Nutr Res Pract.  2018 Oct;12(5):426-435. 10.4162/nrp.2018.12.5.426.

Relationship between dietary intakes and the double burden of malnutrition in adults of Malang, Indonesia: An exploratory study

Affiliations
  • 1Department of Food Science and Nutrition, Pusan National University, 2, Busandaehak-ro 63 beon-gil, Geumjeong-gu, Busan 46241, Korea. hokryu@pusan.ac.kr

Abstract

BACKGROUND/OBJECTIVES
Urbanization and lifestyle changes have resulted in nutrition transition. Over-nutrition causes obesity increase, although malnutrition still exists. This phenomenon is called a double burden of malnutrition (DBM). This study was conducted to confirm the existence of DBM and to investigate the dietary factors related to DBM in Indonesian adults.
SUBJECTS/METHODS
Data for the subjects (51 men and 89 women) who are the adults resided in Malang, Indonesia were collected between July 17 and August 14, 2017, by using questionnaire. Height, weight, waist and hip circumference, blood pressure, blood glucose, total cholesterol, and hemoglobin were also measured for the subjects.
RESULTS
The average age of the subjects was 47.2 years. The average height, weight, and body mass index for men were 160.08 cm, 62.6 kg and 25.45 kg/m², respectively, and those for women were 148.74 cm, 58.09 kg, and 26.21 kg/m², respectively. Of the subjects, 3.6% were underweight, 24.3% were normal or healthy weight, while 72.2% were overweight and obese. Analysis of the dietary intakes revealed high for cereal (7.73 points), but very low for milk (0.25 points) and fruits (0.51 points). Dietary diversity was very few overall (< 5). The occurrence of both anemia (23.6%) and chronic diseases such as hypertension (57.1%), diabetes (12.1%), and hypercholesterolemia (3.6%) was considerably high. The existence of DBM was confirmed by 16.4% of the subjects. DBM was observed significantly higher in women than in men. Dietary diversity and DBM occurrence were inversely correlated. On average, the number of chronic diseases was 1.08 in men and 1.79 in women. Dietary diversity inversely affected systolic blood pressure.
CONCLUSIONS
DBM existed in adults in Malang, Indonesia due to inadequate dietary intakes, and a high rate of chronic diseases.

Keyword

Diet; malnutrition; double burden; chronic diseases

MeSH Terms

Adult*
Anemia
Blood Glucose
Blood Pressure
Body Mass Index
Cholesterol
Chronic Disease
Diet
Edible Grain
Female
Fruit
Hip
Humans
Hypercholesterolemia
Hypertension
Indonesia*
Life Style
Male
Malnutrition*
Milk
Obesity
Overweight
Thinness
Urbanization
Blood Glucose
Cholesterol

Cited by  2 articles

Dietary intakes and obesity of Malaysian adults
Yi Yi Lee, Wan Abdul Manan Wan Muda
Nutr Res Pract. 2019;13(2):159-168.    doi: 10.4162/nrp.2019.13.2.159.

Analysis of Factors Affecting Breakfast Eating Behavior of Children in Indonesia: An Application of the Health Belief Model
Ran Yi Kang, Soo Jin Lee, Ho Kyung Ryu
Korean J Community Nutr. 2020;25(1):1-12.    doi: 10.5720/kjcn.2020.25.1.1.


