Critically ill patients are physiologically unstable, often have complex hypermetabolic responses to trauma. These patients are facing a high risk of death, multi-organ failure, and prolonged ventilator use. Nutrition is one of therapy for critical illness, however, patients often experience malnutrition caused by disease severity, delays in feeding, and miscalculation of calorie needs. The study aims to evaluate clinical improvement in critically ill participants that were given 3 kinds of early enteral feeding formulas, which were control (5% Dextrose), high-protein polymeric, or oligomeric formulas. A total of 55 critically ill participants admitted to the intensive care unit (ICU) between October 2017–March 2018 and assigned in this controlled trial. Early enteral feeding was initiated within 24–48 h after ICU admission. Each enteral feeding group were categorized to traumatic brain injury (TBI) or non-TBI. The primary endpoints were changes in white blood cell count, Acute Physiologic and Chronic Health Evaluation (APACHE) II score, and Nutrition Risk in the Critically Ill (NUTRIC) score from baseline to day 3. Baseline characteristics were similar between control (n=22), high-protein polymeric (n=19) and oligomeric (n=14) groups. There were significant decreases for white blood cell count (13,262.5±6,963.51 to 11,687.5±7,420.92; p=0.041), APACHE II score (17.33±3.31 to 13.83±1.95; p=0.007), and NUTRIC scores changes (3.08±1.44 to 1.92±1.00; p=0.022) in non-TBI participants receiving highprotein polymeric compared those in control or oligomeric participants. But there is no significant clinical improvement in TBI patients. In conclusion, non-TBI patients benefit from early enteral feeding with high-protein polymeric formula.

Cardiovascular diseases is increasing its pace day by day. Though the traditional biomarkers are made available the novel biomarkers are being incorporated to predict the risk of cardiovascular diseases for earlier detection. The present study aimed to investigate the impact of calcium score level the novel biochemical parameter in preventing the progression of the cardiovascular patients to PTCA (percutaneous transluminal coronary angioplasty) and CABG (coronary artery bypass grafting). Four hundred cardiovascular patients irrespective of sex were randomly selected from Visakhapatnam district Andhrapradesh. Information of subjects was collected using an interview schedule. Data collected were consolidated and tabulated. From this group a sub sample of 50 patients was selected and grouped as primordial, secondary and post PTCA. The subjects were then analyzed for their biochemical parameters before and after intervention. Statistical analysis was done and interpreted. An extensive evidence of calcium score was shown among 61.2% of the cardiovascular patients, a minimum evidence of 22.2% and moderate evidence of about 16.5%. The paired sample t-test is employed to observe any statistical significant difference between the before and after treatment effects. The analysis for the calcium score level was found to be significantly lower (mean difference=424.0134; t=13.297; df=49; p=0.01) in post intervention (mean=88.3766±88.40) than pre-intervention (512.39±260.79812). The present study identified calcium score the novel biochemical parameter as a key preventive measure among the usual biochemical management conducted by the clinicians to diagnosis and confirm the progression of the disease.

It has been proposed that a high sugar intake was associated with cardiovascular disease (CVD) risk and metabolic syndrome depending on the amount of carbohydrate (CHO), other nutrients in foods, and underlying metabolic disturbances. This study aimed to investigate the effects of high (HS) and low sugar (LS) diets on metabolic profiles in 25 middle-aged men at increased CVD risk in a 12-week randomised cross-over intervention study. An isocaloric dietary exchanged model consisted of HS (24% energy from sugar) and LS (6% energy from sugar) with comparable total CHO, fat and fibre composition in normal foods was used. Anthropometric, blood pressure and plasma lipid profile were measured pre- and post-intervention. Body weight, waist circumference and fat mass increased and decreased significantly after HS (by 0.7±0.3 kg, 1.4±1.0 cm and 0.5±0.3 kg) and LS (by 2.1±0.5 kg, 2.0±0.8 cm and 1.4±0.3 kg) (p<0.05), respectively. Plasma TG increased significantly after HS by 0.26±0.07 mmol/L and decreased after LS by 0.35±0.16 mmol/L. Plasma HDL decreased by 0.11±0.03 mmol/L (p<0.05) after HS, whilst, plasma TC and LDL decreased significantly by 10% after LS. There was no significant change in other parameters after either diet. This study confirmed that a diet with a greater proportion of sugar increased CVD risk via negative changes in metabolic profiles including body weight, waist circumference and lipid parameters, whereas LS produced the positive effects. A restriction of sugar intake to lower than 10% energy intake is vital to reduce CVD risk.

Overweight or obesity will increase the risk of morbidity and mortality from cardiovascular disease. In older people, the risk is higher, but also paradoxically associated with lower mortality rates. Overweight patients vary in body composition and when it coupled with limited reliable sources to make caloric requirements estimation will make nutrition therapy extremely challenging. This case study reveals the nutrition therapy support in critically ill overweight elderly patient with heart failure, myocardial infarction, pneumonia, and chronic kidney disease. An 80-year old moderate malnourished male patient (body mass index 24.6 kg/m²) with acute lung edema, cardiogenic shock, myocardial infarction, pneumonia, and chronic kidney disease was admitted in the cardiovascular intensive-care unit. The patient was treated with diuretics, vasopressor support, and antibiotics. Oral intake was reduced due to shortness of breath and loss of appetite. The physical examination revealed basal lung rales, wheezing, muscle wasting, edema. Blood tests showed hyperkalemia, leucocytosis, depletion of the immune system, hyperuricemia, hypoalbuminemia, and dyslipidemia. The patient was on stage 5 renal failure (GFR 6.2 mL/min) but refused hemodialysis treatment. Nutritional therapy was given gradually with calorie target 1900 kcal and protein 0.6–1.2 g/ideal body weight/d using normal foods, oral nutrition supplement, and amino acids parenteral nutrition. After 13 d of nutritional treatment, the patient was discharged from the hospital with no shortness of breath, adequate nutrition intake, increased renal function (GFR 22.4 mL/min), and improvement of the blood test results (immune status, uric acid, albumin, and lipid profile). Critically ill overweight elderly patients are hypercatabolic and have increased nutrient demands. Nutritional support in these patients is required to provide necessary nutrient substrates and to alter the course and outcome of the disease.

The incidence of metabolic syndrome (MS) which is a predictor of increasing CVD is on the rise among adults in urban India. The present study was designed to measure the prevalence of cardio metabolic risk (CMR) as per MS among employed adults in Delhi, India. Study design was cross-sectional. Anthropometric and biochemical measurements were carried out using standard techniques on apparently healthy males and females (n=455) working in various government and private organisations in Delhi, India after obtaining ethical permissions. It was found that more than one-third of the study population had MS (43.8%). A significant difference in the prevalence of MS was seen among males (34.7%) and females (57.5%, p<0.05). The prevalence of MS components was: abdominal obesity (54.3%), hypertriglyceridemia (61.9%), hypertension (56.6%), hypertriglyceridemia (27.4%), low HDL-c levels (63.7%). CMR (assessed from 0–5, where 0 means no MS). It was found that CMR increased with age (β: 0.01; 95% CI: 0.009,0.01; p=0.000) especially among females (β: 0.29; 95% CI: 0.19,0.38; p=0.000) who were consuming frequent non-vegetarian foods (β: 0.04; 95% CI: 0.01,0.09; p=0.07), had family history of diseases (β: 0.08; 95% CI: 0.01,0.18; p=0.09) and were sedentary workers (β: 0.05; 95% CI: 0.00,0.10; p=0.06). Unhealthy worksite food environment characterised by high fast food outlet density (β: 0.003; 95% CI: 0.00,0.007; p=0.04) in close proximity (β: 0.17; 95% CI: 0.36,0.00; p=0.05) to worksite were also associated with MS. There is a high prevalence of individual components of MS and overall prevalence of MS. Food environment and physical inactivity were two paramount factors resulting in increased CMR among the study population.

