Addressing Obesity in Indonesia Through Nutrition and Policy
Obesity in Indonesia
Kathleen Peterson
Food System and Nutrition, University of Washington
NUTR 420 A: Global Nutrition: Challenges and Opportunities
Dr. Adam Drewnowski
December 8, 2023
Abstract
Despite Indonesia being on the rise as the largest economy in Southeast Asia, it is facing its own difficulties. The increase of obesity has doubled in Indonesia in the past decade and is a direct result of a rising economy. The adverse effects of obesity in the country lead to economic disparities, higher risks for chronic diseases, and lower overall productivity. In order to address the factors contributing to the problem, a multi-sectoral approach is used. By targeting breastfeeding mothers, growing children, and working adults, the complication at hand can be reduced. If all four of these adaptable factors are implemented, the country can begin to come back into its power.
Introduction
Indonesia is currently facing one side of a nutritional dual burden. Obesity is the result of malnutrition. Cheap and unhealthy foods have become part of their everyday lifestyle. Wealthier people and lower income people are choosing to switch from their once traditional Indonesian diet, to the more convenient processed diet. This nutritional challenge affects children, adolescents, and adults. However, people living in urban settings are more likely to be obese. According to the National Library of Medicine, the wealthiest districts in Indonesia had the highest rates of childhood obesity. The easy access to processed foods, and sedentary lifestyle does not make a person healthy. The country is faced with overnutrition, and a lack of nutrition. Food security should mean that not just food is accessible, but healthy food. There is a higher intake overall of unhealthy fats and sugars which lead to endless adverse health complications including obesity and cardiovascular issues. Due to the poorly designed infrastructure of the cities, people are not getting enough space to exercise. There is also a lack of greenery and parks, another place where people often workout. Indonesia is very similar to Malaysia. The rates of obesity prevalent in both countries is around 20%. For two countries that are almost completely surrounded by water to have such poor nutrition it is surprising. It is vital for Indonesia to take immediate action. It requires an encompassing approach that combines nutritional awareness, policy reforms, healthcare interventions, and a commitment from the food and beverage companies to create healthier food.
Main Nutrition Challenge
In Indonesia, the primary nutrition challenge this paper will focus on is obesity. Obesity is so dangerous because people are not aware of the risks. The World Health Organization stated that there are more obese people in the world than people who are underweight . Specifically, in Indonesia, “one in three adults, one in five children aged 5-12, and one in seven adolescents aged 13-18 are overweight or obese (1).” Wealthier children experiencing obesity is due to lack of exercise and an overconsumption of energy-dense processed foods. Although lower income families face stunting and wasting as an opposite challenge, they still face childhood obesity when there is a high consumption of these non nutritious foods, due to the affordability. Adults are more likely to have obesity when they live in a city. This is because the country has been developing more transportation and infrastructure. The way they have designed it makes for a perfect non active lifestyle. This is the breeding ground for health issues like diabetes and obesity when also fueled by tons of unhealthy food. The reason why this is so important is because it can cause the society to collapse if no action is taken. Childhood obesity raises the most concerns because the new generation needs to be healthy in order to keep the country running. Obesity happening at a young age has been linked to premature death and early onset of adult obesity with a higher risk of related illnesses. Obesity is a major risk for strokes and other heart related problems which is the leading cause of death worldwide (2). Obesity has also been linked to some cancers. Even if a person is only slightly overweight, the higher their body mass index is, the more at risk they are. To conclude, the more children that are overweight or obese, the more adults will become obese. This leads to lower productivity and more health bills due to the adverse problems related to obesity. Since the working class in cities are the population with the highest obesity rates, it is unlikely they can afford to live and pay for the health issues that come with their lifestyle. Without some sort of change, the economy will just fall apart if a third of the working population is highly at risk for chronic diseases, and a fair amount end up passing away due to their respective issues. It is essential for change immediately in order to create a productive, healthy society in Indonesia.
Intervention Strategy
Indonesia is faced with the biggest challenge that is obesity. It is a result of a rapidly developing economy. In order to address the nutrition challenge, a multi-sectoral approach is necessary. There are many underlying factors that end up creating this problem. The ones targeted in this paper are to address not only adult obesity, but the epidemic of childhood obesity. For the time being, there is not much to be done if policy change does not happen. This occurs if there is enough knowledge on the topic to want to change it. The four interventions chosen are breastfeeding focus for women, nutrition in school in order to educate children, increase nutritional awareness on food to adults, and create beneficial diet and fitness recommendations. UNICEF states that “studies have shown that exclusive breastfeeding from birth to 6 months of age reduces the risk of infants becoming overweight or obese (2).” This is why breastfeeding needs to be addressed as a strategy to reduce childhood obesity. The World Health Organization also found that about 52% or half of 2.3 million children under 6 months of age are exclusively breastfed (3). This is so concerning given the rate of obesity in the country. Another statistic from WHO states, increasing breastfeeding globally could save more than 820,000 children each year (3). This could potentially save many children from the risks of obesity in the future. Along with this is implementing more nutrient dense options at school. Along with this comes education on what is being provided and why. It is so important to eat healthy and to know why you are eating healthy, it can be especially confusing for children who grew up knowing only processed foods. The next level of action is to target adults. This is especially challenging because many people are resistant to change, and do not want to live a healthy life. In order to help people make better conscious decisions when buying food or beverages, labeling can be made easier to understand. It is also essential to make sure the nutritional information stands out for the consumer in order to quickly decide if something is healthy or not. The problem is, the WHO specifically addresses this, but the bad stuff is hidden in food that is consumed everyday. “Instant noodles and sugary drinks also lead to elevated levels of C-reactive protein – a marker of cardiovascular risk – according to research using nationally representative data. (4).” Our main source of nutrition and health should not be the leading cause of our sicknesses. This is why there needs to be a diet plan implemented for the whole country, specifically those most at risk. The diet has to change to being wholefoods focused. Along with this diet plan should be an exercise agenda people can follow. It is imperative for a shift in priorities leading to a desire for health through an improved diet and an active life. People who lack the knowledge to know something is bad for them are at a disadvantage in life, so making this plan accessible to everyone is fundamental.
