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"Pekerja duduk termasuk ke dalam kelompok yang rentan mengalami masalah kesehatan karena gaya hidup sedenter yang dimiliki merupakan faktor risiko obesitas. Indikator untuk menentukan obesitas adalah indeks massa tubuh (IMT), persentase lemak, dan ukuran lingkar pinggang. Program latihan fisik berbasis tempat kerja dirancang bagi pekerja duduk untuk mengurangi risiko obesitas pada pekerja duduk. Penelitian ini dilakukan dengan secara potong lintang menggunakan data sekunder penelitian intervensi terhadap pekerja duduk, untuk lebih jauh mengetahui pengaruh kepatuhan melakukan program latihan fisik berbasis tempat kerja selama 12 minggu terhadap perubahan komposisi tubuh (IMT, persentase lemak, dan ukuran lingkar pinggang). Terdapat 41 subjek uji dan 41 subjek kontrol. Hasil yang didapatkan yaitu persentase kepatuhan subjek uji sebesar 39,73%, sebanyak 19 subjek tergolong patuh, dan 22 lainnya tidak patuh. Pada analisis data didapatkan perbedaan tidak bermakna secara statistik antara tingkat kepatuhan dan perubahan komposisi tubuh. Secara klinis, kepatuhan paling berpengaruh terhadap perubahan ukuran lingkar pinggang pada kelompok uji. Analisis data membandingkan perubahan komposisi tubuh antara kelompok uji dan kontrol menunjukkan perbedaan yang tidak bermakna secara statistik dan klinis. Hasil pada penelitian ini berbeda jika dibandingkan dengan penelitian lain. Perbedaan diduga karena tidak ada intervensi faktor lain yang memengaruhi komposisi tubuh dan durasi program yang belum optimal.

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Sitting workers are vulnerable to various health problems because of their sedentary lifestyle which is one of obesity’s factors. Body mass index (BMI), body-fat percentage, and waist circumference can be used as the indicators of obesity. A workplace-based physical exercise is conducted to reduce the risk of obesity among sitting workers. This is a cross-sectional study using secondary data from an interventional study, for furthermore to evaluate the effect of compliance to 12-weeks workplace-based physical exercise program on body composition (BMI, body-fat percentage, and waist circumference) in sitting workers. There were 41 interventional and 41 control subjects. The subjects’ attendance to exercise program was 39,73%, there were 19 complied, and 22 not complied subjects. Based on analysis data, statistically, there were no significant difference of body composition changes between complied and not complied subjects. However, clinically, the effect of compliance was greater on waist circumference changes. There were no significant difference statistically and clinically of body composition changes between interventional and control subjects. The results in this study are different when compared with other studies. The difference was suspected because there are no interventions on other factors that affect body composition and the duration of the program was not optimal."

"Proporsi tingkat kesegaran jasmani kurang pada anak usia remaja (10-I9 tahun) di Indonesia diketahui masih cukup tinggi, hal ini akan memberi dampak buruk pada daya tahan kerja, kecerdasan, dan produktivitas mereka. Tujuan penelitian ini adalah ingin mendapatkan informasi tentang proporsi tingkat kesegaran jasmani kurang pada siswa SLTP Negeri dan faktor-faktor yang berhubungan dengan tingkat kesegaran jasmani mereka. Penelitian dilaksanakan di Kecamatan Tanjungkarang Barat Kodya Bandar Lampung atas dasar bahwa penelitian semacam ini belum pernah ada dan jumlah SLTP Negeri yang ada di kecamatan tersebut paling banyak dibandingkan kecamatan lainnya di Kodya Bandar Lampung. Rancangan penelitian yang digunakan adalah cross sectional dengan jumlah sampel 200 orang siswa kelas I s/d III yang dipilih secara acak sederhana dari 5 SLTP Negeri. Tingkat kesegaran jasmani sampel diukur dengan menggunakan Tes Kesegaran Jasmani Piagam Presiden Untuk Siswa SMTP, sedangkan analisa data dilakukan dengan metoda regresi logistik. Hipotesa yang diajukan adalah ada hubungan antara faktor jenis kelamin, umur; aktivitas fisik, status gizi, keadaan kesehatan, kebiasaan makan pagi, atau kebiasaan merokok dengan tingkat kesegaran jasmani siswa. Hasil penelitian ini menunjukkan bahwa 69,4% dari seluruh siswa yang diteliti ternyata memiliki jasmani yang tidak segar. Setelah dikontrol dengan faktor lainnya ternyata status gizi, kebiasaan makan pagi, jenis kelamin, dan keadaan kesehatan siswa merupakan faktor-faktor resiko yang berhubungan dengan tingkat kesegaran jasmani. Salah satu kesimpulan yang diperoleh dari penelitian ini adalah bahwa kebiasaan makan pagi merupakan faktor yang paling besar tingkat resikonya terhadap kesegaran jasmani siswa, karena siswa yang tidak biasa makan pagi ternyata memiliki resiko untuk mendapatkan jasmani yang tidak segar sebesar 14,13 kali lebih tinggi dibandingkan siswa yang biasa makan pagi (POR = 14,13; 95% CI: 1,79 - 111,24; p = 0,0119 ). Saran yang bisa diberikan adalah meningkatkan KIE kepada siswa, guru, dan orang tua murid dalam berbagai kesempatan dan cara tentang pentingnya makan pagi bagi kesegaran jasmani siswa.

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Milt physical fitness level proportion at teenagers (10-19 year old) in Indonesia has been known still in high level, furthermore that would become a damage effect on work endurance, intellegentia, and their productivity.

