The combination of nutrition education at school and home visits to improve adolescents' nutritional literacy and diet quality in food-insecure households in post-disaster area (De-Nulit study): A study protocol of cluster randomized controlled trial (CRCT)

Nutrition education is selected as a method which often used to change eating behaviour, yet, the effectiveness of this method in adolescents who live in household with food insecurity status is rarely investigated. The purpose of this study was to assess the impact of a combination of nutritional education held at school and home visits for increasing the nutritional literacy and its effect on the quality of adolescent diet, so that the result can be used as a strategy to improve nutritional literacy dan diet quality in those adolescents who live in food-insecure households in post-disaster areas. The De-Nulit Study is a Cluster Randomized Controlled Trial (CRCT) with an intervention from a combination of nutritional education given at school and home visits conducted for three months for adolescents who live in food-insecure households with ages ranging from 15 to 17 years old. A randomization sampling was carried out at four schools located the nearest locations which were affected heavily by the major natural disasters in 2018. The nutritional education intervention groups in schools were given in eight sessions, whereas home visits with an interview approach for students with a motivational interview approach were carried out four times. The control group will receive leaflets three times a month for three months, and each group will receive a food stamp $ 7.6 per month for three months. The trial research has been recorded in Thai Clinical Trials Registry (TCTR) with identification number of TCTR 20220203003 issued on 03 February 2022.

Validitas dan reliabilitas kuesioner literasi gizi pada remaja (Nulit) di Wilayah Pascabencana

The validation of the nutritional literacy questionnaire with a broader concept has never been published in Indonesia. This study aims to describe the validation of a nutritional literacy questionnaire (Nulit) in adolescents in post-disaster areas. Content validation was carried out qualitatively and quantitatively. They involve nine panellists by calculating the content validity index (CVI) and multi-rater kappa statistics. Face validation involved ten adolescents living with their mothers in Palu during the 2018 natural disaster. The face validation, item validity, and reliability were assessed by the impact score, the correlation score of each item with the total score, and the value of Cronbach's Coefficient Alpha. The results found that the I-CVI on all items was between 0,78 - 1, which is considered very good. The validation of the questionnaire display found the statement items to be essential and appropriate in the daily life of adolescents, and the impact factor value was 3,9 - 4,3. A total of 21 items are valid; the Cronbach's alpha value is FNL= 0,73, INL= 0,70 and CNL= 0,71. In conclusion, the Nulit Questionnaire is valid and reliable for measuring nutritional literacy in adolescents in post-disaster areas.

Consumption Traditional Food Description in Children Under Five in the Coastal Family of Bengkulu City, Indonesia

Background: Traditional food is the most potent food to develop and is an essential component in intervention strategy for increasing toddler daily consumption. Traditional food contributes to micro-nutrition and protein, which are needed for toddler growth. Objectives: This research aimed to identify traditional food and toddlers' traditional food consumption in coastal families in three ethnicity in Bengkulu. Methods: This research used a cross-sectional design. Samples were mothers as food givers in the family, and the analysis unit was the toddler, in a total of 115, picked randomly from 137 households with 12-59 months old toddlers. Data was collected using quantitative and qualitative techniques, in-depth interviews, and food recall forms. Traditional food identification comes from FFQ (Food Frequency Questionnaire). Consumption of toddler fisherman family data that had been collected and compared with RDA 2019. Analyses were done by formulating the results from the in-depth interview and uni variate analysis.  Results: Traditional food contribution to fisherman's toddler contained 19.34% energy, 40.86% protein, 17.65% fat, 17.65% carbohydrate, 16,3% PUFA fat acid, and 13.8% MUFA. Many different traditional foods often consumed by Melayu, Serawai, and Minang ethics in coastal families could be classified as fish, vegetables, and snacks. Conclusions: Traditional food contribution could fulfill nutritional needs of energy and macro-nutrients ranging from 17-41%. We must increase traditional food consumption in coastal families by varying processing so that each ethnicity's distinctive taste in traditional food can be maintained. 

Study Characteristics of School Adolescent Girls on Iron Folic Acid Supplementation Program as the Prevention of Anemia in Adolescent

Background: Efforts to accelerate stunting reduction involve specific and sensitive nutrition interventions. School adolescent girls are the target group in reducing stunting through anemia prevention. Iron folic acid (IFA) supplementation program is the specific nutrition intervention to prevent anemia in adolescent girls. Objectives: This research aims to study the characteristics of students who received the IFA supplementation program. Methods: Research design was a cross sectional that involved 123 students from 12 public high schools in Cianjur District, West Java Province. Student’s characteristics consist of knowledge on anemia and their adherence on IFA supplementation program. Data collection is carried out by self-administering questionnaires monitored by enumerator. Data is performed by using mean ± SD and n (%). Results: Student’s knowledge on anemia mostly (61.8%) were categorized as low, as 30.9% were moderate, and only 7.3% were high. Students (44.7%) knew how to detect anemia is by measuring blood hemoglobin levels. As of 59.3% and 51.2% students knew the main causes of anemia are inadequate iron intake and blood loss during menstruation. Approximately 60-80% students recognized the common symptoms and sign of anemia. Most students (76.8%) have received IFA on a weekly basis and 41.2% students acknowledge their adherence in the IFA consumption with aim to prevent anemia (85.1%), the rest 23.4% and 14.9% due to the advice by the teachers and health officers. Students who have no adherence were due to their fear on the side effects, the tablet taste, forgetfulness, and feeling healthy. Conclusions: Iron folic acid supplementation program have been conducted and well targeted, however, student’s understanding on the objectives, benefit, and their adherence is needed to be gained.

Maternal Nutritional Knowledge as a Determinant of Stunting in West Java: Rural-Urban Disparities

Background: Maternal nutritional knowledge must be strengthened to lower the problem of stunting. However, there is currently a lack of information regarding the nutritional knowledge of mothers of stunted and non-stunted children in West Java's rural and urban areas. Objectives: This study compares the nutritional knowledge of mothers of under-five children in West Java across four groups: those who are stunted in rural areas (SR), those who are stunted in urban areas (SU), and those who are not in rural (NR) and urban (NU). Methods: This cross-sectional study was conducted in Cianjur (rural) and Sukabumi City (urban) in June 2022. Data was collected through interview to 300 mothers of children underfive using pretested questionnaire. Nutritional knowledge comprised of 20 questions about infant and young child feeding and balanced nutrition. One-way ANOVA and Tukey HSD Post Hoc Tests were applied for data analyses using IBM SPSS 22.0. Results: Overall, both prevalence of stunting in rural and urban was 33.3% and 30.7%, respectively. Mothers in four groups had moderate nutritional knowledge, with total scores ranging from 70.9 to 75.2. Mothers of NU were found to have more nutritional awareness than NR and SR. In comparison to NR, mothers of NU babies are more likely to be aware that their 2- or 3-month-old infants cannot consume bananas or papayas. Compared to SR, more NU mothers are aware that vegetables do not contain protein. There are more mothers of NU know that sweetened condensed milk is not more nutrient rich compared to powder or liquid milk than NR and SR. Conclusions: Urban mothers have superior nutritional knowledge than rural mothers. Even, knowledge of rural mother with stunted child is the poorest. With the high prevalence of stunting, access to nutritional information should be enhanced, with a focus on the feeding practices of young children.

Effects of Walking Exercise Program Based on Duration on the Body Composition and Lipid Profile in Overweight and Obesity Female College Students

The lack of physical activity is one factors that causes the increased prevalence of overweight and obesity in Indonesia. A walking exercise program is a simple strategy for weight loss and the prevention of various chronic diseases. This research aims to analyze the effects of walking exercise programs base on duration which involve an increased number of daily steps on the body's composition and lipid profile. The quasi-experimental design included 40 female university students aged 20–30, whose body mass index (BMI) was ≥25 kg/m2. They are divided into two groups: 60 minutes (WE-60) and 40 minutes (WE-40) walking program. All groups performed the program intervention five times per week, carried out for a total of 12 weeks, with a heart rate of 50%-75%. The results showed that an additional 60-minute walking exercise program led to a greater increase in the total daily steps (P<0.001), and it has a significant effect on weight (P=0.005), BMI (P=0.002), WC (P=0.003), visceral fat (P=0.001), fat mass (P=0.001) and the body fat percentage (P=0.007), compared to the 40 minutes walking group intervention. However, the lipid profiles of both groups were not significantly different. In conclusion, the addition of a 60-minute walking exercise program (WE-60) five times per week, improved the daily steps and significantly affected body composition, but it had no significant effect on the lipid profile.

