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RESEARCH STUDY
OPEN ACCESS
English Version

Factors Influencing Nutritional Status in Overweight and Obese

Adolescents
Faktor-Faktor Yang Mempengaruhi Status Gizi Pada Remaja Overweight dan
Obese
Iriyani Kamaruddin1*, Lilik Kustiyah2, Hadi Riyadi2, Ruqayah Junus3
1FakultasKesehatan Masyarakat, Universitas Mulawarman, Samarinda, Indonesia
2Departemen Gizi, Fakultas Ekologi Manusia, Institut Pertanian Bogor, Bogor, Indonesia
3Jurusan Gizi, Politeknik Kesehatan Kementerian Kesehatan Manado, Indonesia

ABSTRACT
ARTICLE INFO Background: One of the target groups at risk of becoming overweight and obese is
teenagers. East Kalimantan is one of the largest provinces in Indonesia with a prevalence
Received: 15-09-2023 of overweight and obesity in children aged 13-15 years with a body massa indeks for age
Accepted: 31-12-2023 ( BMI/A) indicator of 19.1% in 2018, where overweight was 12.0% and obesity was 7.1%.
Published online: 31-12-2023 Objectives: To analyze the factors that influence nutritional status in overweight and
obese adolescents aged 11-15 years.
*Correspondent: Methods: This study is a cross-sectional survey conducted at State Junior High Schools
Iriyani Kamaruddin in Samarinda City from January to March 2021. The sample size was 290 students,
iriyani@fkm.unmul.ac.id determined using the Lemeshow and David formula, and selected through simple
random sampling. Data collection includes the characteristics of the subject and their
DOI: parents, measurement of body weight and height, food consumption, nutritional
10.20473/amnt.v7i2SP.2023.31 behavior, physical activity, and exercise habits using interviews using questionnaires.
1-319 Data were analyzed using the Kruskal-Wallis test and Logistic Regression test.
Results: There are differences in the nutritional status of boys and girls (p=0.006),
Available online at: mother's education and occupation (p=0.007; p=0.007), father's and mother's
https://e- nutritional status (p=0.001; p=0.014), exercise habits (p=0.009), protein adequacy level
journal.unair.ac.id/AMNT (p=0.000), and fat adequacy level (p=0.016).
Conclusions: Gender, occupation, education, nutritional status, eating habits, exercise
Keywords: habits, level of protein adequacy, and level of fat adequacy influence the occurrence of
Adolescents, Nutritional status, overweight and obesity in adolescents. It is necessary to increase sports activities which
Overweight dan Obese must be done at least 3-5 times a week for 30 minutes intensively and get used to
consuming 3-4 portions of vegetables and fruit daily, as well as paying attention to
appropriate meal portions.

INTRODUCTION social and psychological impacts on school-going

Adolescents are an especially high-risk group for adolescents or children. Adolescents facing obesity tend
overweight and obesity. According to the 2018 National to experience low self-esteem, poor self-worth,
Basic Health Research (Riskesdas), the prevalence of difficulties in learning and school, which can
overweight and obesity among adolescents aged 13-15 subsequently lead to depression11.
years is 16%, with 11.2% classified as overweight and The factors effecting to overweight and obesity in
4.8% classified as obese, shows an increase compared to adolescents include dietary patterns, fast food
the nutritional prevalence in this age group in 2013 5. In consumption, education levels, gender, genetic factors,
2018, the prevalence of overweight and obesity among physical activity, and socio-economic factors12–15. Race
adolescents aged 13-15 years in East Kalimantan, and family history are related to genetic factors.
Indonesia, was 19.1%, with 12.0% classified as Individuals experiencing obesity are more likely to have a
overweight and 7.1% classified as obese, as determined genetic predisposition. Unmodifiable risk factors for
by the Body Mass Index for Age (BMI/A) 7. obesity include race and family history. People facing
Overweight and obesity in children and obesity are at a higher risk within certain ethnic groups.
adolescents can lead to disruptions in glucose One example is the Tamil ethnic group in Sri Lanka 16 and
metabolism and degenerative diseases such as heart African Americans17. Groups with parents experiencing
disease, blood vessel blockages, type 2 diabetes, and obesity are found to have a higher prevalence of
others10. Being overweight or obese can have negative obesity18.