This study aims to analyze the effect of Bilih fish bars (BFB) on oxidative stress based on the levels of MDA and SOD in diabetic rat models. This study used a Randomized Complete Design (RCD). Forty white male rats of the Sprague-Dawley strain were placed into the following five groups: normal and diabetic rats that were fed either the standard feed and metformin, BFB, BFB, and metformin or BFF with a zinc dose of 0.54 mg. A single dose of STZ (40 mg/kg) was used to induce diabetes in the rats. The intervention lasted for 30 d. The differences in MDA and SOD levels between groups were determined with one-way ANOVA followed by Duncan’s New Multiple Range Test, and the significance of the statistical level was set at p<0.05. The intervention with BFB and metformin, BFB, and BFF resulted in a decrease in blood glucose levels. The levels of MDA in rats that received the intervention with Bilih fish were 8.236±0.46 μmol/L for the BFB group and 8.266±0.66 μmol/L for the BFF group, which were both lower compared to the control normal rats (8.279±0.51 μmol/L). The levels of SOD in rats that received the intervention with BFB and BFF were higher compared to the diabetic rats with standard feed, but this increase was not significant (p>0.05). BFB and BFF lowered blood sugar levels and decreased the oxidative stress levels based on MDA levels in a diabetic rat model.

Tuberculosis (TB) affects one-third of the world’s population and is the leading cause of human mortality and morbidity. Tuberculous meningitis (TBM) is the most severe type of extrapulmonary diasease. Medical treatment and nutritional management is the most efficient and cost-effective of all health interventions. In case: A 25-y-woman presented with loss of appetite, fluctuating fever for two weeks, and loss of consciousness for 9 d. There was no history of headache, nausea, vomiting and neck pain. Physical examination shows signs of meningeal irritation, anemia, dermatitis in neck, armpit and back, decubitus and limb paralysis. Laboratory examinations showed normocytic normochromic anemia, immune depletion, hypoalbuminemia, hyponatremia, hyperlipidemia and elevated liver transaminase. Nutritional therapy was given by enteral nutrition, contained of high protein and choline ONS (oral nutritional supplement), blenderized diet. Vitamin A, B complex, C, D, zinc, and cork fish extract as the source of albumin, immunonutrient such as fish oil was given as supplementation. After 35-d of treatment, there were increased of albumin plasma and lymphocyte level, accelerated wound healing, dermatitis, and functional capacity. Home healthcare visit and physiotherapy was conducted for about 1-month to support oral feeding from liquid to blenderized diet to porridge and improve cognitive and functional capacity. This report is intended to describe how nutritional support with transitional feeding to enhance adequate intake can accelerate wound healing, decrease morbidity and mortality rate in TBM patient.

Elderly is defined as an age group that is susceptible to various diseases. The aging process in the elderly is associated with an increase in oxidative stress activity which can lead to various health problems which are a major cause of high mortality and morbidity. This study aimed to analyze the effect of supplementation of catfish (Clarias gariepinus) oil enriched with omega-3 soft capsule on oxidative stress and cognitive function of elderly people. The design of this study was a single blind randomized control trial. A total of 29 elderly subjects were chosen following these inclusion criteria: aged >60 y; had dyslipidemia; and signed the informed consent. Subject were divided into three groups i.e. SO (soybean oil), CFO (commercial fish oil), and CO with omega-3 (catfish oil enriched with omega-3). The intervention was 1,000 mg oil/d administered for 90 d. The results showed that different supplementation groups had significant effects on oxidative stress and cognitive function (p<0.05). Supplementation of catfish oil enriched with omega-3 was able to significantly decreased malondialdehyde (MDA) level (p<0.05) and significantly increased mini mental state examination (MMSE) score (p<0.05). Overall, CO with omega-3 supplementation for 90 d was able to improve oxidative stress and cognitive function of the elderly better than other groups.

Metabolic syndrome can affect the inflammatory state which results in increased high-sensitivity C-reactive protein (hs CRP) and decreased adiponectin levels. Tempe gembus is a functional food that can reduce the risk of metabolic syndrome through the inflammatory pathway. This study applied a quasi experimental method, with a post-test only control group design. Sprague Dawley rats (n=30) were divided into 2 control groups (K− and K+) and 3 treatment groups (P1, P2, P3) which were given a 4-wk diet that included 2.5 g (P1), 5 g (P2), and 7.5 g (P3) of tempe gembus. Adiponectin and hs CRP levels were measured with ELISA. Statistical analysis was done with a one-way ANOVA test and a Kruskal Wallis test. It apprears that administering tempe gembus in these amounts can reduce the hs CRP levels (p=0.037) and increase adiponectin levels in rats with metabolic syndrome (p=0.008). This research has shown that a 2.5 g of tempe gembus can have a strong effect on hs CRP and 5 g of tempe gembus have a strong effect on adiponectin.

Large of food waste can be one indicator of nutritional deficiencies in patients. This lack of nutrition is a factor that can increase morbidity, length of stay and cost of care. The acceptance of the taste of food in patients with low-salt diets is often a problem. This study aimed to assess the effect of taste and appearance of foods on food waste in patients with low-salt diets. The study was a cross-sectional design with observational methods. Data was collection from interview using questionnaire. The study was conducted at the Jasa Kartini (JK) Hospital, Tasikmalaya in August-October 2017. Subjects (n=30) were patients in low-salt diet. The acceptance of the taste and appearance of food from JK Hospital according to the respondents, the value was quite varied, generally above the median value on a scale of 1–3. The average of food waste from patients with low-salt diets at JK Hospital was still above the PGRS (Nutritional Guideline for Hospital) standard 2013, which was 26%. Based on the analysis between variables, there was a significant relationship between food waste and food taste (p=0.002) and food waste and food appearance (p=0.000) in low-salt diets patients. The taste and appearance of food significantly affect the food waste in low-salt diet patients.

The prevalence of vitamin D deficiency (VDD) appears to be increasing. VDD during pregnancy has been associated with several adverse pregnancy outcomes. This study aimed to investigate the association between VDD and fetal anthropometric measurement. This prospective cohort study consisted of 232 pregnant women in their first trimester who were recruited at the antenatal clinics and they maintained to be subjects of the study until their delivery time. Serum 25-hydroxyvitamin D (25(OH)D) concentration was measured at first and third trimester using enzyme-linked immunosorbent assay. The prevalence of VDD in the first-trimester was 82.8%. Mean of 25(OH)D concentration in the third-trimester was significantly higher than in the first trimester (14.00 (6.98) vs. 21.22 (10.17) ng/mL). After adjusting age, pre-pregnancy BMI, and gestational age at delivery, it was found that VDD during pregnancy was not significantly associated with neonatal anthropometry (p>0.05). It was concluded that VDD was common in a tropical country. Large, well designed, multicentre observational studies are required to determine whether VDD enhances the risk of adverse pregnancy outcomes.

