Hubungan Asupan Karbohidrat dan SAFA dengan Overweight Siswa Sekolah Dasar
DOI:
https://doi.org/10.35730/jk.v12i3.435Abstract
Menurut WHO, prevalensi obesitas di seluruh dunia meningkat hampir tiga kali lipat sejak tahun 1975 sampai 2015. Pada tahun 2016, lebih dari 340 juta anak dan remaja berusia 5-19 tahun mengalami overwieght. Di Indonesia, prevalensi overweight dan obesitas anak usia 5-12 pada tahun 2013 sebesar 18,8% dan meningkat menjadi 20% pada tahun 2018. Penelitian ini bertujuan untuk melihat hubungan antara kecukupan asupan zat gizi makro dengan overweight pada siswa sekolah dasar. Penelitian ini merupakan studi kuantitatif dengan desain studi crossectional menggunakan data sekunder dari penelitian primer yang dilakukan bulan September-Oktober 2020 di SDN 1 Karangmulyan Kabupaten Lebak Banten. Populasi penelitian adalah seluruh siswa dengan kriteria inklusi memiliki z-score IMT/U -2 SD sampai dengan >+2 SD. Metode pengambilan sampel menggunakan total purposive sampling dengan jumlah sampel sebanyak 120 siswa. Variabel dependen dalam penelitian ini adalah status gizi overweight sementara variabel independent meliputi usia, jenis kelamin, kecukupan asupan energi, protein, lemak, karbohidrat, rata-rata asupan serta total asupan SAFA, protein heweni, protein nabati, dan total sukrosa. Analisis data dalam penelitian ini menggunakan uji chi-square dan uji nonparametrik mann-whitney. Hasil penelitian ini menunjukkan bahwa sebanyak 11,7% siswa memiliki status gizi overweight dan obesitas. Adanya hubungan signifikan antara kecukupan energi OR 3,93 (95%CI: 1,21-12,8), kecukupan karbohidrat OR 9,28 (95%CI: 2,55-33,1) , dan total asupan SAFA dengan overweight. Penelitian ini tidak menunjukkan hubungan signifikan antara usia, jenis kelamin, kecukupan asupan protein, kecukupan asupan lemak, total asupan SAFA, total asupan protein hewani dan nabati, serta total asupan sukrosa.References
Wells, JC, et.al, " The double burden of malnutrition: aetiological pathways and consequences for health," The Lancet; London, vol. 395, Iss. 10217, 2020. [online]. Available: 75-88. DOI:10.1016/S0140-6736(19)32472-9. [Diakses 20 Mei, 2021]
World Health Organization (WHO), Obesity and overweight factsheet from the WHO. Geneva: WHO [online]. Available: http://www.who.int/mediacentre /factsheets/fs311/ en/. [Diakses 20 Mei, 2021]
Fleming T, et. al, " Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: A systematic analysis for the Global Burden of Disease Study 2013," . Lancet, vol. 384, no. 9945, pp. 766-81, 2014. [online]. Available: 7 doi: 10.1016/S0140-6736(14)60460-8. [Diakses 20 Mei, 2021]
Ng M, et. al. 2014, " Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: A systematic analysis for the Global Burden of Disease Study 2013," . Lancet, vol. 384, no. 9945, pp. 766-81, 2014. [online]. Available: 7 doi: 10.1016/S0140-6736(14)60460-8. [Diakses 20 Mei, 2021]
World Health Organization (WHO), Obesity and overweight. Geneva: WHO, 2021 [online]. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight [Diakses 20 Mei, 2021]
Riset Kesehatan Dasar (Riskesdas), Laporan Nasional Riskesdas, . Kementerian Kesehatan RI: Badan Penelitian dan Pengembangan Kesehatan; 2018. [online]. [Diakses 20 Mei, 2021]
Riset Kesehatan Dasar (Riskesdas), Laporan Nasional Riskesdas, . Kementerian Kesehatan RI: Badan Penelitian dan Pengembangan Kesehatan; 2013. [online]. [Diakses 20 Mei, 2021
Salehi-Abargouei A, Akbari F, Bellissimo N, Azadbakht L, "Dietary Diversity Score and obesity: A systematic review and meta-analysis of observational studies" Eur J Clin Nutr, vol. 70, no. 1, pp. 1-9, 2016. [online]. Available: doi: 10.1038/ejcn.2015.118. [Diakses 23 Mei, 2021]
De Pergola G, Silvestris F, " Obesity as a major risk factor for cancer" J Obes, vol.291456, 2013. [online]. Available: doi: 10.1155/2013/291546. [Diakses 23 Mei, 2021]
