces in Indonesia
The results of the bivariate analysis revealed that the consumption of animal source foods (p=0.001), the consumption of oil and fat (p=0.006), the proportion of people with low physical activity (p=0.01), the average study duration (p=0.001), total per capita expenditure (p= 0.000), food and non-food expenditure (p=0.000), and the share of food expenditure (p=0.005) had significant effects on the proportion of adulthood overweight and obesity in Indonesia (Table 1)
Summary
Obesity is a global health problem, and its prevalence is increasing from year to year throughout the world. The prevalence of obesity increased from 7% in 1980 to 12.5% in 2015 or increased by almost 80% over the past 35 years.[1] In 2016, 39% of the global population aged 18 years and over were overweight, with a total of 13% of the adult population worldwide being obese.[2] In Indonesia, the overweight prevalence in 2018 only increased by 0.1 % from 2013.3,4 the surge in the prevalence of obesity in the adult group in 2018 was 6.4%, which became 21.8% in five years.[3,4]. The contribution of obesity to cardiovascular disease, among others, is through the mechanism of proinflammatory mediators in obese people that causes oxidative stress on vascular walls, inflammation, and endothelial dysfunction that triggers atherosclerosis.[8]
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