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Abstrak :
Obesitas pada remaja berdampak pada konsekwensi fisik, psikis dan sosial yang berpengaruh besar terhadap tumbuh kembang dan kualitas individu di masa mendatang. Obesitas pada remaja juga merupakan faktor risiko terjadinya berbagai penyakit metabolik dan degenerative seperti penyakit kardiovaskuler, diabetes melitus, kanker, osteoarthritis dll. Determinan penyebab terjadinya obesitas pada remaja sangatlah banyak diantaranya yaitu wilayah tempat tinggal, umur, jenis kelamin, tingkat pendidikan ibu, pekerjaan ibu, aktifitas fisik, kebiasaan konsumsi buah dan sayur serta pola kebiasaan makanan yang beresiko misalnya makanan instan, minuman manis, makanan manis, makanan gorengan/berlemak, minuman berenergi dan soft drink/minuman bersoda. Tujuan penelitian ini untuk mengetahui determinan/ faktor- faktor penyebab terjadinya obesitas remaja di Indonesia Tahun 2018. Penelitian ini menggunakan desain cross sectional (potong lintang) dan menggunakan data sekunder yang berasal dari data hasil survey riset kesehatan dasar tahun 2018 (Riskesdas 2018) dengan jumlah sampel sebanyak 95779 orang. Pengolahan dan analisis data dengan complex samples menggunakan uji chi square (bivariabel) dan regresi logistik ganda model determinan (multivariabel). Hasil penelitian menunjukkan bahwa prevalensi obesitas remaja di Indonesia Tahun 2018 sebesar 4,5 %. Hasil uji chi square menunjukkan bahwa terdapat 6 variabel yang secara statistik mempengaruhi kejadian obesitas remaja yaitu umur (p = 0,001), tingkat pendidikan ibu (p = 0,001) , wilayah tempat tinggal (p = 0,001), konsumsi makanan instan (p = 0,040), konsumsi minuman manis (p = 0,001), Konsumsi minuman berenergi (p = 0,006). Hasil uji regresi logistik ganda model determinan menunjukkan bahwa terdapat 4 variabel yang berhubungan secara signifikan dengan kejadian obesitas remaja yaitu wilayah tempat tinggal, umur, tingkat pendidikan ibu dan konsumsi minuman manis. Variabel yang paling dominan secarastatistik mempengaruhi kejadian obesitas remaja yaitu wilayah tempat tinggal dengan nilai OR sebesar 1,5 artinya responden yang tinggal didaerah perkotaan memiliki risiko 1,5 kali lebih tinggi untuk mengalami obesitas dibandingkan dengan responden yang tinggal di pedesaan setelah dikontrol oleh umur, tingkat pendidikan ibu dan konsumsi minuman manis. Edukasi tentang dampak yang disebabkan oleh obesitas pada remaja sangat penting untuk disosialisasikan melalui media sosial yang banyak digemari oleh para remaja diperkotaan seperti melalui youtube maupun Instagram diharapkan dapat mencegah atau menanggulangi kejadian obesitas. ......Adolescent obesity has an impact on physical, psychological, and social consequences, which will have a major impact on the growth and quality of people in the future. Adolescent obesity is also a risk factor for various metabolic and degenerative diseases such as cardiovascular disease, diabetes mellitus, cancer, osteoarthritis, etc. The determinants of the causes of obesity in adolescents are very numerous, including where they live, their age, their gender, mothers level of education, mothers work, physical activity, fruit and vegetable consumption habits and risky eating habits such as instant foods, sweet drinks, sweet foods, fried/fatty foods, energy drinks, and non-alcoholic drinks/non-alcoholic drinks. The aim of this study was to determine factors of adolescent obesity in Indonesia in 2018. Design of this study is a cross-sectional design using secondary data from basic health research survey in 2018 (Riskesdas 2018) recruited 95779 participants, and the complex samples using chi-square test (bivariable) and logistic regression with determinant models (multivariable) was analyzed. The results showed that the prevalence of obesity among adolescents in Indonesia was 4.5% in 2018. Bivariable analyses using chi-square test show that there were 6 variables having relation with the obesity incidence in adolescents, namely age (p = 0.001), mothers educational level (p = 0.001), residential area (p = 0.001), instant food consumption (p = 0.040), sweet drinks consumption (p = 0.001), energy drinks consumption (p = 0.006). The multiple logistic regression test using determinant model showed that there were 4 variables related to obesity incidence in adolescents, namely a place of residence, age, level of education of the mother, and consumption of sweet drinks. Residential areas showed as a dominant factor for increasing obesity while living in urban area are more likely 1,5 times to increase obesity incident among adolescents after controlled age, mother education level, and sweet drinks consumption. Education about the impact caused by obesity in adolescents is important to be socialized through social media which is much favored by urban teenagers such as via YouTube or Instagram is expected to prevent or overcome the incidence of obesity.