Zabetian A, Hadaegh F, Sarbakhsh P, Azizi F, " Weight change and incident metabolic syndrome in Iranian men and women; a 3 year followup study" BMC Public Health, vol. 9, no. 138, 2009. [online]. Available: doi: 10.1186/1471-2458-9-138. [Diakses 23 Mei, 2021]
Rathnayake, KM, Roopasingam, T, Wickramasighe, V, "Nutritional and behavioral determinants of adolescent obesity: a case-control study in Sri Lanka " BMC Public Health, vol. 14, no. 1291, 2014. [online]. Available: doi:10.1186/1471-2458-14-1291. [Diakses 23 Mei, 2021]
Park MH, Falconer C, Viner RM, Kinra S " The impact of childhood obesity on morbidity and mortality in adulthood: a systematic review" . Obes Rev, vol. 13, pp. 985-1000, 2012. [online]. Available: doi:10.1186/1471-2458-14-1291. [Diakses 23 Mei, 2021]
Reilly JJ, Kelly J, "Long-term impact of overweight and obesity in childhood and adolescence on morbidity and premature mortality in adulthood: systematic review" . Int J Obes, vol. 35, pp. 891-898, 2011. [online]. Available: doi:10.1186/1471-2458-14-1291. [Diakses 23 Mei, 2021]
Zeynab, A, et. al, "Association of Weight Status with Dietary Intake and Dietary Diversity Score in 10 -12-Year-Old Children in Tehran: A Cross-Sectional Study", ran J Pediatr, vol. 29, no. 4, pp.e85317, 2019. [online]. Available: doi: 10.5812/ijp.85317. [Diakses 23 Mei, 2021]
Azadbakht & Esmaillzadeh, A, "Dietary energy density is favorably associated with Dietary Diversity Score among female university students in Isfahan Leila", Nutrition, vol. 28, pp. 991-995, 2012. [online]. Available: doi:10.1016/j.nut.2011.12.017. [Diakses 25 Mei, 2021]
Wang, et. al, " Consumption of sugars, saturated fat, and sodium among US children from infancy through preschool age, NHANES 2009–2014", Am J Clin Nutr , vol. 108, pp. 868-877, 2014. [online]. Available: doi:10.1016/j.nut.2011.12.017. [Diakses 25 Mei, 2021]
Te Morenga L, Mallard S, Mann J, " Dietary sugars and body weight: systematic review and meta-analyses of randomised controlled trials and cohort studies", BMJ, vol. 346, no. e7492, 2013. [online]. Available: doi:10.1016/j.nut.2011.12.017. [Diakses 25 Mei, 2021]
Vartanian LR, Schwartz MB, Brownell KD, "Effects of soft drink consumption on nutrition and health: a systematic review and metaanalysis", Am J Public Health, vol. 97, no. 4, pp. 667-75, 2007. [online]. Available: doi:10.1016/j.nut.2011.12.017. [Diakses 23 Mei, 2021]
Madrigal C, et. al, " Dietary Intake, Nutritional Adequacy and Food Sources of Total Fat and Fatty Acids, and Relationships with Personal and Family Factors in Spanish Children Aged One to <10 years", . Nutrients, vol. 12, no. 2467, 2020. [online]. Available: doi:10.3390/nu12082467. [Diakses 28 Mei, 2021]
Jumbe, T.; Comstock, S.; Harris, W.; Kinabo, J.; Pontifex, M.; Frenton, J, " Whole-blood fatty acids are associated with executive function in Tanzanian children aged 4–6 years: A cross-sectional study", Br. J. Nutr, vol. 9, pp. 1537-1545, 2016. [online]. [Diakses 28 Mei, 2021]
J López-Sobaler, A.M., et. al, "Adequacy of usual macronutrient intake and macronutrient distribution in children and adolescents in Spain: A National Dietary Survey on the Child and Adolescent Population", ENALIA, 2013. [online]. [Diakses 28 Mei, 2021]
Ruiz E, Avila JM, Valero T, Del Pozo S, Rodriguez P, Aranceta-Bartrina J, et al, " Macronutrient distribution and dietary sources in the Spanish population: findings from the ANIBES study", Nutrients, vol. 8, pp. 177, 2016. [online]. [Diakses 24 Mei, 2021]
Menteri Kesehatan Republik Indonesia, Peraturan Menteri Keseharan RI No. 28 Tahun 2019. Angka Kecukupan Gizi yang Dianjurkan untuk Masyarakat Indonesia, Kementerian Kesehatan RI. [online]. [Diakses 22 Mei, 2021
