Journal of Economic & Management Perspectives,2018, Volume 12, Issue 1,459-463.

Relationship Knowledge and Attitude About Fast Food with Obesity

on Teenagers

Rosihan ADHANI*
Faculty of Medicine, Lambung Mangkurat University, Jl. Ahmad Yani Km. 36,3,
Banjarbaru 70714, South Kalimantan Indonesia. [email protected].

Qomariyatus SHOLIHAH
Faculty of Medicine, Lambung Mangkurat University, Jl. Ahmad Yani Km. 36,3,
Banjarbaru 70714, South Kalimantan Indonesia.

Alfian YUSUF
Health Polytechnic Banjarmasin, Ministry of Health, Jl. H. Mistar Cokrokusumo,
Banjarbaru 70714, South Kalimantan, Indonesia.

ABSTRACT

The purpose of this study is to determine the relationship between knowledge and attitude about fast food with
obesity on teenagers in Banjarbaru City, South Kalimantan Province. This study is observational analytic with
cross-sectional design. The population in this study were junior high school students in Banjarbaru City, school
sample taken by simple random sampling with sample obtained 150 people. The results using chi-square test shows
significant relationship between knowledge and obesity on teenagers and significant relationship between attitude
and obesity on teenagers. The teenagers are advised to reduce consumption of fast foods. Fast food is not good for
health and can lead to obesity and other degenerative diseases. Schools need to provide information to students
about healthy eating and providing books on healthy eating at the Library. In addition, schools must ensure the
type of food sold in the school canteen is healthy food and to the parents for more attention to the food intake of
their children.

JEL Classification: D83; L66.

Keywords: Knowledge; Attitude; Fast Food; Obesity.

* Corresponding author.

1. INTRODUCTION

Currently in Indonesia have occurred multiple nutritional problems. The problem of malnutrition still not over yet,
while it appeared more nutritional problems. Excessive consumption of carbohydrates causes obesity. Obesity is
caused by an imbalance between energy intake with the amount of energy needed by the body for a variety of
biological functions such as physical nourishment and energy to move. Obesity occurs when the body mass index
(BMI) of children who are above the 95th percentile on growth charts and development of children according to
gender. Obesity can be experienced by all ages from toddlers to adults. But in this study are discussed in teenagers
aged 12-14 years. Adolescent period is a time of fun, but also a critical and difficult period, because it is a period
of transition from childhood to adulthood, marked by changes in physical, mental, and psychosocial. Obesity
during adolescence will cause health problems in adulthood such as diabetes mellitus, hypertension and high
cholesterol. The cause of obesity is very diverse. Factors that can lead to obesity are environmental factors, genetic,
psychological, health, medicine and physical activity. Environmental factors play an important role.
Environmental factors include lifestyle and diet (Indriani et al., 2014).

Fast food can affect the body's energy levels. Fast food does not contain the nutrients needed by the body. This
makes the body tired in carrying out daily activities. High levels of sugar in fast food makes the body's metabolism
is not controlled, when eating simple sugars, the pancreas secretes insulin in high quantities in order to prevent an
increase in blood sugar levels. Fast food contributes to obesity, fast food contain lots of fat. Obesity in Indonesia
began with the increasing number of events. Based on data from Health Research Association in 2007. The
prevalence of obesity and overweight according to BMI for age ≥15 years were 10.3% and 8.8%.

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 Journal of Economic & Management Perspectives,2018, Volume 12, Issue 1,459-463.

Data from the Health Research in 2010 showed the prevalence of obesity in Indonesia among persons aged> 15
years in males 13.9% and females 23.8%, whereas in children aged 6-14 years in men 9.5 % and females 6.4%.
Data from the Health Research of Ministry of Health of Indonesia (2013), shows the national obesity problem at
the age of 5-12 years is still high at 18.8%, 10.8% consists of overweight and 8.8% obese. While the prevalence
of obese teenagers aged 13-15 amounted to 10.8%, consisting of 8.3% overweight and 2.5% obese. World Health
Organization (WHO) (2016) estimates that in the world there are about 1.6 billion teenagers are overweight and
400 million obese people (obese) and more than 700 million adults will be obese (overweight) in 2015.

