ISSN: 13412051 Volume 25, Issue 02, February, 2020

Epidemiological analysis of sedentary lifestyle, and its relationship with weight in female university students in Banda Aceh, Indonesia

Yusni Yusni1*, Amiruddin Amiruddin2, Razali Razali2, Nirwana Lazuardi Sary1

Department of Physiology, Faculty of Medicine, Universitas Syiah Kuala, 23111 Banda Aceh, Indonesia1 Physical Education, and Recreation, Faculty of Teacher Training and Education, Universitas Syiah Kuala, 23111 Banda Aceh, Aceh, Indonesia2.

Abstract— A sedentary lifestyle is a single factor for various metabolic . The aim of this study was to determine the prevalence of sedentary lifestyles and its effects on weight and (BMI) in female university students in Banda Aceh, Indonesia. This study was a cross-sectional study. A survey using a questionnaire was carried out on 865 female university students of Universitas Syiah Kuala and aged between 17-19 years. All participants were measured weight and height. Data analysis was using descriptive statistics and independent sample t-tests (p<0.05). In the total of 865 female students, the sedentary lifestyles were 38.61% and non-sedentary 61.39%. There was a significant difference between body weight (p=0.001) and Body Mass Index (BMI) (p=0.003) between the sedentary and non-sedentary groups. Common types of physical activity are walking as much as 71%, gymnastics around 19% and Jogging 10%. The highest frequency of physical activity per week is as much as 2 times/week with 39%, 3 times/week as much as 37%, and >3 times/week by 24%. The duration of physical activity that was mostly done by female students in Banda Aceh was <30 minutes by 47%, 30-35 minutes by 40%), and 60 minutes by 7% and >60 minutes by 5%. The prevalence of sedentary and non-sedentary was 38.61% and 61.39%. The prevalence rate of sedentary lifestyle is higher than Indonesia's national prevalence rate. A sedentary lifestyle is an influence on and BMI in female university students in Banda Aceh, Indonesia.

Keywords— sedentary, lifestyle, physical activity, female, Banda Aceh.

1. Introduction Regular physical activity has a good impact on global health, decreases mortality and morbidity otherwise physical inactivity or sedentary lifestyles contribute to the global burden of .[1,2] A sedentary lifestyle is defined as any waking activity characterized by low energy expenditure (metabol1.5 metabolic equivalents), a or reclining posture, and runs every day in less than 5000 steps.[3,4] Sitting position for a long time more than 3 hours is included in the sedentary lifestyle. A sedentary lifestyle is emerging as an independent risk factor for human health and metabolic disease.[5–7] Sedentary lifestyles include people who work in long-term sitting positions (>3 hours) such as school workers (teachers and lecturers), university students, car drivers, and watching television, playing video games, using computers).[2]

Sedentary lifestyle is a major public health issue in almost all countries of the world, including in Indonesia.[1,8] Physical inactivity is responsible for more than five million globally per year.[1] The sedentary lifestyle is a priority issue of the Indonesian government today because of its effect on the global burden on health issues.[6,9] Changes in people's lifestyle towards sedentary lifestyles have an impact on the increasing population of people with sedentary lifestyles. A sedentary lifestyle contributes greatly to the incidence of metabolic syndromes (METS) such as , type 2 , , and 519

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dyslipidemia.10,11 Sedentary lifestyle is a single risk factor for the occurrence of .12,13 An increased sedentary lifestyle is an effect on increasing body weight and contributing to risk factors of obesity.[7,13]

