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Abstrak :
ABSTRAK
Modernisasi kota-kota besar di Indonesia terutama Jakarta meningkatkan jumlah perempuan bekerja dengan pcrubahan terhadap gaya hidup terutama dalam jumlah dan komposisi asupan makanan. Hal tersebut bila disertai dengan mulai meourunnya honnon estrogen pada perempuan di awal masa klimakterlum, dikhawatirkan telah teljadi perubahan profil lipid dan distribusi lemak. Tujuan pcnalitian ini adalah diketahuinya asupan total energi dan asupan makronutrien serta profit lipid karyawati di awal rna.- klimakterium yaitu usia 35-45 tahun, serta hubungannya dengan ukuran lingkar pinggang. Stodi ini adalah studi potong lingtang yang dilakukan di Poliklinik Departemen Kebudayaan dan Pariwisata RJ. Sebanyak 66 orang karyawati menandatangani lembar persetujuan menjadi subyek pcnelitian, dengan 52 orang (78,8%) subyek menyelesaikan studi ini. Pengumpulan data ditakukan dengan wawancara, pcngukuran antropometri dan pcaitaian asupan makanan menggunakan merode food record 3x24 jam. Dilakukan juga pemeriksaan tahoratorium untuk mengukur kadar kolesterol LDL, HDL dan trigliserida serum. Rerata ulruran lingkar pinggang subyek adalah 84,8 ± 9,42 em dengao sebagian besar subyek (67,3%) tennasuk dalarn kategori lebih. Rerata asupan total energi subyek penelitian adalah 1571 ± 303,2 kkal, dengan sebagian besar subyek tennasuk dalarn kategori cukup jika dibandingkan dengan kebutoba energi total. Rerata asupan makronutrien untuk karbohidrat adalah 213,7 ± 40,73 gr (54,7 ± 6,24 o/oE), sera! 11,2 ± 4,52 gr, protein 54,0 ± 13,25 gr (13,7 ± 1,89 %E), lemak 56,0 ± 17,76 gr (31,6 ± 5,62 %E), SAFA 25,8 ± 8,84 gr (14,6 ± 3,44 %E), MUFA 14,1 ± 5,07 gr (8,0 ± 2,02 %E), PUFA 12,3 ± 5,85 gr (6,9 ± 2,84 %E) dan kotesterol 242,2 ± 118,36 mg per hari. Berdesarkan aujuran asupan oleh PERKENI, asupan kaibohidrat, protein, MUF A dan PUF A sebagian besar subyek dikategorlkan cukup. Sementara asupan lemak, SAP A dan kotesterol sebagian besar subyek dikategorikan lebih dan asupan serat kurang. Kadar kolesterol LDL, HDL dan trigliserida subyek berturut-turut adalah 126,3 ± 29,71 m8fdL, 58,2 ± 9,46 mg/dL dan 84,7 ± 35,81 mg/dL. Kadar ko1esterol LDL dan trigliserida serum sebagian besar subyek dalam kategori normal. Kader kolesterol HDL serum seluruh subyek dahun kategori normal. Tidak terdapat hubungan bermakna antara jumlah asupan energi total dan masing-masing makronutrien terhadap ukuran lingkar pinggang. Namun terdepat korelasi derajat lemak antara kadar trigliserida serum dan ukuran lingkar pinggang.

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Abstract
Modernization on some major cities in Indonesia specially Jakarta bas raised the number of working women from year to year, and alter their !!restyle including their total nutrition intake and macronutrient composition. Accompanied with decreasing estrogen level in early climacteric women, there was big concern that there had been alteration on lipid profile and fat distribution among these women. The aim of the study was to evaluate daily intake of total energy, macronutrients and lipid profile among healthy female government employee on early climacteric phase (aged 35-45 years), and their association with waist circumference. This cross sectional study took place in Cultural and Tourism Department of Republic Indonesia. Sixty six women have provided consent, while 52 subjects (78.8%) have completed the study. Data collection were conducted from interviews, anthropometric measurements and dietary assessment using 3 x 24 hours food record. Serum triglyceride, LDL, HDL cholesterol level were assessed as well. Mean value of waist circumference was 84.8 ± 9.42 em, and categorized as high, as well as on the majority of subjects (67.3 %).Mean value and standard deviation of to!al energy intake was 1571 ± 303,2 kcal, and categorized as moderate. The mean intake value of carbohydrate was 213,7 ± 40,73 g (54,7 ± 6,24 %E), fiber 11,2 ± 4.52 gr, protein 54.0 ± 13.25 g (13.7 ± 1.89 %E), fut 56.0 ± 17.76 g (3L6 ± 5.62 %E), SAFA 25.8 ± 8.84 gr (14.6 ± 3.44 %E), MUFA 14.1 ± 5.o7 gr (8.0 ± 2.02 %E), PUFA 12.3 ± 5.85 gr (6.9 ± 2.M %E) and cholesterol 242.2 ± 118.36 mg!day. Based on PER.KENI recommendation for macronutrient intake, majority of subject's intake of carbohydrate, protein, MUFA and PUF A were categorized as moderate, the intake of daily fat, SAFA and cholesterol were high, and all subject's intake of fiber was low. Subject's serum LDL and HDL cholesterol level were 126.3 ± 29.71 mg/dL and 58.2 ± 9.46 mg/dL respectively, while serum triglyceride level was 84.7 ± 35.81 mg!dL. Majority of subject's lipid profile categorized as normal. No significant associations were found among total energy as well as macronutrients with waist circumference. Nevertheless, there was weak significant association between triglyceride serum level and waist circumference.

