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"Obesitas merupakan fenomena saat ini yang banyak terjadi pada semua umur tak terkecuali anak usia sekolah. Pola makan yang salah serta gaya hidup kurang gerak merupakan salah satu faktor yang mendukung terjadinya obesitas selain faktor keturunan. Dampak yang terjadi pada anak-anak maupun dewasa merupakan hal yang mengkhawatirkan bagi individu, keluarga dan masyarakat. Keluarga merupakan orang terdekat bagi anak dan berfungsi melakukan perawatan pada anak. Penelitian ini bertujuan untuk mendapatkan arti dan makna pengalaman keluarga dalam merawat anak usia sekolah dengan obesitas di kota Yogyakarta. Penelitian ini dilakukan melalui pendekatan kualitatif dengan desain fenomenologi deskriptif dengan metode wawancara mendalam. Partisipan adalah keluarga baik ayah atau ibu (care giver) yang mempunyai pengetahuan cukup dan mampu menjelaskan fenomena, dan dapat berbahasa Indonesia. Jumlah partisipan keseluruhan ada 8 orang. Data yang dikumpulkan berupa rekaman wawancara dan catatan lapangan yang dianalisis dengan teknik Colaizzi. Penelitian ini mengidentifikasi 9 tema. Persepsi keluarga dengan anak obesitas mempunyai tema yaitu persepsi baik dan persepsi buruk anak obesitas. Hambatan keluarga dalam perawatan obesitas mempunyai tema norma keluarga yang tidak tepat. Makna pengalaman keluarga merawat anak obesitas mempunyai tema perasaan membolehkan dan melarang, kepercayaan (believe) keluarga yang salah tentang anak obesitas, obesitas bukan hambatan percaya diri dan mekanisme koping pada anak. Harapan keluarga dalam perawatan obesitas mempunyai tema perbaikan pola makan pada anak obesitas dan dukungan keluarga yang mempunyai tema memotivasi anak obesitas mencapai berat badan ideal. Hasil penelitian diharapkan dapat memberikan gambaran perawatan anak usia sekolah dengan obesitas serta bermanfaat untuk mengurangi kejadian obesitas di masyarakat dan membuat kebijakan untuk mencegah obesitas bagi pemerintah.

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Obesity is phenomena that dwelly with most of ail people include school age children. Pattem of eat and sedentary iife style and also genetic cause obesity and dangerous for individu, family and community. Family are the closest with children and caring for children. This study was aimed to provide deep understanding and meaning of family to explain school age children and how the family caring children with obesity in Yogyakarta. This study was descriptive phenomenology with indepth interview method. The participant were family (father or mother) whose caring school of children with obesity, have enough knowledge to explained the phenomena and able to spoke Indonesian language welL Data were gathered by indepth interview recording and field notes, and analyzed with Colaizzi’s analysis method. This study involved 8 participants. This study identified 9 themes, obesity child’s family have themes good perception, and bad perception. Inhabated family in caring obesity have themes norm in ineffective pattem. Mean of experiences of obesity child’s family have themes wrong of pattem of care feel of agree and do not agree, family’s believe of wrong to children with obesity, obesity was not make down of self confidence and child coping mechanism. Family hope in caring obesity child have themes to repair eat pattem of child obesity and to family enhance have themes expect to motivation children with obesity to ideal body. The result of this study were expected to explained caring of child age obesity and function to decrease incident obesity in community, and for the govemment to make police obesity prevence."