2. LITERATURE REVIEW

Sturm and Ruopoeng (2014) mention that the pathogenesis of obesity are known to be multifactorial, including
genetic factors and environmental factors that influence in terms of weight, metabolism and eating behavior. Food
intake is one of the causes of obesity especially those containing high calories and fat. Examples of food high in
calories and fat is fast food. Teenagers need to get the attention of their parents in choosing food. Many fast food
is high in calories, fat, sugar, and sodium (Na), but low in vitamins A, ascorbic acid, calcium, and fiber. The food
selection is important to note by teenagers. The habit of eating fast food can lead to obesity. Food intake is almost
instantaneous, soft drinks, snacks such as burgers, pizza, hot dogs, kebabs, sausages contribute in causing obesity.
This is compounded by the habit of eating less healthy foods with a high caloric content without the consumption
of vegetables and fruits as a source of fiber (Nugraha, 2009).The prevalence of obesity in teenagers has increased
in many countries, including Indonesia. The high prevalence of obesity in teenagers is caused by the growth of
urbanization and lifestyle changes, including energy intake. According to the WHO, 1 million children under 5
years of age are affected by being overweight or obese (defined as the proportion of children with weight-for-
height value z-score of more than 2 SD and more than 3 SD, respectively, WHO growth of average standard.

In 2014, children under age 5 who are overweight, 48% live in Asia and 25% in Africa. Children of overweight
and obese live in countries of low and middle-income countries than in high-income countries. Prevalence data
are available for children and teenagers are currently being verified and will be released by the WHO in 2016.
Sukma, and Margawati (2014) found a significant link between diet and obesity. Obesity can occur because of an
imbalance between energy intake with energy needs. There are three causes of obesity are physiological factors,
psychological factors, and factors of accidents. Based on the results of preliminary studies in Banjarbaru City
prevalence of obesity tended to increase both in children and adults. Students who are overweight complain, they
get annoyed when learning takes place because often feel hungry and sleepy. In the afternoon, after school most
of them do not actively participate in extracurricular activities because they feel tired, lacking in confidence and
lazy. This study aims to determine the relationship between knowledge and attitudes about fast food with obesity
in teenagers aged 12-14 years.

3. METHODOLOGY

The study method was observational analytic with cross sectional design. The population in this study were junior
high school students in the Banjarbaru City, while school sample taken by simple random sampling. Samples of
students with the criteria for having a body mass index (BMI)> 25, is a junior high school students grade II-III,
age 12-14 years. Based on predefined criteria obtained 150 samples consisted of 75 samples of male and 75 female.
The data collection is done by filling in a spreadsheet to identify the identity of the respondents, the data on weight
and height as well as questionnaires to measure knowledge and attitudes about fast food respondent. To determine
the knowledge and attitude of the respondent then set the measurement scale with the technique of choice is right
or wrong with the number of 10 questions. Knowledge and attitudes measured by providing answers to the
questionnaire that was assessed. Every question gets a value of 2 for a correct answer and 0 for a wrong answer.
Based on the obtained value from the respondents can be categorized as follows:

a. High/Positive if the total value 11-20.

b. Low/Negative if the total value 0-10.

Data collection is done in the classroom and the weight and height measurements carried out in the school health
unit. The study was conducted in January and February 2016. The data collected is processed by steps as follows:

1. Editing: Editing is done to check the completeness of the answers on the sheet and questionnaire.

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2. Coding: The data has been collected, corrected each category, such as gender, status of obesity, fast food eating
habits, knowledge and attitudes.

3. Entry data: The data has been collected incorporated into the master data to conduct further analysis of the data
by using a computer program.

Data analysis was performed using the statistical computer programs and can be described as follows:

a. The univariate analysis

Data were analyzed descriptively and then presented in a frequency distribution table.

b. The bivariate analysis

Statistical methods used in this study is Chisquare test with significance level α = 0.05.

3. RESULTS AND DISCUSSION

Based on Table 1 can be seen most respondents had low knowledge (69.3%), 64% of respondents have negative
attitudes and 53,3% respondets is obesity.

Table 1. Overview of Knowledge, Attitudes and Obesity

Knowledge Total Percentage (%)

High 46 30,7
Low 104 69,3
Attitudes Total Percentage (%)
Positive 54 36
Negative 96 64
Obesity Total Percentage (%)
Yes 80 53,3
No 70 46,7
Total 150 100

The results using chi-square test showed there is relationship between knowledge and attitudes with obesity with
the p-value <0.05, as shown in Table 2.