Nithya, DJ, & Bhavani, RV, "Dietary diversity and Its Relationship with Nutritional Status Among Adolescent and Adults In Rural India", J. Biosoc. Sci, vol. 50, pp. 397-413, 2018. [online]. doi: 10.1017/S002193201
[Diakses 24 Mei, 2021]
Meng, L, Wang, Y, Li, T, Loo-Bowman, CA, Zhang, Y, Szeto, MY, " Dietary Diversity and Food Variety in Chinese Children Aged 3–17 Years: Are They Negatively Associated with Dietary Micronutrient Inadequacy?", Nutrients, vol. 10, pp. 1674, 2018. [online]. Available doi:10.3390/nu10111674. [Diakses 24 Mei, 2021]
Hatloy, A.; Torheim, L.; Oshaug, A, " Food variety—A good indicator of nutritional adequacy of the diet? A case study from an urban area in Mali, West Africa", Eur. J. Nutr, vol. 52, pp. 891-898, 1998. [online] [Diakses 23 Mei, 2021]
Menteri Kesehatan Republik Indonesia, Peraturan Menteri Keseharan RI No. 2 Tahun 2020. Standar Antropometri Anak, Kementerian Kesehatan RI. [online]. [Diakses 25 Mei, 2021
Park MH, Falconer C, Viner RM, Kinra S, " The impact of childhood obesity on morbidity and mortality in adulthood: a systematic review", Obes Rev, vol. 13, pp. 985-1000, 2012. [online] [Diakses 23 Mei, 2021]
Amirhamidi, Z, et. al, " Association of Weight Status with Dietary Intake and Dietary Diversity Score in 10 - 12-Year-Old Children in Tehran: A Cross-Sectional Study", Iran J Pediatr, vol. 29, no. 4, pp. E85319, 2012. [online] Available doi: 10.5812/ijp.85317 [Diakses 23 Mei, 2021]
Li, Ping, et. al, "Nutritional status and risk factors of overweight and obesity for children aged 9–15 years in Chengdu, Southwest China", BMC Public Health, vol. 12, pp. 636, 2012. [online] Available http://www.biomedcentral.com/1471-2458/12/636 [Diakses 23 Mei, 2021]
Putri, VR, Angkasa Dudung, Nuzrina R, " Konsumsi Fast Food, Soft Drink, Aktivitas Fisik, dan Kejadian Overweight Siswa Sekolah Dasar di Jakarta", [online] E-ISSN 2355-3987 www.ijhn.ub.ac.id [Diakses 23 Mei, 2021]
Ermona dan Wirjatmadi, "Hubungan Aktivitas Fisik dan Asupan Gizi dengan Status Gizi Lebih pada Anak Usia Sekolah Dasar di SDN Ketabang 1 Kota Surabaya Tahun 2017", [online] available doi: [Diakses 23 Mei, 2021]
Radhika, IMS, Swetha, B, Kumar, BN, Krishna, NB, and Laxmaiah, "Dietary and nondietary determinants of nutritional status among adolescent girls and adult women in India", Ann. N.Y. Acad. Sci, vol. 1416, pp. 5-17, 2018 [online] available doi: 10.1111/nyas.13599 [Diakses 23 Mei, 2021]
Degarege, D., A. Degarege & A. Animut " Undernutrition and associated risk factors among school age children in Addis Ababa, Ethiopia", BMC Public Health, vol.15, pp. 375-383, 2015. [online] available doi: 10.1111/nyas.13599 [Diakses 23 Mei, 2021]
World Health Organization (WHO), Anthroplus for personal computers manual: software for assessing growth of the world’s children and adolescents. Geneva: Department of Nutrition for Health and Development, World Health Organization [online]. Available: http://www.who.int/ growthref/en/ [Diakses 30 Mei, 2021]
Hosmer, D.W. & S. Lemeshow, B Applied Logistic Regression. 2nd ed. New York: John Wiley & Sons, 2000
Azadbakht L, Esmaillzadeh A, " Dietary Diversity Score is related to obesity and abdominal adiposity among Iranian female youths", Pub Health Nutr, vol. 14, pp. 62-9, 2011 [Diakses 23 Mei, 2021]
Bay, J.L., S.M. Morton & M.H. Vickers, Realizing the potential of adolescence to prevent transgenerational conditioning of non-communicable disease risk: multi-sectoral design frameworks. Healthcare (Basel) 4, 2016
Mokdad, A.H., M.H. Forouzanfar, F. Daoud, et. al, "Global burden of diseases, injuries, and riskfactorsfor young people’s health during 1990–2013: a systematic analysis for the Global Burden of Disease Study", Lancet, vol. 387, pp. 2383-2401, 2013. [Diakses 23 Mei, 2021]
