Energy Distribution Of Macronutrient Among Adolescents In Indonesia: Secondary Analysis Of Total Diet Study Data

In nutrition through the lifecycle concept, nutritional adequacy for each age group should be seriously considered, including in adolescent group. Adolescent balanced nutrition needs to be addressed in order to prevent future diseases. Balanced nutrition can be assessed based on the energy distribution of macronutrients that have been formulated through national summit. Thus, this study aims to evaluate energy distribution of macronutrients as well as percent adequacy intake of energy, protein, and fat among adolescence in East Java province, Indonesia. Data from Total Diet Study were used to investigate the intakes of macronutrient and demographic data of adolescents aged 16 – 18 years who lives in East Java Province (n=708). Data of intakes were assessed using 24 hr recall. Mann-Whitney U tests and Independent t-test were conducted to compare macronutrient consumption, percent adequacy intake of energy, protein, and fat between sex and locality. The results show energy distribution of macronutrient was 56.55% energy from carbohydrate: 14.36% energy from protein: 29.09% energy from fat. Energy distribution of macronutrient of adolescent was changed from 2010 in which energy from protein and fat were increase while energy from carbohydrate was decrease. Percent distribution of energy from carbohydrate was significantly higher in boys (p=0.000), but percent energy from protein was significantly higher in girls (p=0.000). There was no significant different in energy distribution of macronutrients between urban and rural adolescents. Compared to Indonesian Recommended Dietary Allowances (RDA), mean intake of energy, protein, and fat were 75.17%, 101.45%, and 74.82%, respectively. There was no significant different in percent adequacy intake of macronutrients both for sex and locality. This analysis demonstrates a balanced energy distribution of macronutrient intake. These results should be considered by those responsible for ensuring adequate nutrient intakes of adolescents.

Thirty Days Snail Biscuit Supplementation Improved Height-for-age Z-score (HAZ) of Malnourished Children in Slum Surabaya

Background: Indonesia is now still suffering from malnutrition. It was reported that at least 1.39% out of 136,155 children under-five in Surabaya were severely. Severe malnutrition caused by direct factors including infectious diseases and food intake. Therefore, an alternative to overcome that problem is crucial, such as using snail flour for a weaning food. Snail is known as one of the good protein source with complete essential amino acid. Objective: This research aims to determine the effect of snail biscuit (Achatina fulica) toward z-score improvement in severely malnourished children under five according weight for age and height for age index in Ujung sub-district, Surabaya. Methods: This was an experimental research which divided into two groups; case group that given snail biscuit for a month and control group that given coconut biscuit in a same time period. Paired t-test was done to analyze the different between before and after treatment. Results: The result showed that there was no effect of snail biscuit to weight-for-age z-score (WAZ) improvement in children under five (p-value>0.05). However, a month snail biscuit intervention improved height-for-age z-score (HAZ) in children under five (p-value=0.02); while the control group did not show significant result (p-value=0.84). The strength of intervention shown by Exp(B) value=1.02 means that children under five who consume snail biscuit for a month had 1.02 higher height-for-age z-score improvement compared to those who consumed coconut biscuit. Conclusion: It can be concluded that snail biscuit give better improvement of nutritional status based on height-for-age z-score compared to coconut biscuit in malnourished children under five. It is suggested for the intervention study to expand intervention period to 90 days similar to government supplementary feeding intervention.   ABSTRAK   Latar belakang: Malnutrisi masih menjadi masalah gizi utama yang dialami di Indonesia. Dinas Kesehatan Kota Surabaya pada tahun 2009 melaporkan sebesar 1,888 (1.39%) dari 136,155 balita mengalami gizi buruk. Penyebab gizi buruk terdiri dari faktor langsung dan tidak langsung, dimana faktor langsung terdiri dari penyakit infeksi dan asupan makanan. Salah satu alternatif yang dapat digunakan adalah penggunaan tepung bekicot sebagai makanan pendamping. Bekicot diketahui sebagai salah satu sumber protein dengan kandungan asam amino esensial yang lengkap. Tujuan: Penelitian ini bertujuan untuk mengetahui efek pemberian biskuit bekicot  (Achatina fulica) pada perbaikan z-score berat badan menurut usia dan tinggi badan menurut usia balita gizi buruk di Kelurahan Ujung, Surabaya. Metode: Penelitian ini menggunakan desain studi eksperimental dengan pembagian dua kelompok; kelompok intervensi yang diberikan biskuit bekicot selama 30 hari dan kelompok kontrol yang diberikan biskuit kelapa dalam jangka waktu yang sama. Uji statistik yang digunakan yaitu paired t-test. Hasil: Hasil analisis menunjukkan tidak ada efek pemberian biskuit bekicot selama satu bulan pada indeks status gizi berat badan menurut umur (BB/U) (P-value>0,05). Namun, intervensi pemberian biskuit bekicot secara statistik mempengaruhi perbaikan status gizi tinggi badan menurut usia (TB/U) pada balita gizi buruk, sedangkan biskuit kelapa tidak mempengaruhi TB/U balita gizi buruk (P-value=0.84). Kekuatan pengaruh intervensi berdasarkan perhitungan Exp(B)=1.02, artinya bahwa balita gizi buruk yang mengonsumsi biskuit bekicot memiliki 1.02 kali perbaikan yang lebih baik pada status gizi TB/U dibandingkan balita yang mengonsumsi biskuit kelapa. Kesimpulan: Dapat disimpulkan bahwa biskuit bekicot dapat menjadi alternatif perbaikan status gizi balita gizi buruk. Penelitian selanjutnya disarankan dapat memperpanjang durasi intervensi hingga 90 hari seperti anjuran pemerintah dalam pemberian makan tambahan

