Adriana Ortega1, Haslinda Abdullah1,2 and Steven Krauss1 (Abd. Lateef)
1Institute for Social Science Studies (IPSAS), Universiti Putra Malaysia, 43400 Selangor
2Faculty of Human Ecology, Universiti Putra Malaysia, 43400 Selangor [email protected]
ABSTRACT
For the past few decades, obesity became one of the most common chronic disorders among children and adolescents in the ASEAN region; and its prevalence continues to increase fast.
This rapid increased obesity risks among young people can have detrimental effects on individual health and wellbeing and serious repercussions in terms of economic and social costs for developing society. This paper presents preliminary findings from a project on lifestyle, obesity and wellbeing among young people in Malaysia. The sample consisted of Malaysian secondary and university students and young workers (16 to 35 years old). The overall results indicate that 20.6% of the participants were overweight, 76.5 % were obese.
The results also showed that male respondents exhibited higher BMI; spent more hours in physical activities and exercising, and engaged more in mood related eating behaviour than their female counter parts. Female participants were more weight conscious, relied more on their friends to avoid gaining weight and were more influenced by their friends eating attitudes and behaviour than the male participants. Furthermore, young people working exhibited higher BMI, reported less hours spent in physical activities and exercise during the week and weekends when compared with secondary and university school. Young worker also reported to be more weight conscious and influenced by their friends eating attitudes and behaviour more often than secondary school and university student. Secondary school student reported less frequently to eat their meals and/or snack while watching TV than did university student and young workers. These results suggest that the programs and policies designed to address increased risk of obesity among young people should be tailored to the appropriate gender and the current status of young Malaysians (i.e. secondary school, university students or young workers).
Keywords: lifestyle; obesity; youth; ASEAN.
INTRODUCTION
Obesity impacts people’s social ecosystem (e.g. workplace and family), and impairs people’s ability to work and perform efficiently in their daily. Thus, obesity among youth is potentially detrimental to the healthiness and progress of Society. According to the available data, in the ASEAN region, the prevalence of obesity in children and adolescents is rising and as a result there has been an alarming increase of obesity-related problems such as type 2 diabetes, high blood pressure, high cholesterol and cardiovascular diseases among youth. Eating behavior trends and patterns and sedentary life style among youth in developing countries have been associated with increase of obesity and. Based on the available data, there has been increasing interest in implementing health promotion and disease prevention programs for children and adolescences under 16 years old. However research on obesity and its impact on quality of life, health and wellbeing among youth at post-secondary education level (18-35 years old) is lacking. Similarly, health promotion initiatives for young people between 18 to 35 years old
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are scarce in many ASEAN countries. This paper presents preliminary findings from a project on obesity and youth quality of life and wellbeing carried out in Malaysia. The main objective of the research project was to assess the risk of obesity and its related factors and impact among youth at secondary and post-secondary level (e.g. university and workplaces) in Malaysian.
A. Obesity among children and youth
Recent statistics show major shifts in morbidity and mortality trends among young people between 10 and 24 years old (Patton, Coffey, Sawyer, Viner, et al., 2009), and youth’s eating behavior patterns is listed as one of the factors related to this increase of in mortality rates.
The World Health Organization (WHO) reported that the prevalence of obesity in children and adolescents was rising rapidly. As result of this ‘obesity epidemic’, risk of type 2 diabetes, high blood pressure, high cholesterol and cardiovascular diseases in children and young people are becoming common health problems (WHO, 2012). That is, children and young adults are having health concerns that typically were observed in older adults in the past.
According to the statistics reported by World Health Organization, currently about 42 million children under the age of five are overweight; and approximately 74% of these children live in developing countries (WHO, 2012). In the ASEAN region, the rapid economic growth and marked socio-economic advancement has resulted in significant changes in the lifestyles and eating habits. An imminent and worrisome problem related to these changes is the increased prevalence of obesity among children and teenagers. For example, the prevalence of obesity among school children in the Philippines is around 30.7%
(Florentino, Villavieja, & Laña, 2002) and in Singapore is about 22.5% (Sabanayagam, Shankar, Chong, Wong & Saw, 2009). In Thailand it was reported that 7.9 % of urban school children between 7 and 9 years are obese (Langendijk and colleagues, 2003); and in Myanmar the results from national survey indicate that the prevalence of obesity among children and adolescents is 7.6% (Latt, Ko, Aye, Thidar and Khin, 2011).
In Malaysia, according to the available statistics, 14% of Malaysian children under 18 years old are obese (Institute for Public Health, 2008). The Malaysian Society for the Study of Obesity has indicated that Malaysia ranks sixth in the Asia-Pacific region for obesity and first in in South-East Asia for both obesity and diabetes. This is alarming because not only obesity has detrimental impact on young people’s health and wellbeing, but it can also have serious repercussions in terms of economic and social costs for a young, developing nation such as Malaysia. As the negative impact of overweightness and obesity among children and young people can spill over to society and derail the country’s economic plans of becoming a fully developed nation.