(PAHO), Underweight, short status, and overweight in adolescents and young women in Latin America and the Caribbean, 2017 [online]. Available http://www2.paho.org/hq/index.php?option=com_docmanandtask=doc_downloadandgid=15146andItemid=270. [Diakses 30 Mei, 2021]
Mirmiran P, Azadbakht L, Esmaillzadeh A, Azizi F, " Dietary Diversity Score in adolescentsda good indicator of the nutritional adequacy of diets: Tehran Lipid and Glucose Study", Asia Pac J Clin Nutr, vol. 13, pp. 56-60, 2004. [Diakses 27 Mei, 2021]
Ello-Martin JA, Ledikwe JH, Rolls BJ, " The influence of food portion size and energy density on energy intake: implications for weight management", Am J Clin Nutr, vol. 82, pp. 235S-41S, 2005. [Diakses 27 Mei, 2021]
World Health Organization (WHO), Adolescent nutrition: a review of the situation in selected South-East Asian countries. Geneva: Department of Nutrition for Health and Development, World Health Organization 2006
Du H, van der A DL, Ginder V, Jebb SA, Forouhi NG, Wareham NJ, et. al, "Dietary energy density in relation to subsequent changes of weight and waist circumference in European men and women". PloS One, vol. 4, pp. e5339, 2009. [Diakses 24 Mei, 2021]
Bes-Rastrollo M, van Dam RM, Martinez-Gonzalez MA, Li TY, Sampson LL, Hu FB, " Prospective study of dietary energy density and weight gain in women". Am J Clin Nutr, vol. 88, pp. 769-77, 2008. [Diakses 28 Mei, 2021]
Savage JS, Marini M, Birch LL, "Dietary energy density predicts women’s weight change over 6 y". Am J Clin Nutr, vol. 88, pp. 677-84, 2008. [Diakses 28 Mei, 2021]
Ledikwe JH, Blanck HM, Khan LK, Serdula MK, Seymour JD, Tohill BC, Rolls BJ, "Low-energy-density diets are associated with high diet quality in adults in the United States ". J Am Diet Assoc, vol. 106, pp. 1172-80, 2006. [Diakses 28 Mei, 2021]
Ledikwe JH, Blanck HM, Khan LK, Serdula MK, Seymour JD, Tohill BC, Rolls BJ, " Reductions in dietary energy density are associated with weight loss in overweight and obese participants in the PREMIER trial". Am J Clin Nutr, vol. 85, pp. 1212-21, 2007. [Diakses 24 Mei, 2021]
Longvah, T., R. Ananthan, K. Bhaskarachary & K. Venkiah, Indian food composition tables. National Institute of Nutrition, Indian Council of Medical Research, Hyderabad, 2017
Urke, H.B., T. Bull & M.B. Mittelmark, " Socioeconomic status and chronic child malnutrition: wealth and maternal education matter more in the Peruvian Andes than nationally". Nutr. Res, vol. 31, pp. 741-747, 2007. [Diakses 24 Mei, 2021]
National Nutrition Monitoring Bureau, B. Diet and nutritional status of rural population. Report of third repeat survey. Hyderabad: National Institute of Nutrition, Indian Council of Medical Research. Technical report No. 26, 2012
Raatz, Susan K, et. al, "Relationship of the Reported Intakes of Fat and Fatty Acids to Body Weight in US Adults". Nutrients, vol. 9, pp.438, 2017. [online] available doi:10.3390/nu9050438 [Diakses 24 Mei, 2021]
Santiago, et. al, "Carbohydrate quality, weight change and incident obesity in a Mediterranean cohort: the SUN Project ". European Journal of Clinical Nutrition, vol. 69, pp. 297-302, 2015. [online] available doi:10.1038/ejcn.2014.187 [Diakses 24 Mei, 2021]
Frayn KN, Karpe F, Fielding BA, Macdonald IA, Coppack SW, " Integrative physiology of human adipose tissue" Int J Obes Relat Metab Disord, vol. 27, pp. 875-88, 2015.
Brouns F, "Overweight and diabetes prevention: is a low-carbohydrate-high-fat diet recommendable?" Eur J Nutr, vol. 57, pp. 1301-12, 2018.
Ha K, Kim K, Chun OK, Joung H, Song Y, "Differential association of dietary carbohydrate intake with metabolic syndrome in the US and Korean adults: data from the 2007-2012 NHANES and KNHANES " Eur J Clin Nutr, vol. 72, pp. 848-60, 2018.
Choi H, Song S, Kim J, Chung J, Yoon J, Paik HY, et al, " High carbohydrate intake was inversely associated with high-density lipoprotein cholesterol among Korean adults" Nutr Res, vol. 32, pp. 100-6, 2012.
