Influence of Fast Food Consumption, School Day Activity and Heredity Factor Againt in Childhood

Obesity (BMI > 27 kg/m2)

(Literature Review)
1
Margareta Hilda Kristia, 2Indrawati Aisah, 3Habsidiani Rolita Amalia, 4Ma'rifah Vifta Fatih
1
Nutrition Program, State University of Surabaya,
2
Nutrition Program, State University of Surabaya, chaisah12@gmail.com
3
Nutrition Program, State University of Surabaya, rolitaamalia@gmail.com
4
Nutrition Program, State University of Surabaya, viftafatih3@gmail.com

Abstract
The prevalence of overweight and obesity in children aged 5-12 years reached 18.8%. Provinces that have
a prevalence above the national average one of which is East Java (Ministry of Health Republic of
Indonesia, 2013). The role of parents and the school is very important in teaching healthy living through
consumption of balanced nutritious food and increasing physical activity to prevent the incidence of
obesity in children. The purpose of this study is to analyze the pattern of food consumption, physical
activity and heredity against the incidence of obesity in children.Desain study of the article are 6 articles
using cross sectional study, 2 articles using cohort study, and 2 articles using case control study. In
Indonesia, the dominant significant risk factors were having obese parents, frequency of heavy eating, and
drinking milk. It can be concluded that children who consume fast food frequently, have obese parents,
and do more light physical activity are more at risk of obesity.

Keywords: childhood obesity, fast food, physical activity, heredity factor againt.

50-70% of a person's Body Mass Index and excess body

INTRODUCTION
A person is said to be overweight when he weighs 10%
to 20% of normal body weight, while someone is called
obese if being overweight reaches more than 20% of
normal weight. Obesity is currently a world problem
even the World Health Organization (WHO) declared it
as a global epidemic (, 2016).
Since 1970, the incidence of obesity has increased 2
(two) times in children aged 2-5 years and ages 12-19
years, even increasing three (3) times in children aged 6-
11 years. In Indonesia, the prevalence of obesity in
children aged 6-15 years increased from 5% in 1990 to
16% in 2001. In Indonesia, based on Riskesda data by the
Ministry of Health of the Republic of Indonesia in 2013,
the prevalence of overweight and obesity in children aged
5-12 years reached 18.8%. Provinces that have a
prevalence above the national average one of which is
East Java (Ministry of Health Republic of Indonesia,
2013).
Children's physical activity is how children allocate their
time for 24 hours in daily life to carry out certain types of
activities routinely and repeatedly. The activities of
children in this study were distinguished from school day
activities and holidays. The type and time children are
allocated to various activities are presented.
weight are related to genetic influences. There is a 50-
70% chance that a child will be overweight if both
parents are obese and 25-50% if one parent is obese
(Skelton, 2005).
in addition to physical activities undertaken by these
children there are still many who do not optimize the
amount of energy for health, where children often
indulge in activities such as playing gadgets, spending
time watching television so that the energy expended is
not proportional to the energy received. Based on
interviews from these people also mentioned, there are
inheritance factors from parents as well so that parents
who have a history of obesity are at risk of their children
being obese too.
The purpose of this study was to analyze risk factors for
the incidence of obesity in urban children.This study will
increase the needs of program planners, policy makers,
parents or guardians, doctors and all other stakeholders to
emphasize child overweight and obesity.
The role of parents and the school is very important in
teaching healthy living through consumption of balanced
nutritious food and increasing physical activity to prevent
the incidence of obesity in children. Efforts should be
made to prevent and manage obesity risk factors by
instilling health education in children from an early age,

