The Relation between Sedentary Behavior and Physical Activity and

Junior High School Adolescents Nutritional Status in Purwosari

Health Center Surakarta

Jauharotul Farida

, Anisa Catur Wijayanti

Study Programme of Public Health, Faculty of Health Science, Muhammadiyah Surakarta University, Surakarta,

Indonesia

Keywords: Sedentary behavior, physical activity, nutritional status

Abstract: Nutrition is more than a pathological condition; there is excessive fat accumulation from normal body function

needs. Factors causing overweight includegenetic, environmental, psychological, physiological, eating

patterns, physical activity, economy, and sedentary behavior. Based on the results of the 2016 obesity

examination in Surakarta, the highest number was in Purwosari Public Health Center, which was 445 people,

and the results of 2017 overweight screening obtained obesity data in four junior high schools with 92

students. The prevalence of overweight and obesity in adolescents aged 13-15 years in Surakarta (10.9%) was

above the provincial prevalence (9.5%); moderate sedentary behavior 3–5.9 hours (57.1%) was above the

average in Central Java; and physical activity (26.5%) was classified as less active. This study aims to analyze

the relationship between sedentary behavior and physical activity and overweight status in adolescents in

junior high school Purwosari Public Health Center Surakarta. The study belongs to quantitative observation

with cross-sectional approach. The research population is junior high school students (ages 13-15 years) in

the area of Purwosari Community Health Center as many as 520 students. The study sample was 107 students

selected using proportionate random sampling. Data was analyzed using chi-square test. The results showed

that there was a relation between sedentary behavior (p = 0.032) and physical activity (p = 0.023) and

nutritrional status in adolescents in junior high school in the area of Purwosari Public Health Center, Surakarta

City.

1 INTRODUCTION

Overweight is more a pathological state, where there

is excess fat accumulation than is needed for normal

body function. Overweight that occurs in adolescents,

resulting in teenagers having less confidence (Marmi,

2013). The Qur'an Surah Al-A'raaf verse 31 mentions

the command to eat and drink is not excessive

manner, meaning that it is not to exceed the limit and

it is proportional (balanced) in eating and drinking.

WHO (World Health Organization) states that in

2016, more than 340 million children and adolescents

aged 5-19 years are overweight or obese. According

to Riskesdas data (2013), overweight status of

adolescents in Indonesia aged 13-15 years is 10.8%

(8.3% fat and 2.5% obese). Meanwhile, the

nutritional status of adolescents aged 13-15 years in

the province of Central Java has overweight

prevalence according to BMI / Age at the provincial

level of 9.5% (7.1% overweight and 2.4% obese) and

Surakarta (10.9%), which were above the provincial

prevalence.

Factors causing overweight include genetic,

environmental, psychological, physiological,

developmental factors, dietary patterns (nutrient

intake), physical activity, and economy (Sutanto,

Farida, J. and Wijayanti, A.

The Relation between Sedentary Behavior and Physical Activity and Junior High School Adolescents Nutritional Status in Purwosari Health Center Surakarta.

DOI: 10.5220/0008381000660072

In Proceedings of the 1st Inter national Conference on Social Determinants of Health (ICSDH 2018), pages 66-72

ISBN: 978-989-758-362-9

2010). Another cause is sedentary behavior. It is a

relaxed behavior that is often carried out such as

watching TV, surfing the internet, playing mobile

phones, doing assignments with a computer, playing

games, but not including bedtime (Ministry of Health,

2013).

The average proportion of sedentary behavior in

Central Java is in the category of 3–5.9 hours

(43.2%), while that in Surakarta is above the Central

Java average (57.1%). Besides sedentary behavior,

other physical activities also need more energy, such

as walking, running, and exercising (Haskell et al.,

2007). The proportion of physical activity is

classified as "less active" in Central Java is 20.5%;

while the data found in Surakarta (26.5%) is above

the Central Java average.

Based on the data from the Surakarta City Health

Office, from the number of obesity examinations in

2016 at seventeen health centers, the highest number

of obesity was in Purwosari Health Center (445

people). The results of a preliminary study conducted

through nutritional screening in four junior high

schools at Purwosari Health Center in 2017revealed

that 92 students are overweight. Based on these, it is

necessary to conduct research that discusses "The

Relation between Sedentary Behavior as well as

Physical Activity and Nutritional Status in

Adolescents in Junior High School in Purwosari

Public Health". This study aims to analyze the

relation between sedentary behavior and physical

activity and nutritional status in adolescents in junior

high school in the area of Purwosari Public Health

Center, Surakarta City.