Kim, Ha-Na dan Song, Sang-Wook, " Association between carbohydrate intake and body composition", The Korean National Health and Nutrition Examination Survey. Nutrition, vol. 61, pp. 187-193, 2018. [online] available https://doi.org/10.1016/j.nut.2018.11.011. [Diakses 1 Juni 2021]
Hall KD, Bemis T, Brychta R, Chen KY, Courville A, Crayner EJ, et al, "Calorie for calorie, dietary fat restriction results in more body fat loss than carbohydrate restriction in people with obesity " Cell Metab, vol. 22, pp. 427-36, 2014.
Naude CE, Schoonees A, Senekal M, Young T, Garner P, Volmink J, " Low carbohydrate versus isoenergetic balanced diets for reducing weight and cardiovascular risk: a systematic review and meta-analysis " PLoS One, vol. 9, no. e100652, 2014
Lagiou P, Sandin S, Lof M, Trichopoulos D, Adami HO, Weiderpass E, "Low carbohydrate-high protein diet and incidence of cardiovascular diseases in Swedish women: prospective cohort study" Bmj, vol. 344, no. e4026, 2012
Brinkworth GD, Noakes M, Clifton PM, Bird AR, "Comparative effects of very low-carbohydrate, high-fat and high-carbohydrate, low-fat weight-loss diets on bowel habit and faecal short-chain fatty acids and bacterial populations" Br J Nutr, vol. 101, pp. 1493-502, 2009
Cani PD, Bibiloni R, Knauf C, Waget A, Neyrinck AM, Delzenne NM, et al, "C Changes in gut microbiota control metabolic endotoxemia-induced inflammation in high-fat diet-induced obesity and diabetes in mice" Diabetes, vol. 57, pp. 1470-81, 2008
Leidy HJ, Clifton PM, Astrup A, Wycherley TP, Westerterp-Plantenga MS, Luscombe-Marsh ND, et al, "The role of protein in weight loss and maintenance", Am J Clin Nutr, vol.101, pp. 1320s-9s, 2015
Wycherley TP, Moran LJ, Clifton PM, Noakes M, Brinkworth GD, " Effects of energy-restricted high-protein, low-fat compared with standard-protein, lowfat diets: a meta-analysis of randomized controlled trials", Am J Clin Nutr, vol.96, pp. 1281-98, 2012
Field, A.E.; Willett, W.C.; Lissner, L.; Colditz, G.A, "Dietary fat and weight gain among women in the nurses’ health study ", Obesity, vol.15, pp. 967-976, 2007
Corella, D.; Arnett, D.K.; Tucker, K.L.; Kabagambe, E.K.; Tsai, M.; Parnell, L.D.; Lai, C.-Q.; Lee, Y.-C.; Warodomwichit, D.; Hopkins, P.N, " A high intake of saturated fatty acids strengthens the association between the fat mass and obesity-associated gene and BMI", J. Nutr., vol.141, pp. 2219-2225, 2012
Phillips, C.M.; Kesse-Guyot, E.; McManus, R.; Hercberg, S.; Lairon, D.; Planells, R.; Roche, H.M, "High dietary saturated fat intake accentuates obesity risk associated with the fat mass and obesity-associated gene in adults", J. Nutr., vol.142, pp. 824-831, 2004
He, K.; Song, Y.; Daviglus, M.L.; Liu, K.; Van Horn, L.; Dyer, A.R.; Greenland, P, " Accumulated evidence on fish consumption and coronary heart disease mortality", Circulation. vol.109, pp. 2705-2711, 2004
Kien, C.L.; Bunn, J.Y.; Tompkins, C.L.; Dumas, J.A.; Crain, K.I.; Ebenstein, D.B.; Koves, T.R.; Muoio, D.M, " Substituting dietary monounsaturated fat for saturated fat is associated with increased daily physical activity and resting energy expenditure and with changes in mood", Am. J. Clin. Nutr, vol.97, pp. 689-697, 2013
Casas-Agustench, P.; López-Uriarte, P.; Bulló, M.; Ros, E.; Gómez-Flores, A.; Salas-Salvadó, J, " Acute effects of three high-fat meals with different fat saturations on energy expenditure, substrate oxidation and satiety", Clin. Nutr, vol.287, pp. 39-45, 2009
Micallef, M.A.; Munro, I.A.; Garg, M.L, " An inverse relationship between plasma n-3 fatty acids and c-reactive protein in healthy individuals", Eur. J. Clin. Nutr, vol. 63, pp. 1154–1156., 2009