Maternal anthropometry and its influence on the birth weight has been studied widely, but effects of maternal undernutrition in-utero depicted by surrogate measures of sitting height and head circumference are largely unknown. We have studied the maternal sitting height along with other conventional nutritional status indicators at registration in predicting the risk of low birth weight (LBW) among 204 young rural women. Information on socio-demographic and economic profile, anthropometric measurements at registration and neonatal birth weight after delivery was recorded. Mothers were thin (mean weight; 46.4±6.1 kg), had short stature (mean height: 153.3±5.7 cm) and 33.8% were undernourished (body mass index (BMI) <18.5 kg/m²). Prevalence of LBW was 27.5%. Maternal weight, height, BMI, head circumference, sitting height and %body fat at registration were significantly (p<0.05) associated with birth weight. Significant risks for LBW were observed for low (<42.26 kg) weight (OR=3.69; CI: 1.6–8.1), short (<150 cm) height (OR=2.3; CI: 1–5.1), low (<18.5 kg/m²) BMI (OR=3.27; CI: 1.4–7.3), low (<70 cm) sitting height (OR=2.3; CI: 1.0–5.1), small (<52 cm) head circumference (OR=3.3; CI: 1.6–7.1), and low (<22.7%) %body fat (OR=4.98; CI: 2.2–11.2). Interestingly, these risks remained significant for sitting height (OR=3.4; CI: 1.5–7.6, OR=2.5; CI: 1.1–5.8) and head circumference (OR=2.4; CI: 1.1–5.6, OR=2.2; CI: 0.9–5.03) even after adjusting for BMI and %body fat respectively indicating their independent influence. Our findings highlight that in addition to the current maternal undernourishment, maternal undernourishment in-utero (small head circumference and short sitting height) imposes risk for LBW.

The purpose of this study was to analyze effect of linear growth and psychosocial aspects of caregiving on cognitive development of toddlers. Methods: Longitudinal studies were carried out from pregnancy to three years old children in Bogor. The collected data included body height, nutritional status based on height by age index, morbidity, aspects of caregiving, and cognitive development of three years old children. Linear growth data is obtained from anthropometric measurements of height at birth, age six months, and twelve months measured using a length measuring instrument body with a precision level of 0.10 cm. Caregiving of psychosocial aspect divided by some characteristics, such as learning stimulation, language stimulation, academic stimulation, modelling, warmth and acceptance, caregiving variation, punishment & acceptance and physical environment. Cognitive development measurement was divided into two categories, namely delay and appropriate to age. Multiple logistic regression was applied to analyze the effects. Toddlers who were born stunted and continued to be stunted until they were three years old had lower cognitive development than stunted newborns that were able to achieve normal height at three years old. In addition, children who experience caregiving with poor psychosocial aspects had lower cognitive development than those with good caregiving. This study highlighted the importance efforts to improve nutritional status of children as well as providing good care for them.

Children’s Eating Behavior Questionnaire (CEBQ) was widely used in western countries to measure children’s eating behavior and played an important role in the research on the risk of childhood obesity, but it is rarely used in China yet. This study aimed to examine the Chinese version of CEBQ’s reliability and validity in a pilot study, then applied it to bigger population. Data was collected with CEBQ in two districts of Shanghai, respectively. Using stratified cluster sampling method, a total of 2,520 children were included in the study. The questionnaires were filled out by children’s parents. It was proved that the Cronbach’s coefficient α of the questionnaire was greater than 0.7, indicating that the questionnaire had good internal consistency. Aside from the subscales ‘Emotional undereating’ and ‘Food fussiness’, the Pearson’s correlation coefficients of the other subscales were all greater than 0.5. It showed that test-retest reliability of CEBQ was acceptable. We found that boys and girls had different eating behavior characteristics. And there was a graded association between eating behavior and nutritional status of school-age children. It suggested that appetitive traits of school-age children could be used as indicators of susceptibility to weight gain. In conclusion, the Chinese version of CEBQ was of good reliability and validity, so it is considered as a reliable tool that can be applied to Chinese school-age children’s eating behavior and related studies.

Nutrition education message that is developed based on linear programming could help arrange complementary feeding recommendations (CFR) using locally available food to improve infants’ nutrient adequacy. This study examined deficient nutrients to optimize complementary feeding for infants. Data were collected from the Health District Office of Yogyakarta province that consisted of 91 breastfed infants aged 6–11 mo old. Their dietary intake was assessed by quantitative 24-h recall and data were processed using the software Nutrisurvey, MS Excell, and Optifood. Meat, fish, eggs, fruit, legumes, nuts, and seeds were infrequently consumed. Intakes of Fe and Zn could not fully reach the Recommended Nutrient Intake (RNIs), while the vitamins C, B6, folate, B12, and A could achieve 100% of RNIs by using optimized food pattern. Local foods that could be used to help improve the nutrients, except for Fe and Zn. The CFR were as follow: continue breastfeeding frequently; feed quality protein source food such as 3 servings/wk of all type of eggs and liver, 5 servings/wk of locally available flesh of fish; provide 2 servings/wk of enriched/fortified baby porridge; offer plant protein foods (legumes, nuts or seeds) 2 servings/wk including 1 serving/wk of mung bean porridge. Locally available foods had potential to improve diet quality of infants aged 6–11 mo, providing that the consumption frequency is increased. Consumption of food sources for Fe and Zn needs to be improved in terms of both portion and frequency.

The culture of breastfeeding has been inherited for a long time in Indonesia. Changes in lifestyle have caused an increase in the number of working mothers. Results of the Basic Health Research in 2018 reported exclusive breastfeeding coverage was decreased as much as 17% between 2013 and 2018. The purpose of this study was to determine association of health workers support and other factors on exclusive breastfeeding practice among working mothers in industrial area. Methods: A cross-sectional study was conducted in April-June 2018 in industrial area at Cibinong, Bogor, Indonesia. As many as 126 working mothers who had babies aged 7–24 mo were selected using a purposive sampling technique. Results: Only 37.3% of working mothers breastfed their babies exclusively. The support of health workers was the most dominant factor associated with exclusive breastfeeding {(p=0.001; OR: 6.210 (1.184–6.257)}. Husband’s support {(p=0.014; OR: 5.228 (1.306–10.234} were also associated with exclusive breastfeeding. Working mothers who obtained support from health workers were 6.210 times more likely to breastfeed exclusively as compared to mothers who did not receive support from health workers. Conclusions: Actual and direct support from husband and health workers from the period of pregnancy to lactation is important for the success of exclusive breastfeeding among working mothers.

Zinc deficiency was common among women, which mainly determined by adequacy of zinc intake, type of zinc compound in the diet, and presence of inhibitors of zinc absorption. This study aimed to assess the zinc status and zinc intake among postpartum women. A cross-sectional study was conducted in three community health centres located in coastal area of Makassar, Indonesia. Eighty-seven women participated in the study. A short Semi-Quantitative Food Frequency for zinc sources was used to collect dietary data. Venous bloods were drawn from all woman and serum zinc concentrations were measured using QuantiChrom^TM Zinc Assay Kit (DIZN-250). Pearson correlation tests were undertaken to investigate relationship between zinc intake, phytate intake, and serum zinc concentration. All women were zinc-deficient (<66 mcg/dL) and 21.8% respondents had inadequate zinc intake. The average zinc intake was 15.9 mg/d with rice and legumes were the main contributors to zinc intake (54.10% and 11.33%, respectively). The average phytate intake was 6.5 gram/d, also with rice and legumes as the main contributors (63.30% and 14.97%, respectively). No significant association was observed between zinc intake and serum zinc concentration as well as between phytate intake and serum zinc concentration (r=0.063; p=0.053 and r=0.150; p=0.165, respectively). Postpartum women in coastal area of Makassar were zinc deficient and had low intake of zinc. The main dietary zinc sources were mainly plant source foods which have low bioavailability and high phytate content.

