Dietary Intake of Obese Adult Men in Jakarta

Karima Yudhistina

, Erfi Prafiantini

and Novi S. Hardiany

Deparment of Nutrition, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia

Department of Biochemistry & Molecular Biology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia

Keywords: Obesity, Adult men, Dietary intake

Abstract: Obesity is caused by excessive storage of fat reserves in the body due to an imbalance of energy stored and

energy expended. Excess and unhealthy eating patterns are associated with the incidence of obesity in

Indonesia. In Indonesia itself, the population with obesity was 21.8% in 2018, and the prevalence of obesity

was 29.8% of Jakarta population. The study aims to describe obese adult men's food intake as the preliminary

data that can be used for dietary education material. This research was a descriptive study conducted on 50

participants living in Jakarta. The participants were healthy adult men aged 19 -59 years with BMI ≥25 kg/m

Food intake was assessed through an interview with the 24-hour recall method implemented twice (once on

a weekday and once on the weekend). The average total energy per day was 1597 kcal/day, the protein was

64 g/day, the fat was 71 g/day, and the carbohydrate was 198 g/day. The amount of energy, carbohydrate, and

protein intake was still less than the recommended dietary allowance (RDA). These findings suggest that the

occurrence of obesity in adult men in Jakarta might be influenced by other factors, such as genetics and

physical activity

1 INTRODUCTION

The incidence of obesity is continuing to increase.

Obesity is a significant risk factor for many chronic

diseases including metabolic and degenerative

diseases such as cardiovascular disease, diabetes, and

cancer which increase the death risk (Jeon 20111).

Based on data from the World Health Organization

(WHO) in 2018, 39% of adults were overweight, and

1% were obese. In Indonesia, the number of people

with obesity was 21.8% in 2018 (Riskesdas 2018).

DKI Jakarta had the second largest prevalence of

obesity with 29.8% of the population can be

categorized as obese.

Obesity is a condition where there is an imbalance

of energy intake and energy expenditure resulting in

accumulation of fat in adipose tissue. (Kim 2019).

Dietary factors such as excessive food consumption

related to the risk of obesity. Dietary fat has been

known as the leading cause of weight gain. More

recently, other dietary composition factors such as

fiber, energy density, and eating patterns such as

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eating frequency, snacking, or skipping meals have

been suggested to have a potentially significant

influence on energy regulation (Howarth 2005)

The increasing urbanization occurred in most

countries worldwide associated with an unhealthy

diet towards high fat, high energy-dense foods, and

sedentary activity. Inadequate dietary intake pattern

is one of the significant contributors to the

development of obesity and many non-communicable

diseases. As populations become more urbanised and

has better income, the consumption of sugar and fat

is increasing and replacing more conventional diets

of high complex carbohydrates and fiber. Traditional

cuisine and unique conventional food habits are being

replaced by fast foods, soft drinks, and increased

animal-based food consumption. Homogenization

and westernization of the global diet have increased

energy density (Swinburn 2004). A study conducted

by Khusun H et al. in Indonesia's major urban areas,

including Jakarta, found that men significantly

consumed instant noodles, egg, and sugar-sweetened

beverages (SSB) nonmilk (particularly coffee) more

often than women. This study also showed that men

190

Yudhistina, K., Praﬁantini, E. and Hardiany, N.

Dietary Intake of Obese Adult Men in Jakarta.

DOI: 10.5220/0010489901900193

In Proceedings of the 1st Jenderal Soedirman International Medical Conference in conjunction with the 5th Annual Scientiﬁc Meeting (Temilnas) Consortium of Biomedical Science Indonesia

(JIMC 2020), pages 190-193

ISBN: 978-989-758-499-2

significantly consumed fewer vegetables, biscuits,

and sweet foods. Frequent consumption was defined

as the number consumption of more than 13 times in

a month. The study population generally had very

high sedentary activities that lead to low physical

activity levels and low energy expenditure (Khusun

H 2016).

In this study, we want to describe the food intake

of obese adult men in Jakarta as preliminary data that

can be used to develop dietary education materials.

2 MATERIALS AND METHODS

This study was a descriptive study conducted from

July-September 2020 at national companies PT.