Physical activity is related to lower obesity risk and better fitness, bone health, and cognitive performance.[1,14,15] Being active lowers the risk of METS, colon , and in adults.[1,16] Data on the prevalence of sedentary lifestyles in the adult age group (>18 years) in Indonesia and Aceh are not known. Basic Health Research from the Ministry of Health of the Republic of Indonesia reports that the prevalence of obesity in adults in Indonesia from year to year increases dramatically.[8] It was reported that the prevalence of obesity in adults in Indonesia in 2007 was around 13.9%. The prevalence of obesity increased from 13.9% to 15.5% in 2010 and dramatically doubled to 32.9% in 2013. Increasing the prevalence of obesity which has doubled over 3 years is likely due to changes in the lifestyle of Indonesian people from active lifestyles to a sedentary lifestyle.[8] The prevalence of obesity in Indonesia was higher in women compared to men and the high prevalence of obesity is thought to relate to the increasingly sedentary lifestyle.[17] We think that there is a need for accurate data on the prevalence of sedentary in adults as a basis for taking preventive measures to prevent a surge in an and obese population. This study aims to determine the prevalence of sedentary lifestyle and its effect on body weight and BMI in female university student in Banda Aceh, Indonesia.

2. Materials and Methods This is a prevalence survey study. The design used was a cross-sectional study. Total participants in this study were 865 Universitas Syiah Kuala students. Participants were female, aged between 18-20 years old, healthy and volunteered to be a participant. The sample size was determined based on total population sampling. The total population was 1200 students, male (n=335) and female (n=865). All participants lived in the student dormitory of Universitas Syiah Kuala. This study had received ethical approval from the Health Research Ethics Committee of the Faculty of Medicine at the Universitas Syiah Kuala in Banda Aceh, Indonesia with an ethics approval letter number 03/EA/FK-RSUDZA/2018. This study has conducted a survey using a questionnaire consisting of several questions. Questions are answered in writing on the answer sheets provided by the researcher. All participants were volunteers as research samples. Written informed consent was obtained from all participants who participated in this study.

Data collection was carried out from February-April 2019. All participants were measured anthropometric consisted of weight, height, and BMI. Weight measurements were carried out using a weight scale. Height measurement was carried out using a height scale. BMI is determined using the BMI calculation formula. Data analysis was performed using descriptive analysis and parametric statistics with independent sample t- test (p<0.05).

3. Results The results showed that the number of female students with a sedentary lifestyle in Banda Aceh was 38.61%, as shown in Figure 1. This prevalence is higher than the national prevalence rate in Indonesia (21%). The cause of the high prevalence of sedentary lifestyle in Banda Aceh was not investigated therefore it is necessary to do further research to be able to provide a solution to decrease the incidence of a sedentary lifestyle.

Analysis of differences in age and anthropometric values (weight and BMI) between sedentary and non- sedentary female students were performed using independent sample t-test (p<0.05), as shown in table 1. There were no significant differences from age between sedentary and non-sedentary groups (p=0140). There 520

ISSN: 13412051 Volume 25, Issue 02, February, 2020 was a significant difference in body weight (p=0.001) and also the BMI (p=0.003) between the sedentary and non-sedentary female students. This study showed that sedentary lifestyle influences weight gain and BMI in young women. 61.39%

38.61% Total (%) Total

Life Style

Figure 1. Number of female students with sedentary and non-sedentary lifestyles

Table 1. Differences in age, body weight and body mass index between the sedentary and non-sedentary groups Group Variable Sedentary Non-sedentary p-value Mean±SD Mean±SD Age (year) 18.21±0.77 18.13±0.76 0.140 Weight (kg) 52.27±8.94 50.32±8.26 0.001* Height (m2) 156.12±6.83 155.58±6.09 0.229 Body Mass Index (kg/ m2) 21.45±3.44 20.60±3.05 0.003* *Significantly at the level of error of 5% (p<0.05)

Table 2. Types of physical activity, duration of physical activity and frequency of physical activity per week in young female non-sedentary

Outcome Frequency Percentage (%) (n=531) Types of physical activity Gymnastics 99 19% Jogging 53 10% Walking 379 71% Total 531 100% Duration of physical activity <30 Minutes 249 47% 30-45 Minutes 214 40% 60 Minutes 39 7% >60 Minutes 29 5% Total 531 100% The frequency of physical activity per week 2x/week 208 39 3x/week 198 37 >3x/week 125 24 Total 531 100%

Table 2, shows that the type of physical activity most commonly done by young women in Banda Aceh is walking. This is likely because the subject of this study uses female students who live in the dormitory and do not have private transportation; therefore, walking is the choice to go to campus. Besides the cost savings, 521

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the possibility for public transport at least in Banda Aceh, forcing students to walk into a place of learning. Table 2 also shows that the duration of physical activity most students do is less than 30 minutes per physical activity. The duration of physical activity required to improve health is about 30-60 minutes for each session of physical activity. The highest frequency of physical activity carried out by female students is with a frequency of 2 times a week and the least is >3x/week.

