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"Latar Belakang : Prevalensi obesitas pada populasi dewasa di dunia pada tahun 2014 hampir mencapai 13, sementara di Indonesia telah mencapai 32,9 pada tahun yang sama. Obesitas merupakan faktor risiko berbagai penyakit tidak menular yaitu diabetes tipe 2 ataupun penyakit kardiovaskular. Sebagian besar orang yang berhasil menurunkan berat badan gagal mempertahankannya dan mengalami kenaikan berat badan berulang weight cycling. Berbagai penelitian tentang program diet memberikan hasil yang berbeda-beda. Tujuan dari penelitian ini adalah untuk mengevaluasi perubahan komposisi tubuh dengan diet kalori rendah protein tinggi dibandingkan dengan protein standar pada penyandang obesitas dengan riwayat weight cycling. Metode: Penelitian ini merupakan uji coba klinis acak terbuka pada penyandang obesitas dengan weight cycling. Sebanyak 61 penyandang obesitas mengikuti penelitian ini. Subjek diberikan diet kalori rendah dan secara acak didistribusikan ke dalam dua kelompok intervensi, yaitu kelompok protein tinggi 22 ndash;30 dari total asupan kalori dan kelompok protein seimbang 12 ndash;20 . Antropometri dan data komposisi tubuh diambil pada awal dan akhir penelitian. Subyek diikuti hingga 8 minggu, diberikan buku catatan makan harian dan konseling seminggu sekali. Hasil: 54 peserta menyelesaikan penelitian. Terdapat penurunan yang signifikan dalam berat badan dan indeks massa tubuh IMT , massa lemak, persentase massa lemak, massa otot, dan kenaikan persentase massa otot terjadi pada kedua kelompok protein seimbang: p

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Background: The world prevalence of obesity in the adult population in 2014 was nearly 13 while in Indonesia, it has reached 32.9 in the same year. Obesity is an established risk factor for cardiovascular diseases. A large proportion of people who had succeeded to reduce body weight failed to maintain it and underwent weight gain repeatedly weight cycling. Studies have been inconclusive about the best diet programme for such people. The purpose of this research was to evaluate the body composition changes resulting from low calorie high protein and standard protein diet programme in obese people with a history of weight cycling.

Methods: This is an open randomized clinical trial of a weight loss program in obese individuals with weight cycling. A total of 61 adult obese individuals with a history of weight cycling were recruited. Subjects were assigned to a low calorie diet and were randomly distributed into two intervention groups, namely high protein group 22 ndash 30 of total caloric intake and standard protein group 12 ndash 20. Anthropometry and body composition data were taken at baseline and at the end of the study. Subjects were followed up to 8 weeks, with daily reminders and weekly counselling.

Results: 54 participants completed the study. Significant reductions in body weight and body mass index BMI , fat mass, fat mass percentage, muscle mass, and gain in muscle mass percentage occurred in both groups Standard protein p"

"Obesitas merupakan masalah yang umum terjadi di dunia. Sebanyak 12,8 persen penduduk berusia 18 tahun ke atas di Indoensia menyandang berat badan berlebih. Dari angka tersebut, 20,7 persen penyandang obesitas. Obesitas dapat meningkatkan risiko penyakit kronis seperti penyakit hipertensi, kardiovaskular, dan penyakit tidak menular lainnya. Untuk mengatasi obesitas, dilakukan penurunan berat badan dengan berbagai cara. Namun, penurunan berat badan pada penyandang obesitas sering naik kembali dan tidak bisa dipertahankan pada hasil penurunan tersebut. Hal ini disebut sebagai weight cycling. Pada keadaan weight cycling, massa lemak lebih rendah dari massa bebas lemak yang ada di dalam tubuh. Hal ini meningkatkan risiko penyakit kardiovaskular dan diabetes mellitus tipe 2. Untuk mengatasi weight cycling, dianjurkan diet yang teratur. Diet kalori rendah protein tinggi sering dianggap dapat menurunkan berat badan dengan hasil yang memuaskan. Pada subjek obesitas, terjadi hipoksia pada jaringan lemak. Keadaan ini meningkatkan kemungkinan terjadinya stres oksidatif. Tujuan: Penelitian ini bertujuan untuk mengetahui perbedaan aktivitas antioksidan SOD total plasma yang diukur pada subjek penyandang obesitas dengan weight cycling pada kelompok yang diberi edukasi diet kalori rendah protein tinggi dengan diet kalori rendah protein standar. Metode: Subjek adalah karyawan Pusat Pelayanan Kesehatan di Balai Kota DKI Jakarta yang berumur 20-50 tahun penyandang obesitas dengan weight cycling. Subjek dibagi menjadi kelompok kontrol yang mendapatkan edukasi diet kalori rendah protein standar dan kelompok perlakuan yang mendapatkan edukasi diet kalori rendah protein tinggi. Aktivitas SOD diukur setelah subjek mendapat perlakuan selama 8 minggu. Hasil: Hasil penelitian menunjukkan tidak terdapat perbedaan aktivitas SOD total plasma yang bermakna antara kelompok subjek yang diedukasi diet kalori rendah protein tinggi dengan diet kalori rendah protein standar. Kesimpulan: pemberian edukasi diet protein tinggi dan standar tidak mempengaruhi aktivitas SOD total plasma pada subjek obesitas dengan weight cycling.