"Obesitas merupakan fenomena saat ini yang banyak terjadi pada semua umur tak terkecuali anak usia sekolah. Pola makan yang salah serta gaya hidup kurang gerak merupakan salah satu faktor yang mendukung terjadinya obesitas selain faktor keturunan. Dampak yang terjadi pada anak-anak maupun dewasa merupakan hal yang mengkhawatirkan bagi individu, keluarga dan masyarakat. Keluarga merupakan orang terdekat bagi anak dan berfungsi melakukan perawatan pada anak. Penelitian ini bertujuan untuk mendapatkan arti dan makna pengalaman keluarga dalam merawat anak usia sekolah dengan obesitas di kota Yogyakarta. Penelitian ini dilakukan melalui pendekatan kualitatif dengan desain fenomenologi deskriptif dengan metode wawancara mendalam. Partisipan adalah keluarga baik ayah atau ibu (care giver) yang mempunyai pengetahuan cukup dan mampu menjelaskan fenomena, dan dapat berbahasa Indonesia. Jumlah partisipan keseluruhan ada 8 orang. Data yang dikumpulkan berupa rekaman wawancara dan catatan lapangan yang dianalisis dengan teknik Colaizzi. Penelitian ini mengidentifikasi 9 tema. Persepsi keluarga dengan anak obesitas mempunyai tema yaitu persepsi baik dan persepsi buruk anak obesitas. Hambatan keluarga dalam perawatan obesitas mempunyai tema norma keluarga yang tidak tepat. Makna pengalaman keluarga merawat anak obesitas mempunyai tema perasaan membolehkan dan melarang, kepercayaan (believe) keluarga yang salah tentang anak obesitas, obesitas bukan hambatan percaya diri dan mekanisme koping pada anak. Harapan keluarga dalam perawatan obesitas mempunyai tema perbaikan pola makan pada anak obesitas dan dukungan keluarga yang mempunyai tema memotivasi anak obesitas mencapai berat badan ideal. Hasil penelitian diharapkan dapat memberikan gambaran perawatan anak usia sekolah dengan obesitas serta bermanfaat untuk mengurangi kejadian obesitas di masyarakat dan membuat kebijakan untuk mencegah obesitas bagi pemerintah.

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Obesity is phenomena that dwelly with most of all people include school age children. Pattern of eat and sedentary life style and also genetic cause obesity and dangerous for individu, family and community. Family are the closest with children and caring for children. This study was aimed to provide deep understanding and meaning of family to explain school age children and how the family caring children with obesity in Yogyakarta. This study was descriptive phenomenology with indepth interview method. The participant were family (father or mother) whose caring school of children with obesity, have enough knowledge to explained the phenomena and able to spoke Indonesian language well. Data were gathered by indepth interview recording and field notes, and analyzed with Colaizzi’s analysis method. This study involved 8 participants. This study identified 9 themes, obesity child’s family have themes good perception, and bad perception. Inhabated family in caring obesity have themes norm in ineffective pattern. Mean of experiences of obesity child’s family have themes wrong of pattern of care feel of agree and do not agree, family’s believe of wrong to children with obesity, obesity was not make down of self confidence and child coping mechanism. Family hope in caring obesity child have themes to repair eat pattern of child obesity and to family enhance have themes expect to motivation children with obesity to ideal body. The result of this study were expected to explained caring of child age obesity and function to decrease incident obesity in community, and for the government to make police obesity prevence. "

"ABSTRACTStunting or short stature in children is a significant nutritional problem in developing and underdeveloped countries. Stunting during childhood might affect brain development and impair development cognitive function. Additionally, this condition associated with the increased risk for obesity during adulthood. Several studies have shown that the increment risk of obesity and overweight in children with a short stature was due to their metabolic efficiency. Children with stunting have lower resting energy expenditure compared to non stunting children. Additionally, stunted children has higher respiratory quotient and carbohydrate oxidation but lower fat oxidation compared to non-stunting children. These results might explain why stunted children easily become obese, which is due to lower fat oxidation and leading to tendency to store fat.This review discussed the current status on studies in the nutrigenetic aspects of the relationship between stunting in the childhood and obesity in adulthood. I hypothesized that stunted children are more likely to become obese in their later life because they have lower metabolic rate and higher tendency of fat storage. There are several candidate genes and pathway involved in obesity and I suspected that ghrelin and its receptor growth hormone secretague receptor (GHSR) were responsible."

