Determinants of late adolescent nutritional status in Indonesia: a nation-wide cross-sectional survey

This study aims to examine determinants of underweight and overweight nutritional status among late adolescents in Indonesia.

A cross-sectional analysis of the 2015 Indonesian Family Life Survey 5 (IFLS-5) was conducted. Respondents for this study were selected through stratified and multistage random sampling. Of all IFLS-5 respondents, 2,791 were adolescents 18–24 years old. Multinomial logistic regression was applied to identify major determinants of nutritional status among late adolescents.

The prevalence of underweight and overweight nutritional status was 19.10% and 12.79%, respectively. Underweight status among late adolescents was strongly associated with smoking (adjusted odds ratio [AOR] = 1.72, 95% confidence interval [CI] = 1.29–2.33). Moreover, living in urban areas showed the strongest association with overweight status among the same group (AOR = 1.77, 95%CI = 1.29–2.44).

This study gained the advantage from the use of national data that are collected by trained enumerators. Therefore, the possibility of bias is very small, and the study results can be generalized to a late adolescent group in Indonesia. However, this study also has limitations in the types of data available, as it uses secondary data. The lack of detailed data regarding food security, frequency of food consumption in a month and sources of income of the adolescents limit the interpretation of the study. Further studies should consider using a retrospective cohort approach in all adolescent age groups using data from the IFLS-1 to IFLS-5 so that the temporal relationship of the multifactorial nutrition variables can be identified.

Provide input and advice to policymakers in all sectors related to adolescent health and educational curricula for consideration in making interventions that focus on improving nutrition by taking into account the characteristics of adolescents, such as smoking habits, area of residence, income and age of adolescents because nutritional problems are multifactorial.

This study can provide education to adolescents to create healthier consumption habits to reduce non-communicable diseases (NCDs) in the adult phase, ideal body weight, reduce unhealthy lifestyles (smoking, drinking alcohol and drugs) and increase self-esteem and reduce depression.

This study brings significant findings on the dominant determinant of nutritional status among late adolescents in Indonesia and their vulnerability to NCDs. To address the high prevalence of underweight and overweight nutritional status in Indonesia, a collaboration between smoking cessation, community nutrition and reproductive health programs is required for preventing the underweight nutritional status in adolescents, with a focus on obesity prevention for adolescents living in urban areas. It is expected that this collaboration will support the early prevention of NCD risks.