The ThyroMobil model for standardized evaluation of iodine deficiency disorder control in Indonesia.

Indonesia used to be affected by varying degrees of iodine deficiency. Salt iodization has been the adopted strategy on a national basis since 1979. The prevalence of goiter in school-age children (SAC) determined by palpation subsequently markedly decreased within the next 15 years. The objective of the present work was to perform an updated evaluation of the status of iodine nutrition in Indonesia by using standardized methods for the measurement of thyroid volume by ultrasounds and the concentration of urinary iodine in SAC. The survey included 7,447 SAC ages 6 to 12 years from 129 sites selected by multistage and stratified sampling in five provinces (4 in Java plus Sumatra and the Province of Bali). A mobile unit (ThyroMobil van) equipped with a sonographic device and facilities for the collection of urine samples visited all sites. In Java plus Sumatra, the median urinary iodine was 195 microg/L. Thirty-four percent of the values were within normal limits (between 100 and 200 microg/L); 17.2% were below 100 microg/L and 48.8% were above 200 microg/L, including 18.2% above 300 microg/L and 0.7% above 1000 microg/L. In Bali, the median was 81 microg/L with 58.3% of the values below 100 microg/L and only 14.7% of the values above 200 microg/L. The prevalence of goiter determined by ultrasounds and using the World Health Organization/International Council for Control of Iodine Deficiency Disorders (WHO/ICCIDD) normative values for gender and age was 3.0% in Java plus Sumatra and 1.9% in Bali. The values were 8.0% and 12.5%, respectively, when using reference values for Indonesia established during the present survey in an iodine replete area in central Java. In conclusion, (1) iodine deficiency has been eliminated in large parts of Indonesia; (2) Bali is still affected by mild iodine deficiency; (3) in many places, iodine deficiency has been replaced by iodine excess, occasionally potentially toxic; (4) the WHO/ICCIDD normative values for thyroid volume measured by ultrasound in SAC are not valid for Indonesia; (5) in Indonesia, the level of salt iodization could be decreased and the biological monitoring of urinary iodine at the population level should be reinforced and maintained; (6) the ThyroMobil model has, as in other parts of the world, demonstrated its efficiency in the organization of partnership evaluation and monitoring of iodine nutrition, as well as in social mobilization.

Body fat distribution and lipids profile of elderly in southern Jakarta.

A cross-sectional study on 222 elderly subjects was carried out at Health Centers in 10 subdistricts in south Jakarta, Indonesia. The anthropometric data (body mass index (BMI), body fat distribution), fasting blood glucose, serum total cholesterol, low density lipoprotein (LDL) cholesterol and triglycerides were assessed. There was a positive correlation between body fat distribution and serum lipid concentration (total cholesterol, LDL cholesterol and triglycerides). Body fat distribution appears to be a stronger determinant of serum lipids than BMI.

Food intake and eating patterns of Indonesian elderly before the 1998 economic crisis.

The Nutrient and Metabolic Study of Indonesian Elderly (NUMSIE) was conducted in part to identify differences in eating patterns and in food and energy intakes between elderly people residing in urban metropolitan Jakarta (JAK) and in urban non-metropolitan Semarang (SEM) in order to investigate the prevalence of food and energy deficiencies. Data on food intake were collected from 212 JAK elderly and 238 SEM elderly aged 60 years and over using a quantitative food frequency questionnaire (FFQ). Although most of the elderly lived with their families or extended families, a large proportion of the subjects were eating alone, especially in the SEM sample. Jakartan elderly had significantly higher intakes of most food groups, except for added sugar and cow's milk. Total food intake of JAK subjects was also significantly higher (p<0.0001) than that of SEM subjects. The ratio of plant to animal food was lower among SEM elderly due principally to their higher intake of milk. Thirty percent of both JAK and SEM elderly consumed less than the recommended amounts of cereals, followed by vegetables and fruits (10%, 47% JAK; 22%, 75% SEM, respectively). Finally, it was found that the range of daily energy intakes was higher in JAK (1251-2079 kcal) than in SEM (939-1579 kcal). This suggests that SEM elderly were more likely to be energy deficient than were JAK elderly. While the results of this study indicate that food and energy intakes may be inadequate in Indonesian elderly, especially in non-metropolitan areas, more analyses are required to ascertain the true prevalence of malnutrition in this age group using anthropometric and blood measurements.