P37 - Interrelationships of Multiple Forms of Transitions in Indonesia

Abstract

Background (Background, Rationale, Prior Research, and/or Theory): Barry Popkin proposed the term of “nutrition transition” to better describe the changes of diets over time and their impact on health. The term of “transition” has also been used to signify the temporal changes in other areas such as physical activity, body weight, and epidemiologic areas. Only a few attempted to understand the interrelationships of the multiple forms of transitions. Objective: This study aimed to examine whether and how the transition of socio-economic, dietary, physical activity, and body weight were correlated and contributed to epidemiologic transition in Indonesia. Study Design, Setting, Participants, Intervention: This study analyzed data of the household's main persons (2,749 over 19 years old) from Indonesia Family Life Survey (IFLS) 2007 and 2014 cross-sectionally and longitudinally. IFLS was designed to provide information for examining behaviors and outcomes, hence including wide-range data on the individuals and households from economic, education, family matters, to health status. Most data were self-reported, but, health data were measured. Outcome Measures and Analysis: Education represented socio-economic transition. Dietary transition was examined with individual weekly household expenditure on rice, sugar and sweeteners, vegetable oil, animal fat, milk, etc. Physical activity transition was studied with transportation-related, occupation-related, and leisure-related activities. Body weight transition was examined by body weight status. Epidemiological transition was examined with non-communicable diseases (hypertension, diabetes, dyslipidemia, stroke, heart problems) and communicable disease (tuberculosis). Nutrition transition could not be examined because of data unavailability. All analyses were conducted with SPSS. Results: Analyses revealed improving education level, more consumption of sugar and sweeteners and vegetable oil, less physical activity, more overweight and obesity, and increasing non-communicable diseases. Multiple logistic regressions showed that higher risk for high blood pressure was consistently associated with being female (cross-sectional: OR 3.35 (2007) and 2.16 (2014); P < .001 and longitudinal: OR 1.95; P < .05) and overweight (cross-sectional: OR 2.18 and 1.38; P < .05 and longitudinal: OR 1.01; P < .05). Physical activity transition were associated with lower risk of high blood pressure in 2007 with doing vigorous activities (OR 0.73; P < .05) and moderate activities (OR 0.69; P < .05), but not in 2014. No significant associations were found with dietary transition. Conclusions and Implications: All transitions occurred in line with literatures and were interrelated. In Indonesia, only body weight transition appeared to be consistently associated with epidemiologic transition, even after adjusting for other transitions. Funding: None.