Delameta Bilano and PT. Rekayasa Industri in East

Jakarta. The research participants were male

employees with obese nutritional status, aged 19-59

years, BMI ≥25 kg/m

, and had no history of chronic

diseases such as impaired liver function, impaired

kidney function, heart disease, and type 2 diabetes

mellitus. The data were collected through anamnesis

and examination physical. All participants were

agreed to take part in the research. There were 67

obese male individuals screened for the research, 14

individuals were unwilling to participate in the study,

and three individuals did not meet the study inclusion

and exclusion criteria. A total 50 individuals

participated in the research. All research participants

were subjected to characteristics interview, intake

interview, and anthropometric measurement. The

research participants in this study were recruited

consecutively. This study received ethical clearance

from the Ethical Committee Faculty of Medicine,

Universitas Indonesia with reference number KET-

281/UN2.F1/ETIK/PPM.00.02/2020. All participants

signed informed consent to participate in the study

before data collection were done.

A registered enumerator or nutritionist performed

anthropometric measurements to all participants.

Bodyweight was measured using bioelectrical

impedance analysis (BIA) with an accuracy of 0.1 kg.

The body weight was measured two times and the

average of both measurements was used in the

analysis. Height was measured in centimeters with

accuracy 0.1 cm, in standing position with socks and

shoes removed using Shorrboard.

Nutritional status is measured by the body mass

index (BMI) which were calculated by dividing the

weight in kg by the height in meters. The BMI was

categorized into two categories which were on the

classification of the degree of obesity, namely obese

I and obese II according to international standard

(WHO 2012)

The food intake was assessed using the 2x24 hour

food recall method and measured two times on

weekdays and weekends. In the food recall method,

the subject is asked to remember and mention the type

of food consumed in the last 24 hours and is asked to

explain the food/drink's name, how to make it, the

ingredients needed, and the portion consumed using

the household size (Shim 2014). The data from the

food intake assessment were analyzed using the

nutrisurvey program.

The statistical analysis was conducted using

SPSS version 20. Data normality was tested using

Shapiro-Wilk. Continuous variables with normal

distributions were presented as mean ± SD, and those

with abnormal distributions were presented as median

(minimum-maximum). Categorical variables were

described as proportion and percentage.

3 RESULTS

The demographic and anthropometric characteristics

of the participant are shown in tabel.1. The

participants had the average of age 31.5 years. In term

of body weight of the participants, the average of

height was 168 cm while the weight and BMI average

were 87 kg and 30.6 kg/m

respectively.

Table 1: Demographic and anthropometric characteristics

of subjects.

Variables Total subjects

(n=50)

Age, years 31.5 (19

–

54)

Hei

ht, c

168

(

158 -187

)

Wei

ht, k

(

–

123

)

BMI, kg/m

30.6 (25

–

44)

Level of education, n(%)

- Moderate

- High

14 (28)

36 (72)

Household income, n(%)

- Low

- Moderate

7 (14)

43 (86)

Type of work, n(%)

- Administration

- Field workers

- Others

20 (40)

14 (28)

16 (32)

Smoking history, n(%)

- No smoked

- Mild

- Moderate

- Heav

19 (38)

18 (36)

10 (20)

3 (6)

Dietary Intake of Obese Adult Men in Jakarta

191

Table 2 describes the dietary intake of study

participants. The average of total energy of

participants was still below the recommended dietary

allowance (1597±468.7). Similar findings were found

in the intake of carbohydrate (198±57) as well as for

protein intake (64±29). The dietary intake of fat was

slightly higher than the recommendation (71±98)

(AKG 2019).

Table 2: Description of dietary intake.

Total

(

n=50

)

RDA

Total energy,

kcal/da

1597±468,7 2150-2650

Fat,

/da

71±98 70

Protein,

/da

64±29 65

Carbohydrate, g/day 198±57 415-430

4 DISCUSSION

This study was aimed to describe the food intake of

obese adult men in Jakarta which can be used to

develop dietary education materials. Findings from

this study showed that the energy and carbohydrate

intake of the participants were lower than the

recommended dietary allowances (RDA). The protein

intake was slightly lower than the RDA while the fat

was adequate according to the RDA.

In recent years, there have been medical and

nutritional recommendations for reducing the

consumption of saturated fatty acid (SFA) due to the

increase of low-density lipoprotein (LDL) as a risk

factor of cardiovascular disease. Population studies

have demonstrated that elevated LDL cholesterol and

apolipoprotein B (apo B) levels are directly

associated with the risk of atherosclerotic events.

