1. Emyr Reisha Isaura, Te-Chih Wong, Shwu-Huey Yang
Nutrition literacy and trend of double burden malnutrition in Indonesian adolescent since
Emyr Reisha Isaura, Te-Chih Wong, Shwu-Huey Yang

2. Outline Background Objective Methods Results Discussion Conclusion
Suggestion

3. Background
WHO, 2014

4. Indonesia NCDs country profile
Cardiovascular disease, cancer, respiratory diseases, and diabetes are four major types of NCD killers
WHO, 2014

5. Risk factors
Tobacco use, physical inactivity, the harmful use of alcohol, overweight and obesity increase the risk of dying from an NCD
“Along with other lifestyle choices and genetic predisposition, excessive intake of calories is one of the main common factors behind those conditions and risk factors” Kolčić, 2014

6. The Double Burden of Malnutrition
WHO, 2015

7. Double burden of malnutrition is a growing concern in Indonesia
In 2008, 37.2% of children under the age of five are stunted
In 2013 Indonesian national survey, the prevalence of combined stunting and overweight/obesity in adolescence as 6.8%, a higher prevalence than that of children who were of healthy body height but who were overweight or obese 5.1%.
The public awareness is low , which means low nutrition literacy
BPS, 2013

8. related with the double burden malnutrition
Objective
To describe the trends of the Indonesian adolescence body mass index according to nutrition status
related with the double burden malnutrition

9. Subject and Methods Subject : Adolescence aged 15-19 years old
Normal (without physical disability)
Not pregnant/breastfeeding
Methods:
Cross-sectional
Data from Indonesian Family Life Surveys (IFLS) in Indonesia ( )
Body weight, body height
Body mass index (BMI),based on 2007 WHO Growth Standards
Overweight/obesity was defined as >85th percentiles
Underweight were defined as <15th percentiles

10. Exclusion criteria Aged <15 or >19 Having physical disability
Sickness/refuse
Pregnant/breastfeeding
Missing data
No body weight/height
No sex

11. Results
There are 522, 3022, 3623, 3087 and 3414 separate adolescents in the 5 waves, respectively.
The prevalence of underweight increased from waves 1 to 3 (28.4% to 33%), and slightly decreased to waves 5 (31.9%).
The prevalence of overweight/obesity increased from 3.4% to 9.1% (P<0.05).
Mean of body height is increased from to 157.9, the same in body weight from 47.6 to 51.0.
Prevalence of overweight/obesity is elevating from 3.4% to 5.0%, accompanied by underweight from 28.4% to 33.5%.

12. From this figure, both of body mass indexs are increasing by the time in boys, but the underweight problem still exist in the population

13. Almost similar phenomenon for Girls

14. Body height of boys are slowly increasing

15. For girls, the body height are slower than boy, and it will be more vulnerable to have stunted, and overweight in the future

16. Discussion
Unequally distribution related to the population’s economic condition
Domestic economic problem  food security problem  food insecurity on several areas  malnutrition problem
Indonesia national statistical data, 2015
“Shortness is not the real problem. When it comes to stunting, other processes in the body are also stunted, such as brain development, which affects intelligence”
Achadi, 2015
May lead to poorer health outcomes particularly related to NCDs prevention and management
Education and income protect Indonesians from being undernourished.
Hanandita and Tampubolon, 2015

17. Conclusion
The existence of the double burden malnutrition from which remain increase in Indonesia.
Understanding the risks associated with and the causes of the DBM is not an easy task, not only because of the complexity of the issue but also because of the rapidly evolving situation in most low- and middle-income countries
People with better the nutrition literacy would have more appropriate BMI.

18. Suggestion
So, the combination of management of concurrent under and over nutrition through the compulsory education curriculum to increase the nutrition literacy as the prevention of the non-communicable diseases could be a policy solution.