BMI-for-Age Z-Score, Waist-to-Height Ratio, and Physical Activity Across High School Grades in West Aceh
Abstract
Adolescent nutritional status and physical activity may vary across school grades, yet evidence integrating BMI-for-age z-score (BAZ), waist-to-height ratio (WHtR), and physical activity among Indonesian senior high school students remains limited. This study aimed to compare BAZ, WHtR, and physical activity across Grades 10, 11, and 12 at SMA Negeri 3 Meulaboh, West Aceh, Indonesia. An analytical cross-sectional study included all 158 students in the defined population through complete enumeration. Physical activity was assessed using an adapted IPAQ-SF-derived seven-day recall and expressed as a study-specific score in MET-minutes/week. BAZ was calculated using WHO AnthroPlus according to the WHO 2007 Growth Reference, and WHtR was derived from waist circumference and height. Physical activity and WHtR were compared using Kruskal–Wallis tests with Bonferroni-adjusted Mann–Whitney U comparisons, while BAZ was analyzed using one-way ANOVA with Tukey HSD. Median physical activity scores were 2965, 1647.5, and 1127.5 MET-minutes/week in Grades 10, 11, and 12, respectively (H(2)=54.595, p<0.001, ε²=0.339), with all pairwise comparisons significant after correction. Median WHtR values were 0.528, 0.520, and 0.460, respectively (H(2)=44.445, p<0.001, ε²=0.274); Grade 12 differed from Grades 10 and 11, whereas Grades 10 and 11 did not differ after correction. Mean BAZ values were −0.136, −0.177, and −0.669, respectively (F(2,155)=3.163, p=0.045, η²=0.039), but no Tukey-adjusted pairwise comparison was significant. Physical activity showed the clearest between-grade pattern, WHtR differences were concentrated in Grade 12, and evidence for BAZ differences was weaker. These findings represent cross-sectional between-grade differences and should not be interpreted as developmental or causal effects of advancing school grade.
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