The Effectiveness of Implementation of Healthy Living Community Movement in Overcoming Metabolic Syndrome Among Female Workers in East Kalimantan, Indonesia

The metabolic syndrome occurs in almost 25% of the world’s adult population. A workplace is an ideal place for implementing health interventions to reduce metabolic syndrome risk factor. One of the Indonesian government’s health programs to improve public health and prevent non-communicable diseases is called Healthy Living Community Movement (HLCM). This research aims to determine the effectiveness of HLCM implementation to overcome metabolic syndrome among female workers in Indonesia. This quasi-experimental study included 42 female workers with metabolic syndrome, which were divided into an intervention group and a control group. The intervention group was given an 8-weeks combination of health education and implementation of HLCM activities that consisted of fruit and vegetables provision as much as 400 grams per day and physical exercise for at least 150 minutes per week. The intervention for control group included only health education. Subjects’ parameters were measured and adherence to HLCM activities was evaluated by a questionnaire. Adherence to HLCM implementation was carried out by 52.4% of the subjects which resulted in a significant reduction in their waist circumference, systolic and diastolic blood pressure, and triglyceride levels (p < 0.05, respectively). After 8 weeks of interventions, 13 subjects (65%) from the intervention group were no longer included in the metabolic syndrome criteria, while in the control group only 2 subjects (10.5%) were not included. Therefore, the implementation of HLCM in the workplace is effective in overcoming the metabolic syndrome.

Pola Asuh Makan dan Konsumsi Pangan Balita Anemia di Kabupaten Cirebon

Background: Anemia is a global nutritional problem with a prevalence of 36.8% of children in Indonesia were anemic. Food consumption, feeding pattern, and socio-economy factors can affect to the anemia status of children.Purpose: This study aims to analyze the correlation between feeding pattern with food consumption and the correlation between feeding pattern and food consumption with hemoglobin levels for children with anemia.Methods: Design of this study is cross sectional design and conducted in August-November 2020 with a total sample of 54 anemic children(Hb<11 g/dL) in Gegesik District, Cirebon Regency which were selected by purposive sampling. Characteristics of household, characteristics of children and nutritional status, children feeding pattern, and food consumption were collected through interviews and direct measurements. Data analysis was performed by univariate and bivariate using spearman correlation test.Results: More than half (51.9%) mothers aged 26-35 years with low education level (90.7%) and household income below the regional minimum wage (66.7%). The average hemoglobin level for children was 9.2±1.4 g/dL and 66.7% were moderate anemia. Most (44.4%) children aged 25-36 months were undernourished based on HAZ and WAZ indicators. Good food pattern were applied with an average score 88.9±7.5, but the level of energy, fat, and carbohydrate adequacy of children was still under recommendation. The results of statistical analysis show that hemoglobin levels have a significant relationship only with food consumption factors, especially the level of adequate energy, fat, and carbohydrates, and frequency of chicken liver consumption.Conclusion: Feeding pattern was not related to food consumption and hemoglobin level of children, whereas food consumption (energy, fat, and carbohydrate adequacy level, and chicken liver consumption is significantly related to and hemoglobin level on anemic children. Information related to nutritional and health status that needs to be improved, especially regarding food consumption and anemia prevention, so as to reduce the prevalence of anemia in children.ABSTRAK Latar Belakang: Anemia merupakan masalah gizi global dengan prevalensi 36,8% balita di Indonesia mengalami anemia. Konsumsi pangan, pola asuh makan, dan sosial ekonomi dapat mempengaruhi status anemia balita.Tujuan: Penelitian ini bertujuan menganalisis hubungan pola asuh makan dengan konsumsi pangan dan hubungan pola asuh makan dan konsumsi pangan dengan kadar hemoglobin balita anemia.Metode: Desain penelitian ini adalah cross sectional dan dilakukan pada bulan Agustus-November 2020 dengan jumlah sampel 54 balita anemia (Hb<11 g/dL) di Kecamatan Gegesik, Kabupaten Cirebon yang dipilih secara purposive sampling. Data yang dikumpulkan terdiri atas karakteristik rumah tangga, karakteristik balita dan status gizi, praktik pola asuh makan, serta konsumsi pangan balita yang diperoleh melalui wawancara dan pengukuran langsung. Analisis statistik data dilakukan secara univariat maupun bivariat menggunakan uji korelasi spearman.Hasil: Lebih dari separuh (51,9%) ibu berusia 26-35 tahun dengan tingkat pendidikan rendah (90,7%) dan pendapatan rumah tangga di bawah UMR (66,7%). Rata-rata kadar hemoglobin balita sebesar 9,2±1,4 g/dL dan 66,7% mengalami anemia tingkat sedang. Sebagian besar (44,4%) balita berusia 25-36 bulan tergolong status gizi kurang berdasarkan indikator TB/U dan BB/U. Pola asuh makan yang diterapkan sudah baik dengan rata-rata skor 88,9±7,5, akan tetapi tingkat kecukupan energi, lemak, dan karbohidrat balita masih berada dibawah anjuran. Hasil uji statistik menunjukkan bahwa kadar hemoglobin berhubungan signifikan hanya dengan faktor konsumsi pangan, terutama tingkat kecukupan energi, lemak, dan karbohidrat, serta frekuensi konsumsi hati ayam.Kesimpulan: Pola asuh tidak berhubungan dengan konsumsi pangan dan kadar hemoglobin balita anemia (p-value > 0,05), sedangkan konsumsi pangan (tingkat kecukupan energi, lemak, dan karbohidrat, serta kebiasaan konsumsi hati ayam) berhubungan signifikan dengan kadar hemoglobin balita anemia (p-value < 0,05). Informasi terkait dengan status gizi dan kesehatan perlu ditingkatkan khususnya tentang konsumsi pangan dan anemia serta pencegahannya sehingga dapat mengurangi prevalensi anemia pada balita. 

The Integrated Nutrition Education on eHealth Intervention and Its Effectiveness on Improvement of Anthropometric Status and Behavioural Outcomes of Obese Adults: A Systematic Review

Background: The problem of overnutrition has become an epidemic issue at the global level. As one of the effective ways to prevent and overcome obesity, nutrition education is growing by utilizing eHealth media as a message delivery channel.  Objectives: To identify studies that integrate nutrition education with eHealth-based technology in the prevention and control of obesity, behavioral theory and BCT (Behaviour Change Technique), their effectiveness in improving the anthropometric status and behavioral outcomes in obese adults. Discussion: Article searches were conducted using PubMed, Science Direct, ProQuest, and using manual search Google Scholar in reputable journals in the last ten years, and 17 English articles were obtained. Two forms of communication channels and activities were used to deliver nutrition education messages, namely interpersonal channels and internet-based mass media with or without assistance. Mobile applications were the most widely used as a messaging tool. The most frequently used theory was Social Cognitive Theory, and the majority of BCT were self-monitoring, goal setting, and feedback. The eHealth method (online) gave the same results on anthropometric status, physical activity, and treatment adherence compared to face-to-face (offline) by providing the same BCT-based obesity management intervention. Conclusions: Integrating nutrition education into eHealth media channels that emphasizes modification of eating behavior and physical activity has a significant effect on improving anthropometric status but was inconsistent on eating behavior and physical activity outcomes in adults with short-term intervention (≤3.5 months/ 14 weeks). This effect will give benefit the outcomes if followed by personal or group mentoring accompanied by well-design BCT.