Abstrak :
Pendahuluan Prevalensi obesitas meningkat terutama pada dewasa muda, yang berisiko pada penyakit kardiometabolik. Salah satu penyebabnya adalah karena generasi muda sering mengalami kesulitan dalam memenuhi keseimbangan makronutrien. Perubahan tubuh saat obesitas dapat diamati melalui rasio leptin/adiponektin. Penelitian ini bertujuan untuk mengetahui hubungan antara asupan makronutrien dengan rasio leptin/adiponektin pada populasi dewasa muda Indonesia. Metode Penelitian potong lintang ini merekrut mahasiswa Universitas Indonesia berusia 16-25 tahun pada tahun 2018 dan 2019. Pengukuran yang dilakukan meliputi indeks antropometri, komposisi tubuh melalui bio-impedance analyzer, kadar leptin dan adiponektin, serta 3-days food record untuk mengetahui asupan harian (karbohidrat, protein, lemak, serat). Hubungan tersebut diuji dengan uji korelasi, dilanjutkan regresi linier multipe untuk penyesuaian variabel perancu. Hasil Dari 405 subjek, didapatkan korelasi negatif yang signifikan (p <0,05) antara asupan karbohidrat (r = -0,229) protein (r = -0,129); dan lemak (r = -0,130) dengan rasio leptin/adiponektin, sedangkan tidak dengan asupan serat (p = 0,955). Setelah dilakukan analisis multivariat untuk menyesuaikan variabel perancu, asupan makronutrien tidak lagi menunjukkan hubungan yang signifikan. Jenis kelamin perempuan (β = 0,323); lingkar pinggang (β = 0,213); perkotaan (β = 0,150); dan persentase lemak tubuh (β = 0,389) menjadi faktor independen yang berhubungan secara signifikan. Kesimpulan Penelitian ini menunjukkan bahwa ada kemungkinan peran unik dari jenis makronutrien tertentu dalam memperbaiki leptin dan adiponektin, serta mekanisme adaptif adipokin pada populasi dewasa muda. Penelitian lebih lanjut diperlukan untuk mengkonfirmasi hubungan sebab akibat tersebut. ......Introduction Obesity prevalence increased mostly in young adults, put risk in early onset of cardiometabolic disease. One possible cause is young generation often experiences difficulties in meeting macronutrient balance. Adiposity progression can be reflected by increased leptin/adiponectin ratio. This study aims to investigate the association between macronutrient intake to leptin/adiponectin ratio in Indonesian young adults. Method This cross-sectional study recruited Universitas Indonesia student aged 16-25 years old in 2018 and 2019. Measurement included anthropometric indices, body composition using bio-impedance analyzer, serum leptin and adiponectin level, as well as 3-days food record to obtain daily intake data (carbohydrate, protein, fat, fiber). The association was tested using correlation test, continued to multiple linear regression for adjustment. Results From 405 subjects, significant (p <0,05) inverse correlation observed between carbohydrate (r = -0,229); protein (r = -0,129); and fat (r = -0,130) intake to leptin/adiponectin ratio, while not with fiber intake (p = 0,955). After adjustment for confounding variables, macronutrient intake no longer showed significant association. Female (β = 0,323); waist circumference (β = 0,213); urban (β = 0,150); and fat body percentage (β = 0,389) became significant independent factor. Conclusion This study suggests that certain macronutrients may lower leptin/adiponectin ratio. Besides that, the decreased ratio could indicate adaptive mechanism in healthy young adults that might raise the risk of weight gain in the future. Body fat and its distribution - –represented by confounding variables– have major role to mediate effect between two. Further studies in regards of young adults are required to confirm this finding.