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Obesity is a common problem around the globe. In Indonesia, 12.8 percent of above 18 years old population has excess body weight. From the mentioned number, 20.7 percent counts as obesity. Obesity can increase the risk of chronic diseases such as hypertension, cardiovascular, and other non-communicable diseases. To treat obesity, several ways have been done to lose body weight. However, weight loss in obesity is difficult to retain and often comes back to the starting point. This fluctuation on body weight is called weight cycling. In weight cycling, lipid mass level is lower than free lipid mass level, which can lead to increased risk of cardiovascular disease and type 2 diabetes mellitus. Well-managed diet has been prescribed to treat weight cycling, in which low calorie high protein diet is often recommended for best result. In obesity, oxidative stress occurred in the fat tissue because of hypoxia. This study aims to observe the difference in total plasma SOD activity between the subject groups with low calorie high protein diet and low calorie standard protein diet. Methods : Subjects are 20-50 years old workers at Pusat Pelayanan Kesehatan in Balai Kota DKI Jakarta and are obese with weight cycling. Subjects are divided into the control group, which receives low calorie standard protein diet education, and the treatment group, which reveives low calorie high protein diet education. Results : The result showed no significant difference in total plasma SOD activity between the low calorie high protein diet group and low calorie standard protein group. Interpretation & conclusion : high protein and standard protein diet educations do not impact total plasma SOD activity in obese subjects with weight cycling."

"Latar Belakang: Diet kalori rendah protein tinggi dianggap dapat membantu seseorang dalam menjaga fungsi tubuhnya dibanding diet protein seimbang, khususnya pada orang dengan riwayat weight cycling. Penelitian bertujuan untuk mengetahui dampak diet kalori rendah protein tinggi terhadap aktivitas katalase. Metode: Penelitian ini dilakukan dengan menggunakan desain eksperimental dengan sampel tersimpan. 15 Sampel Plasma kelompok protein seimbang dan 14 sampel kelompok protein tinggi diperiksa aktivitas katalasenya kemudian dilakukan uji bivariat uji t tidak berpasangan. Hasil: Dari hasil perhitungan absorbsi, diketahui bahwa kualitas Plasma tersimpan kurang baik dari banyaknya hasil uji yang menunjukkan aktivitas katalase 0. Dari hasil uji t tes tidak berpasangan didapatkan tidak ada perbedaan pada aktivitas katalase Plasma subjek diet kalori rendah protein tinggi dengan diet kalori rendah protein seimbang, dengan nilai uji p=0,2275. Kesimpulan: Tidak terdapat peningkatan yang signifikan pada diet kalori rendah protein tinggi dibandingkan kontrol. Penelitian sebelumnya memiliki hasil yang berkebalikan.

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Background: Low calories high protein is believed to help body keep its function compared to balanced protein.

Objective: The study aimed to know the impact of low calories high protein diet on catalase activity compared to low calories balanced protein on subject with weight cycling obesity.

Methods: The study was conducted by using experimental method on stored sample of previous research. The sample consist of 15 subject of balanced protein group and 14 subjects of high protein group. Catalase activity data were gathered from the sample and from the data, two-samples t-test was conducted to see the difference on catalase activity.

Results: The quality of sample is compromised as there are some sample with 0 catalase activity. From the rest of the sample, two sample t test results in p=0.2275, indicating there is no difference on catalase activity between high protein diet and balanced protein diet.

Conclusion: Our research Conclude there is no significant improvement over Plasma catalase in subject on low calories high protein diet compared to control . Previous researches also give conflicting results. Thus, we need further research in this area."