2 SUBJECTS AND METHODS

The research is a quantitative observation with a

cross-sectional approach. This study was conducted

in May-June 2018. The population were adolescents

(ages 13-15 years) totaling 520 students consisting of

State Junior High School2 Surakarta are 244 students,

Regina Pacis Junior High School Surakarta are 169

students, and Al-Mu'ayyad Junior High School

Surakarta are 107 students. The sample of this study

was 107 students, which were selected using

proportionate random sampling technique. The

primary data were obtained from filling out

questionnaires, namely ASAQ questionnaire

(Adolescent Sedentary Activity Questionnaire) and

PAQ-A questionnaire (Physical Activity

Questionnaire of Adolescent). Univariate analysis

was employed to describe the variables studied by

calculating the frequency distribution. Bivariate

analysis is useful to determine the relation between

the independent variables (sedentary behavior and

physical activity) and the dependent variable

(nutritionalstatus) using Chi-Square statistical test

with a significant level of α = 0.05 (95% confidence

level).

3 RESULTS

Characteristics of Respondents

The characteristics of the respondents analyzed

included gender, age, school origin, genetic history

with nutritional status, and family history with

nutritional status.

Table 1. Frequency Distribution of the Respondents’

Characteristics

Characteristics of Respondents

Total

Sex

Male

38,3

Female

61,7

Age

13 year

87,9

14 year

9,3

15 year

2,8

Mean

13,17

Std.Dev

0,43

Min-Max

13 – 15

Origin School

2 State Junior High School

Surakarta

46,7

Regina Pacis Junior High School

Surakarta

32,7

Al-Mu'ayyad Junior High School

Surakarta

20,6

Genetic History With Overweight

Status

Yes

66,4

33,6

Family History With Overweight

Status

Father

40,9

Mother

53,5

Both

5,6

Based on Table 1 that included a total number of

107 students, it is known that the majority of the

respondents was female, as many as 66 students

The Relation between Sedentary Behavior and Physical Activity and Junior High School Adolescents Nutritional Status in Purwosari Health

Center Surakarta

(61.7%). The highest number of age group who took

part in the study was 13 years, as many as 94 students

(87.9%). Based on the grouping of school origins, the

respondents whose numbers most participated in this

study were State Junior High School 2 Surakarta

which was as many as 50 students (46.7%). Most of

the respondents had a genetic history with

Overweight status that came from parents or

grandparents, namely as many as 71 students

(66.4%). The family history with overweight status

came from mothers, namely 38 students (35.5%).

Univariate Analysis

Univariate analysis was used to describe the

characteristics of the respondents, sedentary

behavior, physical activity, and nutritional status. The

results of the analysis are presented in table form as

follows:

Table 2. Respondents’ Frequency Distribution Based on

Sedentary Behavior, Physical Activity, and Nutritional

Status

Research Variable

Frequency (n)

Percentage (%)

Sedentary Behavior

High (> 8 hours/day)

49,5

Low (≤ 8 hours/day)

50,5

Physical Activity

Low (≤ median 56)

52,3

High (> median 56)

47,7

Nutritional Status

Obesity

21,5

Fat

31,8

Normal

46,7

Total

107

100

Frequency distribution is based on sedentary

behavior, in that more respondents have low

sedentary behavior, as many as 54 students (50.5%).

Meanwhile, in terms of physical activity, more

respondents, 56 students, had low physical activity

(52.3%).The frequency distribution based on

nutritional status shows that the majority of

respondents achieved normal status, as many as 50

students (46.7%) and obese, as many as 34 students

(31.8%).

The variable of sedentary behavior consists of 11

behaviors grouped in 5 dimensions filled by

respondents for 7 days (a week). The following is a

table of dimensions of sedentary behavior:

Table 3.Dimensions of Sedentary Behavior

Dimensions of Sedentary

Behavior

Frequency (n)

Percentage (%)

Small Screen Recreation(SSR)

High (>2 hours/day)

Low (≤2 hours/day)

Education

High (>2 hours/day)

40,2

Low (≤2 hours/day)

59,8

Travel

High (>2 hours/day)

40,2

Low (≤2 hours/day)

59,8

Culture Activities

High (>2 hours/day)

67,3

Low (≤2 hours/day)

32,7

Social Activity

High (>2 hours/day)

92,5

Low (≤2 hours/day)

7,5

Based on the dimensions of sedentary behavior in

Table 3, the most frequently done by respondents is

the Social Activity dimension with a high category (>

2 hours / day), by 99 students (92.5%).