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Food consumption behavior is linked to the Socio-economic, educational, and nutritional

intake of macronutrients and micronutrients, habits knowledge factors can contribute to overweight and
involving fast food, snacks, vegetables, fruits, high-calorie obesity in children. Children from high socio-economic
and sweet foods, and soft drinks. Energy and status families have a lower rate of overweight, while
macronutrient intake are directly proportional to children from younger families with lower educational
obesity19,20. Obesity occurs due to the excessive storage levels are more likely to experience overweight31, and
of energy intake in the body. For every excess 3,500 Kcal, Nutritional knowledge is linked to childhood obesity and
the body can only store around 500 grams of fat. overweight32. Based on the background provided, This
Therefore, micronutrient consumption, especially fat- study aims to determine the factors influencing the
soluble vitamins (A, D, E, K), is inversely related to the nutritional status of adolescents aged 11-15 who are
occurrence of obesity, both in terms of body mass index overweight and obese.
(BMI) and waist circumference (WC)21.
Individuals experiencing obesity have a higher METHODS
amount of body fat compared to those who are not The study used a survey research design,
obese. Body fat serves as the primary storage site for fat- specifically a cross-sectional study, conducted at a Public
soluble vitamins in the body. The more body fat present, Junior High School in Samarinda City from January to
the fewer fat-soluble vitamins circulate in the blood22. March 2023. The sample size was determined using the
Consuming large amounts of animal fat can pose a higher Lemeshow and Davis formula. The number of potential
risk of obesity than consuming fiber-rich foods and dropouts, 20% was added, resulting in a total sample size
grains25. Fats and oils contribute the most to energy of 290 participants. The participants were selected
intake compared to other nutrients. Obesity in urban through simple random sampling.
adults is influenced by the consumption of oil exceeding Collected data were subject characteristics (age
30 ml per day24. Obesity in adulthood is associated with and gender), parental characteristics (education,
micronutrient deficiencies. To prevent the accumulation occupation, income, and nutritional status), nutritional
of body fat, individuals can incorporate micronutrient- status (weight and height), nutritional behavior
dense foods, such as vegetables and fruits, into a low- (knowledge, attitude, practice), and physical activity.
energy diet, as these foods contribute to energy Data collection involved structured questionnaire-based
metabolism. Consuming a higher quantity of low-energy interviews and direct anthropometric measurements
fruits reduces risk of obesity26. using a digital scale for weight and a microtoise for
Physical activity habits are linked to obesity. height.
Improving both dietary habits and regular physical The Kruskal-Wallis test compared groups when
activity is crucial for increasing energy expenditure. A the data was not normally distributed. Logistic regression
study conducted in West Africa (2019) found that physical analysis was conducted using the Backwards logistic
activity is a protective factor for individuals with obesity, regression method. In logistic regression analysis,
particularly those living on suburban areas 27. On the variables with p-values <0.25 during the Chi-Square test
other hand, a lack of physical activity contributes to are considered.
obesity. Screening time, including habits like watching
television, is one of the sedentary activities commonly RESULTS AND DISCUSSION
observed in urban communities 23,28. Watching television
Respondent Characteristics
is a risk factor that can increase the occurrence of obesity,
especially if done for more than 2 hours per day29. Lack of The characteristics of the subjects studied in this
physical activity is a risk factor for obesity. Laziness means research include gender, age, weight, height, ethnicity,
taking part in activities that involve minimal physical pocket money, pocket money utilization, and living
exertion. Watching TV is a sedentary activity linked to a arrangements with parents or guardians. The distribution
lack of physical activity, and extending periods of of subjects based on individual characteristics and
television watching have been found to increase the nutritional status can be seen in Table 1.
possibility of obesity30.