Nutrition Knowledge, Breastfeeding and Infant Feeding Practice of Mothers in Cirebon Regency

Background: Exclusive breastfeeding should be supported by early initiation of breastfeeding (EIBF), provision of colostrum and not providing pre-lacteal feeding.   Objectives: The study objective was to analyze nutritional knowledge and factors related to breastfeeding and feeding practices of lactating mothers. Methods: A cross-sectional study was conducted in March–November 2020 in Sibubut, Kedungdalem, and Bayalangu Kidul Villages, Cirebon Regency. Study respondents were 44 lactating mothers with under six months infants. Mothers’ nutritional knowledge of breastfeeding and breastfeeding/feeding practice were obtained using a validated questionnaire, while the food consumption data of mothers was obtained from two days of 24-hour food recall (weekday and weekend). Spearman’s correlation test and Chi-Square analysis were used to analyze the correlation between variables, while the Mann-Whitney test was used to analyze the difference in nutritional knowledge and breastfeeding/infant feeding practice variables based on education level. Results: Family characteristics (age, mother’s education and occupation, household income, parity, family size, and Body Mass Index (BMI) were not correlated with breastfeeding/infant feeding practice (p=0.427; 0.136; 0.481; 0.056; 0.699; 0.241; 0.547, respectively). There was no significant correlation between nutritional knowledge and breastfeeding/infant feeding practice of mothers (p=0.728). No significant difference was found in the nutritional knowledge of breastfeeding (p=0.828) and breastfeeding/feeding practice of infants (p=0.572) between mothers with education > elementary school and < elementary school. More mothers with low education provided pre-lacteal food than mothers with higher education (p =0.046). Conclusions: The breastfeeding/feeding practice of mothers are still poor regardless of education level. Nutrition education for breastfeeding mothers is required to encourage good breastfeeding/infant feeding practices.

Validity and reliability of the theory of planned behavior questionnaire on the balanced dietary behavior of adolescents in a post-disaster area

Introduction: The assessment of mediator components of behavior change based on the Theory of Planned Behavior (TPB) can be carried out with a questionnaire instrument. Meanwhile, the questionnaire to assess the mediator of adolescents’ balanced dietary behavior in post-disaster areas has not yet been developed. Failure to recognize nutritional problems in this period can increase morbidity and mortality. Therefore, this present study attempts to provide the overview of the implementation of content and face validity as well as reliability of the TPB questionnaire on the balanced dietary behavior of adolescents in the post-disaster area by taking a study case in Palu City, Central Sulawesi, Indonesia.Methods: By involving nine expert panelists, the content validity was conducted qualitatively and quantitatively by calculating the Content Validity Index (CVI) and Kappa statistics scores. Face validity was conducted qualitatively by interviewing ten adolescents’. Meanwhile, Cronbach’s Coefficient Alpha was calculated to measure the reliability by interviewing 30 adolescents aged 15–17 years old living in the disaster site with their mothers during the massive disaster in 2018.Results: The results showed that the Item CVI and the kappa statistics scores were between 0.75 and 1 and 0.72 and 1, respectively. The final version of the questionnaire was resolved based on the panelists’ recommendation, the face validity’s findings, and the results of the questionnaire reliability assessment. There were 14 items of attitude, 12 items of subjective norms, 17 items of behavioral control, and eight items of intention components with acceptable questionnaire reliabilities.Conclusion: Overall, the TPB questionnaire on the balanced dietary behavior of adolescents has excellent validity and reliability to measure the mediator of balanced dietary behavior changes of adolescents.

Overview of Helicobacter pylori Infection in Indonesia: What Distinguishes It from Countries with High Gastric Cancer Incidence?

Helicobacterpylori infects more than half the human population. However, the prevalence in Indonesia is low, as is the prevalence of gastric cancer. Hence, it could be instructive to compare these prevalence rates and their determining factors with those of countries that have high gastric cancer incidence. Ethnicity and genetic characteristics of H. pylori are important determinants of the H. pylori infection rate in Indonesia. The infection rate is higher in Bataknese, Papuans and Buginese than in Javanese, the predominant ethnic group. Ethnicity is also an important determinant of the genetic characteristics of H. pylori. Analysis of CagA in the EPIYA segment showed that the predominant genotypes in Papuans, Bataknese and Buginese are ABB-, ABD- and ABC-type CagA, respectively. Meanwhile, in the countries with high gastric cancer incidence, almost all strains had East Asian type CagA. An antibiotic susceptibility evaluation showed that the standard triple therapy can still be used with caution in several cities. There is a very high rate of resistance to second-line regimens such as levofloxacin and metronidazole. Recent studies have shown that furazolidone, rifabutin and sitafloxacin are potential alternative treatments for antibiotic-resistant H. pylori infection in Indonesia. Rather than focusing on early detection and eradication as in countries with high gastric cancer prevalence, countries with low gastric cancer prevalence should focus on screening the several groups that have a high risk of gastric cancer. (Gut Liver 2021;15:-665)

MATERNAL CHARACTERISTICS AS PREDICTORS FOR STUNTING IN RURAL AGRICULTURAL HOUSEHOLDS IN INDONESIA

This study aimed to analyze the associations of maternal characteristics and nutritional status of primary caregivers with the occurrence of stunting in children aged 6 – 59 months from rural agricultural households in Indonesia. This study used a sequential explanatory mixed method design. It started with a cross-sectional survey, followed by a qualitative study to explore community perceptions related to findings from the quantitative analysis. The survey involved 200 mother and child dyads. multiple logistic regression was carried out with the dependent variable being the incidence of stunting in children, and maternal characteristics as independent variables. Data analysis showed that WDDS and the maternal length of education in years were significant predictors for the incidence of stunting in children. The adjusted odds ratio (AOR) for WDDS was 0.78 (95% CI 0.63 - 0.98), while for the length of education of mothers was 1.22 (95% CI 1.01 - 1.48). We also conducted a qualitative study to explore food distribution and utilization within the household. Qualitative data analysis showed that, except for pregnant mothers, “good food” was prioritized the least for mothers. The persistent barriers for utilization of quality and diverse food are access to such food rather than knowledge of what is considered “good food for health”. Increasing access and consumption of diverse foods for all mothers beyond pregnancies is an important factor for preventing stunting in Indonesian children from rural agricultural households.

The Factors Associated with Consumption Diversity of Toddlers Aged 24-59 Months

Latar Belakang: Masa balita merupakan masa yang memerlukan asupan gizi optimal untuk pertumbuhan dan perkembangan serta mencegah terjadinya masalah gizi. Keragaman konsumsi adalah salah satu indikator yang digunakan untuk menilai kualitas konsumsi dan kebutuhan zat gizi. Kualitas konsumsi secara langsung dapat memengaruhi status gizi balita.Tujuan: Penelitian ini bertujuan untuk megidentifikasi keragaman konsumsi balita dan menganalisis faktor yang berhubungan dengan keragaman konsumsi balita usia 24-59 bulan di Kecamatan Gunung Halu Kabupaten Bandung Barat.Metode: Penelitian ini menggunakan desain cross-sectional studi dengan 97 balita usia 24-59 bulan. Penelitian ini dilaksanakan pada bulan November hingga Desember 2019. Balita dipilih secara acak menggunakan teknik random sampling. Keragaman konsumsi didapatkan dari konsumsi makanan sehari sebelumnya dan dianalisis berdasarkan standar FAO yang terdiri dari 9 kelompok pangan tanpa jumlah konsumsi minimal. Faktor yang berhubungan dengan keragaman konsumsi dianalisis menggunakan model regresi logistik. Jika total skor keragaman konsumsi ≤4 diklasifikasikan sebagai tidak beragam dan >4 beragam.Hasil: Sebanyak 76.3% balita pada penelitian ini mengonsumsi makan yang tidak beragam dan didominasi oleh makanan tinggi energi. Tidak terdapat hubungan yang signifikan antara keragaman konsumsi balita dengan kejadian stunting. Status pekerjaan ibu (OR:4,63;95%CI:1,1-18,9), jenis kelamin (OR:5,1;95%CI:1,7-15,7), dan pengetahuan gizi ibu (OR:3,4,95%CI1,1-10,3) berhubungan signifikan dengan keragaman konsumsi balita.Kesimpulan: Ibu yang bekerja, balita laki-laki, dan pengetahuan gizi ibu yang kurang secara signifikan menjadi faktor yang berhubungan dengan keragaman konsumsi balita yang rendah.