B. Risk of Obesity and impact on youth wellbeing and health
Obese and overweight children are at high risk of suffering from hypertension, increased blood clotting; insulin resistance syndrome, cardiovascular diseases, liver or gall bladder disease, gastritis, reflux disease, sleep apnea, hypertension, breathing difficulties, joint and musculoskeletal problems (Rosen, Larkin, Kirchner et al. 2003; Must, Anderson, 2003;
Tounian, Aggoun, B Dubern, et al. 2001; Srinivasan, Myers, & Berenson , 2002). Childhood obesity has also being associated with children and adolescents’ high risks of being stigmatized as unhealthy, prone to failure, or as being socially incompetent (Teachman, &
Brownell, 2001). Also studies have showed that children and adolescents that are either overweight or obese also suffer from negative self-image, depression, and as they get older
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these young people are prone to develop eating disorders (e.g. anorexia nervosa, bulimia) and addiction to substance abuse (Davison & Birch, 2001; NOO, 2011 Strauss, 2000). As poor health and negative wellbeing at young age tend to progress into adulthood, the increasing prevalence of obesity and overweight in Asian youth can result in huge economic costs related to health and social security systems in the near future (Sherina & Rozali, 2004).
Being overweight or obese has detrimental effects on individual health and wellbeing and serious repercussions in terms of economic and social costs for developing nation. Children and adolescents who are overweight or obese face increased risk of type 2 diabetes, high blood pressure, high cholesterol and cardiovascular diseases, impaired glucose tolerance, decreased insulin resistance, liver or gall bladder disease, gastric reflux disease, sleep apnea, and hypertension, breathing difficulties, asthma, joint and musculoskeletal problems (Must, Jacques, Dallai, Bajema, Dietz 1992; Whitaker, Wright, Pepe, Seidel, Dietz, 1997; Must, Anderson, 2003); all of these health problems used to be considered exclusively adult diseases and health complaints.
The impact of obesity on young people’s health status, wellbeing, satisfaction and happiness can spill-over their physical, emotional, social, functioning (Varni, Seid & Kurtin, 2001). The long term health related problems among overweight and obese children and adolescence include impaired psychosocial and social adjustment; low social competencies, poor self- worth and depressive symptoms (Varni &, Setoguchi, 1996). However, there is still little information about the quality of life of obese children and adolescents. And particularly in the ASEAN region, the quality of life of children and young people under 35 years old have not yet received much attention.
This conference paper presents the preliminarily descriptive results obtained from the study on lifestyle, obesity and wellbeing among young people in Malaysia.
MATERIALS AND METHODS
The research project consisted of a cross-sectional survey of life style and obesity risks among Malaysian youth between 16 and 35 years old who were studying or working in Klang Valley. Data were collected during January-July 2015. A total of 934 young people took part in the study; 42.2% of them were secondary school students; 26% were university students and 31.8% were young people working in government, public & private sector.
Body Mass Index (BMI) was used as indicator of risk of obesity; it was calculated in Kilograms divided by height in meter squared. For the porpoise of this paper a normal range BMI oscillate between 18.50 and 24.99; a BMI between 25 and 29.99 indicate risk of Obesity (Pre-Obesity) and a BMI of 30 and greater was indicator of obesity.
RESULTS AND DISCUSSIONS
Participants Body Mass Index ranged between 18.12 and 137.07; with a mean BMI of 36.83 + 9.95. This result indicates that overall these young people are either pre-obeseor obese.
More specifically 20.6% of the participants were pre-obese while 76.5% were obese (Table 1).
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TABLE 1: BMI DESCRIPTIVE AND RANGE AS INDICATOR DISTRIBUTION
Body Mass Index N %
Normal range (BMI range 18.50-24.99) 27 2.9
Pre obese (BMI range >25-29.99) 190 20.6
Obese (BMI range >30) 705 76.5
Table 2 summarizes the demographic characteristics of the sample and the frequency distribution of BMI. The information presented in table 2 indicates that the prevalence of risk for obesity (pre-obese) and obesity are high for all demographic groups.
TABLE 2: DEMOGRAPHIC CHARACTERISTICS AND THE DISTRIBUTION OF BMI
N % BMI indicator
Pre-obese Obese
Gender >25-29.9 >30
Male 338 36.2 15.3% 82.0%
Female 596 63.8 23.6% 73.3%
Age group
16-18 years old 401 42.9 29.6% 65.3%
19-24 years old 253 27.1 20.1% 77.5%
25-30 years old 191 20.4 9.6% 89.8%
31-35 years old 89 9.5 - 95.5%
Ethnicity
Chinese 71 7.7 33.8% 66.2%
Indian 78 8.4 16.9% 79.2%
Malay 742 80.0 19.4% 77.4%
East Malaysian 36 3.9 25.0% 72.2%
Type of participant
Secondary School Students 394 42.2 29.7% 65.2%
University Students 243 26.0 21.6% 75.9%
Young worker 297 31.8 7.6% 92.1%
Overall male respondent exhibited significant higher BMI (39.12 +11.90) than female respondents (35.53 + 8.39) [t (921) =5.34; C.I.= 2.27-4.90; p <0.05]. The Analysis of variance results and post-hoc test indicated that male respondents exhibited higher BMI;
spent more hours in physical activities and exercising, and engaged more in mood related eating behaviour than their female counter parts (p<0.05) . Female participants were more weight conscious, relied more on their friends to avoid gaining weight and were more influenced by their friends eating attitudes and behaviour than the male participants(p<0.05).
