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"Penelitian ini bertujuan untuk mengetahui pengaruh dari optimized food-based recommendation FBR dan biskuit fortifikasi terhadap performa kognitif siswa sekolah dasar. Cluster randomized controlled trial selama enam bulan pada anak sekolah usia 7-9 tahun n=252 dilaksanakan di 12 sekolah di Kota Nyaundon yang terdiri dari 3 kelompok; kombimasi optimized FBR dan biskuit fortifikasi, optimized FBR, dan kontrol. Performa kognitif, antropometri, dan indicator biokimia diukur sebagai outcome. Pada kedua kelompok intervensi optimized FBR dengan biscuit fortifikasi dan optimized FBR terdapat pengaruh yang significant terhadap performa kognitif, weight-for-age z-scores dan kadar besi serum. Akan tetapi kombinasi optimized FBR dengan biscuit fortifikasi menghasilkan skor performa kognitif yang lebih tinggi dibandingkan optimized FBR saja dengan skor yang lebih tinggi secara signifikan pada daya ingat 1.1 0.1: p-vale

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The study aimed to determine the effect of optimized food-based recommendation FBR and fortified biscuits on cognitive performance of primary school children. A six-month cluster randomized controlled trial among 7-9 years old school children n=252 were conducted at 12 schools in Nyaungdon Township with three intervention groups; optimized FBR with fortified biscuits, optimized FBR, and control. The cognitive performances, anthropometry and biochemical indicators were assessed as outcomes. Analysis of covariance and multiple linear regression analysis were done. Both intervention optimized FBR with fortified biscuits and optimized FBR groups had significant effect on the cognitive performances, weight-for-age z-scores and serum iron status. But combined optimized FBR with fortified biscuits improved cognitive performances higher scores than optimized FBR alone with significantly higher in memory 1.1 0.1: p-vale."

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LATAR BELAKANG: Praktik diet yang kurang memadai berdampak negatif terhadap asupan zat gizi dan kejadian penyakit kronis yang berhubungan dengan gizi. Penelitian ini bertujuan untuk mengembangkan Panduan Gizi Seimbang Berbasis Pangan Lokal (PGS-PL) berdasarkan pola makan masyarakat Minangkabau, dalam rangka perbaikan asupan gizi pada wanita usia subur (WUS) penderita dislipidemia. Selanjutnya pada tahap intervensi, dilihat efek promosi PGS-PL terhadap perubahan praktik diet, asupan zat gizi, status gizi dan profil lipid pada WUS Minangkabau dengan dislipidemia.

METODE: Studi tahap pertama menggunakan disain potong lintang, melibatkan 74 WUS suku Minangkabau dengan dislipidemia. Berdasarkan pola makan setempat, identifikasi problem nutrient dan penyusunan PGS-PL dilakukan dengan pendekatan Linear programming, menggunakan tiga dari empat modul pada software Optifood yang dikembangkan oleh WHO. Pada tahap ke dua dilakukan studi intervensi komunitas menggunakan disain pengukuran sebelum dan sesudah dengan kelompok kontrol. Subjek penelitian ditempatkan secara acak yang dikluster ke dalam kelompok PGS-PL (mendapatkan promosi PGS-PL selama 12-minggu) atau kelompok non-PGS-PL (mendapatkan satu kali konsultasi gizi dari pelayanan kesehatan tingkat dasar). Sebanyak 102 WUS (48 pada kelompok PGS-PL dan 54 pada kelompok non-PGSPL) selama 12 minggu. Pada akhir studi, analisis perbedaan antar- dan inter kelompok perlakuan dilakukan untuk melihat perubahan praktik diet, asupan zat gizi, status gizi dan profil lipid darah (kadar kolesterol total, Lipoprotein densitas rendah, Lipoprotein densitas tinggi, dan Trigliserid).

