2. Background

Penjelasan latar belakang ilmiah dari penelitian dan alasan mengapa harus dilakukan penelitian tersebut,Menunjukkan konteks penelitian,Apa yang sudah diketahui mengenai tema tersebut, Knowledge gap (kesenjangan antara teori dan keadaan saat ini), Permasalahan apa yang ingin dipecahkan dengan penelitian tersebut,Didukung penelitian yang relevan dan systematic review

IntroductionThroughout the world, among children and adolescents, overweight and obesity have become an epidemic. The World Health Organization further projects that by 2015, approximately 2.3 billion adults will be overweight and more than 700 million will be obese. Globally, in 2010 the number of overweight and obese children under the age of five, has been estimated to be over 42 million with about 35 million living in developing countries. Once considered a problem only in high-income countries, overweight and obesity are now dramatically on the rise in low- and middleincome countries, particularly in urban settings. In Chile, there is an elevated and increasing prevalence of obesity affecting about 10% of children under six years of age and increasing to 20% by the time they start elementary school. Overall, overweight and obesity affects over half of Chiles adult population.Biological and genetic factors coupled with environmental and socio- economic conditions have been found to determine obesity from early life to adulthood.There is solid scientific evidence of the inverse association of low birth weight and cardiovascular disease in adulthood. Existing evidence points out that high birth weight in addition to rapid weight gain at an early age, is a risk factor for childhood obesity at a later age. However, there is insufficient evidence of the relationship between birth weight and later obesity.

12. Statistical methodsGambarkan semua metode statistik, termasuk yang digunakan untuk mengontrol perancuJelaskan metode yang digunakan untuk memeriksa subgrup dan interaksiJelaskan bagaimana data yang hilang itu ditujukanstudi Cohort-Jika berlaku, menjelaskan bagaimana mangkir-up ditujukan Studi kasus-kontrol-Jika berlaku, menjelaskan bagaimana pencocokan kasus dan kontrol telah ditangani Studi cross-sectional-Jika berlaku, menjelaskan metode analisis dengan memperhitungkan strategi pengambilan sampelJelaskan setiap analisis sensitivitas

(a) Gambarkan semua metode statistik, termasuk yang digunakan untuk mengontrol perancu

Chi Square

Odd Ratio

Metode Statistik adjusted multiple logistic regression model

b) Jelaskan metode yang digunakan untuk memeriksa subgrup dan interaksi, Jelaskan bila dilakukan subgrup analysis dan interaksi antar subgrup.Chi- Square

Metode Statistik adjusted multiple logistic regression modelMetode Statistik yang digunakan untuk mengendalikan confounding faktor

(c) Jelaskan bagaimana data yang hilang itu ditujukan, Jelaskan apakah dilakukan analisis terhadap missing data

Tidak dijelaskan adanya data yang hilang

d) studi Cohort-Jika berlaku, menjelaskan bagaimana untuk menganalisis loss to follow up

Tidak dijelaskan adanya data yang loss to follow up

(e) Penjelasan setiap analisis sensitivitas

13. ParticipantsRecommendation:(a) Cohort studyGive the eligibility criteria, and the sources and methods of selection of participants. Describe methods of follow-upCase-control studyGive the eligibility criteria, and the sources and methods of case ascertainment and control selection. Give the rationale for the choice of cases and controlsCross-sectional studyGive the eligibility criteria, and the sources and methods of selection of participants

Participants(b) Cohort studyFor matched studies, give matching criteria and number of exposed and unexposedCase-control studyFor matched studies, give matching criteria and the number of controls per case

ParticipantsJelaskan kriteria subjek penelitian, populasi asal subjek, metode seleksi, metode follow-upPopulasi penelitian biasanya dibatasi dengan karakteristik geografis, demografi, dan klinis.

