Purpose: Indonesia is facing an increasing occurrence of non-communicable diseases (NCDs) every year. We assessed the modifiable, non-modifiable, and physiological risk factors of NCDs among the Indonesian population. Methods: Secondary data was analyzed from the 2018 Indonesian basic health research (RISKESDAS). The national survey included participants aged 15– 54 years and obtained 514,351 responses. Linear systematic two-stage sampling was conducted by RISKESDAS. Furthermore, chi-square and binary logistic regression were utilized to explore the determinant of NCDs with a significance level of 95%. Results: We found that almost 10% respondents in Indonesia had NCDs. We observed that depression has a higher odd (aOR: 2.343; 95% CI: 2.235– 2.456) contributed to NCDs and followed other factors such as no education (aOR: 1.049; 95% CI: 1.007– 1.092), passive smoking (aOR: 0.910; 95% CI: 0.878– 0.942), fatty food (aOR: 1.050; 95% CI: 1.029– 1.073), burnt food (aOR: 1.033; 95% CI: 1.005– 1.062), food with preservatives (aOR: 1.038; 95% CI: 1.002– 1.075), seasoned food (aOR: 1.057; 95% CI: 1.030– 1.084), soft drinks (aOR: 1.112; 95% CI: 1.057– 1.169), living in an urban area (aOR: 1.143; 95% CI: 1.119– 1.168), living in central Indonesia (1.243; 95% CI: 1.187– 1.302), being female (aOR: 1.235; 95% CI: 1.177– 1.25), and obese (aOR: 1.787; 95% CI: 1.686– 1.893). Conversely, people in Indonesia who undertook vigorous activity (aOR: 0.892; 95% CI: 0.864– 0.921), had employment (aOR: 0.814; 95% CI: 0.796– 0.834), had access to improved sources of drinking water (aOR: 0.910; 95% CI: 0.878– 0.942), and were aged 35– 44 years (aOR: 0.457; 95% CI: 0.446– 0.467) were less likely to develop NCDs. Conclusion: Modifiable, non-modifiable, and physiological risk factors have a significant influence on NCDs in Indonesia. This finding can be valuable information for Indonesian Government to arrange a cross-collaboration between government, healthcare workers, and society through advocacy, partnership, health promotion, early detection, and management of NCDs.

Background: Currently, the determinants of anxiety and its related factors in the general population affected by COVID-19 are poorly understood. We examined the effects of spirituality, knowledge, attitudes, and practices (KAP) on anxiety regarding COVID-19. Methods: Online cross-sectional data (n = 1082) covered 17 provinces. The assessment included the Daily Spiritual Experiences Scale, the Depression, Anxiety, and Stress Scale, and the KAP-COVID-19 questionnaire. Results: Multiple linear regression revealed that individuals who had low levels of spirituality had increased anxiety compared to those with higher levels of spirituality. Individuals had correct knowledge of early symptoms and supportive treatment (K3), and that individuals with chronic diseases and those who were obese or elderly were more likely to be severe cases (K4). However, participants who chose incorrect concerns about there being no need for children and young adults to take measures to prevent COVID-19 (K9) had significantly lower anxiety compared to those who responded with the correct choice. Participants who disagreed about whether society would win the battle against COVID-19 (A1) and successfully control it (A2) were associated with higher anxiety. Those with the practice of attending crowded places (P1) had significantly higher anxiety. Conclusions: Spirituality, knowledge, attitudes, and practice were significantly correlated with anxiety regarding COVID-19 in the general population.

Coronavirus disease 2019 (COVID-19) has become a pandemic. We examined the KAP’s relationship with factors associated with practice toward the COVID-19 pandemic in Indonesia. This cross-sectional survey study was conducted between March and April 2020 and included 1033 participants. Knowledge scores of COVID-19 were positively associated with wearing a mask when leaving home (odds ratio (OR): 1.22, p < 0.05). Although men had a lower knowledge score, they were less likely to go to a crowded place compared with women (OR: 0.79, p < 0.05). However, women (OR: 1.25, p < 0.05) were more likely than men to wear a mask when leaving home. Furthermore, men (OR: 3.32, p < 0.05) were more likely than women to have a positive attitude toward COVID-19. Indonesian residents had satisfactory knowledge, demonstrated a positive attitude, and followed appropriate practices toward the pandemic. More educated individuals had a more positive attitude. Men and women differed with respect to their knowledge-based practices. Men were less likely to go to crowded places, and women were more likely to wear a mask when leaving home. Furthermore, men were more likely to wear a mask when leaving home than women when men had the attitude that Indonesia can win against COVID-19.

Alkaline electrolyzed water (AEW) and walking are strongly recommended for ameliorating oxidative stress and inflammation. Nevertheless, there is a lack of information on the combination of both on alleviating inflammation, oxidative stress, and improving the quality of life (QoL). We investigated the synergistic effects of drinking AEW and walking on advanced glycation end products (AGEs), advanced oxidation protein products (AOPPs), malondialdehyde (MDA), white blood cells (WBCs), neutrophil-lymphocyte ratio (NLR) and QoL. In total, 81 eligible patients with type 2 diabetes (T2DM) were randomly allocated via single blind to four groups: consumed 2 L/day of AEW (n = 20), instructed to walk for 150 min/week (n = 20), received a combination of AEW and walking (n = 20), and continue their habitual diet and activity (n = 21). Data were collected and analyzed before and after 8 weeks of intervention. Our results showed a significant interaction between the group and time, with both AEW and walking independently and synergistically ameliorating AGEs, AOPPs, MDA, NLR and WBCs levels. Moreover, the AEW group had a higher physical and total QoL score. The walking group and the combined group had higher scores in physical, mental and total QoL compared to the control group. The synergistic effect of AEW and regular walking are an advisable treatment for patients with T2DM.

To analyze the association between smoking status (active smoking and exposure to Second-Hand Smoking (SHS)) and the synergistic effect of smoking status and BMI with gout risk, a community-based case-control design was undertaken among 385 participants, including 304 healthy controls and 81 gout patients from seven community health services. Adjusted Odd Ratios (AORs) and 95% Confidence Interval (CIs) of gout for active smoking and SHS were 3.26 (95% CI = 1.07~9.90) and 4.67 (95% CI = 2.18~10.00) compared to non-smokers. Time-dependent manner of active smoking and SHS significantly increased gout risk with AORs and 95% CIs of 5.95 (1.41~25.03) and 10.12 (3.51~29.14). Dose-dependency of active smokers and SHS showed AORs and 95% CIs of 5.15 (1.28~20.63) and 4.37 (1.33~14.28). Smoking 20 cigarettes (one pack) per day for one year is equivalent to one pack-year. Active smoking >20 pack-year and SHS > 26.5 pack-year increased gout risk with AORs and 95% CIs of 7.18 (1.53~33.67) and 9.95 (3.64~27.22). Participants who smoked (active smoking and SHS) and with Body Mass Index (BMI) of > 24.9 kg/m² synergistically increased gout risk, with an AOR of 9.65 and 95% CI of 3.25~28.65, compared to BMI ≤ 24.9 kg/m² and non-smoker. Smoking status (active smoking and SHS) and the synergistic effect of smoking status and BMI increased gout risk in Indonesia.