Stunting is highly prevalent, including in Indonesia. Zinc intake and zinc status contribute to the etiology of stunting. However, zinc status measurement is not easy. Hair zinc level reflects long term exposure to zinc. This study aimed to analyze the difference in hair zinc level of stunted toddlers as compared to normal toddlers. This case-control study was conducted in Nganjuk with 23 stunted toddlers and 23 normal toddlers selected using simple random sampling. Hair zinc level was measured using atomic absorption spectrometry conducted at the Center of Research and Industrial Consultation Laboratory, Surabaya. The inclusion criteria for this study were children aged 24–59 mo, lived in Puskesmas Wilangan work-areas, and had uncoloured hair with minimum length of 1.5 cmthe list of respondents gathered from EPPGBM website, where it provides list of informations consist of data of malnutrition children. The study revealed that mean hair zinc level among stunted toddlers were 146.21±16.83 mg/L while the hair zinc level among the normal toddlers were 157.07±23.11 mg/L. There was significant difference in hair zinc level between stunted toddlers compared to their normal peers. Conclusions: Hair zinc level was associated with stunting and can be considered as biomarker for stunting.

Exclusive breastfeeding is an effort to obtain optimal growth, as breast milk contains essential nutrients required for the growth and development of infants as well as antibodies for the immune system. This study aimed to explore the strategies of successful exclusive breastfeeding among policewomen in East Nusa Tenggara Regional Police. This was a qualitative study with an explorative design consisting of 10 female police as informants. The result showed that: (1) The informants knew the importance of exclusive breastfeeding for the growth of their children; (2) The informants perceived that occupation was not a barrier to provide exclusive breastfeeding; (3) The informants were adequately exposed to information from mass media related to exclusive breastfeeding; (4) Breastfeeding room was unavailable at the office resulting in their decision to breastfeed at home; (5) Husbands gave support by forbidding their wives to give formula to babies before 6 mo of age; (6) The family provided support to exclusive breastfeeding by taking care of the babies during work time; (7) The chief gave support on exclusive breastfeeding; and (8) The strategy for achieving successful exclusive breastfeeding was originated from the willingness and acceptance of the nature as a woman. Informants had good knowledge, attitudes and information exposure and received support from husbands, families, and supervisors. East Nusa Tenggara Regional Police Office needs to provide breastfeeding rooms to support successful exclusive breastfeeding.

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.

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.

The monitoring of the nutritional status in 2017 showed that the percentage of underweight in West Sumbawa was 20.8%—higher than national (17.8%). In 2016, Pencerah Nusantara, a program that strengthen primary health care through youth empowerment and interprofessional collaboration, encouraged the use of moringa as local food ingredient to improve the nutritional status of children at Poto Tano Health Center, West Sumbawa District. Moringa Program is an innovation program to educate community about nutrition and provide moringa-based foods to improve community nutrition. This program was then implemented not only at one health center but in all sub-districts. Furthermore, BAPPEDA (Local Development Planning Agency) included moringa program to Local Nutrition Action Plans as stipulated in the District Regulation No. 80/2017 about preservation of moringa. This study aims to describe the impact of local regulation on the development of moringa program as one of the solutions to overcome the nutritional problems of children under five. The study uses a case study design on community readiness assessment and is complemented by secondary data collection. The study shows clearly that the regulation is the key factor in strengthening cross-sector partnership and in maximizing efforts to improve community nutrition through the Moringa Program. During the implementation of providing moringa-based foods as a provision of supplementary feeding and complementary feeding at integrates health posts (Posyandu), there was a decrease in cases of underweight in children under five at the Poto Tano Health Center from 21.9% in 2017 to 19.9% in 2018.

Green and blue spaces (GABS) are vital components of sustainable and healthy communities. Evidence suggest that GABS positively affect population health and wellbeing. However, few studies examine GABS influence on childhood obesity. This systematic review investigates the impact of GABS on childhood obesity particularly on children’s physical activity and eating behavior. The search protocol identified 544 studies from PubMed, Medline, PsycINFO, CINAHL, and Web of Science. A two-tier screening process document using the PRISMA flow diagram identified 16 studies which underwent quality analysis using the National Heart, Lung, and Blood Institute (NHLBI) and Critical Appraisal Skills Programme (CASP) tools. Data were interpreted using thematic analysis and narrative synthesis. Selected studies show varying sociodemographic characteristics of sampled populations located in urban and rural settings. The influence of GABS on children’s physical activity and eating behaviour depends on the type, location, proximity, density, facilities, and activity types that interplay with gender, ethnicity, and parent-child relationship. The review demonstrates the significant effect of GABS on children’s physical activity and eating behaviour. GABS provide children with safe venues for socialisation and long, intensive, and enjoyable physical activity; and influence children’s perceptions on vegetable consumption supporting healthier eating behaviour. These spaces have the potential to eradicate childhood obesity if policy, social, economic, environmental, and organisational considerations are addressed.

It is important for football players to maintain muscle strength through the entire match. The aim of this study was to investigate body mass index (BMI), body fat percentage (BF%), dietary intake (energy, carbohydrate, and protein) and its relationship with muscle fatigue among adolescent football players. This was a cross-sectional study involving 26 football players aged 15–17 y. BMI was determined using WHO Anhtro Plus, BF% was analyzed using Bioelectrical Impedance Analysis (BIA) and categorized using bodyfat curves for children, and dietary intake was assessed using 3×24 h dietary recall. Running-Based Anaerobic Sprint Test (RAST) was conducted twice and averaged to identify muscle fatigue. Pearson correlation and multiple-regression analysis were performed to determine the relationship between variables. The results showed that overall participants had healthy weight (17.61±1.82 kg/m2), good diet pattern (energy 99.08±14.34%, carbohydrate 92.88±9.54% and protein 95.96±23.41%), but low body fat (6.76±2.12%). In pearson test, negative correlations were found in muscle fatigue and BMI (r=−0.393, p=0.047), as well as BF% (r=−0.458, p=0.019), but positive between muscle fatigue and energy intake (r=0.538, p=0.005). Furthermore, multiple-regression analysis only confirmed statistically significant relationship between energy intake and muscle fatigue (p=0.028). We conclude that the higher BMI and BF% may lead to greater muscle fatigue, while higher energy intake has significant improvement to reduce muscle fatigue. Hence, it is essential for football players to consume adequate energy, and consider to maintain BMI and BF% at optimal range.

Adolescents are susceptible to nutritional problems. One of the problems in adolescents is the incompatibility of actions related to food selection. An unbalanced diet will affect nutritional status; hence a guide is needed in food selection by considering the principles of balanced nutrition. This study aims to determine the relationship of balanced nutrition practices with obesity in adolescents. This was a cross sectional study. The independent variables in this study were food diversity, hygiene behavior, physical activity and body weight monitoring while the dependent variable was obesity. The independent vaiables reflect the four principle of balanced nutritional guidance. The subjects of this study were 192 high school students. Data were collected by using Semi Quantitative-Food Frequency Questionnaire (SQ-FFQ) to assess food consumption, IPAQ short form to measured physical activities, and questionnaire to assess hygiene and weight monitoring behavior. Results showed that there were 19.8 percent overweight and obesity, 100 percent of dietary consumption was inconsistent with Balanced Nutritional Guidance, 53.6 percent had good hygiene behavior, 52.1 percent had medium physical activity and 63 percent had irregular weight monitoring. There was a relationship between weight monitoring and obesity (p<0.05) and no relationship with other principles. In conclusion adolescents had poor pattern of food consumption. Irregular weight monitoring was associated with overweight-obesity. It is suggested that adolescents have regular weight monitoring to control their nutritional status.