Table 1. Distribution of subjects based on individual characteristics and nutritional status

Normal Overweight Obese
Characteristics (n=162) (n=75) (n=53) Total p-value
n (%) n (%) n (%)
Gender
Man 60 (37.0) 32 (42.7) 33 (62.3) 125 (43.1) 0.006*
Woman 102 (63.0) 43 (57.3) 20 (37.7) 165 (56.9)
Age (years)** 12.52±1.17 13.28±0.98 12.38±0.68 12.69±110
11 years old 36 (22.2) 0 (0.0) 4 (7.5) 40 (13.8)
12 years old 49 (30.2) 20 (26.7) 27 (50.9) 96 (33.1)
0.000*
13 years old 43 (26.5) 22 (29.3) 20 (37.7) 85 (29.3)
14 years 24 (14.8) 25 (33.3) 2 (3.8) 51 (17.6)
15 years 10 (6.2) 8 (10.7) 0 (0.0) 18 (6.2)
Body weight (kg)** 43.95±4.58 61.36±4.91 70.92±13.01 53.38±13.08 0.000*

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Normal Overweight Obese

Characteristics (n=162) (n=75) (n=53) Total p-value
n (%) n (%) n (%)
Height (cm)** 148.73±7.69 159.26±6.17 157.10±7.73 152.98±8.77 0.000*
BMI/U ** 0.41±0.25 1.51±0.27 2.55±0.49 1.08±0.89 0.000*
BMI/Age: Body Mass Index for Age; *p: Significant (p<0.05); **Mean±SD (Standard Deviation); Kruskal-Wallis test.

The study included 290 subjects, comprising obesity has risen in males from 14% to 18% and in
normal weight individuals (55.9%), overweight females from 13.8% to 16%. Males are more likely to
individuals (25.9%), and obese individuals (18.3%). Most experience obesity than females33.
subjects were female (56.9%), with the remaining being
Family Characteristics
male (43.1%). Male and female nutritional statuses
tended to differ from one another. Compared to female The analysis of family characteristics for the
children (37.7%), male children were more likely to have subjects is presented in Table 2. Generally, the education
obesity (62.3%). In contrast, women were more likely level of both parents, fathers and mothers, is mostly
than men (42.7%) to be obese (57.3%) when it came to completed high school (44.8% and 45.9%, respectively).
overweight status (Table 15). The nutritional status of The majority of the fathers work (95.2%), typically in
males and females differed significantly (p=0.006). private employment, while most mothers do not work
According to data from the National Health and Nutrition (68.3%), as household wife.
Examination Survey, the prevalence of overweight and
Table 2. Distribution of subjects based on family characteristics and nutritional status
Normal Overweight obese
Family Characteristics (n=162) (n=75) (n=53) Total p-value
n (%) n (%) n (%)
Father's education
<High school 52 (32.1) 22 (29.3) 7 (2.4) 81 (27.9)
0.076
Senior High School 71 (43.8) 28 (37.3) 31 (58.5) 130 (44.8)
>High school 39 (24.1) 25 (33.3) 15 (28.3) 79 (27.2)
Mother's education
<High school 61 (37.7) 21 (28.0) 6 (11.3) 88 (30.3)
0.007*
Senior High School 66 (40.7) 36 (48.0) 31 (58.5) 133 (45.9)
>High school 35 (21.6) 18 (24.0) 16 (30.2) 69 (23.8)
Father's occupation
Work 152 (93.8) 74 (98.7) 50 (94.3) 276 (95.2) 0.962
Doesn't work 10 (6.2) 1 (1.3) 3 (5.7) 14 (4.8)
Mother's job
Work 41 (25.3) 26 (34.7) 25 (47.2) 92 (31.7) 0.007*
Doesn't work 121 (74.7) 49 (65.3) 28 (52.8) 198 (68.3)
Father's nutritional status
Normal 76 (46.9) 31 (41.3) 12 (22.6) 119 (41.0)
0.001*
Overweight 29 (17.9) 4 (5.3) 6 (11.3) 39 (13.4)
Obese 57 (35.2) 40 (53.3) 35 (66.0) 132 (45.5)
Maternal nutritional status
Normal 54 (33.3) 21 (28.0) 10 (18.9) 85 (29.3)
0.014*
Overweight 34 (21.0) 13 (17.3) 6 (11.3) 53 (18.3)
Obese 74 (45.7) 41 (54.7) 37 (69.8) 152 (52.4)
*p: Significant (p<0,05); **Mean±SD (Standar Deviasi); Kruskal-Wallis Test