Predictor of Obese Mothers and Stunted Children in the Same Roof: A Population-Based Study in the Urban Poor Setting Indonesia

Stunting leads to the poor cognitive development, increases the risk of child mortality, and elevates the risk of non-communicable diseases. This study aimed to determine the magnitude of double burden of malnutrition (DBM) in the urban poor setting in Indonesia and investigate its predictors. This was a cross-sectional study involving 436 mothers proportionally chosen from 16 integrated health posts in Surabaya, Indonesia. The households were categorized into the two groups based on the body mass index (BMI) of mother and the height-for-age z-score (HAZ) of child; households without DBM and household with DBM. Energy, carbohydrate, protein, and fat intake were obtained using 24-h food recall and socioeconomic status was measured using a structured questionnaire. Data on socioeconomic status were educational level of mother and occupation, household income, and food expenditure. The prevalence of household with DBM was 27.5%; 12.4% pair stunted children and normal weight mother; 45.6% pair of overweight/obese mother and normal height children. The logistic regression analysis showed significant differences in the education level and occupation of mother, protein intake of the children, and fat intake of the mother between households with and without DBM. This study offers an important insight to improve the knowledge of mother related to the protein intake of children to reduce stunting risk and fat intake of mother to prevent over-nutrition

The Acceptance and Nutritional Value of Crispy Noodles Supplemented with Moringa oleifera as a Functional Snack for Children in a Food Insecure Area

Wild foods and underutilized foods are a significant source of nutrients and bioactive components for rural and poor households in food insecure areas. Moringa oleifera (or "Kelor" in Indonesia) is a wild plant that can be utilized as a raw food material. The purpose of this study was to analyse preference of and nutrition and bioactive contents in crispy noodles supplemented with M. oleifera leaf puree. This work applied a randomized experimental study design with six repetitions. To determine the difference between formulas (F0=0%, F1=10%, and F2=20%), organoleptic properties with hedonic test and data concerning organoleptics were processed using Friedman test and Wilcoxon signed-rank test (α=0.05). An organoleptic test from 30 untrained panellists showed that formula F1 (10% of M. oleifera leaf puree) was the most preferred level added to the crispy noodles. The content of M. oleifera leaf puree significantly influenced the level of aroma and taste of the crispy noodles (P<0.05), but not the texture or colour. In addition, crispy noodles supplemented with M. oleifera leaf puree provided enough nutrients (protein, vitamin A and C, calcium, and zinc), as well as polyphenol and flavonoid substances, which show several health benefits. Taken together, crispy noodles supplemented with M. oleifera leaf puree is a promising functional snack for children at food insecure areas

Nutrition education using my plate media to improve self-efficacy and parental support towards children in full-day primary school and non-full-day primary school