Data on prevalence of mental health disorders indicates that 4.5% and 3% of the Indian population is suffering from depression and anxiety respectively. Research suggest that a poor quality diet (lacking in macro and micronutrients) may lead to deficiencies that are associated with depression and anxiety disorders. The present research was designed to study the prevalence & association of depression & anxiety with protein intake among adolescent boys and girls (aged 13–15 y) studying in public schools of Delhi. 546 adolescents participated in this cross-sectional study (selected from public schools in Delhi). For the assessment of depression and anxiety symptoms and dietary micronutrient deficiencies Child Behavior Checklist (CBCL; administered to the parents) and 24 h recall and food frequency questionnaire (administered to the subjects) were used respectively. Adolescent Micronutrient Quality Index (AMQI) was further used to assess the protein quality of the diets. Prevalence of depression and anxiety were 33.5% and 27.47% respectively. Assessment of diets through AMQI revealed that low intake of protein rich foods like milk and legumes was significantly associated with higher mean scores of depression (p<0.001) and anxiety symptoms (p<0.001). In the multivariate analysis for depression and anxiety symptoms, it was observed that males who were not consuming milk for breakfast had higher odds of getting depressed (OR: 0.28; 95%CI: 0.10–0.77; p=0.0177) and anxious (OR: 0.28; 95%CI: 0.10–0.77; p=0.0177) and females had higher odds of getting depressed (OR: NE; 95%CI: NE; p≤0.0177). This study highlights the association of mental health with quality and quantity of protein consumed by adolescents. It will also serve as a strategic tool for mental health prevention and management policies designed for adolescents. It also adds to the growing body of research in the area of nutritional psychiatry.

The challenge for nutrition science is to understand strategies to enable a balance between healthy diets and sustainable food systems. This study was to quantify greenhouse gas (GHG) emission of food consumption related to different dietary preferences among Indonesian adults by body mass index (BMI). Methods: We utilized the existing food consumption survey databases. Dietary and anthropometric information were obtained from Total Diet Study (Studi Diet Total/SDT) in 2014 and Basic Health Research (Riskesdas/RKD) in 2013. The most consumed food items from 14 food groups were selected as representatives of rice, cassava, tofu, long beans, banana, chicken meat, chicken liver, mackerel tuna, chicken egg, condensed milk, palm oil, white sugar, shallot, and ground coffee. The GHGs emission factors were acquired from Thai National Life Cycle Inventory Database. Food weight (gram), energy intake (kcal), and GHGs emission (kgCO₂eq) from consumption of these food items were analyzed among BMI groups. Results: Annual GHGs emission by underweight, normal, overweight and obesity group were 794, 827, 801, and 791 kgCO₂eq/person, respectively. The highest contributor of GHG was chicken meat, followed by rice and chicken eggs (190, 175, and 123 kgCO₂eq/person/y, respectively). Indonesian people in the obesity group consumed higher amount of food (p=0.001) than other groups, however, they emitted lowest GHG emission (p=0.001). Conclusion: This finding suggested that selection of food type plays a critical role on the environment and amount of consumption. Food choices of the population may ultimately result in impacts on environment and have public health consequences.

Thirty-two teachers from 10 preschools in Cisalak subdistrict, Subang district, West Java province, Indonesia, received a two-day training on Balance Nutrition and My Plate in February 2018. The main messages underlined in the training were consume a variety of foods, drink enough water daily, wash your hands with soap, be physically active, and monitor your body weight. The training was followed by an eight-week implementation period to preschoolers aged 3 to 6 y. The knowledge of the teachers increased by up to 33 percentage points (average score: 69 to 82 pre- vs. posttest) after training, and the teachers answered correctly to the same questions 15 mo later. The mothers’ knowledge increased by up to 37 percentage points after parenting sessions. All seven teaching aids provided were used by end-line, but their usage decreased after seven months (range: 2 to 7) and further decreased by 12 mo postintervention (range: 2 to 5). A teacher’s handbook and a flipchart were the two aids persistently used. The practices of washing hands with soap, bringing healthy packed lunches, and monitoring weight and height continued after 12 mo postintervention. Dissemination of Balance Nutrition knowledge to fellow teachers of the same school, colleagues from different schools, or to representatives of preschool associations was evident. Training should be scaled up to the district level, using trained teachers as trainers and adopting a cascade training method. National roll-out by teachers’ associations, in collaboration with the Ministry of Education and the Ministry of Health, could improve the knowledge of over 200,000 preschool teachers and potentially improve the nutrition of 19 million preschoolers.

Cassava leaves contain albumin, fat, carbohydrates, vitamin A, vitamin B1, and fibers, thus having the potential to be used as an ingredient in production of cookies. The purpose of this research was to determine the optimum ratios between wheat flour, cassava puree and cassava leaves flour to produces cookies with good nutritional profile. This study was conducted as Completely Randomized Designs with five treatment, namely the ratios between wheat flour: cassava puree: cassava leaves flour (WF:CP:CLF) in grams of 50 : 50 : 0, 49 : 49 : 2, 48 : 48 : 4, 47 : 47 : 6 and 46 : 46 : 8. Each treatment was replicated thrice. Parameters observed were the nutritional content, sensory acceptance, antioxidant activity and glycemic index (GI) of the cookies. The data obtained were analysed with ANOVA, continued by LSD test at α=0.05 for treatment showed a significant effect. The result showed that the chemical characteristics of the cookies were 1.46–5.12, 0.23–2.10, 10.67–20.76, 1.20–4.26, 8.36–10.94 and 64.75–74.09% for moisture content, ash, fat, fibre, protein and carbohydrate, respectively. The energy and antioxidant activity (IC₅₀) of the cookies was at the range of 426.31–480.30 kcal/100 g and 151–200 ppm. The most preferred sample was the one with WF : CP : CLF of 49 : 49 : 2 with a GI value of 77.4. This study showed that cassava leaves flour has potential as an alternative ingredient in improving the nutrition profile of cookies production.

Prediabetes is one of risk factors for degenerative diseases. One of the prevention efforts is by improving the knowledge of nutrition and attitude through a counseling program. Modules are used as the media to convey the message of health with the form of words and pictures. The purpose of the study is to analyze the difference between the influence of nutrition counseling with the module and without the module, toward the raise of nutrition knowledge, attitudes, and the adequacy of macronutrients (energy, protein, fat, and carbohydrates) in prediabetic women. This study used a quasi-experimental method with pretest-posttest control group design. The sample consisted of 29 women ages between 35–50 with prediabetes who were divided into 2 groups: a treatment group provided with modules (n=15); and a control group with no modules provided (n=14). The counselling was done 4 times in 15–30 min duration each session. Paired t test and wilcoxon were used for within group, while independent t-test and Mann-Whitney were used between two groups. In treatment group, there was a significant increase score of pre-test and post-test of knowledge (p=0.01) by 16.16±21.56 and attitude (p=0.04) by 1.46±2.66. In control group, there was a notable increase score of pre-test and post-test of knowledge (p=0.02) by 10.71 ±15.39. There was no indicative difference in the improvement of knowledge score (p=0.443), score of attitude (p=0.783), energy intake (p=0.693), carbohydrates (p=0.585), protein (p=0.458), and fat (p=0.495) between the control group and the treatment group.

Fermented fish is a common seasoning used in Northeastern Thailand and Laos to give food a salty taste. It is also used as a basic ingredient for preparing various seasoning sauces for many local dishes. This study examined the effect of sodium reduced fermented fish (SRFF) on reducing the sodium content in prepared traditional papaya salad. Three local producers provide fermented fresh water fish produced with either normal salt (FF) or 60% sodium-reduced salt (SRFF) that were then used by 3 local sauce producers to make papaya salad seasoning sauces. Three local street food vendors then were used these sauces as the main ingredients for preparing their papaya salads. Sodium contents of the FFs, SRFFs, and papaya salads were analyzed using Inductively Coupled Plasma-Optical Emission Spectrometer. Significant differences between sodium contents in sauces and papaya salads were evaluated using the t-test. Results showed that the SRFF contained 54% less sodium than the FF, while sodium in the SRFF sauces was approximately 42% less than from FF sauces. The papaya salads prepared from SRFF sauces contained on average 492±27 mg sodium per 100 g, which was 33% lower than those prepared from FF sauces. The use of SRFF could significantly reduce sodium content in traditional papaya salad by up to one-third, which could be beneficial in lowering the risk of hypertension among Norteastern Thai and Laotain people with minimal change in eating behaviors.