"Latar belakang. Obesitas merupakan masalah kesehatan masyarakat dunia dengan prevalensi yang semakin meningkat. Obesitas meningkatan risiko sindrom metabolik dan penyakit kardiovaskular, yang diyakini akibat inflamasi dan stres oksidatif. Penurunan berat badan (BB) dengan cara diet dan olahraga merupakan strategi dasar dalam manajemen obesitas. Penyandang obesitas seringkali mengalami peningkatan dan penurunan BB yang dikenal sebagai weight cycling (WC). Penelitian menunjukkan risiko sindrom metabolik dan penyakit kardiovaskular meningkat pada WC dibandingkan dengan penyandang obesitas pemula [first encounter obesity (FEO)]. Penelitian ini bertujuan untuk menilai pengaruh program penurunan BB terhadap komposisi tubuh, petanda sindrom metabolik, petanda inflamasi dan stres oksidatif pada penyandang obesitas WC dibandingkan dengan FEO.Metode. Penelitian ini merupakan uji klinis terbuka selama delapan minggu yang dilakukan di Balai Kota DKI Jakarta. Subyek penelitian diambil secara konsekutif dan diklasifikasikan menjadi kelompok WC dan FEO. Kedua kelompok diberikan program penurunan BB yang terdiri dari pengurangan asupan energi sebesar 1000 kkal/hari dan olah raga intensitas ringan - sedang tiga kali seminggu selama 45 menit. Pengukuran antropometri dan komposisi tubuh (BB, indeks massa tubuh/IMT, massa lemak/ML, massa bebas lemak/MBL, massa otot/MO, rating lemak viseral, intracellular water /ICW yang merupakan indikator anabolisme protein ), petanda sindrom metabolik (kadar trigliserida/TG dan LP), petanda inflamasi (high sensitivity C-reactive protein/hs-CRP, interleukin/IL-6), dan stres oksidatif (F2-isoprostan) dilakukan pada awal penelitian, minggu ke-4 dan pada akhir penelitian (minggu ke-8).Hasil. Dari total 73 subyek (34 subyek kelompok WC dan 39 subyek kelompok FEO) didapatkan karakteristik yang setara dalam hal usia, riwayat obesitas pada keluarga, asupan makanan, proporsi komposisi makronutrien, dan aktivitas fisik, namun tidak terdapat kesetaraan dalam hal distribusi subyek laki-laki dan perempuan, riwayat lamanya obes. Kelompok WC memiliki ML yang lebih tinggi , MBL, MO dan ICW yang lebih rendah, serta petanda inflamasi yang lebih buruk dibanding kelompok FEO, sebaliknya kelompok FEO memiliki kadar TG, F2-isoprostan lebih tinggi daripada WC. Setelah intervensi diet dan olah raga selama 8 minggu, penurunan BB, IMT, ML, MBL, MO, rating lemak viseral dan kadar ICW pada kelompok WC cenderung lebih rendah daripada kelompok FEO (p >0,05). Penurunan LP pada kelompok WC cenderung lebih rendah daripada kelompok FEO (p = 0,23). Kadar TG pada kelompok WC meningkat, sedangkan pada kelompok FEO terjadi penurunan kadar TG, namun perbedaannya tidak bermakna (p = 0,055). Penurunan kadar hs-CRP dan IL-6 pada kelompok WC cenderung lebih besar daripada FEO (p >0,05). Penurunan kadar F2-isoprostan lebih tinggi pada kelompok FEO daripada kelompok WC (p = 0,017).Kesimpulan: Penyandang obesitas WC memiliki ML yang lebih tinggi dari FEO, disamping itu memiliki anabolisme protein yang lebih rendah, oleh karena itu program diet dan olahraga pada WC harus mempertimbangkan modalitas yang mampu meningkatkan anabolisme protein.Penyandang WC memiliki petanda inflamasi yang lebih buruk dibanding FEO, sedangkan setelah menjalani program diet dan olahraga selama 8 minggu pada penelitian ini tidak didapatkan perbedaan perubahan BB, komposisi tubuh, petanda sindrom metabolik, dan petanda inflamasi, kecuali perubahan petanda stres oksidatif yang lebih baik pada penyandang FEO.

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Background. The worldwide prevalance obesity is increasing rapidly and has become serious health burden globally. Obesity increases risks of metabolic syndrome and cardiovascular diseases which may partly caused by inflammation and oxidative stress. Effective weight loss programs include diet and exercise,and these interventions are considered as first line strategy of obesity management. Obese individuals often experience repeated cycles of weight loss followed by weight regain, which is recognized as weight cycling (WC). Several studies demonstrated that weight cycler has higher risk of metabolic syndrome and cardiovascular diseases than individuals with first encounter obesity (FEO). This study aimed to assess the effect of weight loss programs using diet and exercise on body composition, selected markers of metabolic syndrome, inflammation, and oxidative stress in obese subjects with WC and FEO.

Methods.This study was an 8-week open clinical trial held at Balai Kota DKI Jakarta. Subjects were recruited consecutively and classified into WC and FEO groups. All subjects were assigned to receive weight loss programs with the following goals: 1,000 Kcal reduction of total energy intake/day and 45-minute mild-to-moderate intensity exercise, three times a week. Antropometric and body composition (body weight/BW, body mass index/BMI, fat mass, fat free mass, muscle mass, visceral fat rating, intracellular water/ICW as indicator of protein anabolism), markers of metabolic syndrome (triglyceride/TG levels and waist circumference), inflammation (high sensitivity C-reactive protein/hs-CRP, interleukin/IL-6), and oxidative stress(F2-isoprostane)were measured at baseline, week 4, and the end of study (week 8).

Results. A total of 73 subjects consisting of 34 subjects with WC (WC group) and 39 subjects with FEO (FEO group). Both groups had similar characteristics in age, family history of obesity, dietary intakes, macronutrient composition, and physical activities; meanwhile, gender and duration of obesity were significantly different between groups. WC group had more body fat, less fat free mass, muscle mass and ICW, higher markers of inflammation than FEO group. On the other hand, TG and F2-isoprostane levels in FEO group were higher than WC group. Following 8-week intervention with diet and exercise, the reduction in BW, BMI, fat free mass, muscle mass, visceral fat rating, and ICW in WC group was comparable with FEO group (p>0.05). The reduction of waist circumference in WC group tended to be lower than FEO group (p = 0.23). Triglyceride levels in WC group increased, but it declined in FEO group. However, these differences were not statistically significant(p= 0.055). The decline in hs-CRP and IL-6 levels in WC group tended to be higher than FEO group (p>0.05). Meanwhile, the decrease in F2-isoprostane levels in FEO group was significantly higher than WC group (p=0.017).

