The Experiences of Blended Training Implementation from Nutrition Goes to School (NGTS) Program in Indonesia

This study aimed to evaluate the implementation of a blended training for school teachers on adolescent health and nutrition. The training objective was to improve teachers’ knowledge, as well as their capacity to develop and implement action plans on school-based health and nutrition programs. Adolescents continue to face nutrition problems closely linked with poor eating behaviours and lack of physical activity. School has been identified as an effective venue for improving these problems. Many teachers’ training programs were reported on increasing the teachers’ roles in school health and nutrition program, but studies utilizing a blended training is lacking. This study used pre-post intervention with mixed methods design. The participants of this blended training were secondary school teachers who enrolled in a five-phase Nutrition Goes to School (NGTS) training on school-based nutrition promotion program, comprising in-service learning and on-the-job training for ten months. The participants decreased throughout the training to 114 participants completed the whole training. Out of 114 participants, 25 (22%) passed this NGTS blended training. Participants’ knowledge on health and nutrition improved as shown in pre-test median score of 60 and post-test median score of 80 (p<0.001). The final assignment on developing action plans showed a relatively good quality of engagement based on the participants’ understanding on the NGTS program, their resources, and their ability to manage challenges. Blended training with long duration but accompanied with technical assistance can provide added value in understanding the process of the NGTS program implementation and school-based health and nutrition program in general. However, the high attrition rate should be improved by facilitating more varied and engaging activities as part of the technical assistance in the future training program

High-Pressure Pre-Treatment of Kappaphycus alvarezii: Effect of Drying Rate on Physicochemical Properties and Antioxidant Activities

This study focuses on High-Pressure Pre-Treatment to enhance the seaweed's nutritional value and antioxidant potential, which is highly relevant and aligns with the demand for improved food processing techniques that preserve bioactive compounds. High-Pressure Processing (HPP) was applied at varying levels (0, 200, 400, and 600 MPa) to assess its impact on drying efficiency, physicochemical properties, and antioxidant activities. High-Pressure Processing (HPP) at 200 MPa, 400 MPa, and 600 MPa enhanced the drying performance and antioxidant properties of Kappaphycus alvarezii. The 600 MPa treatment achieved the fastest drying rate and the highest antioxidant capacity, thereby enhancing the seaweed’s functional properties. Moreover, the 600 MPa treatment yielded the highest total phenolic content (50.68±1.51 mg GAE/100 g) and a significant enhancement in total flavonoid content (5.54±0.29 mg QE/100 g). These compounds are crucial for neutralizing free radicals and mitigating oxidative stress. Furthermore, the 600 MPa treatment demonstrated a significant increase in ferric reducing antioxidant power assay (44.58±2.56 mg FeSO4/100 g) and 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging activity (18.86±0.66%) relative to the untreated sample, highlighting the improved antioxidant potential associated with high-pressure treatment. These findings indicate that HPP not only preserves but also enhances the antioxidant properties of Kappaphycus alvarezii, which are vital for its health benefits. Additionally, color analysis revealed significant changes in the lightness and chromaticity of the seaweed post-treatment, suggesting improvements in its visual appeal. This research underscores the capability of HPP technology to improve the drying efficiency of Kappaphycus alvarezii, thereby boosting its antioxidative properties, marketability, and versatility in various applications

Higher Ultra-Processed Food Consumption is Associated with Increased Risk of Mental Health Issues in Undergraduates

This cross-sectional study, involving 250 healthy undergraduate students, aimed to examine the association between Ultra-Processed Food (UPF) consumption and mental health status. Mental health was assessed using the 12-Item General Health Questionnaire (GHQ-12), where participants were classified as either normal or high-risk based on their scores. Subsequently, dietary intake was assessed using the Dietary History Questionnaire (DHQ), examining meals throughout the day. Additionally, the degree of food processing was classified using the NOVA food classification. Univariate and multivariate logistic regression analyses were used to evaluate the relationship between mental health status, ultra-processed food consumption, and the contributing factors. The average daily energy intake was 1,216±488 kcal, with 25.7% coming from ultra-processed foods. Those at higher risk for mental health issues typically had a slightly lower fat percentage (26.5±8.5%) but a higher total body water percentage (50.6±4.7%) compared to those with normal mental health. Even after adjustment for confounding factors, high consumption of ultra-processed foods remained strongly associated with an increased risk of mental health problems (OR=2.196, 95% CI:1.056–4.566, p=0.035). Further research is needed to fully understand the effects of ultra-processed foods on mental health and enhance awareness of their risks while promoting fresh, minimally processed alternatives