The purpose of this research is to get more infomation about ratio of milt physical fitness level at Public Yunior High Schools students and factors that related with their physical fitness level. The research was conducted in West Tanjungkarang Subdistrict Bandar Lampung District, based on there was not any similar research before, and the number of Public Yunior High Schools in this subdistrict are greater than in other subdistricts in Bandar Lampung District.

Moreover, cross sectional analysis was used in this design research. The samples consist of 200 students fiom the first to third grade at 5 Public Yunior High Schools, those were choosen randomly. Physical fitness level of the samples were measured with the President Charter of Physical Fitness Test for Yunuior High School Student.

The data were analyzed with logistic regression method. The submitted hypqtesis is there were relationships among sex, age, physical activity, nutritional status, healthiness, breakfast custom, and smoking behavior factor with student physical fitness level.

Further, the result showed that 69.4% of student fiom the samples had tmtit body. In fact, after it was controlled with another factor, it appeared that nutritional status, breakfast custom, sex, and student health condition were risk factors which related with physical fitness level. "

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Latar Belakang: Prevalensi berat badan lebih dan obesitas pada pekerja usia dewasa mengalami peningkatan dari tahun ke tahun seiring dengan perubahan gaya hidup yang terjadi. Kedua hal yang mencerminkan komposisi tubuh yang buruk ini merupakan faktor risiko dari berbagai penyakit kronik. Sebaliknya, daya tahan kardiorespirasi yang baik dapat memberikan berbagai manfaat kesehatan. Tujuan: Mengetahui pengaruh perubahan daya tahan kardiorespirasi terhadap komposisi tubuh pada pekerja duduk. Metode: Penelitian ini menggunakan metode potong lintang dengan sumber data sekunder. Sejumlah 82 subjek penelitian yang merupakan pekerja duduk di Jakarta tahun 2018, dibagi menjadi kelompok uji dan kontrol yang masing-masing terdiri dari 41 subjek. Kelompok uji mendapatkan intervensi berupa latihan fisik berbasis tempat kerja selama 12 minggu. Analisis data dilakukan dengan menggunakan uji korelasi Pearson, Spearman, dan uji T-berpasangan. Hasil: Didapatkan peningkatan rerata nilai Indeks Massa Tubuh sebesar 0,14 kg/m², peningkatan rerata presentase lemak sebesar 0,56%, penurunan rerata ukuran lingkar pinggang sebesar 2,56 cm, dan peningkatan rerata nilai prediksi daya tahan kardiorespirasi sebesar 1,27 mL/kg/menit pada subjek yang menjalani program latihan fisik berbasis tempat kerja selama 12 minggu, walaupun tidak ditemukan hubungan yang signifikan antara perubahan pada nilai prediksi daya tahan kardiorespirasi terhadap ketiga komponen komposisi tubuh tersebut. Simpulan: Peningkatan daya tahan kardiorespirasi dengan program latihan fisik berbasis tempat kerja selama 12 minggu memberikan perbaikan secara klinis pada komposisi tubuh pekerja duduk, meskipun tidak menghasilkan perubahan yang signifikan secara statistik. Diperlukan penelitian lanjutan dengan memerhatikan dugaan faktor-faktor yang memengaruhi hasil tersebut.

 

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Background: The prevalence of overweight and obesity in adults has increased in recent years in line with lifesyle changes that occur. These two things that reflect poor body composition are risk factors for various chronic disease. Conversely, good cardiorespiratory fitness can provide health benefits. Objective: This research was done to determine the effect of changes in cardiorespirator fitness on body composition in sitting workers. Methods: This study uses a cross-sectional method with a secondary data sources. A total of 82 research subject were sitting workers in Jakarta in 2018, which were divided into test and control groups, each grup consisting of 41 subjects. The test group received an intervention in the form of workplace based physical exercise for 12 weeks. Data analysis was performed using the Pearson and Spearman correlation test, and paired T-test. Results: There was an increase in the mean value of Body Mass Index by 0,14 kg/m², an increase in the mean value of percentage of body fat by 0,56 percent, a decrease in the mean value of waist circumference by 2,56 cm, and an increase in the mean predicted value of cardiorespiratory fitness by 1,27 mL/kg/minutes in subjects undergoing a workplace based physical exercise program for 12 weeks, although no significant relationship was found between changes in the predicted value of cardiorespiratory endurance on the three components of body composition. Conclusion: Increased cardiorespiratory endurance with a workplace-based physical exercise program for 12 weeks provided a clinical improvement in sitting workers body composition, although it did not produce statistically significant changes . Further research is needed by considering other factor that may influence this result.

 

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"ABSTRAKPenelitian ini bertujuan untuk mengetahui adanya perbedaan status kebugaran komposisi tubuh berdasarkan status gizi, aktivitas fisik, status merokok dan asupan gizi pada pengemudi taksi Express Group Tahun 2014. Penelitian ini menggunakan desain studi cross sectional pada 96 responden. Indikator kebugaran yang digunakan adalah persen lemak tubuh sebagai representasi kebugaran komposisi tubuh (bugar dengan PLT: 6 ? 10%). Hasil penelitian menunjukkan bahwa 72,9% responden memiliki tubuh yang tidak bugar. Variabel-variabel yang berhubungan dengan status kebugaran antara lain: status gizi dengan (pvalue 0,001), status merokok (0,014), asupan energi (0,004), protein (0,004), lemak (0,015), karbohidrat (0,008), zat besi (0,037), seng (0,001), vitamin B1 (0,020), vitamin B2 (0,037), vitamin B5 (0,013), dan vitamin B6 (0,028).