Awareness about Anaemia and Weekly Iron-Folic Acid Supplementation (WIFAS) among School-Going Adolescent Girls and Parents in East Java and East Nusa Tenggara, Indonesia

Since 2016, Indonesia has been implementing a weekly iron-folic acid supplementation (WIFAS) program in two provinces for school going adolescent girls to reduce anaemia. This study aimed to explore the awareness and understanding of school-going adolescent girls and parents regarding anaemia and WIFAS. The study was conducted in 10 districts, each from East Java province and East Nusa Tenggara province. Twenty focused group discussions (FGDs) were conducted with school-going adolescent girls (n=174) and ten FGDs with parents (n=66). Also, in-depth interviews (IDIs) were conducted with school-going adolescent girls (n=20) and their parents (n=10) from 20 schools. All FGDs and IDIs were audio-recorded, transcribed verbatim, and analyzed for themes using NVivo Pro 12 software. School going adolescent girls and parents had high levels of misinformation about anaemia and healthy nutritional practices, which were influenced by socio-cultural milieu and local dietary habits. Both parents and girls perceived low risk of anaemia for school-going adolescent girls. Girls stated that their parents' opinion about anaemia influenced their desire to consume iron supplements. In conclusion, girls and parents would benefit from increased access to information about anaemia risks and prevention, and the benefits of WIFAS for adolescent girls. Prevention of anemia should include relevant dietary guidance that considers their socio-cultural milieu and local dietary habits.

Coverage and Adherence of Weekly Iron Folic Acid Supplementation among School Going Adolescent Girls in Indonesia

The Weekly Iron Folic Acid (WIFA) supplementation program for school going adolescent girls has been implemented by Indonesian Government since 2016. The objective of this study was to assess the coverage and adherence toward the WIFAS among school going adolescent girls, as part of a baseline assessment of the new intervention.

METHODS

A cross-sectional survey was conducted in East Java (EJ) and East Nusa Tenggara (ENT) in year 2018. The samples were drawn from 60 high schools from 20 districts. The data collection was done by using a semi-structured, self-administered questionnaire.

RESULTS

The total number of respondents in EJ and ENT was 934 and 922 adolescent girls respectively, with a mean age of 17 y. The percentage of girls who reported to have received WIFAS tablet in the last six months was only 10% in ENT and 31% in EJ. The average number of WIFA tablet received was only 0.4-1.4 tablets and the average number of tablets consumed was only 0.4-0.7 tablet in the last 6 mo. Adolescent girls, who consumed at least 1 tablet was only 9% in ENT and 18% in EJ. The frequently causes of not consuming WIFA were that they forgot; did not think it was necessary; and were scared side effects.

CONCLUSION

The coverage and adherence to WIFA program among school going adolescent girls in EJ and ENT provinces were low.

Effect of nutrition education and traditional game-based physical activity interventions, on lipid profile improvement in overweight and obese children in West Java Indonesia

BACKGROUND/OBJECTIVES

One ongoing effort to curtail dyslipidemia in school children is through lifestyle intervention. This study analyzes outcomes of the intervention of nutrition education and Javanese traditional game-based physical activity, on lipid profiles of overweight and obese children.

SUBJECTS/METHODS

The experimental study consisted of three steps: data collection (October to December 2016), intervention processes (January to March 2017), and final report preparation (April to May 2017). This was a split-plot block study, enrolling a total of 72 subjects. Traditional game intervention (12 meetings) and nutrition education (9 meetings) was carried out within 3 months with material related to obesity.

RESULTS

Our results showed no decrease in the levels of total cholesterol in the group receiving nutrition education (rise by 1.56 mg/dL), but when compared to subjects without intervention, total cholesterol levels experienced was increased. The group which did not receive physical activity showed increase in the total cholesterol, whereas the traditional game intervention group showed a decrease of 0.05 mg/dL total cholesterol at the end of the intervention. Nutrition education and physical activity interventions did not influence any reduction in the low-density lipoprotein cholesterol (LDL-C) levels, but rather showed a tendency to increase at the end of the intervention. However, the increase in LDL-c levels in the traditional game group was lower than in other intervention groups. Duncan's test indicated that the effect of nutrition education and physical activity interventions did not differ from the cut-off values of LDL-C and high-density lipoprotein cholesterol.

CONCLUSIONS

Total cholesterol and triglyceride levels in the traditional game group tended to decrease at the end of the intervention, but the results did not differ much from other intervention groups. We deduce that nutrition education and traditional game-based physical activity interventions are not capable of improving blood lipid profiles in overweight and obese children within 3 months. It is necessary to increase the time of physical activity intervention to maintain the lipid profile in another study.

Wild Food Plants and Trends in Their Use: From Knowledge and Perceptions to Drivers of Change in West Sumatra, Indonesia

Wild food plants (WFPs) are often highly nutritious but under-consumed at the same time. This study aimed to document the diversity of WFPs, and assess perceptions, attitudes, and drivers of change in their consumption among Minangkabau and Mandailing women farmers in West Sumatra. We applied a mixed-method approach consisting of interviews with 200 women and focus group discussions with 68 participants. The study documented 106 WFPs (85 species), and Minangkabau were found to steward richer traditional knowledge than Mandailing. Although both communities perceived WFPs positively, consumption has declined over the last generation. The main reasons perceived by respondents were due to the decreased availability of WFPs and changes in lifestyle. The contemporary barriers to consuming WFPs were low availability, time constraints, and a limited knowledge of their nutritional value. The key motivations for their use were that they are free and “unpolluted” natural foods. The main drivers of change were socio-economic factors and changes in agriculture and markets. However, the persistence of a strong culture appears to slow dietary changes. The communities, government and NGOs should work together to optimize the use of this food biodiversity in a sustainable way. This integrated approach could improve nutrition while conserving biological and cultural diversity.

Hubungan antara Perilaku Gizi dan Perilaku Hidup Bersih dan Sehat (PHBS) dengan Status Gizi Baduta Di Kabupaten Cirebon

Background: Cirebon Regency is one of the priority areas that becomes the locus in efforts to accelerate the reduction of stunting in 2018.Objective: This study aims to analyze the relationship between feeding parenting pattern with nutrient intake of under two-years infants and the relationship between nutritional behavior and clean and healthy lifestyle behavior (CHLB) with nutritional status of under two-years infants in Cirebon Regency.Methods: This study used a cross-sectional study design using secondary data from previous studies conducted at the same two locations in Cirebon Regency. The data processing was carried out in November to December 2019. The subjects involved were 70 mothers who had infants aged 0-24 months. Analysis of the relationship between variables using the Rank Spearman test.Results: The results of the correlation test showed that there was no significant relationship (p> 0.05) between feeding parenting pattern with nutritional intake. In addition, maternal nutritional behavior also did not have a significant relationship (p> 0.05) with nutritional status. This study found that there was a significant relationship between clean and healthy living behavior on the indicators of a smoke-free home environment with the nutritional status using HAZ index.Conclusion: Imbalance between knowledge and socio-economic factors of income can lead to inequality in the application of feeding parenting pattern, nutritional behavior, and CHLB to the nutritional status of under two years. Therefore, a continuous monitoring and evaluation system is needed to ensure that the stunting acceleration program runs effectively and efficiently.ABSTRAK Latar belakang: Kabupaten Cirebon merupakan salah satu daerah prioritas yang menjadi lokus dalam upaya percepatan penurunan stunting pada tahun 2018.Tujuan: Penelitian ini bertujuan untuk menganalisis hubungan antara pola asuh makan dengan asupan zat gizi baduta serta hubungan antara perilaku gizi dan perilaku hidup bersih dan sehat dengan status gizi baduta di Kabupaten Cirebon.Metode: Penelitian ini menggunakan desain studi cross-sectional dengan menggunakan data sekunder dari penelitian sebelumnya yang dilakukan pada dua lokasi yang sama di Kabupaten Cirebon. Proses pengolahan data dilakukan pada bulan November hingga Desember 2019. Subjek yang terlibat adalah 70 orang ibu baduta yang memiliki bayi berusia 0-24 bulan. Analisis hubungan antar variabel menggunakan uji Rank Spearman.Hasil: Hasil uji korelasi menunjukkan bahwa tidak terdapat hubungan yang signifikan (p >0,05) antara pola asuh makan dengan asupan zat gizi. Selain itu, perilaku gizi ibu juga tidak memilki hubungan yang signifikan (p>0,05) dengan status gizi. Penelitian ini menemukan bahwa terdapat hubungan yang signifikan antara perilaku hidup bersih dan sehat pada indikator lingkungan rumah bebas asap rokok terhadap status gizi baduta.Kesimpulan: Ketidakseimbangan antara pengetahuan dengan faktor sosio-ekonomi penghasilan dapat mengakibatkan terjadinya ketimpangan dalam penerapan pola asuh makan, perilaku gizi, dan PHBS terhadap status gizi baduta. Oleh karena itu, diperlukan sistem monitoring dan evaluasi secara kontinu untuk memastikan bahwa program percepatan stunting berjalan secara efektif dan efisien.

