Risk factors for nutrition-related chronic disease among adults in Indonesia

Objective: To conduct a secondary data analysis detailing the associations between sociodemographic and behavioral factors and nutrition-related chronic disease. Methods: These analyses utilized 2014 data from the Indonesian Family Life Survey, a home-based survey that collected socioeconomic, dietary intake, physical activity, and biological data among adults. We explored four outcomes in relation to sociodemographic and behavioral determinants: 1) hypertension, 2) elevated high-sensitivity c-reactive protein (hs-CRP), and 3) central obesity, as these are critical metabolic determinants in the progression to cardiovascular disease, and 4) type 2 diabetes. Hypertension was defined as systolic blood pressure ≥140 mm or diastolic blood pressure ≥ 90mm or current use of antihypertensive medication. Elevated hs-CRP was defined as hs-CRP >3 mg/dL. Central obesity was defined as waist circumference ≥ 90 cm if male and waist circumference ≥ 80 cm if female, which are specific to South Asia. Type 2 diabetes was defined as glycated hemoglobin ≥ 6.5%. We employed separate gender-stratified multivariate logistic regression models to test the associations between sociodemographic and behavioral determinants and each nutrition-related chronic disease outcome. All analyses employed sampling weights, which account for the survey design. Results: In 2014, about 30% of adults were hypertensive and one-fifth had elevated hs-CRP. Approximately 70% of women had central obesity and 11.6% of women and 8.9% of men had diabetes. Older-age was consistently associated with nutrition-related chronic disease and being overweight was associated with hypertension, elevated hs-CRP, and type 2 diabetes. Regularly consuming instant noodles (women) and soda (men) were associated with elevated hs-CRP and soda consumption was associated with central obesity among men. Conclusions: Large segments of the adult population in Indonesia now have or are at risk for non-communicable disease. Our analyses provide preliminary empirical evidence that interventions that target healthful food intake (e.g. reduce the intake of ultra-processed foods) should be considered and that the reduction of overweight is critical for preventing chronic diseases in Indonesia.