Factors associated with body weight status among adolescents in Labuan Federal Territory, Malaysia

The prevalence of overweight and obesity among adolescents in developing countries are increasing including Malaysia. A cross-sectional study was conducted to determine socio-demographic characteristics, lifestyle factors, body image perception, family environment and built environment factors associated with body weight status (BMI for- age) among adolescents in Labuan Federal Territory, Malaysia. The study involved 481 secondary school Malaysian students aged 12-17 years. Information on socio-demographic characteristics, lifestyle, body image, family environment and built environment were collected using self-administered questionnaires. Body weight and height of the students were measured using standard procedures while BMI-for-age z-score (BAZ) was determined using WHO Growth Reference 2007. One day 24-hour dietary recall was obtained by face-to-face interview. The buffer analysis was conducted using Geographic Information System (GIS). A majority of the respondents were female (67.4%), Malays (55.0%), from rural schools (55.7%) and had achieved pubertal status (95.7%). The prevalence of overweight and obesity among the respondents was 33.1% (Males: 30.7%; Females: 34.3%), with mean BAZ of the respondents was 0.36±1.46 SD. A majority of the respondents skipped main meals (83.6%), skipped breakfast (68.6%) and snacked between meals (96.9%) daily. About half of the respondents skipped lunch (47.9%) and skipped dinner (49.8%). A total of 28.3% of respondents were at high risk of eating disorders. About three in four respondents were dissatisfied with their body size (73.3%). The mother’s mean BMI and father’s mean BMI were 26.5±5.6kg/m2 and 25.9±4.9kg/m2, respectively. A majority of the respondents did not have fast food outlets within the 500m (95.2%), 1000m (85.2%) and 1500m (79.0%) buffer of their homes. All respondents (100%) did not have fast food outlets within a 500m buffer of their schools. Bivariate analyses indicated that energy intake (r=0.274, p<0.001), higher frequency of eating outside home (r=0.145, p=0.038), not snacked morning tea (t=2.126, p=0.035), not snacked afternoon tea (t=2.414, p=0.017), not snacked supper (t=2.073, p=0.039), higher disordered eating score (r=0.212, p=0.002), dissatisfied body size (t=2.451, p=0.015), higher mother’s BMI (r=0.216, p=0.002), higher father’s BMI (r=0.249, p=0.001), less parental pressure to eat (r=-0.210, p=0.003), perceived higher parent weight (r=0.174, p=0.013), perceived higher teen weight (r=0.364, p<0.001) and were significantly associated with higher BMI-for-age of the respondents. Further, multiple linear regression indicated that being female (β=1.064), higher energy intake (β=0.409), higher disordered eating score (β=0.017), higher body size dissatisfaction (β=0.190), higher father’s BMI (β=0.052), less parental pressure to eat (β=−0.304) and perceived higher teen weight (β=1.020) significantly contributed towards higher BMI-for-age of the acceptable diet reporting respondents at p<0.05 level of significance explaining 41.1% of the variances in BMI-for-age (R2=0.411, F=19.545, p