Nutrition education approach is one of many ways that can be done to change people behavior, mainly regarding in health. There is still lack of nutrition education towards school children by the school because of human resource, facilities, and financial matters. Nutrition education using MyPlate media can help children to choose nutritious food. Nutrition education were given by attractive counseling using audio-visual and cooking demo based on MyPlate food guide. Balanced meal nutrition education using MyPlate are expected to be internalized inside children’ mind. Participants of this study were 50 students from public and private primary school in Surabaya. Data for this study were gathered using pretest and posttest. Pretest was given before and posttest was given after nutrition education process in order to evaluate the result. To compute the data ANOVA statistical test was used. The use of ANOVA statistical test revealed that after nutrition education, students’ knowledge towards MyPlate concept significantly increase in each food group: main food (p-value=0.004), vegetable (p-value=0.002), and water (p-value<0.001). Moreover, nutrition literacy score and literacy about MyPlate also significantly increase with each of it has p-value<0.001. This study showed that there was significant improvement in children literacy about MyPlate food concept before and after nutrition education process has given

Comparison of maternal nutrition literacy, dietary diversity, and food security among households with and without double burden of malnutrition in Surabaya, Indonesia

Introduction: Double burden of malnutrition in the form of stunted child and overweight/obese mother has been increasing in countries experiencing nutrition transition. This study aimed to compare maternal nutrition, literacy, dietary diversity, and food security of households categorised by nutritional status of mother-child pairs. Methods: This cross-sectional study included a total of 685 children under 5 years of age from 14 community health centres (posyandu) in a poor urban area of Surabaya, Indonesia. The Lemeshow formula was used to compute sample size. The children and their mothers were categorised into mother- child pairs based on maternal body mass index (BMI) and height-for-age z-score for the child: non-overweight mother-non-stunted child (NM), non-overweight mother and stunted child (SC), overweight/obese mother and non-stunted child (OWT), stunted child and overweight/obese mother (SCOWT). Nutrition literacy was determined using questionnaires, dietary diversity was estimated using household dietary diversity scores, and food security was determined using the Household Food Insecurity Access Scale (HFIAS). Results: The prevalence of households with SCOWT double burden of malnutrition was 21.2%, OWT 37.7%, SC 15.3% and 25.8% were normal (NM). There were significant differences in maternal nutrition literacy, dietary diversity and household food security status. Households with NM pairs were shown to be most food secure followed by OWT, SC and lastly, the SCOWT pairs. Conclusion: Households with double burden of malnutrition have relatively lower nutrition literacy, dietary diversity, and food security. This study indicates the importance of developing nutritional strategies to enable low-income households to make healthy food choices

Nutrition Education 4.0 to Prevent Overweight and Obesity through Social Media

Introduction: This study was aimed to explore the effectiveness of 2-months online-based nutrition education related to the reduction of obesity and the risk factor of overweight in adulthood aged 17-25 years compared to the control group. The nutrition education was followed by 800 participants which consist of intervention and control groups. The intervention group was given pre-test and post-test each module, on the other hand, control groups only had to join webinar nutrition education. Materials and method: 800 early adulthood participants coming from various regions in Indonesia were invited to join the WhatsApp group to get intervention by modules and webinars on different topics about nutrition. This is a randomized control trial study by giving nutrition education modules to adults. This study targets adult aged 17-25 years using a quasi-experiment design with a pre-post test control group design. The study will be conducted online in 8 urban areas (center) in Indonesia, namely: Surabaya, Yogyakarta, Jember, Medan, Bali, Samarinda, Kupang, Palu City

Hubungan antara Status Gizi, Risiko Anemia, dan Ketahanan Pangan dengan Produktivitas Pekerja Bangunan

Latar Belakang: Produktivitas merupakan suatu upaya atau kemampuan yang diberikan oleh suatu individu dalam menghasilkan barang atau jasa. Pekerjaan konstruksi bangunan merupakan jenis pekerjaan yang secara kualitas memerlukan kondisi fisik dan stamina yang prima untuk lebih produktif dalam bekerja. Banyak faktor yang mempengaruhi produktivitas kerja salah satu diantaranya ialah melalui aspek gizi dan kesehatan seperti status gizi, anemia, dan kondisi ketahanan pangan. Beberapa faktor tersebut akan secara langsung maupun tidak langsung berpengaruh terhadap perbedaan kondisi produktivitas dalam pekerja bangunan. Tujuan: Menganalisis hubungan antara status gizi, risiko anemia, dan ketahanan pangan dengan produktivitas kerja pada pekerja bangunan di wilayah Perumahan Graha Natura, Surabaya. Metode: Penelitian cross sectional ini melibatkan 65 orang pekerja yang terpilih secara acak dengan teknik simple random sampling. Proses pengambilan data dilakukan melalui wawancara untuk variabel ketahanan pangan, pengukuran antropometri untuk variabel status gizi dan pemeriksaan tanda dan gejala klinis untuk variabel risiko anemia. Selain itu penilaian variabel produktivitas dilakukan dengan metode wawancara terkait hasil kerja berupa input maupun output. Analisis data yang digunakan yaitu dengan uji statistik chi-square. Penelitian ini fokus kepada variabel bebas yakni status gizi, risiko anemia, dan ketahanan pangan serta variabel tetap yaitu produktivitas kerja. Hasil: Hasil penelitian menunjukkan adanya hubungan antara risiko anemia pekerja (p < 0,001) (r=0,656) dengan produktivitas kerja, sedangkan status gizi dan ketahanan pangan tidak memiliki hubungan dengan produktivitas kerja {status gizi (p = 0,826), status ketahanan pangan (p = 0,282)}.Kesimpulan: Penelitian ini menyimpulkan bahwa risiko anemia pada pekerja berhubungan dengan produktivitas dalam bekerja. Peningkatan asupan tinggi kalori dan seimbang perlu untuk diterapkan oleh pekerja untuk meningkatkan stamina dalam menjaga produktivitas kerja