Reference

1. World Health Organization. WHO/NMH/NHD/17.3. The double burden of malnutrition. Policy brief [Internet]. Geneva: World Health Organization;2017. cited 2017 November 1. Available from: http://www.who.int/nutrition/publications/doubleburdenmalnutrition-policybrief/en/.
2. NCD Risk Factor Collaboration (NCD-RisC). Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19·2 million participants. Lancet. 2016; 387:1337–1396.
3. Usfar AA, Agnew P, Juniwaty KS, Howell F. The existence of double-burden of malnutrition in the same households in Eastern Indonesia: analysis using global vs. alternative Asian BMI cut-off points [Internet]. Jakarta: Secretariat of the National Team for the Acceleration of Poverty Reduction (TNP2K);2013. cited 2017 November 1. Available from: http://www.smeru.or.id/cpsp/Paper,%20Abstact,%20CV/0201_AvitaUsfar-abstract.pdf.
4. Rachmi CN, Li M, Alison Baur L. Overweight and obesity in Indonesia: prevalence and risk factors-a literature review. Public Health. 2017; 147:20–29.
Article
5. United Nations System Standing Committee on Nutrition (UNSCN). Report of the world nutrition situation: progress in nutrition [Internet]. Geneva: UNSCN Secretariat;2010. cited 2017 October 15. Available from: https://www.unscn.org/files/Publications/RWNS6/html/.
6. Ministry of Health of the Republic of Indonesia. Indonesia health profile 2013 [Internet]. Jakarta: Ministry of Health of the Republic of Indonesia;2014. cited 2017 October 15. Available from: http://www.depkes.go.id/resources/download/pusdatin/profil-kesehatanIndonesia/Indonesia%20Health%20Profile%202013%20-%20v2%20untuk%20web.pdf.
7. Janus ED, Postiglione A, Singh RB, Lewis B. Council on Arteriosclerosis of the International Society and Federation of Cardiology. The modernization of Asia. Implications for coronary heart disease. Circulation. 1996; 94:2671–2673.
8. Soewondo P, Purnamasari D, Oemardi M, Waspadji S, Soegondo S. Prevalence of metabolic syndrome using NCEP/ATP III criteria in Jakarta, Indonesia: the Jakarta primary non-communicable disease risk factors surveillance 2006. Acta Med Indones. 2010; 42:199–203.
9. World Health Organization Western Pacific Region. IASO International Association for the Study of Obesity. International Obesity TaskForce. The Asian-Pacific perspective: redefining obesity and its treatment [Internet]. Balmain: Health Communications Australia Pty Limited;2000. cited 2017 October 17. Available from: http://iris.wpro.who.int/bitstream/handle/10665.1/5379/0957708211_eng.pdf.
10. Shrimpton R, Rokx C. The double burden of malnutrition in Indonesia [Internet]. Jakarta: World Bank Office Jakarta;2013. cited 2017 October 15. Available from: https://openknowledge.worldbank.org/bitstream/handle/10986/17007/761920WP0P12640Box0379884B00PUBLIC0.pdf?sequence=1&isAllowed=y.
11. Soemantri S, Pradono J, Hapsari D. National household health survey morbidity: NCD risk factors in Indonesia [Internet]. Jakarta: SURKESNAS;2001. cited 2017 October 15. Available from: http://www.who.int/ncds/surveillance/steps/indonesia/en/.
12. Chung KH, Shin KO, Yoon JA, Choi KS. Study on the obesity and nutrition status of housewives in Seoul and Kyunggi area. Nutr Res Pract. 2011; 5:140–149.
Article
13. International Diabetes federation (IDF). IDF clinical practice recommendations for managing type 2 diabetes in primary care [Internet]. Belgium: International Diabetes federation;2017. cited 2017 October 15. Available from: https://www.idf.org/e-library/guidelines/128-idf-clinical-practice-recommendations-for-managing-type-2-diabetes-in-primary-care.html.
14. Holzen HV, Arsana L. Food of Indonesia: delicious recipes from Bali, Java and the Spice Islands. Vermont: Tuttle Publishing;2015. p. 8–10.