Adherence to the Mediterranean Diet for a Better Sperm Quality: A Comprehensive Systematic Review and Meta-Analysis

The aim of this study is to investigate whether a higher adherence to the Mediterranean Diet (MD) can enhance reproductive indicators in infertile men. A comprehensive review and meta-analysis were conducted to assess whether increased adherence to the MD can enhance reproductive indicators in infertile men. An extensive search was conducted for pertinent studies in PubMed, Medline, and Google Scholar. The search included relevant publications published in the last 10 years from 2015. The Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) 2020 instrument was used to evaluate the studies. The study's quality was evaluated using the Newcastle-Ottawa Scale (NOS). The data were analyzed and evaluated using RevMan version 5.4.1. The data on sperm volume were not statistically significant. The meta-analysis indicated an odds ratio of 1.06 for low semen volume (<1.5 mL) associated with low adherence to the MD (I2=12%; 95% CI:0.59–1.93, p=0.84). Furthermore, the analysis revealed a 2.86-fold increase in the probability of achieving higher sperm concentration (>15 × 106/mL) in individuals who adhered to the MD (I2=33%; 95% CI:1.58–5.18, p=0.0005). The meta-analysis further suggests that adherence to the MD is associated with a 2.54-fold increase in the likelihood of improving sperm count (>39 × 106/ejaculate) (I2=48%; OR=2.54; 95% CI:1.32–4.90, p=0.005). The meta-analysis on sperm motility demonstrated that individuals who adhere strictly to the MD are more likely to exhibit normal motility (>40%) (I2=0%; OR=4.64; 95% CI:2.41–8.95, p<0.00001). The meta-analysis further revealed a 2.66-fold increased likelihood of better sperm morphology (>4%) (I2=0%; OR=2.66; 95% CI:1.39–5.10, p=0.003) in individuals adhering to the MD. The present systematic review with meta-analysis indicates that higher adherence to the MD is associated with improved sperm quality parameters (sperm count, sperm concentration, sperm motility, and sperm morphology)

Targeted Educational Materials for Sugar-Sweetened Beverage Intervention among Urban Adolescents in Jakarta: A Mixed-Methods Study

This study aims to identify the educational needs of urban adolescents in Jakarta to improve their Knowledge, Attitudes, and Practices (KAP) regarding Sugar-Sweetened Beverages (SSBs). Its goal is to develop tailored educational material topics regarding SSBs related to health risks, such as obesity and Non-Communicable Diseases (NCDs). Employing a mixed-methods approach, the research was conducted across five public senior high schools in all five areas of Jakarta from January to February 2024. The quantitative component involved a survey of 488 students to assess their KAP related to SSBs. The KAP formed the basis of the educational materials. The qualitative approach involves 2 Focus Group Discussions (FGDs) with students and 8 In-Depth Interviews (IDIs) with teachers and experts focusing on adolescents’ nutrition and health. The insights were used for the development of the educational materials. The qualitative data were transcribed, coded, and analysed thematically to pinpoint essential educational materials that could bridge the gaps identified in the quantitative data. Results showed that only 18.8% of adolescents had good knowledge, 13.9% had a positive attitude, and 32.4% exhibited healthy practices regarding SSBs. Findings revealed critical issues: poor knowledge, negative attitude, and unhealthy practice regarding the maximum daily sugar intake, inadequate understanding of the nutritional value of sugar, infrequent checking of sugar content before consuming SSBs, limited awareness of SSBs' negative health impacts, and poor knowledge of SSB examples and food labelling practices. Educational materials are needed to address critical gaps in adolescents’ KAP related to SSBs. These materials should focus on raising awareness about the health risks of SSBs, understanding sugar content, improving food labelling literacy, and promoting healthier beverage choices. Future research should assess the implementation and effectiveness of tailored educational strategies to enhance adolescents' KAP related to SSBs, address critical health risks, and promote informed beverage choices