Vitamin A deficiency is common in many countries where rice is the staple food. Food fortification is an important strategy to address this problem. As rice noodle is the second principal form of rice products widely consumed in Asia, rice noodles could be a potential vehicle for fortification of vitamin A. In this study, rice noodles were prepared from 0, 300, 600, 1,050, and 1,500 μg of vitamin A per 100 g of rice flour. Samples were analyzed for quality, sensory evaluation, and enhancement of vitamin A intakes. Increasing level of vitamin A fortification did not influence quality and sensory properties of the rice noodles, except for the ash content, color, and appearance of the noodles. Rice noodle that was fortified with the highest level of vitamin A was found to be the darkest in color. However, this sample received scores higher than 6 (like slightly) for appearance. Furthermore, sample fortified with the highest level of vitamin A produced rice noodles with the highest level of vitamin A retention suggesting that noodles were good vehicle for vitamin A fortification. Fortification of rice flour with 1,500 μg of vitamin A produced rice noodles with 24.88% of the RDI for vitamin A per serving and provided an effective means of enhancing vitamin A intake.

A photographic food atlas is a series of photographs showing different quantities of different foods. It serves as a portion size estimation aid (PSEA). In Malaysia, the existing food atlases, which display foods in exchanges and standard portion sizes, may not be representative of the actual sizes of the portions of food consumed by the local population. This paper aims to describe the development of a food atlas, namely the ‘MY Food Album’, and assess its usability as a PSEA. Thirty four participants (aged 31.6±20.9 y) served themselves, in a laboratory setting, what they considered to be typical, small, medium, and large portions of 23 amorphus food items. All food portions were weighed to obtain the mean and standard deviation of the range of food portion sizes to be displayed in the food atlas. Using standard camera and lighting settings, various local foods were photographed at an angle of 45º. A total of 393 food items were categorized into 14 food groups and presented as serial (n=101), guide (n=213) and range (n=79) photographs. The usability of MY Food Album was evaluated by six nutritionists and dietitians using an adapted questionnaire. The food atlas was perceived to be useful to aid in the quantification of food during dietary assessment. It was suggested that the function, dimension and application of fiducial markers be introduced in the food atlas to facilitate its use in size estimation. While MY Food Album was well-accepted as a PSEA, futher validation is required to evaluate the effectiveness of this newly developed food atlas in portion size estimation.

Food fortification is a commonly-used method to increase nutritional value of food products in order to reduce the risks of Non-Communicable Diseases (NCDs). Noodles are a versatile and popular staple food, especially in Asia, that can be nutritionally enriched using various types of ingredients and one of them is wheat bran that is rich in dietary fiber. This study aimed to determine effect of fortification of fresh yellow alkaline noodles with wheat bran on its physical and sensorial properties. Addition of wheat bran was varied in concentration (0–20%) and physical properties of fortified yellow alkaline noodles were assessed. Additionally, 9-point hedonic scale and ‘Just About Right’ scale were employed to assess sensory properties of the fortified noodles, using 40 non-trained panelists. Noodles fortified with the highest amount of wheat bran exhibited the highest cooking loss (4.61%) compared to the non-fortified one (2.78%), indicating weak structural integrity, presumably due to the impaired gluten network. On contrary, noodles fortified with various amount of wheat bran did not demonstrate significant alteration of textural properties in terms of springiness, cohesiveness, and resilience. Sensorially, noodles fortified with 10% of wheat bran had the highest preference among the panelist based on general appearance, overall acceptability, color suitability, hardness suitability, and smoothness. Proximate analysis showed noodles supplemented with 10% of wheat bran met regulatory criteria for claim as a high-fiber food, with its dietary fiber content of 5.40 g/100 g of noodles. Conclusively, fortification of yellow alkaline noodles with wheat bran could improve its product properties.

This study aimed to analyze the effect of nutrition education on the consumption pattern, knowledge, and practice in bringing a well-balanced menu (WBM) for lunch among school-aged children. The study was quasi-experimemtal research using one group with pre- and post-test. Subjects were 52 students in fifth grade at SDN Babakan Dramaga 04, Bogor. The study was conducted from February to April 2017 and nutrition education was provided twice in 2 wk. The first post-test for nutritional knowledge was done 1 wk after the nutrition education, while the evaluation of the practice of bringing WBM for lunch was conducted 2 wk after the intervention. The second and third post-tests were performed every 2 wk after that. The knowledge of balanced nutrition increased after the intervention. The initial nutritional knowledge was significantly different from those of the first and second post-tests with p values of 0.003 and 0.01, respectively. Subjects showed an improvement in the practice of bringing a well-balanced menu for lunch after the nutrition education intervention. It was also shown that carbohydrate intake at the third post-test was related to nutritional status after the intervention. The practice of bringing WBM for lunch should be continued by students and monitored by physical education teachers. Parents, especially mothers, should support their children by providing balanced and nutritious food at home.

Beta-carotene is one of phytochemicals which play role as natural antioxidant related to the reduction of oxidative stress that is linked to Non-communicable diseases (NCDs). Sweet leaf (Sauropus androgynous), one of the indigineous plants in Asia, contains high contents of beta-carotene. However, the bioaccessibility of beta-carotene in sweet leaf might be altered among the different cooking methods. Therefore, the effects of different cooking methods (raw, boiling, and microwave cooking) and addition of palm oil on the bioaccessibility of beta-carotene of sweet leaf were investigated before and during in vitro simulated gastrointestinal digestion. We found that the boiling and microwave cooking methods caused the lower beta-carotene contents in cooked sweet leaf compared to raw leaf. However, the addition of 10% (v/w) palm oil during cooking helped increasing the bioaccessible beta-carotene contents after digestion in all cooking methods, compared to those without palm oil addition (p<0.05). In addition, the bioaccessibility of beta-carotenes was found to increase about 20% when the palm oil was added into the microwaved sweet leaf. The findings of this study suggested that the addition of 10% (v/w) palm oil during cooking could improve the bioaccessible beta-carotene contents in the sweet leaf, especially when the sweet leaf was cooked by microwave.

Oil blending is a method that may improve the nutritional profile and stability of frying oil. Tropical vegetable oils, including rice bran oil, coconut oil, and palm oil were blended at ratios of 20 : 20 : 60, 25 : 25 : 50, 30 : 30 : 40, and 35 : 35 : 30 (v/v/v), respectively, and tested for their performance in deep frying French fries at 180ºC for 8 h. The nutritional content of the blended oils increased with the rice bran oil and coconut oil ratio, including polyunsaturated fatty acids, α-tocopherol and γ-oryzanol. The physicochemical property changes, including color, viscosity, fatty acid profile, total polar compounds, free fatty acid, peroxide value, and the thiobarbituric acid reactive substances value of the blended oils were monitored during frying. The lightness of the oil blends was higher than those of palm oil after frying. However, the higher ratio of rice bran oil and coconut oil resulted in a higher increase in viscosity during frying. The oxidative stabilities of the oil blends were better than that of palm oil. Additionally, the sensory characteristics of the fries prepared in these oil blends were evaluated using a 9-point hedonic scale. There was no significant difference in sensory attributes of the fries produced using different oils. The oil blended at a ratio of 30 : 30 : 40 shows the greatest performance as a deep frying media compared to the other blended oils that were tested.