E-test versus agar dilution for antibiotic susceptibility testing of Helicobacter pylori: a comparison study

OBJECTIVE

For evaluating the antibiotic resistance of Helicobacter pylori, the agar dilution method is the gold standard; however, using this method in daily practice is laborious. E-test has been proposed to be an uncomplicated method. This study was aimed at validating the E-test and detecting the presence of any bias between the agar dilution method and E-test.

RESULTS

The agar dilution method and E-test were performed using five antibiotics for 72 strains of H. pylori obtained from clinical patients in Indonesia. The E-test's results showed a higher prevalence of resistance to all the antibiotics tested but the difference was not significant. Results showed high essential agreement (> 90.0%) for all the antibiotics, but only 84.7% for metronidazole. The agreement for MIC value was acceptable for levofloxacin, clarithromycin, and metronidazole. For amoxicillin, it showed only fair agreement (0.25) by the Kappa analysis and significant difference by Passing-Bablok regression. Even though some discrepancies were found, the E-test has an acceptable agreement for levofloxacin, metronidazole, tetracycline, and clarithromycin but further confirmation may be necessary for amoxicillin.

Pengembangan Indeks Ketahanan Pangan Rumah Tangga dan Kaitannya dengan Tingkat Kecukupan Zat Gizi dan Status Gizi Anak Balita

 Background: Household food insecurity is a underlaying causes on undernutrition problems in children under five years. Household food security especially from food acces dimention is reflected from many indicators that are complex and easier to understand in a composite index. Objectives: The purpose of this study was to develop a index of household food security and its relationship to nutrient intake level and nutritional status in children under five years. Method: This cross-sectional study was conducted in four villages in West Bangka Regency in December 2018 until April 2019. The study involved 219 subjects consisting of mothers and children aged 12-59 months. Data were analyzed using Rank Spearman relationship test. Results: The validation results showed that the index score has a negatively correlation (p<0.01) with the proportion of food expenditure and it has a significant correlation with dietary diversity (HDDS Score). In addition, the index score was a significant correlation (p<0.01) with the level of adequacy of energy, protein, fat, calcium, iron, zinc and dietary diversity in children. The index score was a significant associated (p<0.01) with the nutritional status of children based on height for age, weight gor age, and height for wight. Conclusions: The index was developed from this study can be an alternative to evaluate the status of household food security level and stronger marker of food consumption and nutritional status of under five children.ABSTRAKLatar Belakang: Kondisi rawan pangan pada rumah tangga merupakan salah satu penyebab masalah kekurangan gizi pada anak berusia di bawah lima tahun. Ketahanan pangan rumah tangga tercermin dari banyak indikator yang kompleks dan lebih mudah dipahami dalam indeks komposit.Tujuan: Penelitian ini bertujuan mengembangkan indeks ketahanan pangan rumah tangga serta hubungannya dengan tingkat asupan gizi dan status gizi pada anak balita.Metode: Penelitian cross-sectional ini dilakukan di empat desa di Kabupaten Bangka Barat. Penelitian ini melibatkan 219 subjek yang terdiri dari anak berusia 12-59 bulan dan ibu dari anak. Data dianalis menggunakan uji beda Kruskal Wallis dan uji hubungan Rank Spearman.Hasil: Hasil validasi menunjukkan bahwa skor indeks memiliki perbedaan yang nyata (p<0,05) berdasarkan tingkat kerentanan pangan wilayah dan terdapat hubungan negatif yang kuat (p<0,05) dengan proporsi pengeluaran pangan. Selain itu, skor indeks memiliki keterkaitan yang kuat (p<0,05) dengan tingkat kecukupan energi, protein, lemak, kalsium, besi, seng serta keragaman diet pada balita. Skor indeks juga memiliki hubungan yang nyata (p<0,05) dengan nilai z-score status gizi balita berdasarkan indeks antropometri tinggi badan menurut usia, berat badan menurut umur, dan tinggi badan menurut berat badan.Kesimpulan: Indeks yang dikembangkan dari penelitian ini dapat menjadi alternatif dalam menilai status ketahanan pangan rumah tangga serta prediktor yang kuat dalam melihat gambaran konsumsi pangan dan status gizi balita. 

Complementary food supplementation with a small-quantity of lipid-based nutrient supplements prevents stunting in 6-12-month-old infants in rural West Madura Island, Indonesia

BACKGROUND AND OBJECTIVES

Stunting during childhood is a common public health problem in Indonesia. Complementary food supplementation with a small quantity of lipid-based nutrient supplements (SQ-LNSs) can promote growth and prevent undernutrition. This study investigated the effects of the daily provision of SQ-LNSs and biscuits on linear growth and reduction in the incidence of stunting among infants in rural Indonesia.

METHODS AND STUDY DESIGN

A 6-month, non-randomised, controlled trial was conducted on 168 infants who received 20 g of SQ-LNSs, 3 pieces of biscuits, or no intervention. The outcome was length gain and incidence of stunting (length-age-z score (LAZ) <-2SD) during a 6-month follow-up.

RESULTS

After the 6-month intervention, the adjusted length gain and change in the LAZ (8.57 cm and -0.09 z-score unit, respectively) were higher in the SQLNS group than in the control (7.15 cm and -0.87 z-score unit, respectively) and biscuit groups (7.79 cm and -0.46 z-score unit, respectively; p<0.01). The rate of length gain was significantly higher in the SQ-LNS group (1.43 cm/month; 95% CI: 1.12-1.26) than in the biscuit (1.29 cm/month, 95% CI: 1.23-1.36) and control groups (1.19 cm/month, 95% CI: 1.12-1.26; p<0.01). At the end study, the incidence of stunting in SQ-LNS group was lower (1.8%) than in the biscuit group (8.5%) and control group (14.6%). In the SQ-LNS group, the relative risk (RR) of stunting was 0.35 and in the biscuit group (0.94).

CONCLUSIONS

SQ-LNSs improved linear growth and reducing the incidence of stunting over 6-months intervention.