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through increased IEC (communication, information and lifestyle, snack consumption, and frequency of fast food
education), such as the movement of fiber love consumption).
(vegetables and fruits) and to cultivate physical activity.
RESULTS
METHODS Cases and controls were matched in advance of their sex
The research method used in the article is observational (respondent characteristics). Of 148 total samples, 88
analytic research with cross sectional method. The study male respondents consisted of 44 obese and overweight
population in the article is all children aged 6-12 years.people (59.5%) and 44 normal weight people (59.5%),
This research was conducted in Indonesia, Ethiopia and and 60 female respondents consisted of 30 obese and
the United States. The sample was 148 respondents overweight people (40.5%) and 30 normal weight people
(40.5%).
consisting of 74 cases and 74 control children. The case
The age of the respondents consisted of 6-12 years. The
is that children suffering from obesity and overweight
number of respondents aged 6 years consisted of 1 person
control are students who have normal weight. Cases and
obese and overweight (1.4%) and 1 person with normal
controls were matched for sex and age (confounder weight (1.4%), 7 years consisted of 5 people obese and
variable). Research data generated through overweight (6.8%) and 5 people with normal weight
questionnaires. Filling the questionnaire in the form of (6.8%), 8 years consisted of 4 obese and overweight
body weight (BB) data measured by stepping scales and people (9.5%) and 4 normal weight people (9.5%), 9
height (TB) measured by microtoise by researchers then years consisted of 15 obese and overweight people (
BB and TB are included in the CDC IMT curve 20.3%) and 15 people with normal weight (20.3%), 10
(overweight if the BMI between 25-27, whereas obesity years consisting of 26 obese and overweight people
if BMI> 27), hereditary data (father's nutritional status,(35.1%) and 26 people with normal weight (35.1%), 11
maternal nutritional status, number of obese family years consisted of 17 obese and overweight people (23%)
members) and lifestyle (physical activity, sedentary and 17 normal weight people (23%), and 12 years
consisted of 3 obese and overweight people (4.1%) and 3
normal weight people (4.1 %).
Table 1. Characteristics of Respondents Regarding The Incidence of Obesity (N=148)
OBESE NORMAL
Variabel
N % n %
1. Sex
Boy 44 59,5 44 59,5
Girl 30 40,5 30 40,5
Amount 74 100 74 100
2. Age
- 6 1 1,4 1 1,4
- 7 5 6,8 5 6,8
- 8 7 9,5 7 9,5
- 9 15 20,3 15 20,3
- 10 26 35,1 26 35,1
- 11 17 23 17 23
- 12 3 4,1 3 4,1

Table 2. Incidence of Obesity based on Heredity and Lifestyle

Obese Normal
Variabel OR (95% CI) P
n % n %
1. Heredity Factor Agent
Father
- Obese 45 60,82 24 32,4
3,233 1,647-6,345 0,001
- Normal 29 39,2 50 67,6
Amount 74 100 74 100
Mother
- Obese 31 41,9 15 20,3
2,836 1,365-5,891 0,007
- Normal 43 58,1 59 79,7
Amount 74 100 74 100
Number of Obese Families
- <2 39 52,7 60 81
3,643 1,738-7,634 0,000
- ≥2 35 47,3 14 19