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ABSTRACTThis study aims to determine body composition fitness status difference based on nutritional status, physical activity, smoking status and nutritional intake of Express Group Taxi Driver 2014. This research uses cross-sectional study design on 96 respondents. Fitness indicator which is used in this study is body fat percent as to represent body composition fitness (fit status: 6 ? 10% of BFP). The result shows 72,9% of the respondents are unfit. Variables which are significantly related to fitness status are: nutritional status (pvalue 0,001), smoking status, (0,014), energy intake, (0,004), protein intake (0,004), fat intake (0,015), carbohydrate intake (0,008), iron intake (0,037), zinc intake (0,001), vitamin B1 intake (0,020), vitamin B2 intake (0,037), vitamin B5 intake (0,013), and vitamin B6 intake (0,028)."

"Remaja dengan kelebihan berat badan harus diintervensi agar tidak menjadi orang dewasa dengan obesitas. Berkembangnya patient-centered care sebagai upaya pemberdayaan diri dapat menjadi pendekatan terpilih. Dibutuhkan motivasi besar dalam menjalani proses perubahan perilaku. Coaching dilakukan untuk mendampingi klien (coachee) agar mampu mengoptimalkan potensi sehingga memiliki sikap positif, mental yang kuat, dan gaya hidup yang lebih baik. Belum ada penelitian yang mengidentifikasi keberhasilan patient-centered care berbasis pemberdayaan diri dengan metode coaching pada mahasiswa obesitas.Penelitian dilakukan dengan mixed method dalam tiga tahap. Tahap 1 merupakan studi potong lintang untuk mengidentifikasi persepsi mahasiswa terhadap dampak obesitas bagi kesehatan. Kuesioner daring terdiri dari identitas, data antropometri, S-Weight, dan P-Weight. Tahap 2 dilakukan pengembangan model pelayanan dengan cara melaksanakan focus group discussion. Peserta diskusi adalah pakar di tingkat mikro, meso dan makro sistem layanan kesehatan. Tahap 3 menilai kemamputerapan dan efektivitas model layanan yang dikembangkan. Studi dilakukan pada dua kelompok mahasiswa obesitas (usia 18-24 tahun) yang dibagi dalam kelompok intervensi dan kontrol. Pada kedua kelompok diberlakukan model layanan yang sama yaitu pengukuran status antropometrik dan komposisi tubuh, pengisian kuesioner pada awal program, edukasi, dan kembali dilakukan pengukuran status antropometrik dan komposisi tubuh serta pengisian kuesioner pada akhir program. Pada kelompok intervensi ditambahkan uji coba coaching sebanyak 6 sesi setiap dua minggu. Pengukuran awal dan akhir berjarak 3 bulan.Tahap 1 diperoleh 134 mahasiswa obesitas (respons rate 14.1%). Teridentifikasi responden berada pada tahap kontemplasi (35,8%) dan aksi (35,1%) terhadap perubahan perilaku dalam proses menurunkan berat badan. Kesiapan responden bersifat positif (76,9%) pada emosi, dan bersifat negatif pada konsekuensi, dukungan, dan aksi dalam menurunkan berat badan.Tahap 2 dilaksanakan dua tahap FGD terhadap 2 kelompok @ 10 orang. Teridentifikasi bahwa program penurunan berat badan harus diinisiasi dengan membangkitkan rasa kebutuhan untuk lebih sehat dengan berat badan yang ideal. Program harus bersifat personal. Diperlukan dukungan lingkungan seperti ketersediaan makanan sehat dan sarana untuk beraktivitas. Program harus merupakan program yang menimbulkan dukungan terhadap peserta, profesional, dan tersedia di layanan kesehatan. Berdasarkan hal tersebut disusun metode coaching yang sesuai dengan patient-centered care berbasis pemberdayaan diri bagi mahasiswa obesitas dalam program penurunan berat badan. Program terdiri dari 6 sesi coaching. Setiap tema dalam sesi coaching menggunakan langkah SMART dan diberi nama “From Fat to Fit with SMART Program”. Program dilaksanakan dalam waktu 3 bulan. Tema berturut-turut adalah healthy behavior habit, vision strategy, body self-image, timeline perspective/ state line exercise, happiness model, dan healthy behavior habit/ vision board. Kedua kelompok mendapatkan edukasi mengenai dampak obesitas bagi kesehatan, prinsip gizi seimbang, aktivitas fisik dan hidrasi yang sesuai bagi remaja dari para ahli yang terdiri dari spesialis penyakit dalam, spesialis gizi klinik, dan spesialis kedokteran olahraga yang dilakukan secara daring. Pengukuran antropometri, komposisi tubuh (menggunakan Bioelectric Impedance Analysis), pemantauan asupan makanan (menggunakan formulir food record), pemantauan aktivitas fisik (menggunakan bouchard activity record), pemberdayaan diri (menggunakan kuesioner subjective wellbeing dan skala kepuasan healthy behavior habit), dibandingkan antara dua kelompok menggunakan uji T berpasangan (jika distribusi data normal) dan uji Mann-Whitney (jika distribusi data tidak normal).Tahap 3 diawali dengan penerapan program terhadap dua kelompok @ 30 mahasiswa obesitas. Peserta dibagi menjadi kelompok intervensi dan kelompok kontrol. Kelompok intervensi mendapatkan coaching dari health coach yang telah mendapatkan pelatihan sebelumnya dari coach bersertifikat Internasional. Seorang health coach mendampingi 4 mahasiswa obesitas. Health coach berjumlah 8 orang yang terdiri dari dokter spesialis kedokteran keluarga layanan primer, dokter spesialis penyakit dalam, dokter spesialis kedokteran olahraga, dokter pengelola program studi fakultas, dan coach yang berpengalaman dengan pendekatan coaching di tempat kerjanya. Sesi coaching dibagi menjadi enam pertemuan setiap dua minggu secara daring melalui media zoom meeting dengan bantuan host dari tim peneliti. Namun, meningkatnya kondisi PPKM (pemberlakuan pembatasan kegiatan masyarakat) pada tahap ini, mahasiswa yang berhasil menyelesaikan program adalah 23 mahasiswa kelompok intervensi dan 18 mahasiswa kelompok kontrol.Nilai perubahan pada kelompok intervensi secara signifikan lebih besar dibandingkan kelompok kontrol pada komponen total lemak tubuh [-0.9 (-12,9, 0,70) vs 0,0 (-6,9, 3,50), p=0,02) dan healthy behavior habit [13.5 ± 11,85 vs 7,5 ± 8,08, p=0,04]. Nilai perubahan skala kepuasan healthy behavior habit secara signifikan lebih besar dibandingkan kelompok kontrol pada aspek hobby/passion [2(-4,6) vs 1(-2,2), p=0,02], movement exercise [2,3 ± 2,11 vs 1,2 ±1,93, p=0,03], sleep rest [2(-6,5) vs 1(-3,2), p=0,01], dan spiritual [1(0,6) vs 0( -1,3), p=0,00].