Conclusion.Obese subjects with WC had more body fat but lower protein anabolic capacity than those with FEO. These results suggest that diet and exercise program for weight cycler should consider effective ways to enhance protein anabolism.In addition, obese subjects with WC had higher inflammatory process than those with FEO.Using the current model of 8-week intervention with diet and exercise, this study was not able to demonstrate differences between WC and FEO groupsin the magnitude of changes in body composition and inflammation indicators, except oxidative stress indicator."

"Tujuan : Mengetahui pengaruh pemberian diet rendah kalori seimbang selama 14 hari terhadap berat badan (BB), indeks massa tubuh (IMT), tebal lipatan kulit total. (TLK), massa lemak tubuh (ML), massa tubuh bebas lemak (MBL), rasio lingkar pinggang-lingkar panggul (R Lpi-Lpa) , dan kadar leptin serum.Tempat : Rumah Sakit Sumba Waras, GrogolBahan dan cara: Penelitian ini merupakan studi eksperimentai pra dan pasca pemberian diet rendah kalori seimbang 915,23 kkal dengan komposisi 55,81% karbohidrat, 19,46% protein dan 24,73% lemak selama 14 hari terhadap 39 subyek perempuan obes (19-55 tahun) yang telah memenuhi kriteria penerimaan dan penolakan. Data yang dikumpulkan meliputi data karateristik demografi, data asupan energi dan makronutrien, antropornetri, komposisi tubuh, dan kadar leptin serum.Hasil : Terjadi penurunan berat badan secara bermakna (p<0,05) dari 70,99 ± 8,62 menjadi 68,81 ± 8,36 kg (3,07%); penurunan IMT secara bermakna (p<0,05) dari 30,20 ± 3,11 kg/m2 menjadi 29,36 ± 2,94 kg/m2 ( 3,04%); penurunan TLK secara bermakna (p<0,05) dari 99,32 ± 12,07 mm menjadi 91,29 f 10,85 mm (8,08%); penurunan ML secara bermakna (p<0,05) dari 35,41 ± 2,75 % menjadi 33,65 ± 2,73% (1,76 %) peningkatan persentase MBL secara bermakna. (p<0,O5) dari 64,59 2,74 menjadi 66,35 2,73% (2,72%);penurunan Lpi secara bermakna (p<0,O5) dari 85,87 7,31 menjadi 83,35 ± 7,09 cm (2,93%); penurunan Lpa secara bermakna (p<0,05) Bari 107,59 ± 6,67 menjadi 106,49 f 6,37 cm (1,02%); penurunan R Lpi-Lpa secara bermakna (p(O,O5) dari 0,80 ± 0,05 menjadi 0,78 ± 0,04 (2,24 %); penurunan kadar leptin serum secara bermalma (p<0,05) dari 23,31 (12,06-71,22) menjadi 18,18 (7,90-65,11) pg/mL (22,01 %); ditemukan korelasi positif antara kadar leptin serum dengan ML secara bermakna (p<0,05) sebelum perlakuan 0=0,47 ; p t,003) dan sesudah perlakuan (r3,57 ; p=0,001).Simpulan : Pemberian diet rendah kalori seimbang sebesar 915,23 kkal/h selama 14 hari dapat dengan efektif menurunkan berat badan, IMT, tebal lemak bawah kulit, persentase lemak, meningkatkan persentase massa bebas lemak, menurunkan rasio lingkar pinggang lingkar panggul dan kadar leptin serum, serta ditemukan korelasi positif bermakna antara massa lemak tubuh dan leptin serum baik sebelum maupun sesudah perlakuan.

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Objective : To identify the effect of balanced low-calorie diet for 14 days on body weight (BW), body mass index (BMI), total skin fold thickness (SFT), fat mass (FM), fat-free mass (FFM), waist to hip ratio (WHR) and serum leptin level.

Place : Sumber Waras Hospital, Grogol

Material and Method : This study is a pre- and post-experimental balanced low-calorie diet 915.23 kcallday with the composition of 55.81 % carbohydrate, 19.46 % protein and 24.73 % fat for 14 days on 39 obese-women subjects (19-55 years old) who have met the inclusion and exclusion criteria. The collected data include demographic characteristic, macronutrient and energy intake, as well as of anthropometry, FM, FFM, and serum leptin level.