Tempe is an indigenous Indonesian source of protein. In this study, the tempe was produced from Grobogan soybeans with two types of treatment, germinated and non- germinated. The two types of tempe produced were then processed into protein isolates, tempe protein isolate from non-germinated soybeans (NGTI) and tempe protein isolate from germinated soybeans (GTI). This study was aimed to compare the physicochemical properties of NGTI, GTI, and CSI (commercial soy protein isolate). Seen from the physical characteristics, the NGTI and GTI were superior to CSI in their bulk density which was very significantly higher (p<0.01) at 0.54, 0.57 and 0.39 g/mL, respectively, and the a_w value which was very significantly lower (p<0.01) at 0.05, 0.04 and 0.34, respectively. As for the chemical characteristics, the NGTI and GTI were superior to CSI in their protein content which was very significantly higher (p<0.01) at 79.16, 82.89 and 74.90%, respectively, the in vitro protein digestibility which was also significantly higher (p<0.05) at 76.95, 77.82 and 76.68%, respectively, and the fat content which was very significantly lower (p<0.01) at 1.45, 1.28, and 2.74%, respectively.

Consumers nowadays have more awareness for healthy foods and demanded healthier food choices to avoid health-related problems; therefore, industries had included health and nutrition claims on their products. Health and nutrition claims usually influence consumers’ food choice decision. Products with health claim resulted in higher perception of healthiness and nutritional value of the product, even if the product was not considered as a healthy choice. The aim of this study was to assess whether the health and nutrition claims had led to a healthier perception or better evaluation of the product among consumers. Methods: A cross-sectional survey was conducted using an online questionnaire on 385 respondents collected through convenience sampling. The survey consisted of four parts: socio-demographic background, health awareness, understanding and usage of health and nutrition claims, and purchase intention measured through the use of a mock packaging. Data collected were analyzed using SPSS version 22. Results: Most of the respondents aged 18–30 (81.0%) and almost half of them were Malay (45.7%) with bachelor/master or PhD qualification (60.0%). The distribution of household income for all categories was almost similar (18.2–20.8%). There was a significant statistical relationship between health awareness and purchase intention among respondents (r=0.391, p<0.01). Conclusions: Health and nutrition claims influenced consumer’s perceptions and purchase intention, especially for those who were more concerned about their health, thus, more focus on policy regarding claims is needed.

Hypoglycemia is related to lethargy, psychiatric disorders, and impaired brain metabolism. Hypoglycemia is one of the leading factors of death in blood glucose level (BGL) metabolism disorders. Optical methods have been heavily researched due to its potential to eliminate drawbacks of conventional hypoglycemia detection; however, clinical data are still scarce. This study objective was to measure the sensitivity and specificity of non-invasive BGL Measurement Optical Device (NI-BGL-MOD) to detect hypoglycemia. The reference standard is venipuncture spectrophotometry. Researcher has developed NI-BGL-MOD, which we have used in a clinical trial in December 2015. The researchers have used spectral data collected from the device to measure the BGL of randomly selected 110 participants who were older than 17 y old. Each participant was measured five times. There are a total of 550 data sets that were then compared to BGL measurement using the reference standard. The spectral data were optimized using Discrete Fourier Transform and inferred to BGL prediction using the Fast Artificial Neural Network. Researchers have defined hypoglycemia case with BGL level at 75 mg/dL or lower. The researchers have calculated sensitivity and specificity using epiR in Rstudio. Respondents’ BGL values were between 67 to 96 mg/dL. Researchers have classified eighty-nine cases as hypoglycemia. There are 461 cases classified as not hypoglycemia. The sensitivity was 54%, and the specificity was 97%. Diagnostic accuracy was 86%, and the number to diagnose was 1.96. The newly developed method NI-BGL-MOD could be used to detect hypoglycemia.

A nutrition learning model themed “Makananku Sehat dan Bergizi” was aimed for fourth-grade students of elementary school who used the K13 Curriculum K13 that was developed in 2013. The model accommodated the old version of nutrition concept and they were delivered withconventional model. This study aimed to design a new learning model and to discover effect of themodel on nutritional knowledge and behavior of elementary school children in Kendari. Thisstudy was a quasi experimental study using one group with pre-post test design. This study was held in 2017 in Puuwatu district, Kendari. The subjects were 15 fourth-grade teachers and 60 elementaryschool students from SD 05 Mandonga. Data related to knowledge and behavior of the students werecollected and analyzed. The pre- and post-nutrition learning models were analyzed by interview using a questionnaire. Data were statistically tested using paired t-test. Learning model that was developedwas named Model Pembelajaran Gizi Kontekstual or CTL (Contextual Teaching and Learning). There was significant improvement in terms of nutritional knowledge and behavior of the studentsbefore and after introduction to a song titled Kebiasaan Makanku and to a flipchart themed Mengenal Jenis dan Manfaat Makanan. There is a need for nutrition education for elementaryschool teachers, especially for the fourth grade. Thus, teachers would have good knowledge onnutrition and therefore, they could use it to educate their students. Eventually, it would helpimplementation of CTL model.

Banana peels are industrial waste that is normally being utilized for biogas production or disposed of without use. By converting banana peels into flour, the waste product can be reduced and the benefits that originate from its fibre and bioactive substances can enhance the nutritional value in other food products. Furthermore, the flour will increase the economical source of the industry as it is obtainable at a low-cost. The transformation of banana peels (waste) into flour (food ingredient) can improve the sustainability of the food chain and promote consumers’ health. The unripe banana peel flour (UBPF) constitute of 41.4% total starch and 37.6% total dietary fibre with a higher percentage of insoluble dietary fibre than soluble dietary fibre. Various levels of UBPF from Berangan variety ranging from 0% to 40% were incorporated in the formulation of biscuits. The partial substitution of UBPF significantly increased the total dietary fibre content of biscuits from 1.83% to 4.70%. Starch hydrolysis and estimated glycemic index (eGI) of biscuits were analysed by enzymatic in-vitro digestion. The result showed that partial substitution of Berangan BPF significantly decreased (p<0.05) the starch digestion rate thus lowering the eGI of biscuits from high eGI food to intermediate GI food. UBPF has great potential as a functional ingredient to improve the nutritive value of foods as well as to reduce the glycemic index of food products.

The aim of this study was determine mothers knowladge on appropriate complementary feeding of children aged 6–23 mo. A cross-sectional design was applied on 392 mothers of children aged 6–23 mo selected through a cluster sampling in Aceh Besar District Aceh Province Indonesia. Data on mothers knowledge and determinant factors included socio-demographic of mothers were collected using valid and reliable structured questionnaire. The data was analyzed using binary logistic regression at 95% confident interval. Overall, there was less than one-fourth (20.2%) of the mothers have good knowledge on appropriate Complementary feeding. Education level of mothers were significantly associated with mothers knowledge, mothers who have education level elementary school, junior high school and senior high school higher risk of having low knowledge on appropriate complementary feeding (OR=3.11, OR=5.22 and OR=10.20) than those have graduted level. Therefore, an effort and a research to developing nutrition education model is warranted to improving knowledge and skill of mothers is important.

