Subjects: Twenty-seven children and adolescents from the Lipid and Obesity Outpatient Clinic, Department of Pediatrics, University of Vienna, were included in the study (14 boys and 13 girls between 6 and 18 y; mean age 12.6 and 13.1 y). Methods: The body fat percentage was measured with BIA (bioelectrical impedance analyzer BIA 2000-M) and DXA (dual energy X-ray absorptiometry) methods on the same day. Results: The mean difference between the body fat mass percentage measured by BIA and DXA was 4.48 with a standard deviation of 2.93. The results measured by BIA were almost always lower than that by DXA by about 12%. The lower and upper limit of the difference in 95% con®dence interval was À5.64 and À3.32. By paired t-test, these results were signi®cantly different (P`0.001). The correlation between the two measurements was 0.826. The mean percentage of body fat mass measured by BIA was 34.86 AE 7.08% and by DXA 39.75 AE 5.63%. The differences were not changed by age and body fat percentage but they were by sex. Conclusions:The results of the study show that the body fat percentages measured by BIA and DXA method were signi®cantly different. This is very important because BIA technique is a routine technique for clinical purposes. Adjustments to the formula used for calculating the total fat mass in obese children and adolescence are necessary. Underestimation of body fat percentage measured by bioelectrical impedance analysis compared to dual X-ray absorptiometry method in obese children is three times higher with boys than with girls. Sponsorship:

Zn supplementation has shown inconsistent effects on respiratory morbidity in young children in developing countries. Few studies have focused on upper respiratory tract infection (URTI), a frequent cause of morbidity in this group, and potential benefit from Zn supplementation or factors that influence its efficacy. We investigated the effects of Zn supplementation on URTI before and after vitamin A supplementation. This randomised double-blinded controlled Zn supplementation study was conducted on 826 children aged 2–5 years. Placebo or Zn (10 mg/d) was given in syrup daily for 4 months, with 200 000 IU vitamin A (60 mg retinol) given to all children at 2 months. Health workers visited children every 3 d for compliance and morbidity information. We found that 84 % of children experienced URTI during the study. Zn supplementation reduced the percentage of days with URTI (12 % reduction;P = 0·09), with greater impact following vitamin A supplementation (20 % reduction;P = 0·01). Vitamin A supplementation was associated with a decreased number but an increased duration of URTI episodes. We conclude that Zn combined with vitamin A supplementation significantly reduced the percentage of days with URTI in a population of preschool Indonesian children with marginal nutritional status. The results suggest that vitamin A status modifies the efficacy of Zn supplementation on URTI.

Background: Indonesia is undergoing a rapid nutrition transition—a shift in food consumption related to globalization, modernization, urbanization, and economic development—with potentially adverse impacts on diets, health, and the environment. This study sought to understand the perspectives of a multi-disciplinary group of experts on the effects of the nutrition transition on dietary behaviors, cardiovascular disease (CVD) risk factors, and the food environment in Indonesia. Methods: In-depth interviews were conducted online with 27 Indonesian experts, who are either healthcare providers, nutrition researchers, or environmental researchers. Interview question guides were developed based on a socio-ecological framework. We analyzed the data using deductive and inductive approaches. Results: Experts described a disconnect between awareness about and adherence to healthy diets among Indonesians. They highlighted a marked generational divide in food preferences between the younger population (<40y) and older population (40y+), due to the nutrition transition. Experts perceived that the nutrition transition has also resulted in more eating out, which promotes obesity, through the unhealthy menu offerings from restaurants. Experts also implied that traditional diets are no better than modern diets, due to unhealthy cooking practices, especially frying; suggesting that the combination of higher consumption of fast foods and unhealthy cooking practices may have worsened CVD risk factors in the population. Conclusion: Multi-disciplinary experts indicated that the nutrition transition has negatively impacted diets, health, and food environment in Indonesia. Our findings offer potential hypotheses that can be tested using quantitative approaches, to inform policy and the design of programs to reduce the adverse impacts of the nutrition transition in Indonesia.