Results : Body weight reduction occurs significantly (p<0.05) from 70.99 ± 8.62 to 68.81 ± 8.36 kg (3,07%), BMI reduction is significant (p<0.45) from 30,20 + 3,11kglm2 to 29,36 ± 2,94 kghn' (3,04%); significantly reduced SFT (p<0.05) from 99,32 ± 12,07 mm to 91,29 ± 10,85 mm (8,08%); significantly reduced FM (p<0,05) from 35.41 ± 2.75% to 33.65 ± 2.73% (1.76%); significantly increased FFM percentage (P<0.05) from 64.59 ± 2.74 to 66.35 ± 2.73 (2.72%); significantly reduced WC (waist circumference) (p<0.05) from 85.87 ± 7.31 to 83.35 ± 7.09 (2.93%); significantly reduced HC (hip circumference) (p<0.05) from 107.59 ± 6.67 to 106.49 ± 6.37 (1.02%); significantly reduced WHR (p<0.05) from 0.80 ± 0.05 to 0.78 ± 0.04 (2.24%); significantly reduced serum leptin level (p<0.05) from 23.31 (12.06 - 71.22) to 18.18 (7.90 - 65.11) (22.01%); positive correlation is observed between serum leptin level and FM significantly (p<0,05) before treatment (r= 0.47; p = 0.003) and after treatment (r=0,57;

Conclusions : Balanced low-calorie diet may effectively reduce body weight, BMI, skin fold thickness, percentage of fat mass, to increase percentage of fat free mass, to reduce waist to hip ratio and serum leptin level. There is a statistically significant positive correlation between serum leptin and body fat mass both before and after treatment."

"Prevalensi obesitas cenderung meningkat di berbagai belahan dunia sehingga dapat meningkatkan risiko kardiometabolik pada berbagai penyakit. Salah satu tata laksana obesitas yang paling efektif adalah modifikasi gaya hidup, yaitu pengaturan diet. Penelitian ini merupakan studi pendahuluan dengan desain uji klinis acak tersamar ganda, paralel, dua kelompok, bertujuan mengetahui pengaruh suplementasi serat larut dan diet rendah kalori seimbang (DRKS) selama 4 minggu berturut-turut terhadap berat badan (BB), kadar kolesterol highdensity lipoprotein (HDL) dan trigliserida (TG) serum pada subyek obes I usia 30-50 tahun. Berdasarkan kriteria inklusi, didapatkan 31 subyek yang dibagi menjadi dua kelompok, 15 orang kelompok perlakuan (KP) mendapat DRKS 1200 kkal/hari dan psyllium husk (PH) 8,4 g/hari, dan 16 orang kelompok kontrol (KK) mendapat DRKS 1200 kkal/hari dan plasebo. Sebanyak 28 subyek menyelesaikan penelitian ini. Suplementasi PH ditoleransi dengan baik dan tidak ada efek samping yang serius. Jumlah asupan energi total subyek KP 1130,9 ± 221,9 kkal/hari lebih tinggi signifikan (p = 0,02) daripada KK 1024,3 ± 269,9 kkal/hari. Asupan serat subyek rendah; KP 17,2 ± 2,8 dan KK 8,6 (5,2−15,2) g/hari, walaupun dengan suplementasi PH. Penurunan BB dan peningkatan kadar kolesterol HDL serum sedikit lebih banyak tidak signifikan pada KP (-1,8 ± 0,8 kg dan 0,0 ± 4,3 mg/dL) dibandingkan KK (-1,6 ± 0,9 kg dan -0,4 ± 5,9 mg/dL). Penurunan kadar TG serum KP -1,5 (-416−77) mg/dL lebih rendah tidak signifikan dibandingkan dengan KK -10,0 ± 31,3 mg/dL. Pada penelitian ini belum dapat dibuktikan suplementasi PH 8,4 g/hari dan DRKS 1200 kkal/hari dibandingkan DRKS 1200 kkal/hari saja selama 4 minggu berturut-turut lebih baik dalam menurunkan BB dan mempengaruhi kadar kolesterol HDL dan TG serum pada subyek obes I.

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The prevalence of obesity has been increasing globally, thus it likewise made an escalation the risk of cardio metabolic diseases. One method to encounter obesity is lifestyle modification such as the diet. This research was a preliminary study with double blinded randomized clinical trial, parallel, two groups, aims to understand the effects of soluble fiber suplementation and low calorie balanced diet (LCBD) on weight, high-density lipoprotein (HDL) cholesterol and triglycerides serum for obese I subjects age 30-50 years, for four weeks successively. Base on inclusion criteria, 31 subjects are divided into two groups, 15 subjects for treatment (T) receive 1200 kcal/day of LCBD and 8,4 g/day of psyllium husk (PH) and 16 subjects for control (C) receive 1200 kcal/day of LCBD and placebo. 28 subjects accomplish this research. PH suplement were being tolerate decently, and no serious side effect developed. Total energy intake from all T subjects were 1130,9 ± 221,9 kcal, significantly higher (p = 0,02) than C subjects 1024,3 ± 269,9 kcal/day. Subjects intake of fibers were low, even adding PH supplementation; 17,2 ± 2,8 for T subjects and 8,6 (5,2-15,2) g/day for C subjects. Weight loss and HDL cholesterol serum level enhancement were insignificantly higher on T subjects (-1,8 ± 0,8 kg and 0,0 ± 4,3 mg/dL) compared to C subjects (-1,6 ± 0,9 kg and -0,4 ± 5,9 mg/dL). TG serum level derivation on T subjects are -1,5 (-416−77) mg/dL insignificantly lower than C subjects -10,0 ± 31,3 mg/dL. This research has still yet able to prove that suplementation of PG 8,4 g/day and LCBD 1200 kcal/day in compare to only 1200 kcal/day of LCBD and placebo in 4 weeks consecutively are better in weight loss and affect the level of HDL cholesterol and TG serum on obese I subjects."