Abstrak :
[ABSTRAK
Latar belakang: mengetahui hubungan antara asupan makronutrien dan gaya hidup terhadap status HbA1c penyandang diabetes melitus (DM) tipe 2. Metode: penyandang DM tipe 2 dikategorikan ke dalam 2 kelompok, yaitu kontrol glikemik (KG) baik (HbA1c < 7,0) dan KG buruk (HbA1c > 7,0). Data karakteristik dasar seperti usia, jenis kelamin, status gizi, durasi menderita DM, jenis dan jumlah obat DM yang digunakan, serta ada/ tidaknya komplikasi DM yang diderita. Asupan makronutrien terdiri dari asupan energi total harian, asupan karbohidrat, protein, lemak dan serat. Faktor gaya hidup meliputi ketaatan mengikuti diet sesuai yang direkomendasikan, aktivitas fisik, ketaatan konsumsi obat, merokok dan minum alkohol. Data-data dari kedua kelompok kemudian dihubungkan dengan status HbA1c dengan uji Chi square. Hasil penelitian: usia penyandang DM yang lebih muda (< 55 tahun), asupan karbohidrat dan ketaatan mengikuti diet berhubungan bermakna secara statistik dengan status HbA1c (P < 0,05). Rasio asupan makronutrien (karbohidrat, protein, lemak) pada kelompok KG baik adalah 47: 18: 35 dan KG buruk 51: 16: 33. Kesimpulan : Hasil penelitian ini menunjukkan bahwa status HbA1c berhubungan bermakna dengan faktor usia, asupan karbohidrat, dan ketaatan mengikuti diet. Edukasi sebaiknya diberikan kepada penyandang DM tipe 2 dengan KG buruk, terutama yang berusia < 55 tahun agar mengatur pola makannya sesuai dengan yang direkomendasikan dengan memperhatikan jenis, jumlah, dan jadwal.

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ABSTRACT
Background: Determining the relationship between macronutrients intake and lifestyle factors and HbA1c status of diabetic type 2 patient in improving the effectiveness of patient?s nutrition therapy and preventing diabetes complications. Methods: Diabetic type 2 patients were categorized into 2 groups; patients with good glycemic control (GC) or HbA1c < 7.0 and patients with poor glycemic control (PC) or HbA1c > 7.0. Clinical characteristics were differentiated by age, gender, body mass index (BMI), duration of illness, type and amount of diabetic medication, and other diabetic complication. Macronutrient intake consisted of total daily calories and carbohydrate, protein, fat and fiber intakes. Lifestyle factors consisted of the adherence to dietary advice and medication, physical activities, smoking habit, and alcohol intake. The data were be used to determine their relationship with HbA1c status using Chi Square test. Results: Younger diabetic type 2 patients (< 55 years old), carbohydrate intake, and adherence to dietary advice were identified as statistically significant variables related to HbA1c status (P <0.05). Macronutrient intake ratio (carbohydrate : protein : fat) for GC was 47 : 18 : 35 and PC was 51 : 16 : 33. Conclusions: The results demonstrate that HbA1c status in diabetic type 2 patient are related to age, carbohydrate intake and adherence to dietary advice. Education to be provided to younger diabetic type 2 patients (<55 years old) to maintain good dietary pattern according to medical nutrition therapy, Background: Determining the relationship between macronutrients intake and lifestyle factors and HbA1c status of diabetic type 2 patient in improving the effectiveness of patient’s nutrition therapy and preventing diabetes complications. Methods: Diabetic type 2 patients were categorized into 2 groups; patients with good glycemic control (GC) or HbA1c < 7.0 and patients with poor glycemic control (PC) or HbA1c > 7.0. Clinical characteristics were differentiated by age, gender, body mass index (BMI), duration of illness, type and amount of diabetic medication, and other diabetic complication. Macronutrient intake consisted of total daily calories and carbohydrate, protein, fat and fiber intakes. Lifestyle factors consisted of the adherence to dietary advice and medication, physical activities, smoking habit, and alcohol intake. The data were be used to determine their relationship with HbA1c status using Chi Square test. Results: Younger diabetic type 2 patients (< 55 years old), carbohydrate intake, and adherence to dietary advice were identified as statistically significant variables related to HbA1c status (P <0.05). Macronutrient intake ratio (carbohydrate : protein : fat) for GC was 47 : 18 : 35 and PC was 51 : 16 : 33. Conclusions: The results demonstrate that HbA1c status in diabetic type 2 patient are related to age, carbohydrate intake and adherence to dietary advice. Education to be provided to younger diabetic type 2 patients (<55 years old) to maintain good dietary pattern according to medical nutrition therapy]

Abstrak :