POLA ASUH MAKAN, PERKEMBANGAN BAHASA, DAN KOGNITIF ANAK BALITA STUNTED DAN NORMAL DI KELURAHAN SUMUR BATU, BANTAR GEBANG BEKASI

<p>ABSTRACT</p><p>The purposes of this study were to identify the association between nutritional status, language and cognitive development and also differences of language and cognitive development between normal and stunted underfives children. The study design was a cross-sectional. Sample size was 70 children consisted of 35 normal and 35 stunted children. The highest percentage level of education of fathers and mothers only primary school and more than half of children from poor families. There was significant difference (p&lt;0.05) of language and cognitive development between normal and stunted children. It was show that normal children had higher language and cognitive development scores than stunted children. Also there was significant difference (p&lt;0.05) between age of children, mother level of education, and family income with language and cognitive development. Child care practices was no difference between stunted children and non-stunted children, non-stunted mothers child practices scores was higher than stunted children. There was a significant association between nutritional status based on Height/Age with language development (p&lt;0.05).</p><p>Key words: cognitive, language, stunting, underfives children</p><p>ABSTRAK</p><p>Tujuan dari studi ini adalah untuk mengetahui kaitan status gizi dengan perkembangan bahasa dan kognitif pada anak yang berstatus gizi normal dan stunted. Penelitian ini menggunakan desain cross sectional. Total subjek pada penelitian ini sebanyak 70 anak balita, terdiri dari 35 anak balita berstatus gizi stunted dan 35 anak berstatus gizi normal. Sebagian besar pendidikan orang tua adalah SD dan berasal dari keluarga miskin. Hasil penelitian menunjukkan bahwa terdapat perbedaan signifikan (p&lt;0.05) skor perkembangan bahasa dan kognitif pada anak balita normal dan stunted berdasarkan usia balita, tingkat pendidikan ibu, pendapatan keluarga, dan besar keluarga. Kelompok balita normal memiliki pencapaian perkembangan bahasa dan kognitif yang lebih tinggi daripada kelompok anak balita stunted. Tidak terdapat perbedaan pola asuh makan anak balita normal dan stunted (p&gt;0.05), namun skor pola asuh makan ibu anak balita normal lebih tinggi daripada anak balita stunted. Berdasarkan uji korelasi terdapat hubungan signifikan (p&lt;0.05) antara status gizi indeks (TB/U) anak balita dengan perkembangan bahasa, namun tidak terdapat hubungan antara status gizi indeks (TB/U) dengan perkembangan kognitif balita.</p><p>Kata kunci: anak balita, bahasa, kognitif, stunting</p>

Peranan Ultraviolet B Sinar Matahari terhadap Status Vitamin D dan Tekanan Darah pada Wanita Usia Subur

Sinar ultraviolet B adalah sumber utama vitamin D, tetapi wanita usia subur yang bekerja di dalam ruangan mempunyai vitamin D yang rendah meskipun Indonesia negara tropis. Tujuan penelitian ini untuk mengevaluasi peranan paparan sinar matahari pada wanita usia subur terhadap status vitamin D dan tekanan darah. Desain penelitian yang digunakan adalah eksperimen tanpa kelompok kontrol pada 21 wanita sehat. Penelitian ini membandingkan status vitamin D dan tekanan darah sebelum dan setelah mendapat paparan sinar matahari pada wajah dan lengan tiga kali seminggu selama 12 minggu. Analisis data menggunakan uji t-berpasangan. Paparan sinar matahari dapat meningkatkan vitamin D. Serum 25(OH)D meningkat 15,9% dari 15.7 ng/dL menjadi 18,2 ng/dL. Paparan sinar matahari menurunkan tekanan darah sistolik (nilai p = 0,004) dan diastolik (nilai p = 0,011). Ultraviolet B dari sinar matahari 30 menit tiga kali seminggu selama 12 minggu dapat memperbaiki status vitamin D dan tekanan darah.Ultraviolet B sunlight exposure is a primary source of vitamin D, but women of childbearing age who worked in room every day had low serum vitamin D despite Indonesia is a tropical country. The objective of this study was to evaluate the role of sun exposure in women of childbearing age on vitamin D status, and blood pressure. An intervention before-after study without group control was conducted on 21 healthy women. This study compared vitamin D status, and blood pressure before and after receiving ultraviolet B (UVB) from sun exposure on the face and both arms three times a week for 12 weeks. Anthropometric parameter and blood pressure were measured, were determined at baseline and after 12 weeks of sun exposure. The effect of sun exposure can improve vitamin D. Serum 25 (OH)D increase 15.9% from 15.7 ng/dL to 18.2 ng/dL. Sun exposure significantly reduced systolic blood pressure (p value = 0.004), and diastolic blood pressure (p value = 0.011). Ultraviolet B from sun exposure for 30 minutes, 3 times a week for 12 weeks improves the vitamin D status, and blood pressure.

ASUPAN KALSIUM, STATUS GIZI, TEKANAN DARAH DAN HUBUNGANNYA DENGAN KELUHAN SENDI LANSIA DI PANTI WERDHA BANDUNG

The objective of this study was to determine the relationship of calcium intake, nutritional status, and blood pressure to joint pain among elderly in nursing homes in Bandung. The study design was cross-sectional study. Subjects were consisted of 12 elderly men and 69 elderly women from four nursing homes in Bandung. Most subjects had joint pain (59.3%), hypertension (30.9%), and were overweight (39.5%). There was no significant relationship between frequency of consumption of calcium food sources and nutritional status, blood pressure, joint pain, and the level of joint pain (p&gt;0.05). There was no significant relationship between joint pain and the level of joint pain with blood pressure and nutritional status.<br /><br /><br />

ASUPAN ZAT GIZI DAN STATUS GIZI PADA REMAJA PUTRI YANG SUDAH DAN BELUM MENSTRUASI

<p>The objective of this study was to analyze nutrient intake and nutritional status of menstruating and non-menstruating girls. This survey was conducted from April to September 2012 in elementary schools and junior high schools in Bogor. Total subjects consisted of 35 menstruating and 35 non-menstruating girls who were chosen through screening. The results showed that the percentage of menstruating girls in urban (28.0%) were more than in rural (25.1%). About 57.1% of subjects had menarche at 10 years old. The average of nutrient intake on menstruating and non-menstruating girls were under DRI (&lt;90%). Overweight was more prevalent in menstruating subjects (14.3%) compared with non-menstruating subjects (2.9%). Similarly, the percent body fat measurement results showed that overweight and obese subjects were more prevalent in menstruating subjects (17.2%) compared with non-menstruating subjects (2.9%). Independent sample t-test showed significant differences in age, energy and calcium intake, BMI/age, and percent body fat between menstruating and non-menstruating subjects (p&lt;0.05).</p>

Relationship between nutritional status, psychosocial stimulation, and cognitive development in preschool children in Indonesia

The purposes of the study were to analyze nutritional status, psychosocial stimulation, and factors affecting the cognitive development of preschool-age children. This study was conducted in the Village of Babakan, Sub-District of Dramaga, Bogor Regency, West Java. This cross-sectionally designed study was conducted with mothers who had preschool children aged 3-5 years as respondents. Fifty-eight children were included. The distribution of mother's educational level was quite diverse, and the largest percentage (44.8%) had senior high school education. Approximately 78% of the family income per capita was classified into the non-poor category and 22.4% into the poor category. The average mother's nutritional knowledge score was 76.7 ± 2.5 (moderate category). Most of the preschool children (84.4%) had psychosocial stimulation scores in the moderate category (30-45). The nutritional status of children showed that 15.5% were underweight, 5.2% were wasted, 3.4% were severely wasted, and 19% of the children were in the short and very short categories (stunted). The stepwise regression results showed that psychosocial stimulation (P < 0.001), participation in early childhood education (P = 0.002) and nutritional status based on the height index for age (P = 0.028) had a positive and significant effect on cognitive development of the preschool children (adjusted R², 0.434; P = 0.028).