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Adolescents with excess weight should be intervened so as not to become adults with obesity. The development of patient-centred services as an effort to empower oneself could be the approach of choice. It takes great motivation in undergoing the process of behaviour change. Coaching is carried out to assist the client (coachee) to optimize their potential so that they had a positive attitude, strong mentality, and a healthier lifestyle. There has been no research that has identified the success of patient-centred care based on self-empowerment with coaching methods for obese students.

Mixed method research were in three stages. Phase 1 was a cross-sectional study to identify students' perceptions of the impact of obesity on health. The online questionnaire consisted of identity, anthropometric data, S-Weight, and P-Weight. Phase 2 was developing a service model by conducting focus group discussions. Discussion participants were experts at the micro, meso, and macro levels of the health care system. Phase 3 assessed the applicability and effectiveness of the developed service model. The study was conducted on two groups of obese college students (aged 18-24 years) in the intervention group and the control group. Both groups were subjected to the same service model, namely an initial physical examination, a questionnaire at the beginning of the service, and education about how to lose weight. A final physical examination and questionnaire were carried out at the end of the program. However, the intervention group was given a coaching method. Initial and final examinations were 3 months apart.

Phase 1 obtained 134 obese students (response rate of 14.1%). Respondents identified as being in the contemplation stage (35.8%) and action (35.1%) on behaviour change in the process of losing weight. Respondents' readiness was positive (76.9%) on emotions about losing weight and was negative in terms of consequences, support, and action in losing weight.

Phase 2 was carried out in 2 stages of FGD with 2 groups of 10 people. It was identified that a weight loss program should be initiated by generating a sense of the need to be healthier with ideal body weight. Programs should be personal. Environmental support was needed such as the availability of healthy food and facilities for activities. The intervention program should be a program that creates support for participants, professional, and available in health services. Based on this, a coaching method was developed following patient-centred care based on self-empowerment for students with obesity in weight loss programs. The program consisted of 6 coaching sessions. Each session used SMART steps. Each coaching session was themed sequentially and was named “From Fat to Fit with SMART Program”. The program was implemented within 3 months. The successive themes of the coaching session were healthy behaviour habits, vision strategy, body self-image, timeline perspective/ state line exercise, happiness model, and healthy behaviour habit/ vision board. Both groups received online education about obesity, balanced diet, physical activity and hydration from experts consisting of internal medicine specialists, clinical nutrition specialists, and sports medicine specialists. Anthropometric measurements, body composition (using Bioelectric Impedance Analysis), monitoring food intake (using a food record form), monitoring physical activity (using a bouchard activity record), self-empowerment (using a subjective wellbeing questionnaire and healthy behaviour habits satisfaction scale) were compared between the two groups using paired T-test (if the data distribution was normal) and the Mann-Whitney test (if the data distribution was not normal).

Phase 3 began with the application of the program to two groups of 30 obese students. Participants were divided into an intervention group and a control group. The intervention group received coaching from a health coach who had received previous training from an internationally certified coach. A health coach accompanied 4 obese students. There were 8 health coaches consisting of family medicine and primary care specialists, internal medicine specialists, sports medicine specialists, faculty study program manager doctors, and coaches who were experienced with coaching approach in the workplace. The coaching session was divided into six meetings every two weeks online via a zoom meeting with the help of a host from the research team. However, the increasing conditions of pandemic restrictions on community activities at this stage, students who completed the program were 23 students in the intervention group and 18 students in the control group. The value of change in the intervention group was significantly greater than the control group in the component of total body fat [-0.9 (-12.9, 0.70) vs 0.0 (-6.9, 3.50), p=0.02 ) and healthy behaviour habit [13.5 ± 11.85 vs. 7.5 ± 8.08, p=0.04].

The value of the change in the healthy behaviour habit satisfaction scale was significantly greater than the control group in the hobby/passion aspect [2(-4.6) vs 1(-2.2), p=0.02], move exercise [2,3 ± 2.11 vs 1.2 ±1.93, p=0.03], sleep rest [2(-6.5) vs 1(-3.2), p=0.01], and spiritual [1( 0.6) vs 0( -1.3), p=0.00]. This method has been proven to be able to be applied and is effective in reducing total body fat and significantly increasing healthy behaviour habits. This coaching method, which is following self-empowerment-based patient-centred care, has been proven to be able to be applied in the university's primary health services. However, support is needed from supportive university policies so that students participating in the program could follow it completely until all the expected output indicators are achieved properly"

"Latar Belakang : Malnutrisi energi protein sering terjadi pada penyakit ginjal kronik, terutama stadium lanjut (prevalensi 11-54% pada stadium 3 sampai 5). Phase angle (PA) pada BIA menggambarkan integritas membran sel yang nilai rendahnya dapat menjadi prediktor kuat malnutrisi di tingkat seluler.