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 Amount 74 100 74 100
2. Lifestyle
Physical Activity
- Low 45 60,8 31 41,9
0,465 0,241-0,896 0,032
- High 29 39,2 43 58,1
Amount 74 100 74 100
Sedentary Lifestyle
- Light (<1 hour) 0 0 0 0
- Moderate (1-3 hours) 24 32,4 38 51,4 2,199 1,129-4,284 0,03
- Heavy (>3 hours) 50 67,6 36 48,6
Amount 74 100 74 100
Snack
- Yes 25 33,8 17 23
1,711 0,829-3,532 0,202
- No 49 66,2 57 77
Amount 74 100 74 100
studies show the importance of the family environment in
Based on hereditary variables, respondents with obese contributing to an increase in the prevalence of obesity.
fathers are more obese. Of the 69 respondents who had To see the genetic factors that influence the emergence of
an obese father, 45 (60.82%) were obese and 24 (32.4%) obesity in children, this study also looked at the condition
were of normal weight. Of the 46 respondents who had of obesity in both parents of children by measuring the
obese mothers, 31 (41.9%) were obese and 15 (20.3%) Body Mass Index (BMI). This means either the second or
were of normal weight. Obese mothers have more obese one of the obese parents has a tendency to give birth to an
children than are not obese.
obese child. Fat mothers have a great opportunity to have
The number of obese family members <2 is greater in
fat children too. Wirakusumah (2004) states that if there
non obese respondents than obesity. Of the 99
respondents who had obese family members <2, 60 is a hereditary factor of obesity, then there is a tendency
respondents had normal weight (81%), 39 respondents for someone to build more fat than others because there is
were obese (52.7%). inherited metabolic nature, for example there is a gene
High physical activity is more common among inherited in the code for the enzyme Adipose Tissue
respondents who have normal weight. Of the 72 Lipoprotein Lipase is more active. Not only the influence
respondents who performed high physical activity there of genes, child obesity in this study may also be
were 29 people (39.2%) who were obese and 43 people supported by environmental factors (parents' eating
(58.1%) respondents did not experience obesity (normal). habits). Soelistijani and Herlianty (2003) stated that
Sedentary lifestyle> 3 hours more are found in obese children who have a talent for being fat due to genetic
respondents. Of the 86 respondents who did sedentary factors will quickly become obese, especially if
lifestyle> 3 hours there were 50 respondents (67.6%) supported by the eating habits of parents who like high-
were obese and 36 respondents (48.6%) were not obese calorie foods and children imitating their parents' eating
(normal). habits. There is a noticeable difference (0.002 <p 0.05)
Snack consumption for obesity is out of 42 respondents
between heredity and obese children with obesity.
who consumed snacks, 25 respondents (33.8%) were
In addition to genetic factors that can make
obese and 17 respondents (23%) respondents were not
children obese, there is also an age factor. Waspadji et al.
obese (normal).
The frequency distribution of fast food consumption to (2003) states that the speed of body fat gain between men
the incidence of obesity is that of the 27 respondents who and women is different since the age of 8 years. The
consumed fast food with an inadequate frequency amount of female body fat is greater than men. Usually
category there were 16 respondents (21.6%) obese and 11 the amount of fat in the body will tend to increase with
respondents (14.9%) did not experience obesity (normal). age. Thus the tendency to be obese in children who are
initially overweight will increase with age. Besides that
DISCUSSION there are social and economic factors such as, Based on
In this study, genetic factors including factors the results of the interview this happens because the child
that can not be modified turned out to play an important comes from a family with middle to upper socioeconomic
role in the incidence of obesity. The results show that conditions, thus affecting the amount of the child's
children who have obese parents influence the incidence allowance. As stated by Napitu (2004) that pocket money
of obesity with p = 0,000. Deckelbaum (2001) suggests is part of the allocation of income family given to
that the risk of adult obesity is greater in obese and non- children for a certain period of time such as daily, weekly
obese children if at least one parent is overweight. These or monthly needs.