How and Where the Birth Delivery Taking Place Matter towards the Success of Exclusive Breastfeeding

Background: Breast milk is the best nutrition for babies. The coverage of exclusive breastfeeding in Indonesia in 2017 was still low. However, there are many factors that contribute to low rates of exclusive breastfeeding including socio-cultural factors, factors related to the health system, market, environment, and knowledge. Recent studies have shown that there was a relationship between the place and type of delivery with exclusive breastfeeding. Objectives: This study aimed to analyze the correlation between the place and type of delivery with the success of exclusive breastfeeding practice in Indonesia among mothers of infants 0-6 months. Methods: This study was a secondary data analysis using data from the results of the 2017 Indonesia Demographic and Health Survey (IDHS), conducted in 34 provinces in Indonesia with a total sample of 1810 infants aged 0-6 months. The dependent variable was the exclusive breastfeeding. Independent variables were mother’s age, mother’s level of education, parity, place of delivery, and type of delivery. Data collection was carried out for all variables by interviewing using a reproductive woman questionnaire. Data were analyzed using chi square test. Results: The results showed that 48.2% of mothers gave exclusive breastfeeding. The results of the bivariate analysis showed that the variables of place of delivery (p-value=0.045), type of delivery (p-value<0.001), and mother’s age (p-value=0.048) were related to the practice of exclusive breastfeeding. Conclusions: The conclusion of this study was the factors that affecting exclusive breastfeeding in were place of delivery, type of delivery, and mother’s age

The estimation of cholesterol intake in elderly: reliability and validity of short, Semi-Quantitative Food Frequency Questionnaire (SQ-FFQ)

Purpose: High intake of cholesterol leads to cardiovascular disruption. Estimating the actual intake of cholesterol can be beneficial for nutrition intervention. This research aimed to develop Semi-Quantitative Food Frequency Questionnaire (SQ-FFQ) to estimate cholesterol intake and analyze its reliability and validity. Methods: SQ-FFQ was developed by sorting high cholesterol food items in Indonesian food database and food items' availability. A total of 30 older adults were randomly chosen from Public Health Center in Jagir District, Surabaya, Indonesia to test its validity. Reliability test was done by measuring the same developed SQ-FFQ in one-month period, while validity test was done by comparing SQ-FFQ results with 6-days food record. Statistical analysis used for reliability test was paired t-test, the Intra-class Correlation Coefficient (ICC), and Cronbach's α to measure the internal consistency. Meanwhile, validity of developed SQ-FFQ was analyzed using paired t-test and Bland-Altman. Results: Reliability of 2 administered SQ-FFQs showed a good agreement based on paired t-test analysis (p = 0.200), ICC (0.609), and Cronbach's α (0.757). Strong agreement was found in most of food items, but agreements for egg yolk and fried duck were poor. Significant difference was found between those food items (p = 0.001 vs. p < 0.001, respectively) with mean difference were -25.3 mg and 46.2 mg. Validity of developed SQ-FFQ2 compared to 6-days food diary records also found a strong agreement based on paired t-test and the Bland-Altman analysis. Conclusion: This baseline research provides a reasonably valid and repeatable measure of cholesterol intake estimation that can be widely used in nutrition and public health study, especially in Indonesia. No study has been conducted in Indonesia on the development of tools to estimate the cholesterol intake