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a metabolic change in children of stunting with
normal weight (Wilson, 2012, Hoffman, 2000).
Longitudinal studies and cohorts that observed
metabolic changes in stunting generally observed the
changing conditions on stunting subjects who were
previously undernourished but later recovered and
had good nutritional status.
In the Jatinangor study, there was strong
suspicion that stunting teenagers in Jatinangor also
have metabolic changes such as data presented in
Brazil, but in this study there is no history of growth
and nutritional status of the study subjects at first
growth acceleration (age 0-2 years) although
suspected nutritional status of respondents when
under 2 years of age does not vary much with the
current condition considering stunting was a picture
of chronic malnutrition (Martorell, 2010). It appears
that stunting of teenagers in Jatinangor at this time of
study has not undergone a nutritional improvement,
so there has not been a catch-up fat phenomenon as
occurs in short teenagers in other countries. This may
explain why the fat mass of stunting teens in this
study was mostly underfat (53.57%) (table 4).
Sawaya et al, who conducted research in Brazil
from 1990 to 2004, found that children with less
nutrition (skinny and short) grew into adolescents and
obese adults. In Indonesia, it seems that atunting
teenagers have not experienced increased fat mass
because of the absence of nutritional improvements,
although this condition needs to watch out, assuming
that when short teenagers grow up and experience
improved nutritional status or energy intake so
excessive then at that time an increase in body fat
mass causing an increased risk of metabolic-related
illness (Hoffman, 2000; Martin, 2004; Wilson HJ,
2012).
In this study known as 89 people (79.47%) have
mild activity level. World Health Organization
(WHO) in 2010 stated that around 81% of adolescents
aged 11-17 years have less physical activity when
compared with WHO recommendations in that age
group. This data is consistent with data from Basic
Health Research (RISKESDAS) in 2013 which
shows the prevalence of physical inactivity in
children and adolescents aged 10-14 years is 66.9%
(WHO, 2015).
According to WHO, the prevalence of lack of
physical activity is higher in countries with increased
automation of work and the use of vehicles as a means
of transportation. Some environmental factors
associated with urbanization may cause the
population to become less active (Kenneth, 2000,
WHO, 1995). Behavior sedentari or sit-down
behavior, lying in the daily at home, (front computer,
reading, watching TV, playing video games) and
travel / transportation by motor vehicle looks much
done by teenagers in Jatinagor.
There is an interesting data in this study,, although
the average research subject has a low level of
physical activity but not high fat mass. This is
supported by data that teen energy intake of stunting
in Jatinangor is generally low. If this teenager's
energy intake is improved according to his needs,
then physical activity also needs to be adjusted with
the WHO recommendation that there is no increase in
excess fat mass and growth of adolescents short
stature can be optimal.
The Fin Twin Study analyzing 5 consecutive
cohort studies in 4343 subjects aged 22 to 27 stated
that physical activity would significantly increase
muscle mass compared to subjects with sedentary
lifestyles and would decrease the genetic effect on the
risk of obesity and abdominal obesity (Clemente,
2011; Wilson, 2012)
Physical activity will increase the body's energy
requirements, so increased physical activity will
cause a decrease in body mass index. Physical activity
may inhibit the risk of obesity, especially in
individuals with genetic susceptibility. Physical
activity performed regularly and measurably over a
relatively long time will increase fat-free (bone and
muscle) mass, decrease fat mass and increase Growth
Hormone. This increase in the hormone stimulates the
bone growth center of the epiphyseal plate. From the
results of the study found sedentari lifestyle or
lifestyle with very minimal activity will cause linear
growth is not optimal, muscle mass is smaller and
increased fat mass (Cromer, 2011; Guyton, 1991).
5 CONCLUSION
Any change in energy intake in a stunting adolescent
will affect the fat mass, as well as sex, but physical
activity does not affect the fat mass.
REFERENCES
Clemente AP, Santos CL, Martins VJB, Benedito-Silva A,
Albuquerque MP, Sawaya AL. 2011, Mild Stunting is
Associated With Higher Body Fat: Study of a Low-
Income Population. Pediatr (Rio J).;87(2):138-44.
Cromer B. 2011, Adolescent development In: Nelson's
Textbook of Pediatrics. 18 ed. Philadelphia: Saunders
Elsevier, p. 649-659.
FAO/WHO/UNU. 2001. Human energy requirements.
WHO Technical Report Series, no. 724. Geneva: World
Health Organization.
Gibson. R, 2005. Principles of Nutritional Assessment.
NewYork. Oxford University Press.
Guyton, Arthur C, 1991. Textbook of Medical Physiology
(8th ed.). Philadelphia: W.B. Saunders..p. 978-985.
Correlation of Energy Intake, Sex and Physical Activity with Fat Mass in Stunting Teenagers
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