"ABSTRAKPenelitian dengan rancangan uji klinis paralel acak tersamar ganda ini bertujuanmengetahui perubahan kadar apo B pada penyandang obes I setelah suplementasiserat psyllium husk (PH) 8,4 g/hari dan diet rendah kalori seimbang (DRKS) 1200kkal/hari selama 4 minggu. Berdasarkan kriteria penelitian, didapat 31 orangsubyek yang dibagi menjadi dua kelompok, 15 orang kelompok perlakuan (KP)dan 16 orang kelompok kontrol (KK). Subyek KP mendapat PH 8.4 g/hari danDRKS, sedangkan KK mendapat plasebo dan DRKS. Data yang diperolehmeliputi sebaran dan karakteristik subyek, asupan energi, makronutrien, serat, danair, serta kadar apo B awal dan akhir penelitian. Analisis data menggunakan uji ttak berpasangan dan Mann-Whitney, batas kemaknaan 5%. Sejumlah 28 subyekdapat mengikuti penelitian hingga selesai (KP dan KK masing-masing 14). Tidakdilaporkan efek samping berbahaya selama perlakuan. Sebagian besar subyekperempuan, median usia subyek KP dan KK berturut-turut 35,0 (30−45) tahun dan34,50 (30−48) tahun, IMT 28,0 ± 1,1 kg/m2 dan 27,2 ± 1,4 kg/m2. Jumlah asupanenergi total subyek KP 1130,9 ± 221,9 kkal/hari lebih tinggi signifikan (p = 0,02)daripada KK 1024,3 ± 269,9 kkal/hari. Karbohidrat sederhana pada KP (35,6(8,3−69,9)) g/hari lebih tinggi signifikan dibandingkan KK (13,8 (3,4−55,5))g/hari. Asupan serat subyek belum mencukupi anjuran (20–35 g/hari), yaitu KP17,2 ± 2,8 g/hari dan KK 8,6 (5,2−15,2) g/hari walaupun dengan suplementasiPH. Asupan protein, lemak total, dan kolesterol dalam rentang yang dianjurkan,tetapi tidak pada asupan asam lemak tak jenuh tunggal dan jamak. Penurunankadar apo B pada KK (-6,1 ± 8,9 mg/dL) lebih besar tidak signifikan (p = 0,13)dibandingkan pada KP (-1,3 ± 7,3 mg/dL). Dari penelitian ini disimpulkansuplementasi PH 8,4 g/hari dan DRKS 1200 kkal/hari selama 4 minggu tidaklebih baik dalam menurunkan kadar apo B dibandingkan plasebo dan DRKS 1200kkal/hari penyandang obes I.

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ABSTRACTThis double blind randomized clinical trial aims to investigate the change of apoB level in obese I after given supplementation psyllium husk (PH) 8.4 g/day andlow-calorie balanced diet (LCBD) for 4-weeks. By study criteria, 31 subjects wererandomly allocated to one of two groups; 15 subjects for treatment (T) group and16 subjects for plasebo (P) group. The T subjects received psyllium husk (PH) 8.4g/day and LCBD 1200 kcal/day and the P subjects received placebo and LCBD1200 kcal/day. Data collected in this study consist of subject distribution andcharacteristic, intake of energy, macronutrient, fiber, water and apo B level thatassessed before and after treatment. Level of statistical analyses significance was5%, independent t-test and Mann-Whitney. A total 28 subjects (14 subjects ineach group) had completed the intervention. There were no serious adverse eventswere reported along the intervention. Mean of age in T and P groups respectivelywas 35.0 (30.0−45.0) years and 34.5 (30.0−48.0) years, and BMI was 28.0 ± 1.1kg/m2 and 27.2 ± 1.4 kg/m2. The energy intake in T group 1130.9 ± 221.9 kcal/daywas significantly higher (p = 0.02) than P group 1024.3 ± 269.9 kcal/day. Simplecarbohydrate intake in T group (35.6 (8.3−69.9) g/day) was significantly higher (p<0.000) than in P group (13.8 (3.4−55.5) g/day). Intake of dietary fiber in T groupwas 17.2 ± 2.8 g/day had significantly higher than P group 8.6 (5.2−15.2) g/day,even adding PH supplementation cannot meet the recommendation of fiber intake(20-35 g/day). Intake protein and fat in both groups was meet recommendation,differ for intake of mono and polyunsaturated fatty acids. Decreasing of apo Blevel in P group was -6.1 ± 8.9 mg/dL that statistically insignificant difference (p= 0.13) with T group -1.3 ± 7.3 mg/dL. As a conclusion in this study shows, thatPH supplementation 8.4 g/day and LCBD 1200 kcal/day in obese I for 4 weekswasn’t proven to decrease the apo B level."