Tujuan Mengetahui sebaran nilai phase angle pada masing-masing stadium lanjut PGK yaitu stadium 3-5 non-dialisis, mengetahui gambaran komposisi tubuh meliputi indeks massa lemak, indeks massa bebas lemak, cairan tubuh, dan indeks edema yang bermanfaat untuk deteksi dini malnutrisi dan kelebihan cairan.

Metode Penelitian ini menggunakan desain potong lintang di Rumah Sakit Cipto Mangunkusumo (RSCM), RSUP Fatmawati, dan RSUP Persahabatan pada Maret sampai Juli 2023. Pengambilan sampel menggunakan consecutive sampling pada pasien PGK stadium 3-5 non-dialisis, usia 18-60 tahun, tanpa keganasan, sirosis hati, infeksi, maupun autoimun, dengan ADL normal. Kemudian dilakukan pemeriksaan BIA dan SGA pada seluruh subjek.

Hasil Didapatkan 138 sampel, dengan dominasi wanita (58%) kategori obesitas derajat 1, dengan median eLFG 23,2  ml/menit. Proporsi malnutrisi berdasarkan SGA sebesar 19,5%. Profil phase angle mengalami tren penurunan seiring dengan meningkatnya stadium tanpa kemaknaan statistik (p=0,072). Indeks massa lemak menurun dengan p=0,038. Sedangkan ECW dan TBW meningkat bermakna (p=0,001 dan 0,031).

Kesimpulan Profil phase angle pada PGK non-dialisis cenderung sedikit menurun seiring dengan peningkatan stadium PGK. Profil ECW dan TBW mengalami peningkatan signifikan seiring dengan meningkatnya stadium PGK, tanpa disertai perubahan indeks edema (ECW/TBW). Profil FM dan FM-I mengalami penurunan seiring peningkatan stadium PGK.

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Background Chronic kidney disease, especially in its advanced stages, often coincide with protein and energy malnutrition with a prevalence of 11-54% in stages 3 to 5. The phase angle (PA) in BIA describes the integrity of cell membranes whose low values can be a strong predictor of malnutrition at the cellular level.

Objective Firstly, to determine the distribution of phase angle values in each advanced stage of CKD, namely the non-dialysis stages 3-5. Secondly, to identify the profile of body composition including fat mass index, fat-free mass index, body fluids, and oedema index which are useful for early detection of malnutrition and fluid excess.

Method This research is a cross sectional study. It was carried out at Cipto Mangunkusumo Hospital (RSCM), Fatmawati Hospital, and Persahabatan Hospital between March and July 2023. Consecutive sampling method was used with non-dialysis stages 3-5 CKD patients, aged 18-60 years, without malignancy, liver cirrhosis, infection, nor autoimmune, with normal ADLs. Then BIA and SGA examinations were performed on all subjects.

Results 138 samples were collected, which dominated by women (58%) and stage 1 obesity with a median eGFR of 23.2 ml/minute. The proportion of malnutrition based on SGA is 19.5%. Phase angle profile shows a decreasing trend with increasing stage of CKD without a statistical significancy (p=0.072). Fat mass index decreased significantly (p=0.038). ECW and TBW increased significantly (p=0.001 and 0.031) as the increasing stage of CKD.

Conclusion The phase angle profile in non-dialysis CKD tends to decrease slightly with increasing CKD stage. ECW and TBW profiles increased as the CKD stage increased, but there was no change in oedema index (ECW/TBW). The FM and FM-I profiles decreased as the CKD stage increased."