The nutritional status of parents is characterized knowledge is sufficient (93.2%), attitude is

by a high percentage of obesity (45.5% for fathers and sufficient (57.2%), and practice is insufficient (87.9%).
52.4% for mothers). Statistical analysis results show Regardless of nutritional status (normal weight,
significant differences in nutritional status based on overweight, or obese), most study individuals have
maternal education, maternal occupation, paternal adequate nutrition knowledge and attitude but poor
nutritional status, and maternal nutritional status nutrition behaviours. The study found no significant
(p<0.05; p=0.007; p=0.007; p=0.001; p=0.014). Obese differences in nutritional knowledge, attitude, and
parents are more likely to have overweight or obese practice concerning the nutritional status of the subjects
children compared to parents with normal weight. Obese (p=0.503; p=0.621; p=0.882). Good nutritional knowledge
parents have a significantly higher risk of obesity is associated with healthier eating behaviors compared to
compared to those who are not obese34. those with less nutritional knowledge35. A study on
adolescents at SMPN 2 Brebes (2014) found no significant
Nutritional Behavior
difference in nutritional attitudes between obese and
Table 3 shows that level of category of nutritional
non-obese adolescents when choosing snacks 36. A study

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conducted at SMA Yayasan Pendidikan Shafiyyatul the influence of important others, and cultural
Amaliyyah showed a significant influence of attitudes influences38. It is important to note that having a positive
toward the eating patterns of female students 37. This attitude does not necessarily guarantee the development
study found no differences, possibly due to various of good eating habit39.
factors. Influencing factors include personal experiences,
Table 3. Distribution of subjects based on nutritional behavior (knowledge, attitude, and practice) and nutritional status
Normal Overweight Obese
Nutritional Behavior (n=162) (n=75) (n=53) Total p-value
n (%) n (%) n (%)
Knowledge
Insufficient 7 (4.3) 1 (1.3) 2 (3.8) 10 (3.4)
Sufficient 147 (90.8) 72 (96.0) 51 (96.2) 270 (93.2) 0.503
Good 8 (4.9) 2 (2.7) 0 (0.0) 10 (3.4)
Mean±SD 60.49±7.70 60.53±5.67 59.25±3.84 60.28±6.64
Attitude
Insufficient 31 (19.1) 15 (20.0) 9 (17.0) 55 (19.0)
Sufficient 97 (59.9) 40 (53.3) 29 (54.7) 166 (57.2) 0.621
Good 34 (21.0) 20 (26.7) 15 (28.3) 69 (23.8)
Mean±SD 60.37±12.70 61.33±13.68 62.26±13.39 60.97±13.06
Practice
Insufficient 141 (87.1) 67 (89.4) 47 (88.7) 255 (87.9)
Sufficient 19 (11.7) 7 (9,3) 6 (11.3) 32 (11.1) 0.882
Good 2 (1.2) 1 (1.3) 0 (0.0) 3 (1.0)
Mean±SD 53.70±9.74 53.33±9.49 52.83±7.99 53.45±9.35
Mean±SD (Standar Deviasi); uji Kruskal-Wallis

Physical Activity adolescents. Sedentary activities include prolonged

Insufficient physical activity is one of the factors sitting, watching TV/movies, playing video games, etc.
contributing to the rise in overweight and obesity among dll40. The distribution of subjects based on physical
children. Sedentary activity is one of the factors causing activity and nutritional status is presented in Table 4.
an increase in overweight and obesity status in

Table 4. Distribution of subjects based on physical activity and nutritional status

Normal Overweight Obese
Physical Activity (n=162) (n=75) (n=53) Total p-value
n (%) n (%) n (%)
Watching TV/movies/playing games/etc
Yes 142 (87.7) 65 (86.7) 47 (88.7) 254 (87.6) 0.943
No 20 (12.3) 10 (13.3) 6 (11.3) 36 (12.4)
Frequency of watching TV/movies/playing games/etc in a day
Never 20 (12.3) 10 (13.3) 6 (11.3) 36 (12.4)
0.466
< 3 times 50 (30.9) 18 (24.0) 11 (20.8) 79 (27.3)
≥3 times 92 (56.8) 47 (62.7) 36 (67.9) 175 (60.3)

