Behavioural and environmental risk factors associated with primary schoolchildren's overweight and obesity in urban Indonesia

Objectives:To aid the design of nutrition interventions in low- and middle-income countries undergoing a nutrition transition, this study examined behavioural and environmental risk factors associated with childhood overweight and obesity in urban Indonesia. Design:Body height and weight of children were measured to determine BMI-for-age Z-scores and childhood overweight and obesity status. A self-administered parental survey measured socio-economic background, children's diet, physical activity, screen time and parental practices. Logistic and quantile regression models were used to assess the association between risk factors and the BMI-for-age Z-score distribution. Setting:Public primary schools in Central Jakarta, sampled at random. Participants:Children (n 1674) aged 6-13 years from 18 public primary schools. Results:Among the children, 31 center dot 0 % were overweight or obese. The prevalence of obesity was higher in boys (21 center dot 0 %) than in girls (12 center dot 0 %). Male sex and height (aOR = 1 center dot 67; 95 % CI 1 center dot 30, 2 center dot 14 and aOR = 1 center dot 16; 95 % CI 1 center dot 14, 1 center dot 18, respectively) increased the odds of being overweight or obese, while the odds reduced with every year of age (aOR = 0 center dot 43; 95 % CI 0 center dot 37, 0 center dot 50). Maternal education was positively associated with children's BMI at the median of the Z-score distribution (P = 0 center dot 026). Dietary and physical activity risk scores were not associated with children's BMI at any quantile. The obesogenic home food environment score was significantly and positively associated with the BMI-for-age Z-score at the 75th and 90th percentiles (P = 0 center dot 022 and 0 center dot 023, respectively). Conclusions:This study illustrated the demographic, behavioural and environmental risk factors for overweight and obesity among primary schoolchildren in a middle-income country. To foster healthy behaviours in primary schoolchildren, parents need to ensure a positive home food environment. Future sex-responsive interventions should involve both parents and children, promote healthy diets and physical activity and improve food environments in homes and schools.