Challenges and Strategies for Handling Obesity in Children and Adolescents
Obesity is an imbalance of energy intake (energy intake) with energy used (energy expenditure), characterized by abnormal fat accumulation. This can trigger chronic diseases such as coronary heart attacks, strokes, diabetes mellitus (diabetes), and high blood pressure (hypertension).
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Overweight and obesity in children and adolescents can cause degenerative diseases at an early age such as diabetes and hypertension. Now, obesity has become a global epidemic, worrying many countries, including Indonesia. Previously considered an adult problem, obesity is now also affecting the adolescent and child population at an alarming rate.
Related to this problem, the Public Health and Nutrition Research Center, Health Research Organization, National Research and Innovation Agency (BRIN) held a National Webinar with the theme "Obesity in Children and Adolescents in Indonesia: Current Conditions and Challenges" which was held online on Wednesday (29 /05).
Head of the BRIN Health Research Organization, Indi Dharmayanti, in his speech explained that Indonesia is currently experiencing a nutritional transition marked by the prevalence of malnutrition which is still high, but on the other hand, the incidence of excess nutrition in the form of overweight and obesity is also showing an increasing trend. This situation is known as the problem of "double nutrition".
“Efforts to treat obesity in children and adolescents in Indonesia tend to stagnate. Data from the 2023 Indonesian Health Survey shows that the prevalence of overweight and obesity is around 19.7% in children aged 5-12 years and 16% in children aged 13-15 years. These results are not much different from the results of the 2018 Basic Health Research which were around 19.8% and 16.2% respectively in the same age group. "Given these conditions, as well as the challenges that must be faced today, it is deemed necessary to hold this webinar," said Indi.
"Through this webinar, we will discuss together the latest information about the condition of obesity in children and teenagers in Indonesia, the risk factors, the role of Ultra Processed Food (UPF) and its relation to food labeling/obesity in children and teenagers, the implications of obesity in children and teenagers, as well as programs and policies in dealing with obesity in children and teenagers in Indonesia," he continued.
In line with Indi, Head of the BRIN Public Health and Nutrition Research Center, Wahyu Pudji Nugraheni, said that Indonesia is currently still experiencing a triple burden nutritional problem, namely malnutrition, overnutrition (obesity) and lack of micronutrients. These nutritional problems that occur in children and adolescents can threaten the realization of the vision of a Golden Indonesia 2045.
Wahyu said, if treatment is slow, then the dominant risk factor for overweight and obesity in children and adolescents is environmental factors, such as high energy food intake and low physical activity.
Donny K. Mulyantoro, Associate Expert Researcher at the Center for Public Health and Nutrition Research, BRIN, who was one of the speakers at the webinar, gave his presentation with the title "Trends, distribution and risk factors for obesity in children and adolescents in Indonesia".
He explained that overweight and obesity had reached epidemic proportions globally. Previously, obesity was associated with a problem that occurred in high-income countries (HIC), but now it also occurs in low- and middle-income countries (LMIC).
It was also explained that obesity is a cause of mortality and morbidity because it is a major risk factor for many non-communicable diseases (NCDs). In 2019, obesity contributed to approximately 15 million deaths from cardiovascular disease, diabetes, cancer, neurological disorders, chronic respiratory diseases and digestive disorders.
"Globally since 1990 there has been a quite drastic increase, adult obesity has doubled, and adolescent obesity has quadrupled, in fact more than 390 million children and adolescents aged 5-19 years will be overweight by 2022 , including 160 million living with obesity. "This is very worrying for us regarding the future of our children and the golden generation in 2024," explained Donny.
Donny also explained that the consequences of overweight and obesity in school-age children and teenagers include a greater risk of developing asthma, cognitive impairment, as well as social and economic impacts on children, families and society. In the long term, overweight and obesity in children can increase the risk of diabetes, heart disease, several types of cancer, respiratory diseases, mental health and reproductive disorders in later life.
Obesity and overweight that occur throughout life in young women, it is very likely that women will become overweight, so that when they experience pregnancy, their babies are likely to have a larger birth weight, which will make things difficult and will give rise to many problems.
"Risk factors for overweight and obesity in the Bio-Sociology framework are multifactorial, can occur at various levels (individual, family and playmates, child care and schools, society and the built environment, society and public policy). "For this reason, prevention and control efforts are needed at an early age by involving various related parties," concluded Donny.
Meanwhile, Sudikno, an associate expert researcher at the BRIN Center for Public Health and Nutrition Research, explained in his presentation entitled "Obesity and Hypertension in Adolescents in Indonesia" that in the last two decades, hypertension has tended to show an increased risk in young age groups and almost 7% of adolescents are prehypertensive. then suffer from hypertension every year.
“Globally, the number one metabolic risk factor for Non-Communicable Disease (NCD) deaths is increased blood pressure which causes 19% of global deaths, followed by overweight or obesity and increased blood glucose. "Hypertension in childhood correlates with cardiovascular disease in adulthood and increasing obesity in children may contribute to increased blood pressure and hypertension," he explained.
Sudikno further explained that the risk factors for hypertension in adolescents are obesity, lack of fruit and vegetable consumption, lack of physical activity, lack of quality sleep (<8 hours), excessive consumption of sodium and saturated fat, smoking, lack of education, and family history. with hypertension and men are more at risk than women.
"Some of the clinical recommendations are that children have their blood pressure measured every year starting from the age of three, all children and adolescents with hypertension should be screened for hyperlipidemia and kidney disease, children under six years with hypertension and children and adolescents "those with abnormal kidney function or urinalysis results should undergo renal ultrasonography, and obese children and adolescents with hypertension should be evaluated for diabetes mellitus and fatty liver," he explained.
In addition, all children with high blood pressure or hypertension must make therapeutic lifestyle changes, for example losing weight, doing physical activity, eating healthy foods low in salt, avoiding smoking and consuming alcohol to also reduce stress. Ambulatory blood pressure monitoring is also necessary to confirm hypertension in children and adolescents.
He explained that children with symptoms of hypertension, stage 2 hypertension without modifiable factors such as obesity, evidence of left ventricular hypertrophy on echocardiography, any stage of hypertension associated with chronic kidney disease or diabetes, or persistent hypertension despite modification trials lifestyle requires taking antihypertensive drugs.
"Therefore we need to control or limit the use of cell phones, tablets, video games and social media, promote physical activity such as GERMAS, a balanced diet, consumption of healthy foods and limiting food products high in salt and need to consider special diets, especially providing programs "Free nutritious meals for school children and teenagers," he concluded.
Two other speakers, namely Uswatun Hasanah from the Indonesian Ministry of Health, explained the policies and strategies for handling obesity in children and adolescents in Indonesia, while Helda Khusun from SEAMEO RECFON/UHAMKA explained about ultra processed food and food labeling in relation to obesity in children and adolescents.
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