Overweight in Indonesia: an observational study of trends and risk factors among adults and children

OBJECTIVE: To conduct a secondary data analysis detailing overweight prevalence and associations between key hypothesised determinants and overweight. DESIGN: This observational study used publicly available data from the Indonesian Family Life Survey (IFLS) (1993–2014). The IFLS is a home-based survey of adults and children that collected data on household characteristics (size, physical infrastructure, assets, food expenditures), as well as on individual-level educational attainment, occupation type, smoking status and marital status. These analyses used data on the self-reported consumption of ultra-processed foods and physical activity. Anthropometrics were measured. SETTING: Indonesia. PRIMARY OUTCOME MEASURES: We described the distribution of overweight by gender among adults (body mass index (BMI) ≥25 kg/m(2)) and by age among children, over time. Overweight was defined as weight-for-height z-score >2 among children aged 0–5 years and as BMI-for-age z-score >1 among children aged 6–18 years. We also described individuals who were overweight by selected characteristics over time. Finally, we employed multivariable logistic regression models to investigate risk factors in relation to overweight in 2014. RESULTS: One-third of adults were overweight in 2014. Between 1993 and 2014, the prevalence of overweight among adults doubled from 17.1% to 33.0%. The prevalence of overweight among children under 5 years increased from 4.2% to 9.4% between 1993 and 2007, but then remained relatively stagnant between 2007 and 2014. Among children aged 6–12 years and 13–18 years, the prevalence of overweight increased from 5.1% to 15.6% and from 7.1% to 14.1% between 1993 and 2014, respectively. Although overweight prevalence remains higher in urban areas, the increase in overweight prevalence was larger among rural (vs urban) residents, and by 2014, the proportions of overweight adults were evenly distributed in each wealth quintile. Data suggest that the consumption of ultra-processed foods was common and levels of physical activity have decreased over the last decade. In multivariable models, urban area residence, higher wealth, higher education and consumption of ultra-processed foods were associated with higher odds of overweight among most adults and children. CONCLUSION: Urgent programme and policy action is needed to reduce and prevent overweight among all ages.