Prediabetes adalah kondisi peningkatan kadar glukosa darah dari normal, tetapi belum memenuhi kriteria diagnosis diabetes mellitus (DM). Prediabetes menjadi hal yang penting berdasarkan fakta bahwa sebagian besar kasus prediabetes akan berkembang menjadi DM, dan di sisi lain, dengan diagnosis dini dan intervensi yang tepat, dapat pula mengalami regresi menjadi normoglikemia. Intervensi gizi, merupakan salah satu pilar intervensi yang dapat dilakukan untuk mencegah progresivitas prediabetes menjadi diabetes. Adanya faktor polimorfisme genetik menyebabkan penerapan rekomendasi diet yang umum tidak menunjukkan hasil yang memuaskan pada sebagian orang. Penelitian bertujuan untuk mengembangkan rekomendasi diet spesifik untuk pencegahan progresivitas prediabetes menjadi diabetes berdasarkan analisis terhadap 8 single nucleotide polymorphisms (SNPs) yang terkait dengan resistensi insulin, komposisi tubuh, dan preferensi makanan. Penelitian dilakukan di Tangerang Selatan terhadap 193 subjek prediabetes sebagai kasus dan 376 subjek normoglikemia sebagai kontrol. Pengambilan data dilakukan pada Oktober 2019 hingga Juni 2021. Wawancara dilakukan untuk memperoleh data demografi dan faktor risiko; tingkat aktivitas fisik diukur dengan kuesioner IPAQ; data asupan nutrien didapat dengan menggunakan FFQ semikuantitatif dan 24 hours food recall sebanyak 3 kali lalu dianalisis menggunakan Nutrisurvey. Skor Dietary Inflammatory Index (DII) dihitung berdasarkan 29 parameter nutrien. Kadar insulin, leptin, dan adiponektin diukur menggunakan ELISA, DNA diekstraksi dari darah vena dan polimorfisme genetik ditentukan dengan pemeriksaan genotyping. Analisis data untuk menentukan adanya asosiasi dan interaksi antar variabel yang diteliti menggunakan aplikasi Rstudio. Rekomendasi diet spesifik disusun berdasarkan hasil interaksi varian genetik dan asupan nutrien yang ditemukan bermakna. Genotip C/C pada GCKR rs780094 dan genotip G/G pada LEPR rs1137101 merupakan faktor protektif terhadap prediabetes dengan nilai odds berturut-turut adalah 0,48 (IK95% 0,3-0,75, p=0,00097) dan 0,53(IK95% 0,36-0,76, p=0,0014). Analisis interaksi mendapatkan bahwa kecukupan kalori, proporsi karbohidrat, proporsi lemak, proporsi PUFA, proporsi SAFA, kecukupan MUFA, asupan serat, serta skor DII memodulasi varian genetik yang diteliti sehingga berpengaruh terhadap risiko prediabetes, komposisi tubuh, resistensi insulin dan disharmoni adipokin. Atas dasar ini, telah dikembangkan rekomendasi diet spesifik untuk genotip berisiko tinggi pada 8 SNPs yang terkait dengan resistensi insulin, komposisi tubuh, dan preferensi makanan. ......Prediabetes is when the blood glucose level is higher than normal but does not meet the diagnostic criteria for diabetes mellitus (DM). Prediabetes is crucial because most cases of prediabetes will develop into DM; on the other hand, with early diagnosis and appropriate intervention, it can also regress into normoglycemia. Nutrition intervention is one of the pillars of intervention to prevent the progression of prediabetes to diabetes. The existence of genetic polymorphism factors causes the implementation of general dietary recommendations to be unsuccessful for some people. This study aims to develop specific dietary recommendations for preventing the progression of prediabetes to diabetes based on an analysis of 8 single nucleotide polymorphisms (SNPs) associated with insulin resistance, body composition, and food preferences. The study was conducted in South Tangerang on 193 prediabetic subjects as cases and 376 normoglycemic subjects as controls. Data collection was carried out from October 2019 to June 2021. Interviews were conducted to obtain demographic and risk factor data; physical activity level was measured by IPAQ questionnaire; data on nutrient intake was obtained using a semi-quantitative FFQ and 24-hour food recall three times and then analyzed using Nutrisurvey. The Dietary Inflammatory Index (DII) score is calculated using 29 nutrient parameters. Insulin, leptin, and adiponectin levels were measured using ELISA, DNA extracted from venous blood and genetic polymorphisms were determined by genotyping examination. Data analysis to determine the existence of associations and interactions between the variables studied using the Rstudio application. Specific dietary recommendations were prepared based on the results of the interaction of genetic variants and nutrient intake, which were found to be significant. C/C genotype on GCKR rs780094 and G/G genotype on LEPR rs1137101 are protective factors against prediabetes with odds values of 0.48 (95% CI 0.3-0.75, p=0.00097) and 0.53(95% CI 0.36-0.76, p=0.0014). The interaction analysis found that the adequacy of calories, the proportion of carbohydrates, the proportion of fat, the proportion of PUFA, the proportion of SAFA, the adequacy of MUFA, fiber intake, and the DII score modulated the genetic variants studied so that they affected the risk of prediabetes, body composition, insulin resistance, and adipokine disharmony. On this basis, specific dietary recommendations for high-risk genotypes at 8 SNPs related to insulin resistance, body composition, and food preferences have been developed.