PENINGKATAN STATUS BESI DAN KEBUGARAN FISIK PEKERJA WANITA USIA SUBUR

The study aims were to (1) assess the nutritional status, adequacy level, and physical fitness of the nonpregnant reproductive female workers, and (2) analyze the effect of micronutrients supplementation on their iron status and physical fitness. This research employed experimental design of double blind, completely randomized design by involving 338 households of female workers. The experimental unit consists of 39 female workers whose hemoglobin level were 80-125 g/L. However, five of them were drop out due to pregnancy or sickness. The treatments applied in the study were three capsules containing: (1) iron and folic acid (BF), (2) multi-vitamin and mineral (MVM), which contains of 15 different vitamins and minerals, and (3) placebo (P). The body mass index of the female workers were thin 12 percent, normal 70 percent and overweight 18 percent. Most of their nutritional intake of vitamin C, calcium and iron were deficient but they had a good to superior of physical fitness. After 10 weeks of three days per week supplementation, BF significantly increased the hemoglobin (p<0.05) as 8.6 g/L and ferritin as 10.1 μg/L; while MVM only increased the hemoglobin as 6.8 g/L. The micronutrient supplements of BF and MVM groups could improve the physical fitness (VO2max) of the anemia famale workers by 13 percent and 14 percent.<br />Key words: female workers, iron status, physical fitness, iron folic acid, multi-vitamin and mineral

SIKAP AFEKTIF IBU TERHADAP IKAN LAUT NYATA MENINGKATKAN APRESIASI ANAK MENGONSUMSI IKAN LAUT

<p class="MsoNormal" style="margin: 0cm 5.65pt 6pt 14.2pt; text-align: justify; text-indent: 1cm;"><span style="font-size: 10pt;" lang="en-us" xml:lang="en-us">The relationship of mother’s attitude towards specific food consumption is known to influence children’s attitude and eating behavior. Fish consumption is critical towards children development, such as brain development and overall physical health. The objectives of this research were to elaborate the determinants of children’s appreciation for consuming fish or attitude towards consuming fish. This cross-sectional study was conducted in two different locations in Central Java in a coastal and in a non-coastal area. There are 248 students from the fifth and sixth grades of elementary schools participating as subjects, which is the same as that of their mothers. Observations and interviews were carried out using standardized questionnaires to describe the mother and children relationship that determined children’s appreciation for consuming fish by using path analysis. The results showed that location of residence namely coastal area, family collective eating pattern, mother’s affective attitude towards fish and mother’s higher education significantly improved children appreciation for consuming fish. However, cognitive attitude and conduct to make fish available in family menu did not contribute significantly to children appreciation for consuming fish. It can be concluded that even though mother understands the benefits of fish and makes fish available in family menu, when children unable to feel her preference towards fish, children will not appreciate to consume. Therefore, mother’s preference towards fish needs special considerations, since it positively influence children’s appreciation for consuming fish, which will contribute importantly to children’s well-being</span><span style="font-size: 10pt;">.</span></p>

HEALTH AND NUTRITIONAL STATUS OF CHILDREN UNDER FIVE YEARS IN POSYANDU NUTRITION PROGRAM

<p class="MsoNormal" style="margin: 0cm 5.65pt 6pt 14.2pt; text-align: justify; text-indent: 1cm;"><span style="font-size: 10pt;" lang="en-us" xml:lang="en-us">The objectives of this research were to analyze health, nutritional status of children under five years and its influential factor</span><span style="font-size: 10pt;">s</span><span style="font-size: 10pt;" lang="en-us" xml:lang="en-us">. This research was carried out in two sub-districts of Bogor: Sub-District of Ciomas and Sub-District of Darmaga. As many as 16 posyandu </span><span style="font-size: 10pt;">nutrition program </span><span style="font-size: 10pt;" lang="en-us" xml:lang="en-us">were obtained. A total number of 240 mothers had been divided into </span><span style="font-size: 10pt;">c</span><span style="font-size: 10pt;" lang="en-us" xml:lang="en-us">ontrol and intervention groups. Baseline data were collected during the pre-study, while endline data were collected after conducting intervention (experiment). The experiment had been conducted for five months in the form of providing nutrition education once in two weeks and implementing home gardening. The data analysis included estimation of mean, standard deviation, minimum value, maximum value and proportion. Based on the General Linear Model (GLM) analysis, it was found that intervention had significant impact on the nutritional status</span><span style="font-size: 10pt;"> (WAZ)</span><span style="font-size: 10pt;" lang="en-us" xml:lang="en-us"> of children under five years. Intervention did not have significant effects on the nutritional status according to </span><span style="font-size: 10pt;">HAZ and WHZ. </span><em></em></p><em><span style="font-size: 10pt;" lang="en-us" xml:lang="en-us">Key words<strong>: </strong></span><strong><span class="longtext"><span style="font-size: 10pt;" lang="en-us" xml:lang="en-us">.</span></span></strong></em>

ANALISIS DETERMINAN POSITIVE DEVIANCE STATUS GIZI BALITA DI WILAYAH MISKIN DENGAN PREVALENSI KURANG GIZI RENDAH DAN TINGGI

The aim this study was to analyze the determinant of positive deviance nutritional status of under five year old children in poor areas with low and high prevalence of undernutrition. Cross sectional study was conducted in the study using secondary data analysis taken from Basic Health Research 2007 in four provinces with determination samples criterias of high poverty levels according BPS 2009 (&amp;gt;14.15%) and low and high prevalence of undernutrition (+18.4%) which were analyzed through quadrants. The number of samples was 3.494 under five year old children from poor families. The significancy relations among variables were measured using Pearson's correlation and path analysis to analyze the determinants. The results, the determinant of positive deviance were income through mother's characteristics, health upbringing, and health status, the four provinces had the same determinants pathway (β=0.0451), with mother's characteristics (p&amp;lt;0.05) and health upbringing (p&amp;lt;0.05) as the significants variables. The conclusion was that mother with better characteristics in families who were able to manage income better, tended to practice better health upbringing which increase children's nutritional status. These factors determine the poor families living in the poor areas could have well nourished under five year old children rather than other families in the same economic condition. Key words: positive deviance, undernutrition, nutritional status.

High participation in the Posyandu nutrition program improved children nutritional status

The objective of this research was to analyze nutritional status and food consumption of children participating in the Posyandu nutrition program. A total sample of 300 children under five years had been drawn. Sample was divided into two categories namely high participation and low participation in the Posyandu nutrition program. The sample was selected from two sub districts of Cianjur District, West Java. The districts were areas with a high proportion of poor people and many of them take the benefits of Posyandu nutrition program conducted by the government. The participation of children (under five years old) in visiting Posyandus was relatively good, namely, 92.4% (for the high participation group). However, for the low participation group, the number of participating children was relatively low (28.3%). The average consumption of energy for children under five years old was still below the recommended dietary allowance < 80% of RDA, whereas the protein consumption was already above the RDA. The prevalence of underweight, stunting, and wasting among children were respectively 30.0%, 43.7%, and 12.3%. The activities at Posyandus had a positive impact on the nutritional status of children under five years olds, measured in terms of weight for age (W/A) and weight for height (W/H). The more frequent the visit to Posyandus, the better the nutritional statuses would be.

INTERVENSI ISOFLAVON KEDELAI TIDAK BERPENGARUH TERHADAP STATUS INFLAMASI DAN IMUNITAS PADA REMAJA DENGAN KEGEMUKAN

<p class="MsoNormal" style="margin: 0cm 12.8pt .0001pt 14.2pt; text-align: justify; text-indent: 21.8pt;"><span style="font-size: 10pt;">Overweight/obesity is a condition that has been proven to be interrelated with chronic inflammation and compromised immune system due to disregulation of adipocytokine. The aim of the present study was to evaluate the effect of soy isoflavone on the markers of inflammation and immunity of overweight or obese teenagers. Eighteen overweight or obese teenagers, 9 boys and 9 girls each sex were randomized to one of three  intervention groups; 0 ml, 150 ml and 300 ml soy milk, equal to 0 g, 25 g and 50 mg isoflavone everyday for 30 days. The data collected were food consumption, plasma isoflavone concentration, plasma IL6 as indicator of inflammation, and lymphocyte and NK cell count as indicator of immunity. The study showed that nutrient intake of samples were still relatively low. The soy milk intervention significantly increased plasma isoflavone concentration, but not significantly had contribution to the plasma IL6 concentration and lymphocyte and NK cell count. Several kind of food consumed by samples had contribution to the plasma isoflavone concentration, and lymphocyte count. Based on the results, it was suggested that soy isoflavone intervention does not affect the inflammation status and immunity of overweight/obese teenagers.</span></p>