Table 4 in this study shows that the majority of are five times more likely to become obese in adulthood,
subjects have a habit of watching TV/movies/playing and approximately 80% of obese adolescents remain
games, etc. (87.6%), including subjects with normal obese in adulthood41. Lack of physical activity and
nutrition (87.7%), overweight (86.7%), and obese sedentary behavior are significantly associated with
(88.7%). The frequency of watching TV/movies/playing obesity in children 42.
games per day is ≥3 times (60.3%). Environmental factors
have a significant impact on the occurrence of overweight Food Intake
and obesity in adolescents. Children who usually have Overweight and obesity occur when food intake
space to play with their friends become victims because exceeds requirements. The distribution of subjects based
they lack playing space. As a result, physical activities that on food intake, nutritional adequacy, and nutritional
should be done outdoors and energy expenditure are status is presented in Table 5. The results of this study
replaced by less active activities such as watching show that the average energy intake is 2020.50±368.58
TV/movies/playing games/using gadgets. This leads kcal, protein intake is 65.22±19.42 g, fat intake is
adolescents to be less active and at risk of overweight and 70.65±26.55 g, and carbohydrate intake is 262.59±68.91
obesity. Meta-analysis results show that obese children g.

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Table 5. Distribution of subjects based on energy and nutrient intake adequacy and nutritional status
Normal Overweight Obese
Variable (n=162) (n=75) (n=53) Total p-value
Mean±SD Mean±SD Mean±SD
Nutritional Intake
Energy (kcal) 1920.94±330.42 2144.15±390.02 2149.83±361.32 2020.50±368.58 0.000
Protein (g) 66.92±20.63 73.85±19.85 72.64±22.08 65.22±19.42 0.000
Fat (g) 65.91±25.48 77.69±27.84 75.16±25.36 70.65±26.55 0.001
Carbohydrates (g) 252.71±65.36 276.69±73.39 272.86±69.28 262.59±68.91 0.015
Nutritional Adequacy Level
Energy (%) 94.33±18.54 101.39±22.03 203.65±19.75 97.86±20.06 0.004
Protein (%) 101.71±30.80 112.57±37.88 129.69±41.98 109.63±36.39 0.000
Fat (%) 96.09±38.42 109.41±42.98 108.95±39.01 101.89±40.15 0.016
Carbohydrates (%) 81.98±23.17 88.90±25.52 88.71±23.72 85.00±24.06 0.052

Nutrient adequacy levels, including energy, dietary reference intake may increase overweight and
protein, fat, and carbohydrates, indicate that the overall obesity among adolescents. Therefore, it is essential to
energy adequacy level for subjects is (97.86±20.06%), pay attention to portion sizes in their plate for each meal,
protein (109.63±36.39%), fat (101.89± 40.15%), and which should consist of staple foods, side dishes,
carbohydrates (85.00±24.06%). Overall, the energy and vegetables, and fruits, according to the nutritional needs
nutrient adequacy levels are still within the normal of adolescents.
category based on the 2014 Dietary Reference Intakes.
When looking at energy adequacy levels in obese Factors Influencing Overweight and Obese Nutritional
individuals (203.65±19.75%), it is higher compared to Status
overweight individuals (101.39±22.03%) and normal The factors influencing overweight and obese
nutritional status (94.33±18.54%). A similar pattern is nutritional status were analyzed using multivariate tests,
observed in protein adequacy levels in obese individuals including gender, mother's occupation, mother's
(129.69±41.98%), which is higher than overweight education, mother's nutritional status, eating habits,
individuals (112.57±37.88%) and normal nutritional exercise habits, protein adequacy level, and fat adequacy
status (101.71±30.80%), exceeding the Dietary Reference level. The multivariate analysis influencing overweight
Intakes. This suggests that nutrient intake exceeding the and obese status is presented in Table 6.