"Latar belakang: Kegagalan pertumbuhan sering terjadi pada pasien talasemia mayor (TM). Tata laksana nutrisi merupakan salah satu aspek penting untuk mengoptimalkan hasil luaran klinis. Penilaian komposisi tubuh berupa persentase massa otot, persentase masa lemak dan densitas massa tulang (DMT) menjadi komponen penting dalam mengevaluasi status gizi. Hingga saat ini belum ada penelitian di Indonesia yang mengevaluasi hubungan antara asupan makronutrien dan mikronutrien terhadap komposisi tubuh pada pasien TM remaja serta hubungannya dengan berbagai parameter antropometri. Metode: Penelitian dengan desain studi potong lintang melibatkan 55 pasien TM remaja, berusia 10-18 tahun di Pusat Talasemia RSUPN Cipto Mangunkusumo. Status gizi dievaluasi disertai pengukuran lingkar lengan atas (LILA), triceps skin thicknes (TSK), dan mid-upper arm muscle circumference (MUAMC). Asupan makronutrien dan mikronutrien diperoleh melalui food record selama tiga hari. Persentase massa otot, massa lemak, dan DMT dinilai menggunakan dual-energy X-ray absorptiometry (DXA). Kadar vitamin D diperiksa melalui metode enzyme-linked immunosorbent assay (ELISA). Data dianalisis menggunakan korelasi Pearson dan Spearman sesuai dengan pola distribusi normalitas.Hasil penelitian: Gizi kurang dijumpai pada 58,2% subjek dan gizi buruk pada 9,1% subjek. Rerata dan median asupan zat gizi harian dibandingkan dengan kebutuhannya pada subyek lelaki yakni asupan energi 85,6 % (SB 20,19), protein 55% (SB 14,19), lemak 112,4% (SB 35,48), karbohidrat 85,5 % (SB 23,31), vitamin D 29% (RIK 15,68-40,80), vitamin E 34,1% (SB 14,77), kalsium 37% (RIK 16,63-43,45), dan asam folat 32,98% (SB 14,6), sedangkan pada subyek perempuan asupan energi 93,6 % (SB 18,61), protein 59% (RIK 51-63), lemak 112,4% (RIK 105-142,5), karbohidrat 93,3 % (SB 25,5), vitamin D 22% (RIK 13,65-43), vitamin E 24% (RIK 21,65-39,7), kalsium 35,7% (RIK 20,45-55,6), dan asam folat 26,3% (RIK 16,2-41,15). Terdapat korelasi  ringan antara asupan energi dengan persentase massa lemak pada subyek lelaki dan perempuan (r= 0,25, p= 0,017; r= 0,38, p= 0,02). Tidak terdapat korelasi antara asupan karbohidrat, lemak, dan protein, vitamin D, vitamin E, kalsium, dan asam folat terhadap persentase massa otot, persentase massa lemak dan DMT. Kadar vitamin D tidak berkorelasi dengan komposisi tubuh. Terdapat korelasi kuat antara LILA dan MUAMC dengan persentase massa otot (r= 0,54, p<0,001; r= 0,68, p<0,001) dan massa lemak (r=0,77, p<0,001; r= 0,61, p<0,001). Kesimpulan: Lebih dari separuh remaja talasemia mengalami malnutrisi dan kekurangan asupan protein. Komposisi tubuh berkorelasi dengan jumlah asupan energi, tetapi tidak dengan yang lainnya. Kadar vitamin D tidak berkorelasi dengan komposisi tubuh. Lingkar lengan atas (LILA) dan MUAMC berkorelasi dengan persentase massa otot dan massa lemak.

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Background:Growth failure is common in thalassemia major (TM) patients. Nutritional management is an imperative aspect to optimize the clinical outcome. Measurement of muscle mass percentage, fat mass percentage, and bone mass density (BMD) on body composition is important component in assessing the nutritional status. There has been no study in Indonesia for the correlation between macronutrient and micronutrient intake on body composition in adolescents with thalassemia major.

Methods: This cross-sectional study involved 55 adolescent TM patients aged 10-18 years old taken through concecutive sampling at the Thalassemia Center dr. Cipto Mangunkusumo National Hospital Jakarta. Nutritional status was evaluated and anthropometric measurements was performed including  mid-upper arm circumference (MUAC), triceps skin thickness (TSK), and mid-upper arm muscle circumference (MUAMC). Macronutrient and micronutrient intake was obtained through a three-day food record. Muscle mass percentage, fat mass percentage, and BMD were assessed by dual-energy X-ray absorptiometry (DXA). The enzyme-linked immunosorbent assay (ELISA) method was used to examine vitamin D levels. The data was analyzed by Pearson and Spearman correlation depending on the type of distribution.

Result: Moderate malnourish occurred in 58.2% subjects and severe malnourish in 9,1% subjects. The mean and median daily nutrient intake compared to their needs in male subjects were energy intake 85.6% (SD 20.19), protein 55% (SD 14.19), fat 112.4% (SD 35.48), carbohydrates 85.5% (SD 23.31), vitamin D 29% (IQR 15.68-40.80), vitamin E 34.1% (SD 14.77), calcium 37% (IQR 16.63-43, 45), and folic acid 32.98% (SD 14.6), while in female subjects, energy intake were 93.6% (SD 18.61), protein 59% (IQR 51-63), fat 112.4% (IQR 105-142.5), carbohydrates 93.3% (SD 25.5), vitamin D 22% (IQR 13.65-43), vitamin E 24% (IQR 21.65-39.7), calcium 35 .7% (IQR 20.45-55.6), and folic acid 26.3% (IQR 16.2-41.15). There was a mild correlation between energy intake and fat mass percentage in male and female subjects (r= 0,25, p= 0,017; r= 0,38, p= 0,02). There was no correlation between carbohydrate, fat, and proteis, vitamin D, vitamin E, calcium, and folic acid on the proportion of muscle mass percentage, fat mass percentage, and BMD. Vitamin D levels were not correlated with body composition. There were strong correlation between MUAC and MUAMC with the percentage of muscle mass (r= 0.54, p<0.001; r= 0.68, p <0.001) and fat mass (r=0.77, p<0.001; r= 0.61 , p < 0.001).

Conclusion: More than half of adolescent TM patients are malnourished and lack protein intake. Body composition correlates with total calorie intake, but not with anything else. Vitamin D levels are not correlated with body composition. Mid-upper arm circumference and MUAMC correlate with the percentage of muscle mass and fat mass."