The activities included relaxing by using mobile

phone (for example calling). In addition to the Social

Activity dimension, respondents also often carry out

various activities in more than 2 hours / day (high

category), namely in the Small Screen Recreation

(SSR), done by 92 students (86%), and Culture

Activity dimensions by 72 students (67.3%).

Bivariate Analysis

Bivariate analysis showed the results of statistical

tests of the relation between sedentary behavior and

nutritional status. The following table shows the

relation between sedentary behavior and nutritional

status:

ICSDH 2018 - International Conference on Social Determinants of Health

Table 4.Relation between Sedentary Behavior and

Nutritional Status

Sedentary

Behavior

Nutritional Status

Total

p- value

Pearson

Correla-

tion

Obese

Fat

Normal

High

26,4

39,6

100

0,032

0,223

Low

16,7

24,1

59,2

100

Based on Table 4, overweight and obese

respondents had more high-risk behaviors (> 8 hours

/ day), which were 14 students (26.4%) and 21

students (39.6%), respectively. Meanwhile,

respondents with normal nutritional status were more

likely to carry out low sedentary behavior (≤8 hours /

day), which was 32 students (59.2%).

Based on the results of statistical analysis, the p-

value is 0.032 (p-value <0.05). Thus, H0 is rejected,

which shows that there is a relation between

sedentary behavior and overweight status in

adolescents in the Junior High School Purwosari

Public Health Center Surakarta. While the Pearson

Correlation (r) shows the value of 0.223, meaning that

the closeness level of the relationship is weak, that is,

between the coefficient intervals of 0.200-0.399. The

following table shows the relation between physical

activity and nutritional status:

Table 5.The Relation between Physical Activity and

Nutritional Status:

Physical

Activity

Nutritional Status

Total

p- value

Pearson

Correla-tion

Obese

Fat

Normal

Low

30,4

33,9

35,7

100

0,023

0,265

High

11,8

29,4

58,8

100

Based on Table 5, obese and fat respondents had

more low physical activity, done by 17 students

(30.4%) and 19 students (33.9%), respectively.

Meanwhile, respondents with normal nutritional

status had more high physical activity, done by 30

students (58.8%).

Based on statistical tests obtained, the p-value was

0.023 (p-value <0.05), then H0 is rejected, which

shows that there is a relation between physical

activity and nutritional status in adolescents in junior

high school Purwosari Public Health Center

Surakarta. While the Pearson Correlation (r) value

was 0.265, meaning that the closeness level of the

relation is weak, that is between the coefficient

intervals of 0.200-0.399.

4 DISCUSSION

Relationship between Sedentary

Behavior and Nutritional Status

The results of this study indicate that the percentage

of students who are overweight (obese and fat) in

performing high-risk behaviors (> 8 hours / day) is

greater than students who perform sedentary-random

behavior (≤8 hours / day) (66%). Based on the results

of statistical analysis, the p-value is 0.032 (p-value

<0.05), Ho is rejected, which shows that there is a

relation between sedentary behavior and nutrition

status in adolescents in the Junior High School

Purwosari Public Health Center Surakarta.

Meanwhile, the Pearson Correlation (r) value was

0.223, meaning that the closeness level of the

relationship is weak, that is, between the coefficient

intervals of 0.200-0.399.

This research is in line with the research of

Kurdaningsih (2016), in Yogyakarta State High

School, concluding that there is a relation between

sedentary lifestyle and overweight incidence (p-value

<0.001). The results of the Stettler et al., (2002) study

shows that adolescent sedentary behavior is one of the

risk factors that can cause adolescents to experience

degenerative diseases, diabetes mellitus, obesity, and

daily disorders (insomnia, dizziness and aging). The

incidence of overweight reduced the energy

expenditure in the body.

Besides, the addition of food intake often occurs

while doing sedentary behavior. Studies conducted by

NHANES III show that there is a positive relation

between the increasing food intake and the length of

time watching television, which is one of sedentary

behaviors (Brown, 2011). This is in line with Waters'

theory, et al. (2010), which states that children with

growth period tend to have high sedentary behavior.

