ANTHROPOMETRY AND BODY COMPOSITION OF INDONESIAN ADULTS: AN EVALUATION OF BODY IMAGE, EATING BEHAVIOURS, AND PHYSICAL ACTIVITY 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; Indonesian adults 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 body composition and an 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 of body composition is a better approach in the evaluation of 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 of anthropometry and body composition and their associated benefits in Indonesian adults are very limited This may be partly due to the limited field-based methods available to assess body composition in this population Many studies have reported the usefulness of prediction equations from anthropometric measures and bioelectrical impedance analysis (BIA) to provide detailed assessment of body composition However, no data has been reported for Indonesian populations The present study provides knowledge of anthropometry and body composition in Indonesian adults and some associated factors including body image, eating behaviours, and physical activity The present study also develops a number anthropometric and BIA equations to predict body composition in Indonesian adults ii The present thesis was organized into three study parts In study one, the objectives were to provide new knowledge and understanding of the anthropometry and body composition of Indonesian adults and to develop anthropometric prediction equations to estimate body composition 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 Indonesian adults in a previous study resulted in 3.33 ± 4.81% higher values (p