Rapid development in the urbanisation process is linked to a shift in dietary intake and lifestyle. The locality may also determine the differences in socio-demographic and environmental factors related to nutrition between the rural and urban populations. The present study aimed to determine prevalence of obesity and to compare the body weight status on body weight status among school adolescents aged 10 to 17 years within districts of Terengganu. A cross sectional survey involving school adolescents aged 10 to 17 years from all government school in seven districts in Terengganu were carried out. Anthropometrics data were obtained from National Fitness Standard (SEGAK) assessment which was uploaded into specific developed database Health Monitoring System (HEMS) and BMI were classified using WHO BMI-for-age z-score. A total of 62,567 school adolescents were involved in this study. Girls had significantly higher BMI than boys in age groups of 13 to 15 and 16 to 17 years old. There were significant differences in mean BMI between rural and urban school locations school adolescents in all age groups (P <0.001) among boys and girls. Significant differences were also found between rural and urban school location in 10 to 12 years old in Dungun and Marang, whilst Kemaman and Kuala Terengganu districts had significant difference between rural and urban in 16 to 17 years old age group. Marang had the highest obesity prevalence within urban 15.3% school location whilst rural school location within Kuala Terengganu had the highest prevalence of obesity (14.1%). The obesity prevalence increased substantially regardless of school locations compared to previous years. School adolescents in both rural and urban have an equal prevalence of obesity suggesting that intervention and prevention programme should be targeting in both locations. Future studies should look at the association between the potential risk factors to tackle this problem from the origin.
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