The results of this study indicate that the Social

Activity dimension in the high category (> 2 hours /

day) is the most frequent activity done by respondents

with overweight status (fat and obese) and normal

nutritional status,that was 99 students (92.5%). Teens

who sit idly playing their mobile phone released

lower energy. If this condition continues, it can cause

obesity. Therefore it is necessary to exercise to create

The Relation between Sedentary Behavior and Physical Activity and Junior High School Adolescents Nutritional Status in Purwosari Health

Center Surakarta

an energy balance in the body and facilitate the

process of fat oxidation, there by minimizing the

chances of obesity (Amini et al., 2016). Research

Lowry et al. (2002) and Gomez et al., (2007) also

found that watching TV> 2 hours / day causes the risk

of obesity and overweight. This SSR (Small Screen

Recreation) activity can affect body weight and

metabolism if done in the long term.

The results of the study showed that the sedentary

behavior of respondents was included in the high

category (> 8 hours / day), so it is important to reduce

sedentary behavior, especially in Social Activity

activities (playing with mobile phone). Counter

measure can be taken by doing hobbies and

playing/practicing musical instruments. Adolescents

(middle and high school) have a longer school

duration and shorter interaction. Besides, they prefer

to stay at home to play electronic devices and books

(Roemling, C and Qaim M, 2012).

Therefore, there is a need for changes (reduction

of time) related to sedentary behavior in several ways,

especially when staiying at home. The time for

watching television can be reduced by limiting the

screen time (TV or computer) to children, such as no

more than 2 hours / day. Another alternative is

making the children's room free of TV and internet or

not placing them in their room (Cheung, L., 2012).

High sedentary behavior can also be influenced by

a lack of parental supervision of children's television

viewing time and a lack of knowledge about the

benefits of exercise. One strategy that can be done to

reduce the prevalence of sedentary behavior in over

nutritional status of the students is by increasing their

physical activity (Waters, et al., 2010).

Another solution is to encourage children to do

more physical activity outside the home such as

cycling, jogging, and jumping rope. These can

strengthen their heart and lungs. In addition,

adolescents are also encouraged to walk or ride more

frequently, especially in close proximity than using

two-wheeled vehicles (motorcycles). This is in line

with the research of Kurdaningsih et al., (2016) which

states that teenagers who go to school or go close by

walking or cycling are not at risk of becoming

overweight and obese.

The Relationbetween Physical Activity

and Nutritional Status

The results of this study indicate that the percentage

of students who are overweight (obese and fat) in

carrying out low physical activity (64.3%) is greater

than students who do high physical activity. Based on

the results of the statistical analysis, the p-value is

0.023 (p-value <0.05). Thus, H0 is rejected, showing

that there is a relation between physical activity and

nutrition status in adolescents in junior high school

Purwosari Public Health Center Surakarta.

Meanwhile, the Pearson Correlation (r) value was

0.265, meaning that the closeness level of the relation

is weak.

This result is in line with the research of Huriyati,

E., et al (2004), who concluded that there is

significant relationship between physical activity and

the occurrence of obesity in junior high school

adolescents in Yogyakarta City and Bantul Regency.

The results of this study support the theories and

hypotheses arguing that physical activity is related to

the state of being overweight.

The relation between physical activity and the

incidence of overweight is related to the imbalance of

energy usage. The rest of the energy in the body due

to a person's low physical activity will change to body

fat and then associated with overweight (Atkinson,

2005).

This study is in line with the research of Ortega et

al. (2007) that children and adolescents with low

levels of physical activity are more at risk of

overweight or obesity and have a higher risk of

greater waist circumference. This is reinforced by the

results of other studies that show that children who do

not routinely do sports or physical activity have a

chance of over nutrition risk of 1.35 times compared

to children who regularly exercise (Sartika, 2011).

Therefore, children with overweight status,

especially obesity, tend to have low activity.

According to Brown (2011), based on NHANES I, II,

and III data, a decrease in physical activity can

increase the prevalence of over nutrition in children

compared to increased energy intake. Physical

activity depends on the type, frequency, intensity and

duration (Almaeida and Blair, 2002). The more

physical activity carried out, the more energy needed

by the body, thereby more nutrient intake is needed

(Irianto, 2014).