15. Susiloretni KA. Sunarto. Compilation of studies related to food consumption, physical exercise, healthy lifestyle, and nutritional status conducted in Indonesia between 2000-2010: age group adult age 20-54 years. Research report [Internet]. Semarang: Health Polytechnic of Semarang;2010. cited 2017 October 15. Available from: http://www.danonenutrindo.org/research_reports.php.
16. Ministry of Health of the Republic of Indonesia. Regulation of the Ministry of Health Republic of Indonesia No. 41 [Internet]. Jakarta: Ministry of Health of the Republic of Indonesia;2014. cited 2017 June 1. Available from: http://gizi.depkes.go.id/permenkes-tentangangka-kecukupan-gizi.
17. City population. Indonesia: Java-regencies, cities, and districts [Internet]. Denmark: city population;2018. cited 2018 July 21. Available from: http://www.citypopulation.de/php/indonesia-jawaadmin.php.
18. Statistics of Malang Municipality. Kota malang dalam angka 2017 [Internet]. Malang: Statistics of Malang Municipality;2017. cited 2018 July 21. Available from: https://malangkota.bps.go.id/publication/2017/08/12/af218a8b74d037b3f9d87c85/kota-malang-dalam-angka-2017.html.
19. Baksh R, Yustika AE. Sugarcane farmers in east Java: institutional arrangement perspective. J Indones Appl Econ. 2008; 2:43–56.
20. International Diabetes Federation (IDF). The IDF consensus worldwide definition of the metabolic syndrome [Internet]. Belgium: International Diabetes Federation;2006. cited 2017 October 15. Available from: http://www.pitt.edu/~super1/Metabolic/IDF1.pdf.
21. World Health Organization. Waist circumference and waist-hip ratio report of a WHO expert consultation [Internet]. Geneva: World Health Organization;2008. cited 2017 October 3. Available from: http://apps.who.int/iris/bitstream/10665/44583/1/9789241501491_eng.pdf.
22. Liu Y, Tong G, Tong W, Lu L, Qin X. Can body mass index, waist circumference, waist-hip ratio and waist-height ratio predict the presence of multiple metabolic risk factors in Chinese subjects? BMC Public Health. 2011; 11:35.
Article
23. Hastuti J, Kagawa M, Byrne NM, Hills AP. Determination of new anthropometric cut-off values for obesity screening in Indonesian adults. Asia Pac J Clin Nutr. 2017; 26:650–656.
24. Lee KW. The development of the Korean dietary pattern score (KDPS) and its application [master's thesis]. Seoul: Ewha Womans University;2010.
25. Lee BK, Lee JH. Evaluation of dietary variety by body mass index, waist circumference, and exercise habits in female university students. Korean J Food Nutr. 2010; 23:570–581.
26. Bae YJ. Evaluation of nutrient intake and anthropometric parameters related to obesity in Korean female adolescents according to dietary diversity score: from the Korean National Health and Nutrition Examination Surveys, 2007-2009. Korean J Community Nutr. 2012; 17:419–428.
Article
27. Kwon YS, Kim YS. Assessment on dietary diversity according to Korean dietary pattern score of Korean adolescents and children: using 2007-2013 Korea National Health and Nutrition Examination Survey(KNHANES) data. Korean J Food Cook. 2015; 31:660–675.
Article
28. Ministry of Health of the Republic of Indonesia. Balanced nutrition guideline [Internet]. Jakarta: Ministry of Health of the Republic of Indonesia;2014. cited 2017 October 15. Available from: http://gizi.depkes.go.id/download/Pedoman%20Gizi/PGS%20Ok.pdf.
29. World Health Organization. Nutritional anaemias: report of a WHO scientific group [Internet]. Geneva: World Health Organization;1968. cited 2017 October 15. Available from: http://apps.who.int/iris/bitstream/10665/40707/1/WHO_TRS_405.pdf.
30. Beutler E, Waalen J. The definition of anemia: what is the lower limit of normal of the blood hemoglobin concentration? Blood. 2006; 107:1747–1750.
Article
31. Mundi I. Indonesia-prevalence of anemia [Internet]. Washington, D.C.: IndexMundi;2013. cited 2017 November 17. Available from: https://www.indexmundi.com/facts/indonesia/prevalence-of-anemia.
