Objective: To study the relationship between percent body fat and body mass index (BMI) in two different ethnic groups (Indonesians and Caucasians) in order to evaluate the validity of the BMI cut-off points for obesity. Design: Cross-sectional study. Subjects: Not specially selected populations living in southern Sumatra (Palembang, Indonesia) and Caucasian Dutch living in Wageningen. Measurements: Body weight, body height, body fat by deuterium oxide dilution and skinfold thickness. Results: Body fat could be well predicted by body mass index (BMI) and sex in the Indonesians and by BMI, sex and age in the Dutch with a prediction error of 3.6 and 3.3% for the two populations respectively. Although the body mass index in the Indonesian group was about 2 kgam 2 lower compared to the Dutch, the amount of body fat was 3% points higher. Because of small differences between the groups in age, weight and height the differences in body fat were corrected for this (ANOVA). Indonesians having the same weight, height, age and sex have generally 4.8% points more body fat compared to Dutch. Indonesians having the same % BF, age and sex have generally a 2.9 kgam 2 lower BMI compared to the Dutch. Conclusions:The results show that the relationship between % BF and BMI is different between Indonesians and Dutch Caucasians. If obesity is regarded as an excess of body fat and not as an excess of weight (increased BMI), the cut-off points for obesity in Indonesia based on the BMI should be 27 kgam 2 instead of 30 kgam 2 .

Objective: To study the relationship between body fat percent (BF%) and body mass index (BMI) in two different Indonesian ethnic groups (Malays and Chinese) and to relate differences in the relationship to differences in body build and slenderness. Design: Cross-sectional study. Subjects: Except for ethnicity, not specially selected populations living on Java (Depok, south of Jakarta: Malay Indonesians, n 117) and on Sulawesi (Makale, north of Ujung Pandang: Chinese Indonesians, n 109). Measurements: Weight, height, sitting height, waist and hip circumferences and skeletal widths were measured. BMI was calculated and BF% was predicted from BMI, age and sex using a (Dutch) Caucasian prediction formula. Slenderness was expressed as the ratio of weight : sum of knee and wrist width. BF% assessed by deuterium oxide dilution was used as a reference. Results: BF% in the male and female Malay Indonesians was 24.6 AE 7.0 and 35.6 AE 5.6% respectively which was not signi®cantly different from the values in the male and female Chinese Indonesians (24.0 AE 4.3 and 33.8 AE 6.9%). BMI and age were signi®cantly lower in the Malay Indonesians. Malay Indonesians had a more slender body build in terms of skeletal widths compared to the Chinese Indonesians, and they had a higher slenderness index. BF% predicted from BMI using a Caucasian prediction formula was underestimated by 5.8 AE 4.8% and 7.7 AE 3.8% in the male and female Malay Indonesians but only by 1.3 AE 3.0% and 1.7 AE 3.7% in the male and female Chinese Indonesians. After correction for differences in age, sex and BF% the Malay Indonesians had a 1.7 AE 0.3 kgam 2 (P`0.0001) lower BMI than the Chinese Indonesians. After correcting for body build and relative sitting height the difference lowered to 0.9 AE 0.4 kgam 2 (P`0.02). Conclusions: The study con®rmed the results of an earlier study that Indonesians have a higher BF% at the same BMI compared to Caucasians, but that there are apparently also differences among Indonesian subgroups. These differences are at least partly related to differences in body build.

Three different adult Indonesian population groups living on Sumatra (Palembang), Java (Depok) and Sulawesi (Makale) participated in a study on body composition. Body weight, body height and multifrequency bioelectrical impedance (1, 5, 50 and 100 kHz) were measured and in addition total body water (TBW) and extracellular water (ECW) were determined by dilution techniques, using deuterium oxide and sodium bromide, respectively, as tracers. In total 318 subjects, 159 males and 159 females, participated in the study. Predicting ECW and TBW from bio-electrical impedance, using existing prediction formulas from the literature, did not result in valid estimates of these parameters. Therefore new prediction equations for ECW and TBW were developed in this group and the prediction equations were validated in several subgroups. Extracellular water (kg) could be predicted with the formula 0.262 height2/Z1 + 2.7 (SEE = 0.9 kg) and TBW with the formula 0.516 height2/Z100 + 3.5 (SEE = 1.6 kg), where Z1 and Z100 are impedances at frequency 1 and 100 kHz, and SEE is the standard error of estimate. The prediction formulas showed good validity in the three geographical subgroups, in males and females separately and in two randomly selected subgroups. The absolute prediction error (kg) of the newly developed prediction equations is lower compared with values normally reported in the literature, but when expressed as coefficient of variation the errors are comparable with values from the literature. Addition of weight age and sex (for TBW only) improves the prediction equation. The prediction equations were compared with prediction equations developed in Dutch subjects. In the Indonesian subjects the slopes of the regression equations were not different from the Dutch equations but the intercepts were lower. This means that for the same body water compartment and for the same height Indonesians have lower impedance values. This could be explained by a slightly higher ECW/TBW ratio and a more slender body build among Indonesians. A higher environmental temperature and skin temperature of the subjects in this study could have added to the effect. The formulas should preferably be validated before applying them to other Asian populations.

