Judul: Development of Balanced Diet Index for Indonesian Adult Males
Abstrak: Indonesia’s having double burden of malnutrition. At 2011, it is stated Indonesia was at the 5th position of country with the largest number of stunted toddler. Meanwhile the overnutrition problem growed, at 2013 there were 19,7% obese Indonesian adult males. The increasing number of overnutrition was proved to be related with the increasing incidence of non-communicable diseases. To combat the double burden of malnutrtion, Indonesia has developed a food guideline. Although the food guideline has been developed, the instrument to asses the whole eating quality based on the food guideline has not been developed yet in Indonesia. Other countries such as America, Australia and Thailand had developed such instrument called Healthy Eating Index (balanced diet index). The study was aimed to develop the balanced diet index (BDI) for Indonesian adult males. The spesific purposes of this study were to asses food consumption pattern of Indonesian adult males, to develop several alternatives of BDIs and to select the most appropriate BDI for Indonesian adult males, and to analyse factors affecting the BDI. The design of the study was analytical study to develop an index. This study developed several alternatives of BDI through systematic review of literature. The food consumption data from Basic Health Research in 2010 were used to validate the index. This study were conducted on June-November 2013. The data of Basic Health Research 2010 covered 64448 male subjects, and 61129 of them were analyzed in this study. Subjects were excluded if they didn’t have any consumption or anthropometic data, if their BMI less than 13 or more than 40, if their energy intake less than 30% or more than 300% of their BMR and if their nutrient adequacy more than 400%. There were ten alternatives of BDIs developed based on the food group and their intake, and also their scoring systems. The gold standard used to validate the BDI is the mean adequacy ratio (MAR) measured by mean nutrient adequacy of 16 nutrients. The 16 nutrients consist of Energy, Protein, Fat, Carbohydrate, Fiber, Water, Sodium, Calcium, Iron, Phosphorus,Potassium, Zinc, vitamin A, vitamin B1, vitamin B2 and vitamin C. The binary logistic test and the assesment of Sensitivity and Spesifity score were done to see which alternative of BDI was the most appropriate for adult males of Indonesia. The result showed the pearson correlation coefficient of the BDI and MAR range from 0.46 to 0.64; while the sensitivity and spesifisity score ranged from 120.3 to 147.0. The most appropriate and practical BDI to asses MAR is BDI3-60 (r=0.64; Se & Sp= 145.1). BDI3-60 consists of six food groups (cereal, legume, animal food, vegetable, fruit and milk) and implementing 3-level of scoring system. Determinant factors for BDI3-60 are place of living, economic status, marital status, education and occupation of subject. Subjects aged 20-49 years old and lived in rural area were more likely to vii have better diet quality. Subjects with better economic level, had higher education level and worked as civil servant or private businessman were more likely to have better diet quality.
Keyword: adult males, balanced diet index, mean adequacy ratio (MAR)