32. World Health Organization. A global brief on hypertension: silent killer, global public health crisis [Internet]. Geneva: World Health Organization;2013. cited 2017 October 15. Available from: http://www.who.int/cardiovascular_diseases/publications/global_brief_hypertension/en/.
33. National Heart, Lung, and Blood Institute (NHLBI). High blood cholesterol: what you need to know [Internet]. Bethesda (MD): National Heart, Lung, and Blood Institute;2005. cited 2017 October 15. Available from: https://www.nhlbi.nih.gov/health/resources/heart/heart-cholesterol-hbc-what-html.
34. Korea Trade-Investment Promotion Agency (KOTRA). Indonesia [Internet]. Jakarta: Korea Trade-Investment Promotion Agency;2017. cited 2017 November 15. Available from: http://news.kotra.or.kr/user/nationInfo/kotranews/14/userNationBasicView.do?nationIdx=49.
35. Willudjeng LK, Purwani SK, Martiana T, Widjiartini W, Putro G. Profil kesehatan kerja nelayan di kota pekalongan dan kabupaten Lombok Timur. Bul Penelit Sist Kesehat. 2004; 7:14–30.
36. Samsudin M. Hubungan kadar plumbum (Pb) dalam darah dengan nilai FT4 pada kelompok wanita usia subur (WUS) risiko terena paparan Pb di daerah perkotaan [master's tesis]. Yogyakarta: Universitas Gadjah Mada;2007.
37. Wibowo Y, Sutrisna B, Hardinsyah H, Djuwita R, Korib MM, Syafiq A, Tilden A, Najib M. Relationship between intra-household food distribution and coexistence of dual forms of malnutrition. Nutr Res Pract. 2015; 9:174–179.
Article
38. Ministry of Health of the Republic of Indonesia. National Institute of Health Research and Development (NIHRD), Ministry of Health (Indonesia) [Internet]. Seattle (WA): Institute for Health Metrics and Evaluation;2013. cited 2018 February 1. Available from: http://ghdx.healthdata.org/organizations/national-institute-health-research-and-development-nihrd-ministry-health-indonesia.
39. Saibul N, Shariff ZM, Lin KG, Kandiah M, Ghani NA, Rahman HA. Food variety score is associated with dual burden of malnutrition in Orang Asli (Malaysian indigenous peoples) households: implications for health promotion. Asia Pac J Clin Nutr. 2009; 18:412–422.
40. Setiati S, Harimurti K, Dewiasty E, Istanti R, Mupangati YM, Ngestiningsih D, Purwoko Y, Aryana IS, Kuswardhani RT, Pramantara ID, Apandi M, Dwipa L, Budiningsih F, Dinda R, Widajanti N, Siburian P, Sunarti S, Umar S, Jim E, Junaidi-Ar . Profile of food and nutrient intake among Indonesian elderly population and factors associated with energy intake: a multi-centre study. Acta Med Indones. 2013; 45:265–274.
41. World Health Organization. World Health Organization - diabetes country profiles 2016: Republic of Korea [Internet]. Geneva: World Health Organization;2016. cited 2018 January 17. Available from: http://www.who.int/diabetes/country-profiles/kor_en.pdf.
42. Miller WL, Crabtree BF, Evans DK. Exploratory study of the relationship between hypertension and diet diversity among Saba Islanders. Public Health Rep. 1992; 107:426–432.
43. World Health Organization. Noncommunicable diseases: country profile 2014 [Internet]. Geneva: World Health Organization;2014. cited 2017 November 17. Available from: http://apps.who.int/iris/bitstream/10665/128038/1/9789241507509_eng.pdf?ua=1.
44. Wang SB, Cho YC. Body mass index and subsequent risk of hypertension, hyperglycemia and hypercholesterolemia in health checkup examinees. J Korea Acad Ind Coop Soc. 2011; 12:2677–2684.
Article
45. Nurhayati . Recommended alternative daily intake of fruits and vegetables for Indonesian elderly. Health Sci Indones. 2014; 1:30–34.
46. Azadbakht L, Mirmiran P, Esmaillzadeh A, Azizi F. Dietary diversity score and cardiovascular risk factors in Tehranian adults. Public Health Nutr. 2006; 9:728–736.
Article
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