Caffeine Ingestion among Athletes Based on Safe Dose Daily Allowance in Malaysia

This study aims to investigate the category of caffeinated beverages ingested and caffeine ingestion level among athletes based on safe dose daily allowance. A cross-sectional study was conducted among 236 athletes using validated Caffeine Consumption Questionnaire (CCQ) to estimate the caffeine intake among athletes. The findings revealed a high prevalence (69.1%) of caffeine consumption exceeding the recommended daily allowance was observed among the athletes. Among the various Caffeinated Beverage (CB) categories, Coffee Drink (CD) showed the highest median and interquartile range of caffeine intake 243.0 mg (0–919.5 mg). There was a significant correlation (p<0.05) between types of CB Energy Drink (ED) with pre-event (r=0.280), during-event (r=0.447), post-event (r=0.291). Energy Gel (EG) with pre-event (r=0.139), during-event (r=0.498), post-event (r=0.170). Soft Drink (SD) with pre-event (r=0.328), during-event (r=0.228), post-event (r=0.304). CD with pre-event (r=0.534), during-event (r=0.132), post-event (r=0.240). Tea Drink (TD) with pre-event (r=0.148), post-event (r=0.190). Cocoa Drink (CocD) with pre-event (r=0.158), post-event (r=0.137). A significant association (p<0.05) was observed between the range dose allowance of caffeine intake and the timing of ingestion during sports events. The daily caffeine consumption among athletes in Malaysia exceeds the recommended safe dose. Therefore, it is essential to monitor, track and regulate the intake of caffeine-containing beverages by implementing clear guidelines and promoting awareness of caffeine-related facts. This approach aims to prevent potential adverse health effects while ensuring athletes can still harness its performance-enhancing benefits

Relationship between Age, Gender, Education Level, Employment Status and Comorbidity with Nutritional Status in Hemodialysis Patients

This research aimed to determine the relationship between age, gender, education level, employment status, and comorbidities with nutritional status in hemodialysis patients. It employed a cross-sectional design. The population consisted of end-stage renal disease outpatients undergoing hemodialysis, totaling 84 respondents aged 19‒59 years. The sampling method utilized was simple random sampling. This research was conducted from October to November 2024. Nutritional status was measured using the Subjective Global Assessment (SGA) questionnaire. Statistical tests employed included chi-square and logistic regression analyses. The statistical results indicated a significant relationship between employment status and nutritional status, comorbidity and nutritional status in hemodialysis patients (p<0.05). No significant relationships were found between age, gender, and education level with nutritional status among hemodialysis patients (p>0.05). The factors associated with nutritional status among hemodialysis patients are comorbidity (OR=6.618; 95% CI:2.124–20.619, p<0.05) and employment status (OR=5.887; 95% CI:1.585–21.870, p<0.05). Malnutrition is closely related to the presence of comorbidities in hemodialysis patients; therefore, it is crucial to treat and manage comorbidities to prevent the progression of malnutrition in this population. Health workers in the hemodialysis department should pay more attention to the nutritional status of patients who are unemployed

Infant Feeding Practices among Mothers with a History of Gestational Diabetes Mellitus in Selangor

This study aims to determine infant feeding practices including breastfeeding initiation, exclusive breastfeeding, duration of breastfeeding and complementary feeding, feeding practices related factors among mothers with Gestational Diabetes Mellitus (GDM) history, and the association between Infant and Young Child Feeding indicators and GDM status. A cross-sectional study (n=130) was conducted from February to June 2023 in Meru and Bandar Botanic health clinics. Data on infant feeding practices were gathered from GDM mothers and children aged below two years. Findings showed that 43.8% (n=57) of the mothers had initiated breastfeeding within an hour, 57.7% (n=75) infants were exclusively breastfed, 30.0% (n=39) continued breastfeeding for one year and 81.9% (n=68) had an appropriate time of complementary feeding. Mothers who had caesarean-section delivery and GDM were more likely to initiate breastfeeding after an hour of delivery, p<0.05. Exclusive breastfeeding was highly practiced by older, multiparous, and higher education mothers. Unemployed mothers were more likely to continue breastfeeding for one year. GDM mothers were more inclined to delay breastfeeding initiation and introduced complementary feeding appropriately, p<0.05. This study's findings bridge the gap in providing information on infant feeding practices among mothers with a history of GDM and therefore might be beneficial for related personnel to figure out how to overcome this concerning issue in the future