Comparison of hs-CRP in Adult Obesity and Central Obesity in Indonesia Based on Omega-3 Fatty Acids Intake: Indonesian Family Life Survey 5 (IFLS 5) Study.

Obesity and central obesity are associated with dire conditions, such as metabolic syndrome, in which low-grade inflammation plays a part. C-reactive protein (CRP) is an inflammatory marker found to be elevated in those conditions. Omega-3 fatty acids work against inflammation and lower CRP levels in obese individuals. This study compared high-sensitivity CRP (hs-CRP) in adult obesity and central obesity in Indonesia based on omega-3 fatty acid intake using Indonesian Family Life Survey (IFLS) 5 data. Secondary data from household questionnaires were obtained from the IFLS 5 online database. Data from 3152 subjects were used; 76.65% of the subjects were female, with a mean age of 45.27 ± 15.77 years. Subjects were classified into five modified categories of obesity and central obesity based on body mass index (BMI) and waist circumference (WC). Omega-3 fatty acid intake was categorized into "low" and "adequate" based on dietary recommendations from the Mediterranean Diet Foundation (2011). There is a significant difference in hs-CRP based on modified obesity categories (p < 0.05). There was no significant difference in hs-CRP between low and adequate omega-3 intake (p > 0.05). These data suggest that hs-CRP is related to overweight, obesity, and central obesity. Meanwhile, omega-3 fatty acids are unrelated to hs-CRP. Further studies are needed to confirm these results.

Training and Assessing Model for the Ability of Community Health Volunteers in Anthropometric Measurement Using the Rasch Stacking and Racking Analyses.

Background: Inappropriate anthropometric measurements of infants and toddlers lead to a misclassification in nutritional status and loss of important interventions. Considering the practice conducted in this program within a country, its impact on millions of children must be considered. This study assesses the ability of community health volunteers (CHVs) before and after anthropometric training on infants and toddlers. Methods. This study used a quantitative approach with a quasiexperimental and pretest-posttest design. The pre- and posttraining assessments of CHVs were conducted by standardized trainers using instruments developed according to WHO standards. There were 11 and 13 statement items for infants' and toddlers' indicators of assessment in anthropometric measurements, respectively. The result of the assessment was then analyzed using Rasch modeling with stacking and racking data analysis techniques. Results: The CHVs' skills before training were far from adequate. Although widely varied, all trainees improved their abilities. Stacking analysis showed that the skills of all CHVs in measuring infants and toddlers increased by 2.68 and 3.34 logits (p < 0.01), respectively. Racking analysis showed a decrease in the perceived difficulty of all items by 2.61 and 3.07 logits for infant and toddler measurements, respectively (p < 0.01). The results of the racking analysis showed that the difficulty in measuring the anthropometrics of infants decreased more than that of toddlers. Conclusions: CHVs' capacity to monitor child growth must be refreshed regularly. Standardized and proper training and assessment were developed to make CHVs reliable in taking anthropometric measurements of infants and toddlers.

Feasibility of Indonesia Family Life Survey Wave 5 (IFLS5) Data for Air Pollution Exposure-Response Study in Indonesia.

BACKGROUND: Air pollution is an important risk factor for the disease burden; however there is limited evidence in Indonesia on the effect of air pollution on health, due to lack of exposure and health outcome data. The objective of this study is to evaluate the potential use of the IFLS data for response part of urban-scale air pollution exposure-health response studies. METHODS: Relevant variables were extracted based on IFLS5 documentation review. Analysis of the spatial distribution of respondent, data completeness, prevalence of relevant health outcomes, and consistency or agreement evaluation between similar variables were performed. Power for ideal sample size was estimated. RESULTS: There were 58,304 respondents across 23 provinces, with the highest density in Jakarta (750/district). Among chronic conditions, hypertension had the highest prevalence (15-25%) with data completeness of 79-83%. Consistency among self-reported health outcome variables was 90-99%, while that with objective measurements was 42-70%. The estimated statistical power for studying air pollution effect on hypertension (prevalence = 17%) in Jakarta was approximately 0.6 (α = 0.1). CONCLUSIONS: IFLS5 data has potential use for epidemiological study of air pollution and health outcomes such as hypertension, to be coupled with high quality urban-scale air pollution exposure estimates, particularly in Jakarta.

Determinants of adolescent shortness in Tanjungsari, West Java, Indonesia.

BACKGROUND AND OBJECTIVES: Health status during adolescence may predetermine that during adulthood. Being short because of nutritional and health adversity, where stunting is indicative, is a global health concern, possibly in adolescence. This study assessed the prevalence of shortness (defined by HAZ <-2 SD) at age 12 and its determinants. STUDY DESIGN: This Tanjungsari birth cohort of 1988/1989 was revisited in 2001-2002 with 3093 participating children, their parents and households. The cohort was tracked from birth, to ages 2 and 12 with anthropometry, with birth weight, then weight and height-for-age at 2 and 12, dietary history at age 2, health patterns at age 2 and 12, and environmental exposures. RESULTS: The prevalence of adolescent shortness, presumed 'stunting', was 48.8% for which predictor Odds Ratios (OR) were low birth weight 1.64 (95% CI: 1.28-2.09), short height for age at 2-years 1.54 (95% CI: 1.33-1.80), limited maternal education 1.19 (95% CI: 1.01-1.41), unimproved source of drinking water 1.27 (95% CI: 1.08-1.49), unimproved latrine 1.18 (95% CI: 1.01-1.39) and presence of atopic disease at 12 years of age 1.29 (95% CI: 1.01-1.65). Smoking exposure, not breastfed, formula milk consumption and infectious disease at age 2 were not associated with shortness at age 12 on multivariable analysis. CONCLUSIONS: Adolescent shortness was found in almost half of this rural Javanese cohort followed from birth. It was associated with birth weight, and several individual, maternal and environmental factors evident at age 2, along with an atopic disposition at age 12. However, stature itself may not constitute a health risk over and above the associated socio-environmental conditions.