"Remaja dengan kelebihan berat badan harus diintervensi agar tidak menjadi orang dewasa dengan obesitas. Berkembangnya patient-centered care sebagai upaya pemberdayaan diri dapat menjadi pendekatan terpilih. Dibutuhkan motivasi besar dalam menjalani proses perubahan perilaku. Coaching dilakukan untuk mendampingi klien (coachee) agar mampu mengoptimalkan potensi sehingga memiliki sikap positif, mental yang kuat, dan gaya hidup yang lebih baik. Belum ada penelitian yang mengidentifikasi keberhasilan patient-centered care berbasis pemberdayaan diri dengan metode coaching pada mahasiswa obesitas.Penelitian dilakukan dengan mixed method dalam tiga tahap. Tahap 1 merupakan studi potong lintang untuk mengidentifikasi persepsi mahasiswa terhadap dampak obesitas bagi kesehatan. Kuesioner daring terdiri dari identitas, data antropometri, S-Weight, dan P-Weight. Tahap 2 dilakukan pengembangan model pelayanan dengan cara melaksanakan focus group discussion. Peserta diskusi adalah pakar di tingkat mikro, meso dan makro sistem layanan kesehatan. Tahap 3 menilai kemamputerapan dan efektivitas model layanan yang dikembangkan. Studi dilakukan pada dua kelompok mahasiswa obesitas (usia 18-24 tahun) yang dibagi dalam kelompok intervensi dan kontrol. Pada kedua kelompok diberlakukan model layanan yang sama yaitu pengukuran status antropometrik dan komposisi tubuh, pengisian kuesioner pada awal program, edukasi, dan kembali dilakukan pengukuran status antropometrik dan komposisi tubuh serta pengisian kuesioner pada akhir program. Pada kelompok intervensi ditambahkan uji coba coaching sebanyak 6 sesi setiap dua minggu. Pengukuran awal dan akhir berjarak 3 bulan.Tahap 1 diperoleh 134 mahasiswa obesitas (respons rate 14.1%). Teridentifikasi responden berada pada tahap kontemplasi (35,8%) dan aksi (35,1%) terhadap perubahan perilaku dalam proses menurunkan berat badan. Kesiapan responden bersifat positif (76,9%) pada emosi, dan bersifat negatif pada konsekuensi, dukungan, dan aksi dalam menurunkan berat badan.Tahap 2 dilaksanakan dua tahap FGD terhadap 2 kelompok @ 10 orang. Teridentifikasi bahwa program penurunan berat badan harus diinisiasi dengan membangkitkan rasa kebutuhan untuk lebih sehat dengan berat badan yang ideal. Program harus bersifat personal. Diperlukan dukungan lingkungan seperti ketersediaan makanan sehat dan sarana untuk beraktivitas. Program harus merupakan program yang menimbulkan dukungan terhadap peserta, profesional, dan tersedia di layanan kesehatan. Berdasarkan hal tersebut disusun metode coaching yang sesuai dengan patient-centered care berbasis pemberdayaan diri bagi mahasiswa obesitas dalam program penurunan berat badan. Program terdiri dari 6 sesi coaching. Setiap tema dalam sesi coaching menggunakan langkah SMART dan diberi nama “From Fat to Fit with SMART Program”. Program dilaksanakan dalam waktu 3 bulan. Tema berturut-turut adalah healthy behavior habit, vision strategy, body self-image, timeline perspective/ state line exercise, happiness model, dan healthy behavior habit/ vision board. Kedua kelompok mendapatkan edukasi mengenai dampak obesitas bagi kesehatan, prinsip gizi seimbang, aktivitas fisik dan hidrasi yang sesuai bagi remaja dari para ahli yang terdiri dari spesialis penyakit dalam, spesialis gizi klinik, dan spesialis kedokteran olahraga yang dilakukan secara daring. Pengukuran antropometri, komposisi tubuh (menggunakan Bioelectric Impedance Analysis), pemantauan asupan makanan (menggunakan formulir food record), pemantauan aktivitas fisik (menggunakan bouchard activity record), pemberdayaan diri (menggunakan kuesioner subjective wellbeing dan skala kepuasan healthy behavior habit), dibandingkan antara dua kelompok menggunakan uji T berpasangan (jika distribusi data normal) dan uji Mann-Whitney (jika distribusi data tidak normal).Tahap 3 diawali dengan penerapan program terhadap dua kelompok @ 30 mahasiswa obesitas. Peserta dibagi menjadi kelompok intervensi dan kelompok kontrol. Kelompok intervensi mendapatkan coaching dari health coach yang telah mendapatkan pelatihan sebelumnya dari coach bersertifikat Internasional. Seorang health coach mendampingi 4 mahasiswa obesitas. Health coach berjumlah 8 orang yang terdiri dari dokter spesialis kedokteran keluarga layanan primer, dokter spesialis penyakit dalam, dokter spesialis kedokteran olahraga, dokter pengelola program studi fakultas, dan coach yang berpengalaman dengan pendekatan coaching di tempat kerjanya. Sesi coaching dibagi menjadi enam pertemuan setiap dua minggu secara daring melalui media zoom meeting dengan bantuan host dari tim peneliti. Namun, meningkatnya kondisi PPKM (pemberlakuan pembatasan kegiatan masyarakat) pada tahap ini, mahasiswa yang berhasil menyelesaikan program adalah 23 mahasiswa kelompok intervensi dan 18 mahasiswa kelompok kontrol.Nilai perubahan pada kelompok intervensi secara signifikan lebih besar dibandingkan kelompok kontrol pada komponen total lemak tubuh [-0.9 (-12,9, 0,70) vs 0,0 (-6,9, 3,50), p=0,02) dan healthy behavior habit [13.5 ± 11,85 vs 7,5 ± 8,08, p=0,04]. Nilai perubahan skala kepuasan healthy behavior habit secara signifikan lebih besar dibandingkan kelompok kontrol pada aspek hobby/passion [2(-4,6) vs 1(-2,2), p=0,02], movement exercise [2,3 ± 2,11 vs 1,2 ±1,93, p=0,03], sleep rest [2(-6,5) vs 1(-3,2), p=0,01], dan spiritual [1(0,6) vs 0( -1,3), p=0,00].

