The urgency in proposing the optimal obesity cutoff value in Indonesian population: A narrative review

In developing nations such as Indonesia, obesity and central obesity have emerged as major public health issues. Many studies have revealed that morbidity and death from obesity-related diseases are already significant in some "Asian" communities at low body mass index (BMI) levels. A recent study showed that the obesity prevalence in Indonesia is underestimated when using the current BMI cutoff (obese ≥ 27.0). Indonesia faced an increase in obesity-related chronic diseases despite having a lower obesity prevalence than developed countries, which may be explained by the underestimation of obesity levels in Indonesia. This creates a huge global health problem, as well as an economic burden. Another recent study on the Indonesian population depicted the new proposed cutoff of waist circumference (WC), which is lower than the World Health Organization (WHO) standard for detecting the early detection of type 2 diabetes mellitus (T2DM), one of the comorbidities and a strong correlation with obesity. An analysis of 58 studies in 2021 that included Indonesian adult subjects revealed enormous differences and ambiguities in defining obesity cutoffs values among Indonesian researchers. Additionally, we advocate adding the Edmonton Obesity Staging System (EOSS) staging to the anthropometric classification for a better clinical evaluation of obesity. Considering the urgency of obesity determination in Indonesia for clinical application and study purposes, this review highlights the need to revise the optimal cutoff value for obesity to warrant early prevention and control of diabetes complications.

The Effect of Sappan Wood Extract (Caesalpinia sappan L.) on Fetal and Placenta Histopathology of White Rat

Histomorphological assessment of the placenta and fetus was more effective in assessing fetal development on a research scale for determined an active substance during the gestation period in experimental animals. The placenta and fetus connect in the development process. This study aimed to analyze the effect of giving ethanol extract of sappanwood on white rats’ placenta and fetal organs, which were examined histologically at 20 days pregnant rats. The pregnant rats were divided into six groups: The negative group was given aquadest, and treatment groups were given an ethanolic Sappan wood extract 100;200;300;400;500 mg/kg BW. Euthanized with CO2 and cesarian section was performed on pregnant rats on the 20th gestational day. Observation to record fetal body weight, body length, mean placental weight, and the histology of the placental area. Histomorphometry was used to measure the area of the fetal placental region. The group with sappan wood extract had no statistically significant difference in fetal body weight, fetal body length, fetal tail length, the weight placenta, and histomorphometry of the placenta compared to the control group (p > 0.05); this showed that the ethanolic extract of sappan wood does not have a toxic effect on the development of the placenta, which can interfere with fetal development during pregnancy. Sappan wood extract had a nontoxic effect on the placenta and fetal rat development on histological examination, even at the highest dose of 500 mg.kg-1 bw.