Infiltration and retention of apo B containing LDL in

the artery wall are critical in initiating an

inflammatory response. Modified lipoprotein

stimulates macrophages to promote foam cell

formation, which is the hallmark of atherosclerosis's

fatty streak phase (Boren 2020). High-fat levels in the

body stimulate inflammation, which is the

pathogenesis of many chronic diseases. High-intake

of fat and carbohydrate contributes to increased

oxidative stress and also inflammation (Fortes 2020).

Dietary proteins influence body weight regulation

through several mechanisms such as weight

regulation, satiety, thermogenesis, energy efficiency,

and body composition. Protein ingestion results in

higher ratings of satiety than equicaloric amounts of

carbohydrates or fat. Protein intake also induces

higher thermogenesis than for other macronutrients.

The increase in energy expenditure is caused by

protein, urea synthesis, and gluconeogenesis. Higher

intake amounts of protein during dietary management

of obesity resulted in more significant weight loss

than with lower amounts of protein (Keller 2011).

The results of a study conducted by Mansoor et

al. suggest that variation in the ranks of carbohydrate,

protein, and fat consumed may affect obesity

(Mansoor 2016). Besides, various dietary

macronutrients were associated with metabolic

abnormalities that increase cardiovascular disease

and mortality (Kim, 2019). Research in South Korea

states that high carbohydrate intake is associated with

a decrease in high-density lipoprotein (HDL) and

increase triglyceride levels (H.Choi 2012). The

identification of macronutrients in obese people is

essential to have an individual approach regarding an

appropriate diet (Kim 2016).

Obesity is a low-grade inflammatory condition.

The complexity of this chronic disorder becomes

more apparent, exhibiting a multifactorial etiology.

Besides lifestyle factors such as dietary patterns and

exercise, nutrigenetics and nutrigenomics also

contribute to the phenotype of obesity. Nutrigenetics

and nutrigenomics theory explain the genome's

interaction to regulate the development and

progression of obesity and its comorbidities. These

mechanisms explain differences in the obese

phenotype that vary both within and across the

population. (Joffe 2016). The results of this study

showed that most of the subjects were not smokers.

These results are similar to studies in Japan, where

non-smokers are at greater risk of obesity than those

who smoked (Watanabe 2016). Previous studies have

suggested that cigarette smoking itself, in particular

nicotine, could decrease body weight by appetite

suppression and increased energy consumption

(Filozof 2004).

5 CONCLUSIONS

This study found that energy, carbohydrate, and

protein intake of obese adult men in Jakarta were still

lower than the recommended dietary allowance

(RDA) but not for the fat intake. These findings imply

that other factors such as a genetic and physical

activity may contribute to the increased prevalence of

obesity in adult men in Jakarta. Further research is

needed to explore the contribution of those factors to

the increased prevalence of obesity particularly in

adult men population.

JIMC 2020 - 1’s t Jenderal Soedirman International Medical Conference (JIMC) in conjunction with the Annual Scientiﬁc Meeting

(Temilnas) Consortium of Biomedical Science Indonesia (KIBI )

192

ACKNOWLEDGEMENTS

This research was supported by the Ministry of

Research and Technology of Indonesia

REFERENCES

Jeon, K. J., Lee, O., Kim, H. K., & Han, S. N. (2011).

Comparison of the dietary intake and clinical

characteristics of obese and normal-weight

adults.Nutrition research and practice,5(4), 329–336.

World Health Organization. Fact sheet: what causes

overweight and obesity? South-East Asia; 2011.

World Health Organization RO for S-EA. Non-

communicable diseases in the south-east Asia region:

situation and response 2011. New Delhi; 2011.

Riskesdas. Hasil utama riskesdas penyakit tidak menular

2018. Hasil Utama Riskesdas Penyakit Tidak Menular.

Kim, H. N., & Song, S. W. (2019). Associations between

Macronutrient Intakes and Obesity/Metabolic Risk

Phenotypes: Findings of the Korean National Health

and Nutrition Examination Survey.Nutrients,11(3),

628.

Jeon, K. J., Lee, O., Kim, H. K., & Han, S. N. (2011).

Comparison of the dietary intake and clinical

characteristics of obese and normal weight

adults.Nutrition research and practice,5(4), 329–336.

Howarth, N. C., Huang, T. T., Roberts, S. B., Lin, B. H., &

McCrory, M. A. (2007). Eating patterns and dietary

composition in relation to BMI in younger and older

adults. International journal of obesity (2005),31(4),

675–684.

Swinburn, B. A., Caterson, I., Seidell, J. C., & James, W. P.

(2004). Diet, nutrition and the prevention of excess

weight gain and obesity.Public health nutrition,7(1A),

123–146.