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Adolescents with excess weight should be intervened so as not to become adults with obesity. The development of patient-centred services as an effort to empower oneself could be the approach of choice. It takes great motivation in undergoing the process of behaviour change. Coaching is carried out to assist the client (coachee) to optimize their potential so that they had a positive attitude, strong mentality, and a healthier lifestyle. There has been no research that has identified the success of patient-centred care based on self-empowerment with coaching methods for obese students.

Mixed method research were in three stages. Phase 1 was a cross-sectional study to identify students' perceptions of the impact of obesity on health. The online questionnaire consisted of identity, anthropometric data, S-Weight, and P-Weight. Phase 2 was developing a service model by conducting focus group discussions. Discussion participants were experts at the micro, meso, and macro levels of the health care system. Phase 3 assessed the applicability and effectiveness of the developed service model. The study was conducted on two groups of obese college students (aged 18-24 years) in the intervention group and the control group. Both groups were subjected to the same service model, namely an initial physical examination, a questionnaire at the beginning of the service, and education about how to lose weight. A final physical examination and questionnaire were carried out at the end of the program. However, the intervention group was given a coaching method. Initial and final examinations were 3 months apart.

Phase 1 obtained 134 obese students (response rate of 14.1%). Respondents identified as being in the contemplation stage (35.8%) and action (35.1%) on behaviour change in the process of losing weight. Respondents' readiness was positive (76.9%) on emotions about losing weight and was negative in terms of consequences, support, and action in losing weight.

Phase 2 was carried out in 2 stages of FGD with 2 groups of 10 people. It was identified that a weight loss program should be initiated by generating a sense of the need to be healthier with ideal body weight. Programs should be personal. Environmental support was needed such as the availability of healthy food and facilities for activities. The intervention program should be a program that creates support for participants, professional, and available in health services. Based on this, a coaching method was developed following patient-centred care based on self-empowerment for students with obesity in weight loss programs. The program consisted of 6 coaching sessions. Each session used SMART steps. Each coaching session was themed sequentially and was named “From Fat to Fit with SMART Program”. The program was implemented within 3 months. The successive themes of the coaching session were healthy behaviour habits, vision strategy, body self-image, timeline perspective/ state line exercise, happiness model, and healthy behaviour habit/ vision board. Both groups received online education about obesity, balanced diet, physical activity and hydration from experts consisting of internal medicine specialists, clinical nutrition specialists, and sports medicine specialists. Anthropometric measurements, body composition (using Bioelectric Impedance Analysis), monitoring food intake (using a food record form), monitoring physical activity (using a bouchard activity record), self-empowerment (using a subjective wellbeing questionnaire and healthy behaviour habits satisfaction scale) were compared between the two groups using paired T-test (if the data distribution was normal) and the Mann-Whitney test (if the data distribution was not normal).

Phase 3 began with the application of the program to two groups of 30 obese students. Participants were divided into an intervention group and a control group. The intervention group received coaching from a health coach who had received previous training from an internationally certified coach. A health coach accompanied 4 obese students. There were 8 health coaches consisting of family medicine and primary care specialists, internal medicine specialists, sports medicine specialists, faculty study program manager doctors, and coaches who were experienced with coaching approach in the workplace. The coaching session was divided into six meetings every two weeks online via a zoom meeting with the help of a host from the research team. However, the increasing conditions of pandemic restrictions on community activities at this stage, students who completed the program were 23 students in the intervention group and 18 students in the control group. The value of change in the intervention group was significantly greater than the control group in the component of total body fat [-0.9 (-12.9, 0.70) vs 0.0 (-6.9, 3.50), p=0.02 ) and healthy behaviour habit [13.5 ± 11.85 vs. 7.5 ± 8.08, p=0.04].

The value of the change in the healthy behaviour habit satisfaction scale was significantly greater than the control group in the hobby/passion aspect [2(-4.6) vs 1(-2.2), p=0.02], move exercise [2,3 ± 2.11 vs 1.2 ±1.93, p=0.03], sleep rest [2(-6.5) vs 1(-3.2), p=0.01], and spiritual [1( 0.6) vs 0( -1.3), p=0.00]. This method has been proven to be able to be applied and is effective in reducing total body fat and significantly increasing healthy behaviour habits. This coaching method, which is following self-empowerment-based patient-centred care, has been proven to be able to be applied in the university's primary health services. However, support is needed from supportive university policies so that students participating in the program could follow it completely until all the expected output indicators are achieved properly"

"Bayi membutuhkan ASI sebagai makanan tunggal terbaik pada enam bulan pertama kehidupan. Lemak dalam ASI menyumbang bagian terbesar energi bayi yang dipengaruhi berbagai faktor, termasuk faktor ibu. Penelitian potong lintang ini dilaksanakan untuk mencari korelasi antara kadar lemak ASI dengan komposisi tubuh dan asupan energi dan zat gizi makro pada 48 orang ibu menyusui di RSIA Budi Kemuliaan Jakarta. Penelitian ini tidak menemukan adanya korelasi yang bermakna antara kadar lemak ASI dengan massa lemak tubuh, cairan tubuh total, massa otot, serta asupan energi, lemak, karbohidrat, protein, dan air.

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The infant needs breast milk as the best sole food for the first sixth month of life. Breast milk fat content accounted for the largest part of infant energy that influenced by many factors, including maternal factor. This cross-sectional study was conducted to find correlation between the breast milk fat content and maternal body composition, and also energy and macronutrient intake among 48 nursing mothers in RSIA Budi Kemuliaan, Jakarta. This study did not find significant correlation between the fat content of breast milk and body fat, total body water, muscle mass, intake of energy, fat, carbohydrate, protein, and water."

"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"