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ANTHROPOMETRYANDBODYCOMPOSITIONOFINDONESIAN ADULTS: ANEVALUATIONOFBODYIMAGE,EATINGBEHAVIOURS,ANDPHYSICALACTIVITY Janatin Hastuti, S.Si., M.Kes Submitted in fulfilment of the requirements for the degree of Doctor of Philosophy School of Exercise and Nutrition Sciences Faculty of Health Queensland University of Technology 2013 i ii KEYWORDS Anthropometry; body composition; deuterium isotope dilution; bioelectrical impedance analysis; percent body fat; body image; eating behaviours; physical activity; Indonesianadults i ABSTRACT Obesity has been identified as a global epidemic and is associated with significant morbidity and mortality Body Mass Index (BMI) is commonly used to determine overweight and obesity in epidemiological studies, however, BMI cannot differentiate the fat and lean mass in bodycompositionandan increasing number of studies are reporting that the relationship between BMI and %BF is different among different populations (Deurenberg, Deurenberg-Yap & Guricci, 2002; Deurenberg, Yap & van Staveren, 1998) Moreover, assessment ofbodycomposition is a better approach in the evaluationof nutritional and health status Some anthropometric measures and indices such as waist circumference (WC), waist-to-stature ratio (WSR), and waist-to-hip ratio (WHR) are also suggested as better indicators of obesity compared with BMI However, assessments ofanthropometryandbodycompositionand their associated benefits in Indonesianadults are very limited This may be partly due to the limited field-based methods available to assess bodycomposition in this population Many studies have reported the usefulness of prediction equations from anthropometric measures and bioelectrical impedance analysis (BIA) to provide detailed assessment ofbodycomposition However, no data has been reported for Indonesian populations The present study provides knowledge ofanthropometryandbodycomposition in Indonesianadultsand some associated factors including bodyimage,eatingbehaviours,andphysicalactivity The present study also develops a number anthropometric and BIA equations to predict bodycomposition in Indonesianadults ii The present thesis was organized into three study parts In study one, the objectives were to provide new knowledge and understanding of the anthropometryandbodycompositionofIndonesianadultsand to develop anthropometric prediction equations to estimate bodycomposition A total of 600 adults aged 18–65 years from Javanese ethnicity living in Yogyakarta Special Region Province participated in the study Deuterium isotope dilution technique was used as a gold standard measurement to predict total body water (TBW) and subsequently derive fat-free mass (FFM) and fat mass (FM) The body impedance component was measured using a single frequency (50 Hz) BIA analyzer from which TBW, FFM, and FM were predicted Differences between males and females were observed in most of the anthropometric measures Males were taller and heavier than females (p < 0.001), on the other hand, BMI and %BF were higher in females (22.4 ± 3.8 kg/m2, p = 0.01 and 33.3 ± 7.7%, p < 0.001, respectively) compared to males (21.6 ± 3.5 kg/m2 and 21.4 ± 7.0%, respectively) The BMI, WC, WHR, and WSR cut-off values showed low sensitivity in our samples (between 18.4 and 71.1%) and new proposed cut-offs increased the sensitivity to reach 66.7 to 88.5% New cut-offs for BMI, WC, WHR, and WSR for determination of obesity were 21.86 (kg/m2), 76.78 (cm), 0.86, and 0.48 respectively for males and 23.61 (kg/m2), 71.68 (cm), 0.77, and 0.47 respectively for females The present study also indicated that some anthropometric and BIA equations developed from other populations either underestimated or overestimated %BF when applied to participants in this study BMI equations to predict %BF proposed by Gurrici et al (1998) for Indonesianadults in a previous study resulted in 3.33 ± 4.81% higher values (p