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family consists of a father, a mother and two children BPS 2000. The number of family members of the teenager subjects is from small family
≤ 4 people to medium family 5 - 7 people. The mean of teenager family member in the highland and the lowland is 4.6 ±
1.2 and 4.9 ± 1.4 respectively. Meanwhile, the member of the adult family is in range of small to medium. The average number of adult family members in the highland and the
lowland area is 4.5 ± 1.2 and 4.6 ± 2.0 respectively. There is an assumption when the family members are small, the mother attention to the member health care is much
better, and this includes drinking water availability and sufficiency for all family members. According to Harper, Deaton and Driskel 1985, family size related to food consumption,
whereas more the family member tends to less adequate food consumption for the family member.
In the teenager group, the distance of their house to the school in the highland and the lowland is 2.3 ± 2.8 km and 2.2 ± 3.2 km respectively. The teenager subjects
spent about 7 hourday at school, and the air temperature at the school is assumed not different with their home.
In the adult group, the distance of their house to workplace is 3.8±4.4 km in the highland and 9.8±17.2 km in lowland. In the lowland, Northern of Jakarta, where the
urban societies are living, we found the far distance of working place is more than 5 km. However, the temperature of working place is almost similar with their home living about
28°C. The adult subjects spent about 7 hourday at the work place. The environment temperature will influence the body physiological adjustment,
which is related to the body respond, maintain and improve the quality of life. High temperature will increase body temperature and make some adaptation through sweat
excretion mechanism. When the sweat is more and continually excreted without any adequate fluids replacement, it could lead to the dehydration.
The normal category of Body Mass Index BMI is 18.5 – 23.0; as thin if the BMI less than 18.5; and overweight if the BMI more than 23.0 WHO, 2004. The results show
that most of the teenagers are categorized as normal 64.9 in highland and 47.7 in lowland Figure 2. At both regions, the thin CED teenagers are much higher than the
overweight. In highland area, the prevalence of thin teenagers is three times higher than the overweight teenagers. However, it is different in the lowland, the number of
overweight teenagers 22.9 is almost similar with the thin ones 29.4.
23
A
64.9 9.3
25.8
a. Kurus IMT 18.5 b. Normal 18.5
≤IMT≤ 23.0 c. Gemuk IMT 23
B
29.4
47.7 22.9
a. Kurus IMT 18.5 b. Normal 18.5
≤IMT≤ 23.0 c. Gemuk IMT 23
A
31.5
64.2 4.3
a. Kurus IMT 18.5 b. Normal 18.5
≤IMT≤ 23.0 c. Gemuk IMT 23
B
17.6
75.5 6.9
a. Kurus IMT 18.5 b. Normal 18.5
≤IMT≤ 23.0 c. Gemuk IMT 23
Table 7. Social-demography characteristics of subjects
Ecological area No. Subject
Characteristics Highland Low land
Total Teenagers
1 Age years
15.9±1.0 16.0±1.0 15.9±1.0
2 Male 48.5
54.1 51.5
3 Female 51.5
45.9 48.5
4 Family member person
4.6±1.2 4.9±1.4
4.8±1.3 5
Distance from home to school km 2.3±2.8
2.2±3.2 2.3±2.9
Adult
1 Age years
36.7±8.4 40.7±9.8 38.8±9.3
2 Male 40.2
43.1 41.8
3 Female 59.8
56.9 58.2
4 Family member person
4.5±1.2 4.6±2.0
4.5±1.7 5
Distance from home to school km 3.8±4.4
9.8±17.2 6.9±13.1
Figure 2. Nutritional status of teenagers in highland A and lowland B In the adult group, the BMI indicate that most of the subjects are categorized as
overweight 64.1 in highland and 75.5 in lowland; while the normal status is 31.5 and 17.6 respectively Figure 3. It is show that the percentage of imbalance diet and
physical activity in lowland is more higher compared to the highland area. The prevalence of chronic energy deficiency CED or thin adult in the highland area is less than in the
lowland, area which is 4.3 in the highland and 6.9 in the lowland.
Figure 3. Nutritional status of adults in highland A and lowland B
Thin-CED BMI 18.5 Normal 18.5
≤ BMI ≤ 23.0 Overrweight BMI 23.0
Thin-CED BMI 18.5 Normal 18.5
≤ BMI ≤ 23.0 Overrweight BMI 23.0
Thin-CED BMI 18.5 Normal 18.5
≤ BMI ≤ 23.0 Overrweight BMI 23.0
Thin-CED BMI 18.5 Normal 18.5
≤ BMI ≤ 23.0 Overrweight BMI 23.0
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The overweight person indicates that the amounts of calories intake exceed the body requirement, which is called positive balance. The lowland area is a represent a
metropolitan city located in North Jakarta; meanwhile, the highland area is a small towns namely Lembang and Cisarua in West Bandung. The adult subjects who live in the
lowland prefer to eat fast food which is generally rich in simple carbohydrate flour and sugar, high sodium and low fiber, and drink carbonated and high sugar. Their physical
lifestyles are also tending to sedentary body less motion. The high prevalence of overweight adult in lowland is very important when we concern with the risk problem
such as coronary heart disease, hypertension, diabetes mellitus and also cancer. The average heart pulse of teenagers in highland is 79.1 ± 15.3; while in the
lowland is 77.2 ± 12.55. In the adult group, the mean pulse is 77.41 ± 11.4 in the highland and 82.9 ± 8.5 in the lowland. Normal heart pulse range is in between 70 - 110
pulses, bradycardia is less than 70, and tachycardia is more than 110 . Both of the
subjects in two areas categorized as normal. The dehydrated person has a slow heart pulse.
Systolic pressure of the teenagers in the highland is 124.1 ± 12.1 mmHg; while in the lowland is 114.9 ± 14.39 mmHg. For teenager, the normal range of systolic
pressures is 115 - 120 mmHg. For the adult, the systolic pressure in the highland is 129.9±18.1 mmHg and in lowland is 122.5 ± 22.5 mmHg. The mean of systolic pressure
both for teenagers and adult subjects are better in the highland compared to the lowland. The teenagers and adults who live in the low land may have high salt intakes. These
figures are also supported by the urinalyses related to the hydration status. The teenagers in the lowland tends to be hydrated, but not in the highland.
The body temperature of the teenagers in the highland is 36.5 ± 0.5°C and in the lowland is 36.8 ± 0.34°C. Meanwhile, at the adult body temperature in the highland is
36.5±0.3°C and in the lowland is 36.6±0.40°C. The body temperature categorized as normal between 36-37°C. Body heat loses is 75 from radiation, conduction and also
sweat excretion; 20 from exhalation, and 5 from urine and fecal Pearce, 1992. If body temperature increase, the hypothalamus gland will activate the body heat
mechanism. The evaporation is one of the degradation mechanisms of body temperature. On the human body, the evaporation through exhalation lung and sweat husk, and the
most of it is sweat. Process of evaporation will lose a lot of water and salt; and this lead to fluids imbalance in body Ahrens, 2007. When the fluids loss is exceed the limit, then