"Uji klinis acak tersamar ganda paralel ini merupakan penelitian pendahuluan, bertujuan mengetahui pengaruh suplementasi serat larut dan diet rendah kalori seimbang (DRKS) selama 4 minggu terhadap kadar kolesterol low-density lipoprotein (LDL) serum pada obes I usia 30−50 tahun. Sejumlah 31 subyek dipilih dengan kriteria tertentu dan dibagi menjadi dua kelompok dengan randomisasi blok, 15 orang kelompok perlakuan (KP) dan 16 orang kelompok kontrol (KK). Subyek KP mendapat serat larut psyllium husk (PH) 8,4 g/hari dan DRKS 1200 kkal/hari, sedangkan subyek KK mendapat plasebo dan DRKS 1200 kkal/hari. Data terdiri atas usia, indeks massa tubuh (IMT), asupan zat gizi, serta kadar kolesterol LDL serum. Pemeriksaan kolesterol LDL dilakukan pada awal dan akhir penelitian. Analisis data menggunakan uji t tidak berpasangan dan Mann-Whitney, batas kemaknaan 5%. Karakteristik data dasar dan sebaran subyek kedua kelompok sebanding. Analisis lengkap dilakukan pada 28 subyek (KP dan KK masing-masing 14 subyek). Suplementasi ditoleransi baik dan tidak ditemukan efek samping serius. Median usia subyek KP dan KK berturut-turut 35,0 (30−45) tahun dan 34,50 (30−48) tahun serta rerata IMT 28,0 ± 1,1 kg/m2 dan 27,2 ± 1,4 kg/m2. Rerata kadar kolesterol LDL serum awal KP 137,0 ± 37,0 mg/dL dan KK 134,4 ± 29,1 mg/dL. Defisit energi KP lebih rendah tidak signifikan (p = 0,62) dibandingkan KK, berturut-turut -282,0 ± 482,6 kkal/hari dan -331,8 ± 578,3 kkal/hari. Persentase asupan energi terhadap anjuran KP (94,2 ± 18,5%) lebih tinggi signifikan (p = 0,02) daripada KK (85,4 ± 22,9%). Asupan karbohidrat (KH) total KP (613,1 ± 134,5 kkal/hari) lebih tinggi signifikan (p = 0,02) dibandingkan KK (545,4 ± 161,1 kkal/hari). Asupan protein, lemak total, dan kolesterol KP dan KK sesuai rekomendasi NCEP-ATP III. Pada kedua kelompok, asupan asam lemak jenuh cenderung tinggi, tetapi asupan asam lemak tak jenuh tunggal dan jamak rendah. Asupan serat subyek KP 17,2 ± 2,8 g/hari dan KK 8,6 (5,2−15,2) g/hari. Dengan suplementasi PH tidak tercapai rekomendasi asupan serat. Persentase asupan KH sederhana terhadap energi total KP 11,5±5,4% lebih tinggi signifikan (p = 0,00) dibandingkan KK 6,0 (1,2524,2)%. Penurunan kadar kolesterol LDL serum KP -2,1 ± 16,2 mg/dL lebih sedikit tidak signifikan (p = 0,15) dibandingkan pada KK -10,9 ± 15,3 mg/dL. Penelitian ini belum dapat membuktikan suplementasi PH 8,4 g/hari dan DRKS 1200 kkal/hari selama 4 minggu lebih baik dalam menurunkan kadar kolesterol LDL serum dibandingkan plasebo pada subyek obes I.

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This parallel double blind randomized clinical trial is a preliminary study that aims to investigate the effect of soluble fiber supplementation 8.4 g/day and lowcalorie balanced diet (LCBD) for 4 weeks on serum low-density lipoprotein (LDL) cholesterol level in obese I, aged 30−50 years old. A total of 31 subjects were selected using certain criteria and randomly allocated to one of two groups using block randomization; 15 subjects for treatment (T) group and 16 subjects for control (C) group, respectively. The T group received psyllium husk (PH) 8.4 g/day and LCBD 1200 kcal/day, and the C group received placebo and LCBD 1200 kcal/day. Data include age, body mass index (BMI), intake of energy, macronutrient, and fiber, as well as serum LDL cholesterol level. Serum LDL cholesterol level was examined before and after treatment. Statistical analyses include independent t-test and Mann-Whitney with significance level of 5%. Subjects characteristics of the two groups at baseline was not statistically different. Twenty eight subjects (14 subjects in each group) completed the intervention. Supplementation was well tolerated and there were no serious adverse events. The mean age in T and C group was 35.0 (30.0−45.0) and 34.5 (30.0−48.0) years, respectively, and BMI was 28.0 ± 1.1 and 27.2 ± 1.4 kg/m2, respectively. The pretreatment serum LDL cholesterol level in T and C group was 137.0 ± 37.0 and 134.4 ± 29.1 mg/dL, respectively. Energy deficit in T group was insignificantly lower (p = 0.62) than in C group; -282.0 ± 482.6 and -331.8 ± 578.3 kcal/day, respectively. Percentage of energy intake to recommendation in T group (94.2 ± 18.5%) was significantly higher (p = 0.02) than that in C group (85.4 ± 22.9%). Total carbohydrate (CHO) intake in T group (613.1 ± 134.5 kcal/day) was significantly higher (p = 0.02) than in C group (545.4 ± 161.1 kcal/day). Total protein, fat, and cholesterol intake were similar to the NCEP-ATP III recommendation in both groups. Intake of SAFA was higher than recommended, meanwhile PUFA and MUFA intake were lower than those recommended in both groups. Dietary fiber intake in T and C group was 17.2 ± 2.8 and 8.6 (5.2−15.2) g/day, respectively. During the intervention, PH supplementation did not meet the recommendation. Percentage of simple CHO to total energy in T group 11.5±5.4% was significantly higher (p = 0.00) than in C group 6.0 (1.2524.2)%. PH supplementation decreased serum LDL cholesterol level (-2.1 ± 16.2 mg/dL) lower than placebo (-10.9 ± 15.3 mg/dL), but not significant different (p = 0.15). This study shows that PH supplementation 8.4 g/day in combination with LCBD 1200 kcal/day for 4 weeks in obese I aged 30−50 years old is not proven to decrease the serum LDL cholesterol level."