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 In addition to these factors, there are also factors
in children's eating habits, in addition to overeating
consumption of children - children also like Fast Food.
Food intake plays a role in increasing energy intake. One
of them is the frequency of heavy meals in a day. Heavy
meals identified by eating rice have 175 calories in one
serving (RI Ministry of Health, 2014). If the frequency of
these meals increases, the amount of caloric intake will
increase. This is consistent with the research of Toschke
(2005) that the decrease in the prevalence of obesity is
proportional to the decrease in the frequency of eating a
day. The frequency of eating three or less shows a
decrease of 4.2%; eat four times the decrease of 2.8%;
and five or more decreases by 1.7%. In this study
revealed that the frequency of heavy meals a day showed
its role in the incidence of obesity with p = 0.038 with
OR = 2.333 according to the research of Toschke (2005).
This means that children who eat heavily with a
frequency of heavy eating ≥3 times a day are at risk of
getting obesity by 2 times compared to those who do not.
Fast food is generally preferred by children, adolescents
and adults because it tastes according to taste and the
price is affordable. Thus normal children consume fast
food is still within reasonable limits, while obese children
consume excessive food excessively. In accordance with
the statement of Khomsan (2006) many fast foods that
contain high calories so that excessive consumption will
cause obesity problems, but consumption 1-2 times a
week may still be considered reasonable.
In addition to these factors, there are also factors
in children's eating habits, in addition to overeating
consumption of children - children also like Fast Food.
Food intake plays a role in increasing energy intake. One
of them is the frequency of heavy meals in a day. Heavy
meals identified by eating rice have 175 calories in one
serving (RI Ministry of Health, 2014). If the frequency of
these meals increases, the amount of caloric intake will
increase. This is consistent with the research of Toschke
(2005) that the decrease in the prevalence of obesity is
proportional to the decrease in the frequency of eating a
day. The frequency of eating three or less shows a
decrease of 4.2%; eat four times the decrease of 2.8%;
and five or more decreases by 1.7%. In this study
revealed that the frequency of heavy meals a day showed
its role in the incidence of obesity with p = 0.038 with
OR = 2.333 according to the research of Toschke (2005).
This means that children who eat heavily with a
frequency of heavy eating ≥3 times a day are at risk of
getting obesity by 2 times compared to those who do not.
Fast food is generally preferred by children, adolescents
In addition to these factors, there are also factors
in children's eating habits, in addition to overeating
consumption of children - children also like Fast Food.
4
Food intake plays a role in increasing energy intake. One
of them is the frequency of heavy meals in a day. Heavy
meals identified by eating rice have 175 calories in one
serving (RI Ministry of Health, 2014). If the frequency of
these meals increases, the amount of caloric intake will
increase. This is consistent with the research of Toschke
(2005) that the decrease in the prevalence of obesity is
proportional to the decrease in the frequency of eating a
day. The frequency of eating three or less shows a
decrease of 4.2%; eat four times the decrease of 2.8%;
and five or more decreases by 1.7%. In this study
revealed that the frequency of heavy meals a day showed
its role in the incidence of obesity with p = 0.038 with
OR = 2.333 according to the research of Toschke (2005).
This means that children who eat heavily with a
frequency of heavy eating ≥3 times a day are at risk of
getting obesity by 2 times compared to those who do not.
Fast food is generally preferred by children, adolescents
Apart from energy input, energy expenditure
also affects the incidence of obesity such as physical
activity. Children's physical activity is how children
allocate their time for 24 hours in daily life to carry out
certain types of activities routinely and repeatedly. The
activities of children in this study were distinguished
from school day activities and holidays. Children's
activities on school days are different from holidays. On
school days children's activities tend not to be much.
What children do on school days is only learning
activities at school and extracurricular activities at
school. Most children go to school with their parents,
because parents worry about the child. However, there
are children going to school by cycling with their friends.
The differences in the activities of the two children who
were taken by parents on bicycles are certainly different.
The energy expended by children delivered by parents is
less than the energy expended by children to go to school
by cycling. The duration of schoolchildren's time is about
12 hours, and one of the subjects is sports subjects.
Which is where the sports subjects in a week are on just
one day and with a duration of 60 minutes. Therefore
physical activities undertaken by children at school
include mild-moderate activities due to physical activities
undertaken by the learning process and extracurricular
activities (traditional dance, dance, music, volleyball,
soccer, silat).
While on holidays many activities that are done
are more casual or entertainment. Almost all activities
have more time allocation on holidays except learning
activities because there is no mandatory lesson schedule.
During the holidays many children do to play gadgets,
because relatively children today prefer to play gadgets
rather than playing with their peers. So that physical
activities undertaken by children during holidays tend to
be less compared to physical activities during school.
In addition, other activities that are often done
by children on holidays such as traveling with his family.
These activities tend to be casual and just ordinary
activities. But there are some children who play activities
that are not just ordinary physical activities. But it can be
a fun learning tool and indirectly the child also carries out
sports activities by playing it. Playing a child is expected
to play a game that is useful to train muscle and physical
strength, communication skills, socialization, so it can
make children healthy (Maidelwita, 2011). So that daily
physical activity has a role in excessive energy
expenditure. However, in this study physical activity had
no effect on the incidence of obesity. This also happened
in Duncan's research (2011) which showed no effect of
obesity on children's physical activity but there was an
influence on children who had parents who liked to
exercise. Physical activity in this study is any movement
that can cause energy expenditure including mild
physical activity. Mild physical activity was found to
have less influence on reducing the incidence of obesity,
because physical activity from sports and extracurricular
activities is not done routinely every day. Not that
physical activity does not play a role in reducing the
incidence of obesity. WHO recommends physical activity
for children, which is at least one hour of moderate
physical activity 5 times a week so that it can reduce the
incidence of obesity (WHO, 2010).
CONCLUSSION
The prevalence of obesity in school children is
16.7%. Fat children consume fast food often with
frequent frequency (more than 2 times a week), whereas
normal children rarely have frequency (1-2 times a
week). Thus normal children consume fast food is still
within reasonable limits, while obese children consume
excessive food excessively. There is a significant
difference between the frequency of consumption of fast
food in overweight and normal children. The higher the
level of preference, the frequency of consumption of fast
food more often.
For school day activities, significant differences
are found in mild and moderate activities, between obese
and normal children. In this article, it is known that most
obese and normal children have fathers and mothers with
normal nutritional status. However, overweight children
who have fathers who are overweight and obese have
nutritional status compared to normal children, as well as
the nutritional status of mothers. This means either the
second or one of the parents. Obese people have a
tendency to give birth to obese children.
It can be concluded that children who consume
fast food frequently, have obese parents, and do more
light physical activity are more at risk of obesity.