Table 2. Relationship of Knowledge, Attitudes and Obesity

Knowledg Obesity Total P

e Yes % No % Total % Value
High 10 21,7 36 78,3 46 100
0,015
Low 70 67,3 34 32,7 104 100
Obesity Total P
Attitudes
Yes % No % Total % Value
Positive 13 24,1 41 75,9 54 100
0,000
Negative 67 69,8 29 30,2 96 100

The results using chi-square test showed there is relationship between knowledge with obesity In the results, the
majority of respondents (69.3%) had low knowledge and 78.3% of them had obesity. Based on cross tabulation
table can be seen that from the 46 respondents who have a high knowledge about fast food, 78.3% of them did not
obesity, whereas of the 104 respondents who had low knowledge about fast food, 67.3% had obesity. The level of
students' knowledge in selecting a street food affect the attitude in choosing snack foods consumed, with good
knowledge, it is expected students will choose a healthy snack food and nutritionally balanced (Bingham et al.,
2012). Efforts to prevent and manage obesity in adulthood and teenagers usually emphasize information /
knowledge of nutrition, namely, the right selection of snack foods and calorie reduction methods. The assumption
underlying this approach is that a lack of understanding or lack of knowledge can lead to weight gain. One of the
factors that influence obesity is the knowledge about the nutritional value of less.

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Obesity in teenagers is important to note because teenagers who get obesity 80%, obesity likely to experience
obesity as well as adults. In addition, an increase in obesity teenagers are diagnosed with a disease condition that
commonly experienced by adults, such as type 2 diabetes and hypertension (Damopolii et al., 2013). Obesity on
teenagers throughout life are also at higher risk of developing a number of serious health problems, such as heart
disease, stroke, diabetes, asthma, some cancers and the others. Obesity also brings psychological and social
consequences on teenagers, including an increased risk of depression because more often rejected by their peers
and teased and ostracized because of their weight. This fact is consistent with the Notoadmodjo theory which states
that a person whose level of new knowledge to the initial level that know could mean someone remember the
material that has been studied before, but it does not mean that someone is level application which means that a
person has the ability to apply the material learned in real situation or condition in life. Knowledge can be a good
guideline to maintain a healthy body and maintain ideal body weight. The importance of promotion efforts in
dealing with obesity is done by giving knowledge about positive body image. The ability to filter information from
the mass media are also important things that should be imparted to the public so that they can get the right
information from the mass media (Ellulu et al., 2014).

Notoatmodjo also said that changing behavior is more difficult than knowledge because the process of formation
and behavior is influenced by many factors including internal factors (perception, motivation, knowledge) and
external factors (physical and non-physical environment such as social and economic culture). Overweight
sometimes also based on the body's tendency to store more food than it consumes. This means that the process of
metabolism is slow. The body's absorption of food, some people absorbent high calorie, though the food portions
are small, their body fat because all incoming calories can be absorbed properly. This study is in line with
Sumarcana who conduct research in American teenagers and teenagers found that there is a tendency to lower
consumption of fibrous foods fresh fruit and vegetables, are increasingly turning to canned fruit and instant juice
(Greenway, 2015). At the time of teenagers easily influenced by peers is greater than the family, teenagers are
more receptive to the influence of globalization, the influence of dietary Western (European) with a high fat intake
but low in fiber.

One of the causes of overweight in children is the choice of food is less precise, such as high-fat foods. Other
factors that may also influence consumption habits of the family. Consumption of high fat found more consumed
by the upper middle class. This can be caused, because they are more consumptive and more likely to follow the
trend which is now very much a trend that is raised high fat foods such as fast foods are very low in nutritional
value. This is according to research conducted by Nugraha (2009) at Senior High School 2 in Jember, where there
is a significant relationship between students' knowledge of fast food with fast food consumption habits that can
lead to obesity. The research was supported by research conducted by Indriani et al., (2014) on female students at
the High School Education Shafiyyatul Amaliyyah Foundation, which says there is significant influence between
predisposing factors (knowledge) to diet (protein intake level) students. During the study found that teenagers do
not recognize the impact of fast food, because they have not experienced it either from the shape of the body as
well as other health problems caused by fast food. We recommend that students should read more books on the
impact of fast food or the incidence of obesity.