Khusun, Helda & Wiradnyani, Luh & Siagian, Nora.

(2016). Factors associated with overweight/obesity

among adults in urban indonesia. Penelitian Gizi dan

Makanan (The Journal of Nutrition and Food

Research). 38. 10.22435/pgm.v38i2.5539.95-110.

World Health Organization. Regional Office for the

Western Pacific. (2000). The Asia-Pacific perspective :

redefining obesity and its treatment. Sydney : Health

Communications Australia

Shim, J. S., Oh, K., & Kim, H. C. (2014). Dietary

assessment methods in epidemiologic

studies. Epidemiology and health, 36, e2014009.

Frayn, K. N., & Kingman, S. M. (1995). Dietary sugars and

lipid metabolism in humans. The American journal of

clinical nutrition, 62(1 Suppl), 250S–263S.

https://doi.org/10.1093/ajcn/62.1.250S

Kazumi, T. (1997). Effects of Dietary Fructose or Glucose

on Triglyceride Production and Lipogenic Enzyme

Activities in the Liver of Wistar Fatty Rats, an Animal

Model of NIDDM. Endocrine Journal, 44(2), 239-245.

Roche, Helen. (1999). Dietary carbohydrates and

triacylglycerol metabolism. The Proceedings of the

Nutrition Society. 58. 201-7. 10.1079/PNS19990026.

Díaz-Rúa, R., Keijer, J., Palou, A., van Schothorst, E. M.,

& Oliver, P. (2017). Long-term intake of a high-protein

diet increases liver triacylglycerol deposition pathways

and hepatic signs of injury in rats. The Journal of

Nutritional Biochemistry, 46, 39–48.

Jan Boren, M John Chapman, Ronald M Krauss, Chris J

Packart, Jacob F Bentzon, Christoph J Binder, et al.

(2020). Low-density lipoproteins cause atherosclerotic

cardiovascular disease: pathophysiological, genetics,

and therapeutic insight: a consensus statement from the

European Atherosclerosis Society Consensus Panel.

European Heart Journal, 41(24), 2313-2330

Fortes, Fernanda Santos, Almeida, Alinne Paula de, Rosa,

Carla de Oliveira Barbosa, Silveira, Brenda Kelly

Souza, Reis, Nínive de Almeida, & Hermsdorff, Helen

Hermana Miranda. (2020). Dietary Fat Intake and its

Association with Adiposity and Inflammatory Markers

in Individuals at Cardiometabolic Risk. International

Journal of Cardiovascular Sciences, 33(5), 447-456.

Epub March 09, 2020.

Keller U. (2011). Dietary proteins in obesity and in

diabetes. International journal for vitamin and

nutrition research. Internationale Zeitschrift fur

Vitamin- und Ernahrungsforschung. Journal

international de vitaminologie et de nutrition, 81(2-3),

125–133.

Mansoor, N., Vinknes, K. J., Veierød, M. B., & Retterstøl,

K. (2016). Effects of low-carbohydrate diets v. low-fat

diets on body weight and cardiovascular risk factors: a

meta-analysis of randomised controlled trials. The

British journal of nutrition, 115(3), 466–479.

Choi, H., Song, S., Kim, J., Chung, J., Yoon, J., Paik, H. Y.,

& Song, Y. (2012). High carbohydrate intake was

inversely associated with high-density lipoprotein

cholesterol among Korean adults.Nutrition research

(New York, N.Y.),32(2), 100–106.

Joffe, Y. T., & Houghton, C. A. (2016). A Novel Approach

to the Nutrigenetics and Nutrigenomics of Obesity and

Weight Management.Current oncology reports,18(7),

43.

Watanabe, T., Tsujino, I., Konno, S., Ito, Y. M., Takashina,

C., Sato, T., Isada, A., Ohira, H., Ohtsuka, Y.,

Fukutomi, Y., Nakamura, H., Kawagishi, Y., Okada,

C., Hizawa, N., Taniguchi, M., Akasawa, A., &

Nishimura, M. (2016). Association between Smoking

Status and Obesity in a Nationwide Survey of Japanese

Adults. PloS one, 11(3), e0148926.

Filozof, C., Fernández Pinilla, M. C., & Fernández-Cruz,

A. (2004). Smoking cessation and weight gain. Obesity

reviews : an official journal of the International

Association for the Study of Obesity, 5(2), 95–10

Dietary Intake of Obese Adult Men in Jakarta

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