IDENTIFIKASI MUATAN GIZI DALAM MATA PELAJARAN DI SEKOLAH DASAR BANTARJATI 5 BOGOR

<p class="MsoNormal" style="margin: 0cm 12.7pt 10pt 21.3pt; text-indent: 1cm;"><span style="font-size: 10pt;" lang="en-us" xml:lang="en-us">Education and nutrition support enhance each other. Nutrition education is an important thing that have to be integrated in school’s subject, because lack of knowledge regarding proper diet and healthy nutrition represents a major cause of implication in bad eating habits which can cause undernutrition  among school-age children. Therefore, healthy eating habits are important to establish during childhood and sustain thereafter. The objective of this study was to identified the nutrition material that integrated in elementary school’s subject. Cross sectional design was used in this study and four teacher of the fifth grade was interviewed by the researcher. The nutrition material in the subject was identified in qualitative and quantitative way. The result showed that only one topic that contain about nutrition which consist of two sub topic, human’s digestion system and the relationship between food and health. The material explanation in that two sub topic is include complete type and present in sentences and also picture type. The nutrition material was quantitatively attain 37.8% compared with IGD and PUGS as justification. It can conclude that nutrition material in elementary school’s subject was quite good.</span></p>

KAJIAN PROGRAM PEMBERDAYAAN EKONOMI KELUARGA UNTUK PENINGKATAN AKSES PANGAN

<p class="MsoNormal" style="margin: 0cm 13.2pt 6pt 14.2pt; text-align: justify; text-indent: 21.8pt;"><span style="font-size: 10pt;">The objective</span><span style="font-size: 10pt;" lang="en-us" xml:lang="en-us">s</span><span style="font-size: 10pt;"> of the study </span><span style="font-size: 10pt;" lang="en-us" xml:lang="en-us">were</span><span style="font-size: 10pt;"> to</span><span style="font-size: 10pt;" lang="en-us" xml:lang="en-us"> identify national programms of family economic empowerment, to </span><span style="font-size: 10pt;">analyze </span><span style="font-size: 10pt;" lang="en-us" xml:lang="en-us">social-economics of program participants, to evaluate the family economics program, to analize impacts of family economic programs toward food access and to create recommendation for improving family economic empowerment programs.  This study was conducted in Pamijahan sub-dsitrict of Bogor districts and in Bogor Barat and Bogor Utasra sub-district of Bogor municipality in the period of March to November 2009.  Sampling method used was stratified random sampling with equal proportion where the total sample size was 48 households. Data collected include household socio-economics, food consumption of before and after programs and bussines input, proceses and output of before and after program.  The results show that the input, process and output of the programs i.e. PNPM Mandiri, Garda Emas, P2KP and KUBE were relatyively good.  All of the programs are effective because their 1/Cost-Effective are higher than 1.  The probability of Garda Emas  to be succesfull is highest (0.89), while the probability of Mandiri, Dakabalarea, P2KP, Kube  are 0.80, 0.27, 0.36 and 0.72 respectively.</span></p>

GAP ANALYSIS PROGRAM GIZI DAN KESEHATAN DI POSYANDU KABUPATEN BOGOR

<p class="MsoNormal" style="margin: 0cm 12.7pt 6pt 14.2pt; text-align: justify; text-indent: 21.8pt; line-height: normal;"><span style="font-size: 10pt;">Revitalization of Integrated Service Center Post (Posyandu) is successful when  focused to its main function as community institution services. Determine gap analysis program based on tangibles, reliability, responsiveness, assurance, empathy dimension. Exploratory and experimental designs was applied in this study, which was conducted at Darmaga and Ciomas district, Bogor Regency from March to August 2008. The data included primary and secondary data. The respondent in the experiment was 240 mothers of children under five years and 80 cadres. Gap analysis was used to know the expected and the real nutrition and health program of respondent. Totally 96 balita’s mother, pregnancy and reproductive women and 16 cadres were involved in this study. The average of gap realization with standard tool -0,75; Tangibles dimension -0,35; Reliability -0,10; Responsiveness -0,37; Assurance  -0,44, and Empathy -0,47, its mean that a tools accomplisment only 25% (less); tangible dimension 65% (enough); reliability 90% (good); responsiveness dimension 63% (enough); assurance dimension  56% (less) and emphaty 53%  (less), respectively.</span></p>

SOSIO-BUDAYA PANGAN SUKU BADUY

<p class="MsoNormal" style="margin: 0cm 12.65pt .0001pt 14.2pt; text-align: justify; text-indent: 21.8pt;"><span style="font-size: 10pt;" lang="en-us" xml:lang="en-us">Banten</span><span style="font-size: 10pt;" lang="en-us" xml:lang="en-us"> Province in Indonesia has a traditional tribe called Baduy.  Baduy tribe is still maintaining their traditions against modernization. The objectives of this research were to analyze socio-economic and demographic characteristics of Baduy people, socio-cultural and ecological aspects of Baduy community, and food availability of Baduy people. This research is an explorative and descriptive study on the socio-cultural aspects of food system. The data required to meet the research objectives were collected through a direct interview and discussion with respondents as well as a direct observation at the location of respondents. A sample size of 338 households was drawn from the population. The allocation of sample was 303 for Outer Baduy, 10 for Inner Baduy and 25 for Moslem Baduy.   To obtain the data on the cultural aspects, history and socio aspect of food, in-depth interviews was conducted with 19 key persons. The study was last for 12 months. The rice production of Baduy community to supply its basic need is generally insufficient; as a result, they have to purchase rice from outside. In addition, not all rice they produce can be consumed because some of it is for the needs of traditional ceremonies. As much as 25 % of the production is sold or given to their neighbors who are lack of rice, 25 % is sent for their neighbors’ feast and for traditional ceremonies (for the elderly people, Jaro, and Puun), and the 50 % is stored in the rice barn for their daily consumption. Only poor households use their rice for their daily consumption. Baduy community usually purchases their foodstuffs at the market, the shop, or from the vegetable vendor who sells from one village to another. If Baduy people need rice and other foodstuffs, they usually go to another village to fulfill their needs.</span></p>

PENGETAHUAN, SIKAP, DAN PRAKTEK ASI EKSLUSIF SERTA STATUS GIZI BAYI USIA 4-12 BULAN DI PEDESAAN DAN PERKOTAAN

The main aim of this study was to compare breastfeeding knowledge, attitude, and practice and infants nutritional status between rural and urban areas. In this cross-sectional study, Desa Jayabakti, Kabupaten Sukabumi represents rural area, while Kelurahan Kedung Jaya, Kota Bogor represents urban area. Samples were 31 mothers-infants in each area who were selected by simple cluster sampling method. The differences between two areas were analyzed with the independent t-test, chi-square test, and Fisher's exact test. The correlation between variables was analyzed with rank Spearman. The result of this study showed that mother's knowledge and attitude of nutrition, especially about exclusive breastfeeding, was higher in urban than in rural area. There were differences in mothers' knowledge and attitude between rural and urban areas (p&amp;lt;0.05). Exclusive breastfeeding in rural area practiced by 41.9%, which is higher than in urban area (25.8%). Nevertheless, there was no statistical difference in exclusive breastfeeding practice between rural and urban areas (p&amp;gt;0.05). The aspects of breastfeeding practices which statistically difference in rural and urban areas were the introduction of colostrums status and breastfeeding time (p&amp;lt;0.05). Early initiation of breastfeeding was associated with exclusive breastfeeding practice in urban area (p&amp;lt;0.05), but none of the variables were associated with exclusive breastfeeding practice in rural area (p&amp;gt;0.05). Furthermore, exclusive breastfeeding practice was not associated with 4-12 months infants nutritional status (p&amp;gt;0.05). Mothers' family should be targeted as target of audience in breastfeeding promotion.  Keywords: breastfeeding practice, exclusive breastfeeding, knowledge, attitude, infant                  nutritional status, rural and urban areas.