Abstrak :
Obesitas dan asma maih menjadi masalah kesehatan masyarakat di dunia. Meningkatnya prevalensi obesitas seiring dengan meningkatnya prevalensi asma, yang dapat mengganggu produktivitas dan menurunkan kualitas hidup penderita. Asma pada orang dewasa sering mengakibatkan perburukan pada prognosisnya yang disebabkan penurunan fungsi paru yang cepat. penelitian ini bertujuan untuk mengetahui hubungan obesitas dengan asma pada penduduk dewasa umur 40 - 65 tahun di kelurahan Kebon Kalapa Kecamatan Bogor Tengah Kota Bogor tahun 2011, menggunakan data sekunder baseline data studi kohort PTM - Kementerian Kesehatan tahun 2011, dengan jumlah sampel 960 orang dan desain studi cross sectional. Pada analisis multivariat dengan cox regression menunjukkan bahwa tidak ada hubungan yang signifikan antara obesitas dengan asma setelah dikontrol dengan variabel umur, tingkat pendidikan, dan status merokok, dengan nilai PR sebesar 0,674 (95% CI 0,387 - 1,174). Perlu adanya penelitian lebih lanjut mengenai obesitas dan asma dengan jumlah sampel yang lebih besar, menggunakan kelompok umur yang lebih muda dan disain studi yang lebih baik. ......Obesity and asthma reains a public health problem in the world. The increasing prevalence of obesity concomitant with increasing prevalence of asthma, which my interfere with productivity and lower the quality of life of patients. Asthma in adults often results in worsening the prognosis caused a rapid decline in lung function. This study aims to determmine the relationship of obesity with asthma in adults people aged 40 - 65 years at Kebon Kalapa Village, District of Central Bogor - Bogor City in 2011, using secondary baseline data NCD cohort study from Ministry of Health in 2011, with sample of 960 people's and a cros sectional desig study. In multivariate anaysis with cox regression showed no significant association between obesity and asthma after controlled with variabel aged, education level and smoking (PR = 0,674; 95% CI 0,387 - 1,174). for further need a research on obesity and asthma with a larger number of samples, younger age groups and a better design study.