Objectives: The COVID-19 pandemic impacted food systems, health systems and the environment globally, with potentially greater negative effects in many lower-middle income countries (LMICs) including Indonesia. The purpose of this qualitative study was to investigate the potential impacts of the COVID-19 pandemic on diets, health and the marine environment in Indonesia, based on the perspectives of a multidisciplinary group of informants. Methods: We conducted remote in-depth interviews with 27 key informants from many regions of Indonesia, who are either healthcare providers, nutrition researchers or environmental researchers. Interview question guides were developed based on a socio-ecological framework. We analyzed the data using a qualitative content analysis approach. Results: Informants suggested that while the COVID-19 brought increased awareness about and adherence to good nutrition and health behaviors, the impact was transitory. Informants indicated that healthy food options became less affordable, due to job losses and reduced income, suggesting a likely increase in food insecurity and obesity. Environmental researchers described higher levels of marine pollution from increase in hygienic wastes as well as from plastic packaging from food orders. Conclusions: Our findings reveal perceptions by informants that the increased awareness and adherence to health behaviors observed during the pandemic was not sustained. Our results also suggest that the pandemic may have exacerbated the double-burden paradox and marine pollution in Indonesia. This study offers information for generating hypotheses for quantitative studies to corroborate our findings and inform policies and programs to mitigate the long-term impacts of the COVID-19 on diets, health, and the marine environment in Indonesia.

BACKGROUNDIn 2013, the prevalence of stunting in Central Sulawesi province was 41%, which was higher than the national prevalence of 37.2%. Complementary feeding practice, infectious disease, history of exclusive breastfeeding, birth weight and birth length were assumed to contribute to the prevalence of stunting. The objective of the present study was to identify the risk factors for stunting among children aged 12 to 24 months.

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Uncontrolled prediabetes can develop into Type 2 Diabetes mellitus (T2DM). The incidence of T2DM among adults in Pontianak, Indonesia was reported remarkably high. Therefore, this study aimed to investigate the risk factors for prediabetes in adults living in urban areas of Pontianak, Indonesia. A cross-sectional study was conducted in 5 subdistricts of Pontianak. A total of 506 adults underwent screening to obtain subjects with fasting blood glucose (FBS) of ≤124 mg/dL and aged >30 years. Blood pressure and body mass index (BMI) were measured. Interview using a structured questionnaire were performed to obtain data on predictor variables (age, sex, education, income, health insurance, tobacco use, history of hypertension, gout, high cholesterol level, frequency of exercise per week, and diabetic education). The prevalence of prediabetes among subjects was significantly high (76.4%). Subjects were predominantly above 40 years, female, had low income, low education level, and had health insurance. About a third of the subjects had a history of hypertension, gout, and high cholesterol level, respectively. The exercise frequency was mostly less than 3 times/week, and the BMI was mainly classified as overweight and obese. The result of spearman’s rho correlation showed that age (r = 0.146; p = 0.022 ) and BMI (r = 0.130; p = 0.041 ) significantly correlated with prediabetes incidence. Moreover, the chi-square analysis demonstrated that health insurance ownership (OR = 4.473; 95% CI 1.824–10.972; p ≤ 0.001 ), history of hypertension (OR = 3.096; 95% CI 1.542–6.218; p = 0.001 ), and history of gout (OR = 2.419; 95% CI 1.148–5.099; p = 0.018 ), were associated with prediabetes incidence. For all these significant risk predictors except BMI, the significant associations were found only among female subjects after specific sex analysis. Moreover, multivariate logistic regression showed that health insurance ownerships (OR = 5.956; 95% CI 2.256–15.661; p ≤ 0.001 ) and history of hypertension (OR = 3.257; 95% CI 1.451–7.311; p = 0.004 ), and systolic blood pressure (OR = 2.141; 95% CI 1.092–4.196; p = 0.027 ) were the risk factors for prediabetes. It is concluded that the prevalence of prediabetes is probably high especially among urban people in Pontianak, Indonesia. Health insurance ownership and hypertension may have an important role in prediabetes management. The risk factors might be different between male and female.

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