"atar Belakang: Balans energi positif pada obesitas ditandai dengan hiperadipositosis dan merangsang proses inflamasi kronik yang berdampak pada komplikasi penyakit pasien obesitas. Salah satu penatalaksaan obesitas adalah pemberian diet restriksi kalori. Diet restriksi kalori diduga menyebabkan penurunan kondisi inflamasi kronik yang salah satunya ditandai dengan kadar c-reactive protein (CRP). Namun demikian, berbagai studi memberikan hasil yang inkonsisten.Tujuan: Menilai efek diet restriksi kalori terhadap perubahan kadar CRP dan menilai pengaruh durasi diet tertentu terhadap perubahan kadar CRP pasien obesitas.Sumber Data: Pencarian utama dilakukan pada basis data PubMed, ProQuest, EBSCOhost, Embase dan Scopus hingga 30 Oktober 2020. Pencarian sekunder juga dilakukan secara snowballing, Google Scholar, Global Index Medicus, portal basis data nasional, dan perpustakaan digital 40 universitas di Indonesia.Seleksi Studi: Studi uji klinis acak melibatkan pasien dewasa obes yang menilai efek diet restriksi kalori (tanpa mengkombinasikan dengan terapi nondiet lain) terhadap kadar CRP. Tidak ada batasan tahun publikasi dan bahasa. Penilaian terhadap judul, abstrak dan studi dilakukan oleh dua peninjau independen. Dari 2087 artikel, 11 studi diantaranya memenuhi kriteria eligibilitas.Ekstraksi Data: Ekstraksi data dilakukan oleh kedua peninjau. Korespondensi dilakukan dengan menghubungi peneliti dan tidak didapatkan adanya data tambahan.Hasil: Diet restriksi kalori memiliki efek terhadap penurunan kadar CRP pada pasien obesitas dengan nilai Mean Difference -0.22 (IK 95% -0.40 - -0.04, p 0.006). Intervensi restriksi diet ≤ 12 minggu tidak menunjukkan penurunan bermakna pada kadar CRP, sedangkan intervensi restriksi diet > 12 minggu menunjukkan penurunan bermakna pada kadar CRP.KesimpulanDiet restriksi kalori memiliki efek menurunkan kadar CRP pada pasien obesitas.

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Background: Positive energy balance in obesity is characterized by hyperadipocytosis, which stimulates chronic inflammatory processes in obese patients. Management of obesity includes a calorie restriction diet thought to improve chronic inflammatory conditions, characterized by reduced c-reactive protein (CRP). However, studies have yielded inconsistent results.

Objective: To assess the effect of a calorie-restricted diet on changes in CRP levels and the duration of a particular diet that is significant for its effect on changes in CRP levels in obese patients

Data Source: We searched PubMed, ProQuest, EBSCOhost, Embase and Scopus through October 30,2020. Secondary searching was done by snowballing method including references of qualifying articles and manual searching through google scholar, global index medicus, national databases, and digital library of 40 universities in Indonesia

Study Selection: A randomized controlled trial involving obese adult patients assessed the effect of a calorie-restricted diet (without combination with other nondiet therapy) on CRP levels. No restriction regarding year of publication and language. Titles, abstracts, and articles were reviewed by two independent reviewer. Of the 2087 studies identified in our original search, 11 of them met the eligibility criteria.

Data Extraction: Data extraction was done by two reviewers. Correspondence was done by contacting the authors to confirm additional data. No additional data was obtained

Result: The calorie restriction diet has an effect on reducing CRP levels in obese patients with a Mean Difference value of -0.22 (95% CI -0.40 - -0.04, p 0.006). Dietary restriction interventions ≤ 12 weeks did not show a significant decrease in CRP levels, while dietary restriction interventions > 12 weeks showed a significant decrease in CRP levels

Conclusion: A calorie restriction diet has the effect of lowering CRP levels in obese patients"