"Saat ini prevalensi obesitas di Indonesia mengalami peningkatan. Akibat buruk dari obesitas adalah dapat menimbulkan berbagai penyakit kronik. Penelitian ini bertujuan untuk mengidentifikasi faktor-faktor yang menyebabkan obesitas pada anak usia sekolah di SD Islam Al-Azhar 14 Semarang. Desain penelitian ini deskriptik analitik dengan cross sectional study. Dengan teknik stratified simple random sampling, didapatkan jumlah sampel 80 responden. Sebagian besar responden adalah laki-laki dengan rata-rata usia 8,55 tahun, dengan latar belakang orangtua bersuku Jawa. Mayoritas kedua orangtua berpendidikan tinggi dan berpenghasilan menengah ke atas. Rata-rata jumlah anak dalam keluarga 2,51 dengan jumlah anak antara satu sampai dengan lima anak dan sebagian besar ibu bekerja. Terdapat hubungan yang bermakna antara IMT ayah (p=0,000) dan IMT ibu (p=0,000), pola makan (p=0,007), kurang aktivitas fisik (p=0,000), dan tingkat sosial ekonomi keluarga (p=0,005) dengan kejadian obesitas pada anak. Faktor yang paling dominan terhadap kejadian obesitas adalah faktor kurang aktivitas fisik.

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Currently, Indonesia is facing obesity problems, and obesity can result in varied chronic diseases. The objectives of this study was to identify the factors affecting obesity among school-age children at Al-Azhar 14 Islamic Elementary School Semarang. A cross-sectional descriptive-analitic and retrospective study was employed and stratified simple random sampling was used to select the respondents. The majority of responden were male with the mean of age was 8.55 years old. Most of the parents were Javanist. Most parents had high educational background and were in the middle society. The mean number of children was 2.51 and most of the mothers were working mothers. There were four factors that had significant association to children obesity, namely the father's BMI (p=0,000) and mother's BMI of mothers (p=0,000), eating pattern (p=0,007), physical activity (p=0,000), and socio-economic level (p=0,005). The dominant factor was physical activity."

"Prevalens gizi lebih dan obesitas pada anak di Indonesia masih cukup tinggi. Konsumsi susu formula, terutama tingginya kandungan tinggi protein, berhubungan dengan kejadian gizi lebih dan obesitas pada anak sehingga kadar protein pada susu formula dianjurkan untuk diturunkan. Belum pernah terdapat penelitian di Indonesia mengenai hubungan konsumsi susu pertumbuhan dengan kejadian gizi lebih dan obesitas pada anak.Tujuan: Mengetahui rerata asupan energi, rasio kalori susu pertumbuhan dibandingkan kalori total per hari, protein susu pertumbuhan, dan rasio kalori protein susu pertumbuhan dibandingkan kalori protein total per hari dan hubungannya dengan kejadian gizi lebih dan obesitas pada anak usia 2-3 tahun. Metode: Studi potong lintang dilakukan untuk mengetahui proporsi gizi lebih dan obesitas, dilanjutkan dengan studi kasus kontrol untuk mengetahui hubungan susu pertumbuhan terhadap kejadian gizi lebih dan obesitas dengan matching usia dan jenis kelamin. Penelitian dilakukan di Posyandu Jakarta Pusat dan Timur bulan September hingga Desember 2018. Kelompok kasus merupakan subyek gizi lebih dan obes, sedangkan kelompok kontrol merupakan subyek gizi baik. Subyek menjalani pengukuran antropometri dan penilaian asupan nutrisi menggunakan food record selama 3 hari. Hasil: Sebanyak 292 subyek dengan kelompok kasus 34 subyek dan kelompok kontrol 68 subyek. Proporsi gizi lebih dan obesitas pada anak usia 2-3 tahun sebesar 12%. Terdapat perbedaan bermakna pada asupan energi susu pertumbuhan [516,1 (0-1546,7) vs 238,5 (0-1090,4) kkal/hari, p<0,001], rasio kalori susu pertumbuhan dengan kalori total per hari [41,1 (0-83,7) vs 20,8 (0-80,7)%, p<0,001], protein [18,9 (0-71,7) vs 8,6 (0-50,7) g/hari, p<0,001], dan rasio kalori protein susu pertumbuhan dengan kalori protein total [46,9 (0-89,5) vs 19 (0-72,3)%, p<0,001] antara kelompok kasus dan kelompok kontrol. Kesimpulan: Konsumsi susu pertumbuhan yang berlebih berhubungan dengan kejadian gizi lebih dan obesitas pada anak usia 2-3 tahun.