4. Discussion We found that the prevalence of sedentary lifestyles in young women in Banda Aceh is higher than the national prevalence in Indonesia. The Indonesian government's program of the Healthy Living Movement (GERMAS) which is being promoted today through television and print media has not succeeded in changing the lifestyle of the Indonesian people from a physical inactivity lifestyle to an active lifestyle. Increasing the prevalence of population with a sedentary lifestyle in Indonesia affects increasing health problems such as the double burden of disease (infectious and non-communicable diseases). A sedentary lifestyle also has an impact on the occurrence of epidemiological transitions in Indonesia. The Ministry of Health of the Republic of Indonesia states that non-communicable diseases with the highest rank in 2015 are cancer, coronary heart disease, stroke, and diabetes. Non-communicable diseases are closely related to overweight and obesity. A sedentary lifestyle is one of the factors causing the increase in non-communicable diseases (NCDs) in Indonesia.[18] The sedentary lifestyle has an impact on the increased morbidity and mortality from cardiovascular disease.[19] Sedentary is a single risk factor for chronic diseases such as psychological distress, colon cancer, diabetes, heart disease, hypertension, diabetes, and obesity.[20]

Someone has a sedentary lifestyle if more than 3 hours per day in a sitting position.[21] A full class schedule (8-10 hours/day) was allegedly one reason for the increasingly sedentary lifestyle on the students, but need further study. The results of our study found that sedentary lifestyles in young female affect the increase in body weight and BMI, but weight gain is still in the normal range. A sedentary lifestyle is positively correlated with increased BMI. [17,21–23] Chronic weight gain is an impact on increasing the risk of overweight and obesity.24,25 Based on data from the Ministry of Health of the Republic of Indonesia, the prevalence of obesity in Indonesia and Aceh is increasing every year. The prevalence of obesity in various countries including in Indonesia is more in adult women compared to men. [17,18]

Obesity is a serious health problem due to complications and comorbidities such as hypertension, diabetes mellitus, cancer, heart and blood vessel disease, stroke, hypercholesterolemia, dyslipidemia, and renal dysfunction.9,17,26,27 Obesity and physical inactivity are the causes of increasing global mortality rates around 5-6%.28 In line with the increasing prevalence of a sedentary lifestyle, it is predicted that the prevalence of overweight and obesity in the world in adults in 2030 will reach 2 billion.29 Physical activity for 30-60 minutes per day, 2-3 times/week with mild-moderate intensity can reduce the risk of weight gain and obesity.[17,28,30].

5. Conclusions We conclude that the prevalence of female university students with a sedentary lifestyle is high in Banda Aceh, Indonesia. The physical activity most often committed by female university students were walking, the frequency of physical activity is at most 1 time/day and as much as >3 times/week. The most duration of was <30 minutes/physical activity. A sedentary lifestyle is an influence on weight gain and BMI in young women.

6. Conflict of Interests 522

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We declare that there is no conflict of interest in this publication.

7. Author’s Contribution YY designed, conceived, conducted study, and collected data. AA provided study material, analysis data and reviewed paper. RR study implementation, provided logistic support. NLS collected data, interpreted the data and review paper. All authors are responsible for the similarity index and all content of this article.

8. Acknowledgement This project was supported and funded by Universitas Syiah Kuala Banda Aceh, Indonesia. We would like to thanks to all the volunteer participants for their support and cooperation in the implementation of this research.

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