Growth failure has a severe impact on public health problems. Stunting is a particular growth failure contributing to the child mortality and morbidity of non-communicable diseases in adults. Objective: To analyze the determinants of growth failure patterns in children under five years in Indonesia. The further analysis was taken from 6,020 samples, based on the Indonesian National Health Survey (Riskesdas) 2013 (cross-sectional survey with a multistage cluster sampling method). Inclusion criteria are data that have completed records. The exclusion criteria were data having no outlier in anthropometric measurement. Nutrition status is analyzed using WHO AnthroPlus 2009. Data analysis is taken by path analysis in SPSS 21. The growth curve height for the under five-year children in Indonesia is less than the WHO growth standard. The mean height for age z-score (HAZ) has declined in linear patterns among the first five years of life. The determinant of growth is divided into two age groups. Overall, socioeconomic status has an indirect effect adjusted by both age and gender with r 0.10. In children <36 mo, the nutrition status of the mother has a direct and indirect effect on the birth nutrition status with r 0.17, while low birth weight, breastfeeding status, infectious disease, and immunization are the direct factor to HAZ score. In children aged 37–59 mo, infectious disease is a direct factor. Socioeconomic status, BMI of a mother, breastfeeding status, immunization, and infectious disease are the determinants of growth failure patterns in Indonesia.

Background and objectives. The prevalence of NCDs (Non-communicable Diseases) was increasing in Indonesia. The antioxidants have been known as a potential nutrient that prevent and reduce the risk of the NCDs. Flavonoid is the most abundant antioxidant in plant-source diet and commonly consumed in Indonesia. In other side, there was not a flavonoid database based on various Indonesian foods. The aim of this study was to build a flavonoid database based on Indonesian foods. Methods. The selected food items used food items of Indonesian Total Diet Survey 2014 (SDT 2014). We did not determine the flavonoids contents in the laboratories, we compiled its content by using the United States Department of Agriculture Database and related refferences. The estimation for calculating flavonoid content used USDA Database technique. The total flavonoid content for each food items were summarized into six flavonoid subclasses (anthocyanidine, flavan-3-ols, flavanone, flavone, flavonols, dan isoflavone). The total flavonoid content was presented by mg/100 gram of each food items. Results. There were 13 food groups and 1,203 food items in this database. There were 654 food items had flavonoid content. The highest mean of flavonoid content was legumes (45.36 mg/100 g). The vegetables and products were the food group with the most foods containing flavonoid (120 food items). Conclusion. There were 654 food items in Indonesian foods contained flavonoid. The highest mean of flavonoid content were legumes. This findings can provide valuable information for Indonesian people to increase dietary flavonoid intake.

Dietary habits and choice of food influences nutritional status of adolescence. Malnutrition have been associated with adolescents’ dietary habits that may predispose to chronic disease during their adulthood. The aim of this study is to determine the association between food habit and nutritional status of adolescents. In the baseline study, a total of 924 students from 10 secondary schools were randomly selected from a total of 62 secondary schools in Kuala Lumpur. The students were assessed on various dietary components including food habits using a structured questionnaire as well as for anthropometry measurements. All data were analyzed using SPSS 23. The prevalence of obesity was significantly higher among males compared to females (16.4% vs. 8.4%, X²=25.42, p<0.001). Food habit exhibits an inversed association with z-score of body mass index for age (β=−0.107, 95% CI=−0.053, −0.013), especially via food habits such as often eat dinner (r=−0.102, p=0.002), often have breakfast before school (r=−0.100, p=0.002), often eat cake or dessert at meal (r=−0.110, p=0.001), often drink eight glasses of water (r=0.132, p<0.001), often eat food from school canteen (r=−0.071, p=0.031) and often bring own snack from home (r=−0.112, p=0.001). This study suggested that the type of food and timing of meal should be considered to prevent obesity among adolescents.

Tofu is a traditional food such as curd made from soymilk with additional coagulants which is widely consumed by people in Indonesia and Asian countries. Tofu is one of the important sources of micronutrients, such as cobalt (Co), chromium (Cr), iron (Fe), selenium (Se) and zinc (Zn). Therefore, the content of various elements both toxic and essential need to be studied to ensure the food safety and estimating their contribution to daily intake. Methods: In this research, the determination of micronutrient content in tofu was carried out in the samples collected from traditional market in Jakarta, Yogyakarta, West, Central and East Java Provinces during the period 2010–2014. Determination of elemental concentration was carried out using neutron activation analysis (NAA) methods. Results: Analysis result showed that the elemental concentrations of Co, Cr, Fe, Se and Zn in tofu were in the range of 0.001–0.27; ≤0.001–0.35; ≤0.050–62.90; ≤0.0046–5.34 and 0.02–21.19 mg/kg respectively. The daily intake value of tofu is calculated by estimating their contribution based on the concentration and consumption data. The average daily intake of Co, Cr, Fe, Se and Zn contributes to 1.33–11.95; 2.10–2.93; 2.66–5.99, 13.1 and 1.95–2.69% of RDA values for adult women and men. Conclusions: The analysis shows that there are variations in the concentration of micronutrients contained in tofu from the five provinces. Tofu has contributed RDA of Co, Cr, Fe, Se, and Zn in almost all regions observed, tofu consumption contributed only a low fraction of RDA value for an adult.

Many studies on food safety cognition and practice intervention among university students exist, but only few conduct needs assessment surveys. In recent years, We-media has been applied in the field of health education and promotion, but its application in food safety intervention is limited at home and abroad. This study aimed to explore the current situation of We-media use and assess the needs for food safety information through We-media among junior students of an education and a medical university. A cross-sectional survey was conducted among junior students of an education and a medical university in Chongqing, China in 2016. A total of 1,250 education students and 1,434 medical students participated in the questionnaire survey. Findings revealed that 71.4% and 64.8% of the education and medical students were willing to accept food safety educational information by We-media, respectively. In addition, 47.6% and 48.8% of the education and medical students were willing to accept food safety information through WeChat official accounts, respectively. Among the education students, 83.8%, 63.9%, 59.6%, and 13.0% wanted to acquire food safety knowledge by picture, text, video, and voice, respectively. Of the medical students, 84.7%, 67.7%, 62.3%, and 11.9% wanted to acquire food safety knowledge by picture, text, video, and voice, respectively. Gender, school category, and whether food safety information is given attention were the influencing factors of participants’ willingness to accept such information through We-media (p<0.05). This study indicated that We-media could be an appropriate intervention approach for the junior students of an education and a medical university to accept food safety intervention. WeChat was also revealed as the best platform. Pictures, text messages, and videos were observed the most popular means for students to acquire food safety knowledge.

Cardiovascular diseases (CVD) deaths were on the rise in developing countries. In Malaysia, the accelerating economic transition has been accompanied by high prevalence of CVD risk factors which accounts for 35% of total deaths in 2016. This increasing trend involving not only the elderly but also the young adults. Food label reading is reported to be the key to help individual adopt healthy food choice and dietary habits. Hence, the aim of this study is to determine the associations of knowledge, attitude and practices (KAP) of food label on CVD risk amongst university students. A cross sectional study was conducted on 389 university students aged 19 to 35 y old in Selangor. Information on socio-demographic profile, nutrition knowledge, attitude, and practice of food label were collected using self-administrated questionnaires. Anthropometric data of participants were measured using standardize methodology and blood pressure was measured using Omron blood pressure monitor. The data were tested using Chi-Square test. Average age of the respondents were 23 y. Majority of the respondents had no CVD risk (41%) while (59%) had increased CVD risks. There was a significant association between CVD risk factors (BMI, waist circumference, systolic blood pressure (SBP), and diastolic blood pressure (DBP) with knowledge and attitude of using food label (p<0.05). The practice of food label usage showed no significant association (p>0.05) with all CVD risk factors. Considering the importance of understanding and usage of food label in the management of chronic diseases, these findings provide useful information to incorporate nutrition education on food labelling in preventing CVD risks.