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Overweight and obesity prevalence in Indonesia is quite high. Recent studies suggest that consumption of infant formula, particularly high protein content, was related to overweight and obesity in children. Therefore, protein content in infant formula was recommended to be lowered. Currently, there is no data on the association between growing-up milk consumption and overweight and obesity in children aged 2-3 years in Indonesia.

Objective: To determine the average intake of growing-up milk energy, ratio of growing-up milk calories to the total calories per day, growing-up milk protein, and ratio of growing-up milk protein calories to the total protein calories per day and their relationship with overweight and obesity children aged 2-3 years.

Methods: Cross-sectional study was conducted to determine the proportion of overweight and obesity, followed by case-control study to determine the relationship between growing-up milk consumption with overweight and obesity. Overweight and obese subjects were considered as the case group, while normal weight subjects were categorized as control group. Study was conducted in Jakarta since September to December 2018. Three days-food record analysis were performed.

Results: A total of 292 subjects with 34 cases and 68 controls. The proportion of overweight and obesity in children aged 2-3 years was 12%. There were significant differences between case and control group in terms of growing-up milk energy intake [516.1 (0 to 1546.7) vs. 238.5 (0 to 1090.4) kcal/day, p<0.001], ratio of growing-up milk calories to total calories per day [41.1 (0 to 83.7) vs 20.8 (0 to 80.7)%, p<0.001], growing-up milk protein [18.9 (0 to 71.7) vs 8.6 (0 to 50.7) g/day, p<0.001], and ratio of growing-up milk protein calories to total protein calories [46.9 (0 to 89.5) vs. 19 (0 to 72.3)%, p<0.001].

Conclusion: Excessive consumption of growing-up milk had significant relationship with overweight and obesity in children aged 2-3 years. "

"Anak gemuk bukanlah anak sehat seperti anggapan yang sering didengar di kalangan masyarakat. Obesitas merupakan keadaan indeks massa tubuh (IMT) pada grafik tumbuh kembang anak sesuai jenis kelamin berada di atas persentil ke-95. Hal ini terjadi akibat adanya ketidakseimbangan asupan energi dan pengeluaran energi. Anak dengan masalah obesitas akan berisiko menderita penyakit tidak menular, seperti hipertensi, DM, dan sebagainya. Salah satu cara menangatasi masalah obesitas, yaitu dengan cara mengatur pola makan dengan Model Piring T yang merupakan program Kementrian Kesehatan Republik Indonesia untuk memberantas angka obesitas nasional (GENTAS). Penelitian ini diberikan melalui pendekatan asuhan keperawatan keluarga kepada anak sekolah yang memiliki masalah obesitas dengan pemberian intervensi pengaturan porsi makan berdasarkan Model Piring T. Setelah diberikan intervensi didapati beberapa perubahan, seperti peningkatan pengetahuan keluarga terkait obesitas dan cara mengatasinya, serta perubahan perilaku keluarga yang berdampak pada penurunan berat badan anak. Oleh karena itu, terdapat pengaruh pengaturan porsi makan dengan model piring T pada keluarga dengan anak sekolah yang memiliki masalah obesitas terhadap pengetahuan, sikap, dan perubahan berat badan.