Abstrak :
Latar Belakang: Obesitas merupakan kondisi yang meningkatkan risiko gangguan kardiovaskular melalui berbagai mekanisme, salah satunya adalah peningkatan stress oksidatif. Malondialdehid (MDA) merupakan salah satu marker peningkatan stress oksidatif. Ekstrak biji ketumbar (Coriandrum sativum L.) diketahui memiliki kandungan yang bersifat antioksidan dan protektif terhadap kerusakan akibat spesies oksigen reaktif. Metode: Dua puluh sembilan tikus jantan galur Wistar dibagi atas lima kelompok, dibedakan berdasarkan pemberian pakan; kontrol (normal), kontrol dengan ketumbar, preventif, pakan tinggi lemak, dan pakan tinggi lemak dengan ketumbar. Dilakukan nekropsi pada jantung tikus kemudian penilaian kadar MDA menggunakan spektrofotometri. Hasil: Terdapat penurunan kadar MDA pada kelompok pakan kontrol dengan ketumbar (p<0,05) dan preventif (p<0,01) dibandingkan dengan kelompok kontrol. Pada kelompok yang diberikan pakan lemak, kelompok yang diberikan ketumbar memiliki kadar MDA yang lebih rendah (p<0,01) dibandingkan dengan kelompok kontrol lemak. Kesimpulan: Tambahan ekstrak biji ketumbar menurunkan kadar MDA pada jantung tikus obesitas dan tikus yang diberikan pakan normal. ...... Introduction: Obesity is one of the conditions that increases the risk of cardiovascular disorder through multiple mechanisms which includes oxidative stress level elevation. Malondialdehyde (MDA) is one example of the marker of oxidative stress level. Coriander seed (Coriandrum sativum L.) extract is known to have antioxidant and protective properties against damage caused by reactive oxygen species. Method: Twenty-nine male Wistar rat were divided into five groups, differentiated by feeding practice: control (balanced diet), control with coriander seed extract, preventive, high fat diet, and high fat diet with coriander seed extract. After the feeding period had finished, the rats’ hearts were taken and analyzed for its MDA level by spectrophotometry. Results: There was a significant decrease in MDA level in both balanced diet and high fat diet rat groups. The control with coriander seed extract (p<0,05) group and preventive group (p<0,01) is significantly lower MDA level than control group. The rats fed with high fat diet with coriander seed extract has lower MDA level than the rats that was fed by high fat diet(p<0,01). Conclusion: The addition of coriander seed extract in the rat diet reduces MDA level in the heart of both obese and normal rats. high fat diet;antioxidant;reactive oxygen species;oxidative stress;herbal;wistar rat; diet tinggi lemak;antioksidan;spesies oksigen reaktif;stress oksidatif;herbal;tikus wistar

Abstrak :
Pencegahan obesitas perlu dilakukan sejak remaja karena berpotensi menjadi obesitas saat dewasa. Penelitian ini bertujuan untuk mengetahui hubungan antara faktor predisposisi yaitu umur; jenis kelarnin; status gizi siswa; pengetahuan; sikap; status gizi ibu, faktor pemungkin yaitu status pekerjaan ibu; tingkat pendidikan ibu; dan pola makan, dan faktor penguat yaitu pengaruh teman sebaya dengan perilaku pencegahan obesitas. Penelitian ini bersifat kuantitatif dengan desain crosssectional. Pengambilan data dilakukan di SMP Negeri 1 Depok dengan instrumen kuesioner. Penelitian menemukan bahwa 69,1% siswa melakukan pencegahan obesitas. Analisis lebih lanjut menemukan bahwa status gizi siswa, asupan lemak harian, kebiasaan sarapan, konsumsi sayur, serta konsumsi susu dan hasil olahannya berhubungan dengan perilaku pencegahan obesitas pada siswa SMP di Kota Depok tahun 2012. Prevention of obesity needs to be done as adolescent because of the potential of becoming obese as adults. This study aims to determine the relationship between predisposing factors are age; sex; nutritional status of students; knowledge, attitude; maternal nutritional status, enabling factors, namely maternal employment status; level of maternal education, and diet, and reinforcing factors namely the influence of peer groups with obesity prevention behaviors. This study is quantitative with crosssectional design. Data is collected in state junior high school 1 Depok (SMP Negeri 1 Depok) with a questionnaire instrument. The study found that 69.1% of students do prevention of obesity. Further analysis found that the nutritional status of students, the daily fat intake, breakfast habits, consumption of vegetables, as Well as the consumption of milk and processed products, was related to obesity prevention behaviors in students of state junior high school in Depok.

Abstrak :
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]. ......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