The results using chi-square test showed there is relationship between attitudes with obesity, because the p-value>
0.05. Based on cross-tabulation table can be seen that out of 54 respondents who have a positive attitude about fast
food, 75.9% of them did not obesity, whereas of the 96 respondents who had a negative attitude about fast food,
69.8% had obesity. Sukma and Margawati (2014) found a positive perception of the behavior of consumption of
fruits and vegetables that are still lacking on obesity children. The results of Sturm and Ruopoeng (2014) study
also said the cause of obesity is the low consumption of vegetables and fruits, because fruits and vegetables are
low-calorie diet, rich in fiber, vitamins, and minerals to maintain health and maintaining normal body weight.
According to Ellulu et al., (2014) demonstrated a significant relationship between diet and the incidence of obesity
in children with the strength and direction of relationship is a positive relationship, which means increased
consumption of high fat foods has been rising BMI. In accordance with the characteristics of school-age children
in the choice of food is based on the likes and dislikes about food.

However, with the availability of fast food restaurants, the influence of the mass media and the temptation of a
variety of food "junk food" is very large, allowing children to consume high-calorie foods that do not enhance
growth, such as sugar, starch, and fat overload. Easy availability of high-calorie foods combined with a tendency
to lack of physical activity that involves gestures into the factors that play a role in the increased prevalence of
obesity in school-age children. The attitude is influenced by internal factors (derived from the self) and external
factors (which come from outside). Attitude is a reaction or response from someone who is still closed to the
stimulus or object.
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Attitude makes a person towards or away from another person or other objects, but a positive attitude or supportive
of health values are not always materialize in concrete actions. The formation of an attitude influenced by factors
such as personal experiences, the influence of others that are considered important, cultural influences (socio-
cultural), mass media, educational institutions and religious institutions, and emotional factors. The attitude of a
person does not always manifest in the form of deeds or actions.

5. CONCLUSIONS

The purpose of this study is to determine the relationship between knowledge and attitude about fast food with
obesity on teenagers in Banjarbaru City, South Kalimantan Province. The results showed there is a relationship
between knowledge and attitudes to obesity in teenagers. Most teenagers with a low knowledge have excessive
eating habits because they do not know the impact of overeating. This is indicated by a body mass index that is
not normal. Most teenagers who have a negative attitude in the sense not of the type and amount of food eaten also
has a body mass index that is not normal.

Acknowledgement

The authors are grateful for the help and guidance of all Junior High School in Banjarbaru City.

REFERENCES

Bingham, CML., Koski, ML., Puukka, P., Kinnunen, M., Jallinoja, P., & Absetz, P. (2012), Effects of a healthy
food supply intervention in a military setting: positive chages in cereal, fat and augar containing foods,
International Journal of Behavioral Nurition and Physical Activity, 9 (91), pp. 1-11.

Damopolii, W., Mayulu, N. & Masi, G. (2013), Relationship fastfood consumption with the incidence of obesity
in elementary school children in the City of Manado Nursing Ejournal (e-Kp), 1(1), pp. 1-7.

Ellulu, M., Abed, Y., Ranneh, Y., & Ali, F. (2014), Epidemiology of obesity in developing countries: challenges
and prevention. Global Epidemic Obesity, 2(2), pp. 1-6.

Greenway, F. L. (2015), Physiological adaptations to weight loss and factors favouring weight regain. International
Journal of Obesity, Vol. 39, pp. 1188-1196.

Indriani, S. D., Chandra, F., & Masdar, H. (2014), The relationship between knowledge and attitude with the
incidence of obesity in the regional secretariat employees Riau Province, JOM FK, 1(2), pp. 1-6.

Nugraha, G. I. (2009), Etiology and Patofisiology Obesity, Soegih R R, dan Wiramihardja, K. K. Jakarta: Sagung
Seto, pp. 9-18.

Sturm, R. and Ruopoeng, A. (2014), Obesity and Economic Environments, Ca Cancer J Clin, 64(5), pp. 337-350.

Sukma, D. C. and Margawati, A. (2014), The relationship of knowledge and attitude in choosing food snacks with
obesity on teenagers in Senior High School 2 Brebes, Journal of Nutrition College, 3(4), pp. 862-870.

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