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Obese children are not healthy children as the assumption that is often heard in the community. Obesity is a state of body mass index (BMI) on a child's growth and development chart according to sex which is above the 95th percentile. This occurs due to an imbalance in energy intake and energy expenditure. Children with obesity problems will be at risk of suffering from non- communicable diseases, such as hypertension, DM, and so on. One way to overcome the problem of obesity is by adjusting the diet with the Plate T Model which is a program of the Indonesia Ministry of Health to eradicate the national obesity rate (GENTAS). This research was given through a family nursing care approach to school children who have obesity problems by providing an intervention to regulate meal portions based on the T Plate Model. Therefore, there is an effect of setting meal portions with the T plate model in families with school children who have obesity problems."

"ABSTRAKLatar Belakang: Leptin yang diketemukan oleh Zhang dan Friedman pada tahun 1994, dihasilkan oleh adiposit dan berhubungan dengan obesitas. Pada hewan coba, selain mempengaruhi homeostasis berat badan, leptin juga mempengaruhi metabolisme lipid pada jaringan perifer, seperti lipolisis dan lipogenesis. Peningkatan lipolisis dan penurunan lipogenesis menyebabkan peningkatan asam lemak bebas, yang kemudian diikuti oleh peningkatan konsentrasi trigliserida. Pada saat konsentrasi trigliserida tinggi, terjadi pembentukan small dense LDL, yang merupakan komponen dari dislipidemia aterogenik, terutama pada individu obes. Penelitian ini berusaha memperlihatkan perbedaan antara konsentrasi leptin dan profil lipid pada obes dan non-obes, dan terdapatnya hubungan antara leptin dan small dense LDL pada obesitas.Subyek: Berhasil dikumpulkan 297 laki-laki subyek penelitian, yang terdiri dari 205 subyek dengan obesitas sentral dan 92 subyek non-obes, yang presentase terbesar berusia antara 30-59 tahun. Variabel yang diamati pada penelitan ini antara lain, Indeks Massa Tubuh (IMT), lingkar perut, konsentrasi leptin, trigliserida, asam lemak bebas, kolesterol LDL, ApoB, ratio kolesterol LDL dan ApoB, kolesterol HDL, glukosa puasa dan insulin.Metodologi: Penelitian ini menggunakan disain potong lintang, Hubungan antara leptin dengan variabel-variabel seperti IMT, lingkar perut, leptin, trigliserida asam lemak bebas, kolesterol LDL, ApoB, kolesterol HDL dan insulin dianalisis dengan unpaired Nest, dibandingkan antara kelompok obes sentral dan non-obes. Sedangkan hubungan antara leptin dan small dense LDL dianalisis dengan menggunakan regresi logistik.Pemeriksaan laboratorium dari tiap variabel dilakukan dengan metode antara lain, konsentrasi trigliserida dan asam lemak bebas diukur dengan metode kolorimetri enzimatik, kolesterol LDL dan kolesterol HDL diukur dengan metode homogenisasi. Konsentrasi insulin diukur dengan metode ELISA, kadar leptin diukur dengan metode immunoassay.Hasil dan Pembahasan: Terdapat perbedaan karateristik antara kelompok obes dan non-obes, antara lain plasma leptin lebih tinggi pada kelompok obes sentral dibandingkan dengan kelompok normal; 9,71 (1,92) ng/mL vs. 2,63 (2,09) ng/mL, (P<0,001); rerata trigliserida 159,1 (6,97) mg/dL vs. 119,4 (4,8) mg/dL; (P<0,001), asam lemak bebas 0,42 (0,01) mmol/L vs. 0,36 (0,02) mmol/L; (p=0,001), apoB 108,05 (21,1) mg/dL vs. 101,4 (20,4) mg/dL(p=0,012) juga lebih tinggi pada kelompok obes dibandingkan non-obes, kolesterol HDL lebih rendah pada kelompok obes yaitu 40,6 (1,2) mg/dL vs. 46,2 (1,2) mg/dL; (P<0,001). Sedangkan rerata kolesterol LDL tidak berbeda bermakna antara kelompok obes dan non-obes 138,9 (32,2) mg/dL vs. 137,8 (31,9) mg/dL; (P=0,792). Pada subyek dengan Inleptin < 7,5 pg/mL (1,8 ng/mL) peningkatan kemungkinan didapatkannya small dense LDL sebesar 5,92 kali dibandingkan dengan subyek dengan lnleptin > 9,87 pg/mL (19,34 ng/mL).Penentuan indeks massa tubuh sebagai kriteria obesitas; penelitian ini memperkuat pendapat untuk menggunakan kriteria Asia Pasifik (1MT > 25 kg/m2) sebagai klasifikasi indeks massa tubuh (IMT) untuk populasi orang Indonesia.Hubungan lingkar perut dengan small dense LDL, leptin, IMT, dan HOMA-IR; Lingkar perut mempunyai korelasi yang baik dan bermakna secara statistik dengan konsentrasi leptin (r=0,72 dan P<0,05) dan HOMA-IR (r~0,53 dan P<0,05). Lingkar perut pada subyek dengan dan tanpa small dense LDL berbeda bermakna (P=0,016).Nilai normal konsentrasi leptin bagi IMT normal adalah 2,04 ng/mL dengan kisaran: 0,45 - 9,26 ng/mL. dan rerata konsentrasi leptin pada subyek obes sentral adalah 9,71 ng/mL dan subyek non-obes : 2,63 ng/mL.Resistensi dan defisiensi leptin pada obesitas; pada obesitas sentral dapat terjadi resistensi leptin atau defisiensi leptin dan mungkin ambang terjadinya resistensi leptin pada subyek penelitian ini lebih rendah (< 20 ng/mL) dibandingkan etnik Kaukasia.Peran enzim lipase hepatik (HL) pada pembentukan small dense LDL; hubungan peningkatan konsentrasi leptin dengan didapatkannya small dense LDL dapat dihubungkan dengan efek enzim lipase hepatik. Bila pengaruh leptin terhadap didapatkannya small dense LDL terjadi dengan bantuan enzim lipase hepatik (HL) sebagai katalisator dapat dibuktikan, maka akan memperkuat bukti adanya hubungan antara leptin dengan didapatkannya small dense LDL.Hipotesis baru penelitian ini adalah, leptin mempunyai efek inhibisi terhadap enzim lipase hepatik di hati, atau analog dengan efek inhibisi insulin terhadap enzim HSL pada adiposit.Hasil penelitian dibandingkan dengan penelitian lipid sebelumnya; hasil penelitian ini dapat membuktikan perbedaan leptin dan profil lipid, yaitu konsentrasi asam lemak bebas, trigliserida dan kolesterol HDL pada kelompok subyek obesitas sentral dan subyek non-obes. Beberapa penelitian sebelumnya memberikan hasil yang berbeda.Simpulan: Penelitian ini adalah penelitian pertama yang membandingkan konsentrasi leptin dan hubungannya dengan small dense LDL pada kelompok obes dan non-obes pada populasi di Indonesia maupun di dunia. Hasil penelitian ini memperlihatkan bahwa konsentrasi leptin lebih tinggi secara bermakna pada kelompok obes sentral dibandingkan dengan kelompok non-obes, serta berhubungan secara bermakna dengan konsentrasi trigliserida, asam lemak bebas, apoB dan kolesterol HOL. Lebih jauh lagi, penelitian ini juga memperlihatkan hubungan antara leptin dan didapatkannya small dense LDL, di mana makin rendah leptin akan makin meningkatkan kemungkinan terdapatnya small dense LDL, Pada laki-laki dengan obesitas sentral, leptin berhubungan dengan prediksi didapatkannya small dense LDL. Leptin secara independen mempunyai efek protektif terhadap didapatkannya small dense LDL.