Parenting patterns in physical activity affect that

in children. According to Brown (2011), a strategy

that parents must have in increasing children's

physical activity mayinclude providing good

examples of physical activity that involves the

children; encouraging children to do physical

activities at home, at school, and when they are with

friends; limiting the duration of children taking non-

physical activity.

Frequent daily physical activity is a factor

preventing from the increase of body weight and

ICSDH 2018 - International Conference on Social Determinants of Health

abdominal adiposity in children (Abril et al., 2013;

De Bourdeaudhuij et al., 2013 in Lee, S.T et al.,

2015). Strong et al., (2005) recommend physical

activity for children aged 5-18 years, that is to do

moderate to weigh physical activity at least 60

minutes every day. Hence, it is necessary to improve

the habits of physical activity in adolescents, by way

of routinely exercising every weekend with the

family. Physical activity in adolescents is significant

in creating healthy lifestyle that will continue to their

adulthood.

The National Physical Activity Guidelines in

Australia and the World Health Organization (WHO)

have recommended physical activity that can be

carried out for children and adolescents with ages

ranging from 5-17 years, including physical activity

at moderate intensity for 60 minutes every day

(basketball, soccer, swimming, weight lifting,

cycling, dancing, tennis, climbing stairs, etc.) as well

as physical activities that can strengthen muscles and

bones, at least 3 times a week (WHO, 2018).

Meanwhile, according to the Ministry of Health

(2018), the duration of physical activity carried out

regularly at least 30 minutes a day can nourish the

heart, lungs, and other body organs. The more time

used for physical activity, the more benefits obtained.

Further, physical carried out every day regularly

within 3 months will produce good results.

Therefore, children's awareness of physical

activity is influenced by the family and school

environment. Hence, physical activity needs to be

increased at home and at school, both in terms of

frequency and duration, especially by children who

are overweight and obese. Physical activity can be

done by exercising. Teenagers can do anykinds of

exercise according to their favor and the time they

have.

Similarly, teachers have authority over the

students’ activities at school, for example by giving

at least 1 lesson to exercise to increase students'

physical activity. Basically, it is very important for

individuals to maintain ideal body weight to optimize

their health status. Therefore, school-based

intervention is an alternative to overcome obesity in

children.

5 CONCLUSION

There is a relation between sedentary behavior and

over nutrition status in adolescents in junior high

school in Purwosari Surakarta Public Health Center

work area (p-value = 0.032). There is a relation

between physical activity and overweight status in

adolescents in junior high school in the area of

Purwosari Public Health Center, Surakarta City.

For teens, they are recommended to do more

activities outside the home, such as jogging and

jumping rope. And it is recommended to walk or ride

more often, especially in close quarters, rather than

using two-wheeled vehicles (motorcycles).

Teenagers should help parents more in doing

household chores rather than lingering in front of the

cellphone screen. And they should also make changes

related to sedentary behavior by limiting or setting a

time limit in doing activities, such as watching TV,

using a computer / laptop (surfing the internet) more

than 2 hours / day, as well as playing with cellphones,

etc. It should be carried out by particularly those who

are obese to further increase physical activity, both in

terms of frequency and duration. They should

perform physical activities at moderate intensity for

60 minutes every day (such as basketball, soccer,

swimming, lifting weights, cycling, dancing, tennis,

etc.), and do physical activities that can strengthen

their muscles and bones at least 3 times a week (such

as running or jogging, jumping rope, push-ups,

aerobics, lifting weights, martial arts, sports with

racquets, etc.). Besides, they can do any kind of sports

that they like and then adjust the activities to the time

they have.

At schools, primary prevention can be done by

conducting health promotion about healthy lifestyles

in adolescents and their parents. The school can work

with related parties, such as local health centers to

weigh and routinely measure the height of the

students every 6 months. This way, they can monitor

the growth and weight gain of students on a regular

basis through the School Health Unit program. The

school can provide education on the importance of

modification of physical activity as well as

encouraging the students to increase it.

For health centers, it is best to supervise the

School Health Unit in monitoring nutritional status

regularly. The next researchers can do further

research on other factors (such as knowledge, pocket

money, peer support, etc.) that relate to the incidence

of overweight and overweight and obesity status in

junior high school adolescents with more research

subjects.

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ICSDH 2018 - International Conference on Social Determinants of Health