Background: Stunting is a chronic nutritional problem that happens to toddlers in the world nowadays. One of the efforts to prevent stunting is performed by integrated health service (Posyandu) cadres with good capacity to provide optimal services at Posyandu. One way to increase the capacity of cadres is by providing education through various training methods and media.Objectives: In this literature review, various types of cadre capacity building methods will be analyzed to find out which method is the most effective and the best to affect cadre capacity.Methods: The analysis of the literature review was carried out by searching for specific keywords through the Google Scholar electronic database from 2019 – 2021 with various inclusion and exclusion criteria. The effectiveness of various training methods was analyzed based on the p-value and the percentage difference between before and after the training intervention. Results: Various types of capacity can be identified as outcomes, including knowledge, attitudes, skills, performance, and self-efficacy of cadres. The combination of lectures with focus group discussions (FGD) and lectures with audiovisual media is the most effective method for increasing knowledge. Meanwhile, lectures with booklets combined with brainstorming and practice are an effective method for improving attitudes and skills of the cadres. Conclusion: Posyandu cadre training strategies in order to increase capacity can be carried out by utilizing various combinations of methods that act as a stimulus for more than one sense, this can increase the ability of Posyandu cadres to receive and understand information related to stunting. Therefore the role of preventing stunting by Posyandu cadres can be maximized.Keywords: Cadres capacity; Stunting; Training methods ABSTRAKPendahuluan: Stunting adalah masalah gizi kronis yang dialami oleh balita di dunia saat ini. Upaya pencegahan stunting salah satunya diperankan oleh kader Pos pelayanan terpadu (Posyandu) yang perlu memiliki kapasitas baik agar dapat memberikan pelayanan optimal di Posyandu. Salah satu cara untuk meningkatkan kapasitas kader adalah dengan memberikan pelatihan atau pendidikan melalui berbagai metode dan media pelatihan.Tujuan: Literature review ini bertujuan untuk mengetahui metode peningkatan kapasitas kader yang paling efektif dalam memengaruhi kapasitas kader, meliputi pengetahuan, keterampilan, sikap, self-efficacy, dan performa.Metode: Analisis kajian literature review dilakukan melalui pencarian kata kunci spesifik melalui database elektronik Google Scholar dari tahun 2019 – 2021 dengan berbagai kriteria inklusi dan eksklusi. Efektivitas berbagai metode pelatihan dianalisis berdasarkan p-value dan persentase besar perubahan antara sebelum dan setelah interversi pelatihan.Hasil: Dapat diidentifikasi berbagai jenis kapasitas yang menjadi outcome penelitian, meliputi pengetahuan, sikap, keterampilan, performa, dan self-efficacy dari kader. Kombinasi ceramah dengan focus group discussion (FGD) dan ceramah dengan pemutaran video merupakan metode yang paling efektif dalam meningkatkan pengetahuan. Ceramah dengan pemberian booklet yang disertai brainstorming dan praktik merupakan metode yang efektif dalam meningkatkan sikap dan keterampilan.Simpulan: Strategi pelatihan kader Posyandu dalam rangka meningkatkan kapasitas dapat dilakukan dengan memanfaatkan berbagai kombinasi metode sekaligus yang berperan sebagai pemberi stimulus lebih dari satu panca indera, hal ini dapat meningkatkan kemampuan kader dalam menerima dan memahami informasi terkait stunting.Kata kunci: Metode pelatihan; Kapasitas kader; Stunting

Hospital nutritional care requires a timely, accurate and complete information delivery to the patients. Some barriers found in the documentation process include incomplete documentation and errors in calculating patient’s nutritional needs. We developed NUCAPRO (NCP Electronic), a computer-based system, to document the nutritional care process and help dietitians in calculating a patient’s nutritional needs. This computer system was compared with a manual system to find out which of the two provided more accurate and complete documentation. This pre-experimental study used a pre–post-test design. Eight dietitians were recruited from the Internal Medicine Department Hospital in Malang to perform the documentation of the nutritional care of 40 diabetes mellitus patients. The documentation was performed using a manual system and NUCAPRO. The completeness and accuracy of documentation were compared between the two systems. Statistical analysis was done using McNemar. The results showed no difference in terms of completeness and accuracy of documentation between the two systems (p < 0.05). However, the error in calculation using NCP Electronic was found to be lower than the manual system. We suggest developing an alert feature for the system so that the process is more efficient. Keywords: dietetics, documentation, medical informatic application, completeness, accurate, error