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ABSTRACT

Background: Leptin which is discovered by Zhang and Friedman (1994) is secreted by adipocytes and associated with obesity. In animals it has been shown that beside its effect on weight homeostasis, leptin also exerts peripheral effects that include lipid metabolism, i.e. lipogenesis and lipolysis. The results of studies on humans are conflicting. The increased lipolysis and decreased lipogenesis resulted in an increase synthesis of fatty acids which is followed by triglycerides. At a certain level of triglycerides, small dense LDL formation occur, an established component of atherogenic lipoprotein phenotype (ALP). Leptin has been implicated in this process especially in central obese individuals. The aim of the study is to show that leptin and lipid levels are higher in central obese as compared to non-obese individuals and to investigate the relationship between leptin levels and small dense LDL in central obese individuals.

Subjects: A total of 297 male subjects comprising 205 central obese and 92 nonobese age 30-59 years were enrolled in the study. Variables under study includes body mass index (BMI), serum leptin, triglyceride, free fatty acids, LDL-cholesterol, apoB, LDL-cholesterollapoB ratio, HDL-cholesterol and insulin levels.

Methods: This is a cross sectional study. The correlation between leptin and some variables, such as body mass index (BMI), triglycerides, free fatty acids, LDL-cholesterol, apoB, LDL-cholesterollapoB ratio, HDL-cholesterol and insulin levels was analyzed by unpaired t-test. Correlation between leptin and small dense LDL was analyzed by logistic regression. Plasma tryglycerides and free fatty acids were measured by enzymatic colorimetry method; apoB by immunoturbidimetry, LDL-cholesterol and HDL-cholesterol by homogenous method, insulin level by enzym-linked immunosorbent assay (BLISA), Plasma leptin was measured by immunoassay.

Results & Discussion: The characteristics between obese and nonobese subjects were different, such as mean plasma leptin levels were significantly higher in central obese than in nonobese individuals 9.71 (1.92) ng/mL vs. 2.63 (2.09) ng/mL, (P<0.001); mean triglycerides 159.1 (6.97) mg/dL vs. 119.4 (4.8) mg/dL; (P<0.001), free fatty acids 0.42 (0.01) mmol/L vs. 0.36 (0.02) mmol/L; (P=0.001), apoB 108.05 (21.1) mg/dL vs. 101.4 (20.4) mg/dL (P=0.012) were also higher in central obese than in nonobese individuals, and HDL-cholesterol is lower 40.6 (1.2) mg/dL vs. 46.2 (1.2) mg/dL; (P<0.001). LDL-cholesterol 138.9 (32.2) mg/dL vs. 137.8 (31.9) mg/dL (P=0.792). Among subjects with lnleptin < 7.5 pg/mL (L8 ng/mL) the risk of having small dense LDL increases by 5.92 times compared to subjects with lnleptin 9.87 pg/mL (19.34 ng/mL).

In regard to body mass index and the classification of obesity, the present study is in favor with the Asia Pacific classification and criteria for obesity, i.e. BMI > 25 kg/rn2 to be used for Indonesian population.

Relationship between waist circumferences, small dense LDL, leptin, BMI, dan HOMA-IR. There is a statistically significant strong relationship between waist circumference and leptin (r=0.72; P<0.05) and HOMA-IR P<0.05). Furthermore, mean of waist circumference differ significantly between subjects with and without small dense LDL (P=0.016).

Normal leptin levels for subjects with normal BMI is 2.04 ng/mL (range 0.45-9.26 ng/mL); and mean leptin levels for obese and nonobese were 9.71 and 2.63 ng/mL, respectively.

In regard to leptin resistance and leptin deficiency in obese subjects. Both leptin resistance and leptin dificiency is found in obese subjects, and the result indicate that leptin resistance in this population developed at lower leptin level (<20 ng/mL) as compared to Caucasian.

The possible role of hepatic lipase in small dense LDL formation. The relationship of increased leptin levels and the presence of small dense LDL could possibly be due to hepatic lipase (HL) effect. If the effect of leptin on small dense LDL formation is by way of HL as catalysator can be proven, this finding will then support the evidence of relationship between leptin and small dense LDL.

The hypothesis generated from the present study is that leptin inhibits the effect of HL in the liver in analogy with the inhibitory effect of insulin on HSL in the adipocyte.