Table 6. Multivariate analysis influencing overweight and obese nutritional status

Variables p OR 95% CI
Gender 0.005 2.168 1.260-3.730
Mother's Job 0.047 1.782 1.009-3.150
Mother's Education 0.003 0.409 0.225-0.742
Mother's nutritional status 0.076 1.700 0.946-3.055
Eating habit 0.065 0.520 0.259-1.041
Exercise habits 0.029 1.916 1.070-3.432
Protein Adequacy Level 0.000 0.320 0.177-0.580
Adequate Fat Level 0.012 0.447 0.238-0.839
OR: Odds Ratio; 90%CI: Confidence Interval; Logistic Regression Test
Male adolescents have a significantly higher risk prevalence. Kusteviani54's study found a significant
of overweight or obesity compared to female association between gender and central obesity.
adolescents, with a risk factor of 2.168 (OR=2.168, 95% The occupation of a mother has a significant
CI=1.260-3.730). This finding is consistent with the correlation with adolescents overweight or obesity
research conducted by Febriani and Sudarti43, which (p=0.047). Working mothers are at risk of experiencing
suggests that males have a 2.25 times higher likelihood of overweight or obesity, meaning that working mothers
experiencing overweight or obesity compared to girls. have a 1.782 times greater risk of overweight or obesity
The prevalence of overweight or obese males exceeds than non-working mothers (OR=1.782, 95% CI=1.009-
that of overweight or obese females 44–49. The obese 3.150). Working mothers spend less time preparing meals
males are at a higher risk of hypertension, diabetes, and rely more on fast food or ready-to-eat meals, which
hyperlipidemia, and cancers (colorectal and are generally higher in fat and calories than non-working
prostate) 50,51 52
. The results of the study by Lubis et al , mothers55–57. Additionally, school-age children whose
showed a significant relationship between gender and mothers work are more likely to rely on school meals than
the occurrence of obesity (p=0.002; OR=5.2). This finding bringing lunch from home58. Children who eat snacks at
3
aligns with the research conducted by Puspitasari which school are more likely to experience obesity than those
similarly found a correlation between gender and obesity who bring food from home59. Working mothers spend