Evaluation Plan
I believe this is an excellent time for big corporations to figure out how to create healthier options for consumers. The market is now changing as more awareness is being drawn to the health concerns our food raises. It really cannot be that hard, the only reason why it happens is because it is allowed to. There is no legislation or policy stating these terrible foods cannot be made, or the additives put in cannot be added. It is almost impossible to believe that we are still being poisoned through our food every day and it is not being taken seriously. In order to check in to make sure the intervention strategies chosen to be implemented are improving the overall health and obesity rates in the country, a few measures need to take place. The rate of childhood, adolescent, and adult obesity should go down. It might take a few years, but with the actions I urged above, it can happen. With this there needs to be support by the government, enforcing the ban of certain ingredients or foods. The government plays an integral role in the improvement of the health of the citizens. They make money when people are sick, so it also requires dignity to want to help people to make this change. There needs to be increased awareness in the importance of breastfeeding, that means encouraging breaks for women in the workspace. A shift in priorities again is essential to fix this issue. When children start their life healthy, they are more likely to live a healthy adult life. I believe more research needs to be done in urban settings because there is already statistical evidence that is where obesity is most prevalent. This would then create a need for healthier food being more accessible, along with fitness centers. Creating parks or outdoor workout centers will encourage people to move their bodies. If this is achieved, it would be reflected in the productivity of the economy. It would show because the economy would change for the better as they are a rising upper middle income country. This could drastically change the projection of the country's success.
Impact on Global Public Health
Indonesia is much like its neighboring countries in Southeast Asia. Based on research with Malaysia, I found that these countries are very similar. They do share a border, and are both surrounded by water. It makes these two countries isolated, but they are together. The problem Malaysia also faces is the dual burden of undernutrition and overnutrition. The World Blank claims Indonesia as the largest economy in Southeast Asia. This is essential because if Indonesia is able to tackle this burden of obesity, it will pave the way for many other developing countries. With the specific diet and exercise plan proposed, this can be molded to fit anybody’s lifestyle. People need to learn what their bodies need in order to thrive. Once figured out, the plan is no longer needed. A plan is not necessary, but people need structure and rules to follow. It is an effective way to get communities involved in nutrition and what that actually means to them. Soon the entire world will be on board, but nutrition is a necessity in order to grow as a country.
References
Indonesia: Overweight and obesity on the rise in all age and income groups. (n.d.). Retrieved December 7, 2023, from https://www.unicef.org/indonesia/press-releases/indonesia-overweight-and-obesity-rise-all-age-and-income-groups
Obesity. (n.d.). Retrieved December 7, 2023, from https://www.who.int/health-topics/obesity
World Breastfeeding Week: UNICEF and WHO urge greater support for breastfeeding in Indonesia as rates decline during COVID-19. (n.d.). Retrieved December 7, 2023, from https://www.who.int/indonesia/news/detail/01-08-2022-world-breastfeeding-week--unicef-and-who-urge-greater-support-for-breastfeeding-in-indonesia-as-rates-decline-during-covid-19
Indonesia: Obesity rates among adults double over past two decades. (n.d.). Retrieved December 7, 2023, from https://www.who.int/indonesia/news/detail/04-03-2021-indonesia-obesity-rates-among-adults-double-over-past-two-decades
Chong, C. T., Lai, W. K., Mohd Sallehuddin, S., & Ganapathy, S. S. (2023). Prevalence of overweight and its associated factors among Malaysian adults: Findings from a nationally representative survey. PLOS ONE, 18(8), e0283270. https://doi.org/10.1371/journal.pone.0283270
Sulistiadi, W., Kusuma, D., Amir, V., Tjandrarini, D. H., & Nurjana, M. A. (2023). Growing Up Unequal: Disparities of Childhood Overweight and Obesity in Indonesia’s 514 Districts. Healthcare, 11(9), 1322. https://doi.org/10.3390/healthcare11091322
Overview. (n.d.). [Text/HTML]. World Bank. Retrieved December 8, 2023, from https://www.worldbank.org/en/country/indonesia/overview