Table 3 and 4 summarize the mean differences in BMI by type of participant and age group respectively. Young professionals exhibit significant higher body mass index than secondary and university students [F (2) =19.31; p<0.001]. More specifically young professionals have higher BMI mean score than secondary and university students (p<0.05)
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TABLE 3: MEAN DIFFERENCES IN BMI BY TYPE OF PARTICIPANT
N Mean
Std.
Deviation
95% Confidence Interval for Mean
Minimum Maximum Lower Bound Upper Bound
Secondary school students 392 35.18 11.01 34.09 36.28 18.12 137.07
University students 241 36.01 9.22 34.84 37.18 23.33 100.00
Young professional 290 39.73 8.26 38.78 40.69 23.38 74.53
Total 923 36.83 9.95 36.19 37.47 18.12 137.07
Young people between 31 and 35 years old exhibit significant higher body mass index than their younger counterparts [F(3)=13.85; C.I. 39-42.18; p<0.001]. The post-hoc analysis indicates that young people in the older age groups (25-30 and 31-35 years old) had higher BIM than the younger age groups (19-18 and 19-24 years old) (p<0.05)
TABLE 4: MEAN DIFFERENCES IN BMI BY AGE
N Mean
Std.
Deviation
95% Confidence Interval for Mean
Minimum Maximum Lower
Bound Upper Bound
16-18 years old 399 35.21 10.97 34.13 36.29 18.12 137.07
19-24 years old 249 35.98 9.05 34.85 37.11 23.33 100.00
25-30 years old 187 39.64 8.75 38.38 40.90 23.38 74.53
31-35 years old 88 40.59 7.49 39.00 42.18 25.16 60.24
Total 923 36.83 9.95 36.19 37.47 18.12 137.07
Furthermore, young people working exhibited higher BMI, reported less hours spent in physical activities and exercise during the week and weekends when compared with secondary school and university students (p<0.05). Young worker also reported to be more weight conscious andmore often influenced by their friends’ eating attitudes and behaviour than secondary school and university students (p<0.05). Secondary school student reported less frequently to eat their meals and/or snack while watching TV than did university student and young workers (p<0.05).
CONCLUSIONS
The potential implications of obesity related problems for youth quality of life and development are not fully understood. However, we know that young people with overweight related problems are at high risk of becoming unhealthy employees and contribute with a negative work environment. In turn, these negative consequences can spill over to society;
and derail the national development plans that emphasize the need for a well-prepared and productive youth population. Therefore, obesity and overweight among youth in Malaysia and in other ASEAN countries posit an alarming trend that needs to be better understood and addressed. Thus working towards well-structured and systematic research and producing good quality and harmonized methods to assess and address obesity among youth across the ASEAN Nations is vital.
Obesity is not an individual problem, as it impacts the individuals and their social ecosystem (e.g. workplace and family). The health risks related to being obese impair people’s ability to work and perform efficiently in their tasks whether these are at university or at work. Being overweight or obese has detrimental effects on individual health and wellbeing and serious repercussions in terms of economic and social costs for a country. Thus, the consequences of obesity can have a spill-over effect in the community/society. That is because the economic
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burden as result young people’s poor health and negative well-being can have negative impact on communities and the country development. We cannot expect young people to work towards the sustainability of their country’s economy, when they are facing health issues, or battling with chronic illnesses. Obesity among youth is potentially detrimental to the healthiness and progress of developing societies. How could an unhealthy and fat human capital with a vulnerable self-identity contribute to the developing of a nation?
The preliminary results presented in this conference paper suggest that rather than investing time, money and effort in one-off awareness events, more effort should be deploy in developing effective and realistic ways to promote healthier living style among young people.
Promoting healthier and well balanced individuals will reduce national and personal economic burden related to a poor quality of life and unhealthy choices. The programs and policies designed to address increased risk of obesity among young people should be tailored to the appropriate gender and the current status of young Malaysians (i.e. secondary school, university students or young workers). Weather the Malaysian lifestyle has anything to do with ASEAN community lifestyle; it is something that needs to be explored more in future research.
ACKNOWLEDGEMENT
The author would like to acknowledge and thank the Universiti Putra Malaysia (UPM) for awarding the Putra Grant [GERAN PUTRA] (Research Project Number: GP- IBT/2013/9408800) to fund the study leading to the production of this paper.
The authors gratefully acknowledge and thank the Ministry of Education (MOE) for granting access to the schools to collect data, the participating Schools and University, the students and young professionals who took part in the study
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