Results arising from the present study support the view that leptin levels and lipid profile, i.e. free fatty acids, triglycerides, dan HDL cholesterol in obese differ from nonobese subjects, whereas other studies give different results.

Conclusion: This is the first study that compare leptin levels and determine the relationship between leptin and small dense LDL in central obese and nonobese male Indonesian subjects. The results showed that leptin levels are significantly higher in central obese as compared to nonobese individuals, and is correlated with triglycerides, free fatty acids, apoB and HDL-cholesterol in central obese individuals. Furthermore, this study also showed a relationship between leptin levels and small dense LDL in central obese individuals, in which lower leptin levels carries a higher probability of having more small dense LDL. Leptin has an independent protective effect for the occurrence of small dense LDL."

"Obesity is performed by genetic, environmental, and complex interaction between genetic and environmental factors.Fatness levels in obese children are indicative of increased risk for elevated blood pressure, cholesterol, and lipoproteinratios children and adolescents. Serum cholesterol and blood pressure are related to raise atherosclerotic lesion. Certaincardiovascular disease risk factors in obese children are related to the earliest stages of atherosclerosis disease. Obesechildren have the high risk factors of certain cardiovascular disease. Genetic factors affecting metabolic rate can besuccessfully managed by the introduction of environmental factors such as decrease caloric intake and increase physicalactivity. The treatment of obesity and of atherosclerotic patients should include dietary restriction (protein sparingmodified fast and hypocaloric balanced diet), nutrition education, increased physical activity, behavior modification, andfamilial support. Success fully management of obesity can improve the quality of life and reduce the risk of morbidityand mortality associated with obesity."

"Latar Belakang: Diet kalori rendah protein tinggi dianggap dapat membantu seseorang dalam menjaga fungsi tubuhnya dibanding diet protein seimbang, khususnya pada orang dengan riwayat weight cycling. Penelitian bertujuan untuk mengetahui dampak diet kalori rendah protein tinggi terhadap aktivitas katalase. Metode: Penelitian ini dilakukan dengan menggunakan desain eksperimental dengan sampel tersimpan. 15 Sampel Plasma kelompok protein seimbang dan 14 sampel kelompok protein tinggi diperiksa aktivitas katalasenya kemudian dilakukan uji bivariat uji t tidak berpasangan. Hasil: Dari hasil perhitungan absorbsi, diketahui bahwa kualitas Plasma tersimpan kurang baik dari banyaknya hasil uji yang menunjukkan aktivitas katalase 0. Dari hasil uji t tes tidak berpasangan didapatkan tidak ada perbedaan pada aktivitas katalase Plasma subjek diet kalori rendah protein tinggi dengan diet kalori rendah protein seimbang, dengan nilai uji p=0,2275. Kesimpulan: Tidak terdapat peningkatan yang signifikan pada diet kalori rendah protein tinggi dibandingkan kontrol. Penelitian sebelumnya memiliki hasil yang berkebalikan.

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Background: Low calories high protein is believed to help body keep its function compared to balanced protein.

Objective: The study aimed to know the impact of low calories high protein diet on catalase activity compared to low calories balanced protein on subject with weight cycling obesity.

Methods: The study was conducted by using experimental method on stored sample of previous research. The sample consist of 15 subject of balanced protein group and 14 subjects of high protein group. Catalase activity data were gathered from the sample and from the data, two-samples t-test was conducted to see the difference on catalase activity.

Results: The quality of sample is compromised as there are some sample with 0 catalase activity. From the rest of the sample, two sample t test results in p=0.2275, indicating there is no difference on catalase activity between high protein diet and balanced protein diet.

Conclusion: Our research Conclude there is no significant improvement over Plasma catalase in subject on low calories high protein diet compared to control . Previous researches also give conflicting results. Thus, we need further research in this area."

"The prevalance of obesity is increasing globally, both in developed and developing countries including Indonesia. Obesity accurs due to imbalance between energy intake and energy release for a long time as indicated by body mass index (BMI)...."