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less time preparing meals at home than non-working equal to 3 times per day (86.2%) and only more than 3
mothers. times per day (32.7%).
Adolescent overweight and obesity have a strong Physical activity habits have a significant
correlation to educational level (p=0.003). Mothers with relationship with the occurrence of overweight and
higher education are more likely to be overweight or obesity in adolescents (p=0.029). The Physical activity
obese, with a 0.409 times greater risk of being habit is a risk factor for overweight or obesity, meaning
overweight or obese than mothers with lower education that adolescents who do not exercise and only do so for
(OR=0.409, 95% CI=0.225-0.742). Parents' education 15 minutes each time they engage in physical activity
level, especially mothers, can directly influence children's have a 1.916 times greater risk of overweight or obesity
eating habits because mothers are closer to their children compared to those who exercise (OR=1.916, 95%
and can provide the necessary food for their children CI=1.070-3.432). Another study found that adolescents
without restricting what they eat. Parents significantly with light physical activity have a 5 times greater risk of
influence the food available at home, and they can set obesity than adolescents with moderate physical
rules about what their children eat. Some studies show activity71. The frequency of subjects exercising <3
that mothers with lower education levels tend to feed times/week is 39.0%, with an average exercise duration
their children unhealthy foods that can negatively impact of 15 minutes/day being 30.3%. Consistent with the
their health status60,61. The results of Feng et al.'s research by Adiwinanto72, engaging in moderate to
research62 found that children whose mothers have vigorous-intensity exercise three times a week for 40
completed junior high school have a 2.170 times higher minutes per session over 12 weeks in adolescents aged
chance of experiencing overweight/obesity compared to 12-14 can result in a weight loss of 2.5 kg.
children whose mothers have completed junior high The protein adequacy level is significantly related
school or below. Children with mothers who have to overweight and obesity in adolescents (p=0.000). A
completed college have a 2.146 times higher chance of high protein adequacy level poses a risk of overweight
experiencing overweight/obesity compared to children and obesity in adolescents. The imbalance between
with lower levels of education (OR=2.146, 95% CI=1.293– energy intake and expenditure leads to overweight or
3.560). obesity. The risk of obesity is 4.69 times higher compared
Mothers with obese nutritional status are at risk to those who are not obese15. If someone consumes an
of experiencing overweight in adolescents. Specifically, excess of protein, it can lead to overweight. The excess
the risk of overweight or obesity in adolescents is 1.700 protein will be stored in the form of fat.
times higher for mothers who are obese than those who High levels of fat consumption increase the risk of
are not obese (OR=1.700, 95% CI=0.946-3.055). The Body overweight and obesity in adolescents. Adolescents with
Mass Index (BMI) of mother has a significant impact on higher fat adequacy levels have a 0.447 times greater
the BMI of children63–65, in the research by Telisa et al66, probability of experiencing overweight or obesity
obese parents have a 3.9 times higher risk of being obese. than those with sufficient fat adequacy levels (OR=0.447,
A history of obesity in parents increases the risk of obesity 95% CI=0.238-0.839). The Dietary Guidelines or SDT 2014
in adolescents by 2.016 times, and there is a significant classify the fat adequacy level as sufficient (90-120%).
relationship between a history of obesity in parents and The research findings show that most subjects (82.8%)
the occurrence of obesity in adolescents67. The weight consume fried foods, including fried chicken, french fries,
status of parents, reported as an important predictor of and other fried snacks. Fried foods tend to have higher
overweight and obesity in children and adolescents amounts of fat and salt. Consuming fried foods more than
remaja68,69. The correlation between genetics, the 6 times per week increases the risk of being overweight
environment, and the prevalence of childhood obesity is by 3.1 times compared to consuming them only 2.5 times
evident in cases where both parents and children are per week73.
overweight. Genetics increase the risk of overweight in
adolescents who have obese parents or live in the same CONCLUSIONS
environment, and children often imitate their parents. Factors influencing the occurrence of overweight
Therefore, eating habits and lifestyle can influence a and obesity in adolescents include gender, mother's
child's eating patterns, leading to obesity34. occupation, mother's education, mother's nutritional
Eating habits are a significant factor in the status, eating habits, exercise habits, protein adequacy
development of overweight and obesity among level, and fat adequacy level.
adolescents. Most adolescents (75.2%) consume Several things to consider in addressing
breakfast, while a smaller proportion (24.8%) are not. overweight or obesity in adolescents include increasing
There is no significant association between the habit of the habit of having breakfast, regulating snacking habits,
having breakfast and the occurrence of overweight and reducing the consumption of fast food and soft drinks,
obesity in adolescents (p=0.065). Skipping breakfast increasing mandatory daily exercise activities (3-5
increases the likelihood of overweight and obesity in times/week) for 30 minutes intensively, reducing screen
adolescents. Specifically, adolescents who skip breakfast time for watching TV/movies and playing games to no
have a 0.520 times higher risk of experiencing overweight more than 2 hours, monitoring weight regularly
or obesity compared to those who eat breakfast (preferably monthly), cultivating the habit of consuming
(OR=0.520, 95% CI=0.259-1.041). This finding is vegetables and fruits (3-4 servings daily), reducing
consistent with the research conducted by Nugroho and carbohydrate intake, and paying attention to portion
Hikmah70 at SMP Negeri 18 Samarinda found that the sizes according to the nutritional needs of adolescents.
average frequency of meals for adolescents is less than or

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How to cite: Kamaruddin, I., Kustiyah, L., Riyadi, H., & Junus, R. (2023) Factors Influencing Nutritional Status in Overweight and Obese Adolescents: Faktor-
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ACKNOWLEDGMENTS mempengaruhi kejadian obesitas pada remaja. J.

The researchers express their gratitude to the Gizi Klin. Indones. 11, 179 (2015).
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teachers, enumerators, parents, and all students who overweight/obesity in Urban Sri Lanka: findings
participated in this research. Thanks also to the University from the colombo urban study. J. Diabetes Res.
of Mulawarman East Kalimantan for funding this 2019, 1–9 (2019).
research. 17. Grammer, L. C. et al. Obesity and asthma
morbidity in a community-based adult cohort in a
Conflict of Interest and Funding Disclosure large urban area: the chicago initiative to raise
All authors declare no conflict of interest asthma health equity (CHIRAH). J. Asthma 47,
regarding this article. The University of Mulawarman East 491–495 (2010).
Kalimantan financially supported this research. 18. Wang, H. et al. Epidemiology of general obesity,
abdominal obesity and related risk factors in
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How to cite: Kamaruddin, I., Kustiyah, L., Riyadi, H., & Junus, R. (2023) Factors Influencing Nutritional Status in Overweight and Obese Adolescents: Faktor-
Faktor Yang Mempengaruhi Status Gizi Pada Remaja Overweight dan Obese. Amerta Nutrition, 7(2SP), 311–319.