Participantsa. Kriteria subjek penelitian: first grade of elementary public school Chilean childrenb. Sampel: Chilean childrenc. Jumlah sampel: 119.070d. Populasi asal subjek : Chilean populatione. Metode seleksi: tidak dijelaskanf. Metode follow-up: tidak dijelaskan

Populasi penelitian biasanya dibatasi dengan karakteristik geografis, demografi, dan klinisPada jurnal ini, karakteristik dibatasi secara demografi, yakni Chilean children

PartisipantLaporan jumlah individu pada setiap tahap studi-misalnya nomor berpotensi memenuhi syarat, diperiksa untuk kelayakan, dikonfirmasi memenuhi syarat, termasuk dalam studi ini, menyelesaikan tindak lanjut, dan dianalisisBerikan alasan untuk non-partisipasi pada setiap tahapPertimbangkan penggunaan diagram alir

(a) Report numbers of individuals at each stage of studyeg numbers potentially eligible, examined for eligibility, confirmed eligible, included in the study, completing follow-up, and analysed

numbers potentially eligible : Data from a national cohort of 119,070 new born and subsequent measurements at first grade of school were analyzed.

examined for eligibility : Anthropometric measurements and sociodemographic information were obtained from the National Birth Registry and from the nationwide school based Nutritional Assistance Program or Junta Nacional de Auxilio Escolar y Becas (JUNAEB), at birth and at first grade, respectively. About 77% of Chilean children attend public school,17 and it was assumed that this group would be representative of the Chilean population within this age group.

confirmed eligible :

included in the study : After assessing all cases, 93% of cases showed identification correspondence. All those cases were included in the analysis.

completing follow-up :

(b) Memberikan alasan untuk non-partisipasi pada setiap tahap

Tidak terdapat

(c) Pertimbangkan penggunaan diagram alir

Tidak terdapat flow diagrams

18. Key Result

Berisi ringkas temuan-temuan kunci dari penelitian dan dihubungkan dengan tujuan atau hipotesis penelitian

DiscussionThe results of this study showed a positive relationship between different childrens birth weight indicators and obesity at first grade. Macrosomic Chilean infants were more likely to be obese by first grade (OR = 1.55) and after controlling for the effects of confounding pre natal variables with an OR = 1.67, both were statistically significant. These findings corroborate the direct and statistically significant relationship between high birth weight and obesity at first grade in this group of children. These results are consistent with the findings reported recently by Mardones, et al. (2008), who found that higher ORs relating Chilean macrosomic children and obesity at school and also consistent with others international studies. Regarding the attributable risk, it can be concluded that overweight or obesity could have been prevented in about one third of school age children with preventive interventions that target those children identified as macrosomic, or high ponderal index, or large for gestational age at birth.Maternal obesity before conception or during gestation has a strong association with fetal macrosomia,2 and also with the risk of the child developing obesity after birth. This association can be explained by genetic factors, fetal programation or environmental conditions which continue affecting the children after birth. The current study can not determine the strength of these factors, but is very likely that the parents lifestyles can strongly affect the childrens nutritional status.A systematic review of the association of birth weight or rapid growth has indicated that height and weight, as well as rapid growth, increase the likelihood to become obese. In boys and girls, birth weight, maternal weight and fathers occupation, as well as breastfeeding has been found to be significantly associated with BMI through adulthood in British children. In 6 to 13 year old children, as birth weight increased, the overweight risk consistently increased.Low birth weight has been suggested as a protective factor for overweight and obesity among German children. 29 Gestational age, normal and high birth weight and birth length for gestational age were found to be risk factors for overweight and obesity in Swedish youth. Similarly, among Chilean children in this study, birth weight, gestational age and Ponderal Index were identified as risk factors for obesity in childhood.

21. GeneralisabilityRecommendation:Disscuss the generalisability (external validity) of the study results

GeneralisabilityDiscussion:External validityPerlu diberikan informasi yang memadai mengenai lokasi, periode, exposure, outcome, pengamatan secara detil sehingga pembaca bisa menilai.

GeneralisabilityLokasi : Tidak dijelaskan dimana lokasi dari penelitian tersebut. Dalam jurnal hanya dijelaskan bahwa penelitian dilakukan pada anak-anak di daerah ChiliPeriode : Tidak dijelaskanExposure : Tidak dijelaskanOutcome : Hasil penelitian dinilai mampu menjadi rekomendasi dan dapat diaplikasikan pada seluruh anak kelompok usia 6-7 tahun (first grade) pada daerah ChiliPengamatan : tidak dijelaskan

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