HASIL: Berdasarkan pola makan setempat, ditemukan bahwa asam lemak tidak jenuh (polyunsaturated fatty acid/PUFA, n-3, n-6), serat makanan, zat besi, dan seng merupakan problem nutrient pada WUS suku Minangkabau dengan dislipidemia. PGS-PL yang disusun menekankan penggabungan bahan makanan, kelompok atau sub-kelompok bahan makanan bernilai gizi tinggi yang tersedia secara lokal, untuk meningkatkan asupan problem nutrient tersebut. Promosi PGS-PL dapat meningkatkan skor praktik diet secara bermakna. Peningkatan terutama terjadi pada konsumsi makanan dan sub-kelompok makanan yang dipromosikan (ikan laut, unggas, produk kedelai seperti tahu dan tempe, total sayuran, sayuran hijau, buah-buahan, dan kentang). Tidak ada perubahan bermakna pada konsumsi makanan pokok, makanan selingan, telur, dan makanan yang digoreng pada akhir intervensi. Pengaruh promosi PGS-PL pada asupan zat gizi dapat dilihat pada perubahan yang bermakna pada asupan energi dan karbohidrat, persentase energi dari PUFA dan monounsaturated fatty acid (MUFA), serta rasio PUFA terhadap asam lemak jenuh (saturated fatty acids/SAFA) dalam makanan sehari-hari. Namun, asupan lemak jenuh tidak berubah signifikan. Terdapat perbaikan yang bermakna pada berat badan, indeks massa tubuh, dan lingkar pinggang, namun tidak bermakna terhadap penurunan prevalensi obesitas. Tidak terdapat perubahan profil lipid darah yang bermakna setelah intervensi.

KESIMPULAN: Pendekatan linier programming dapat digunakan dalam menyusun PGS-PL untuk meningkatkan praktik diet dan asupan problem nutrient pada WUS dengan dislipidemia. Promosi PGS-PL secara bermakna berdampak terhadap peningkatan praktik diet, asupan zat gizi, dan status gizi, tetapi belum berpengaruh secara statistik terhadap perbaikan profil lipid WUS dengan dislipidemia.

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BACKGROUND: Given the impact of unfavorable dietary practices is on inadequate nutrient intake and nutrition-related chronic diseases, we sought the problem nutrient in the community habitual dietary practices, and developed an optimized food-based recommendation (FBR) for Minangkabau women of reproductive age (WoRA) with dyslipidemia. Although the effect of the FBR promotion seemed to be potential at planning phase, but this has not been tested in the community setting. Therefore, we conducted a community trial and explored the effect of FBR promotion using locally available foods on dietary practice, nutrient intakes, nutritional status and lipid profile among Minangkabau WoRA with dyslipidemia.

METHODS: The first stage of the study was a cross-sectional study, which involved 74 Minangkabau WoRA with dyslipidemia. Linear programming analysis using three modules of the WHO Optifood software was employed to identify problem nutrients and develop an optimized FBR. The second phase of the study was a community-based trials using pre-post with control group design. The subjects were cluster randomized into either FBR group (receiving 12-weeks of FBR promotion) or non-FBR group (receiving once standard nutritional counseling from primary health care program). At the end, 102 WoRA (48 and 54 WoRA in the FBR group and the non-FBR group, respectively) completed 12-weeks of intervention. We analyzed within- and between group differences on changes of dietary practices, nutrient intakes, nutritional status and lipid profile (serum Total Cholesterol, Low-Density Lipoprotein, High-Density Lipoprotein and Triglyceride levels) at the completion of the study.

RESULTS: Our results identified PUFA, dietary fiber, iron, and zinc as problem nutrients among Minangkabau WoRA with dyslipidemia. The final food-based recommendations emphasized the incorporation of locally available nutrient-dense foods, food groups, and sub-groups that would improve the intake of the identified problem nutrients. The FBRs promotion significantly increased the overall dietary compliance. An increase was predominantly occurred on the consumption of promoted and subgroups food items (sea fish, poultry, soybean products, total vegetables, dark green leafy vegetables, fruits, and potato). There were no significant changes in the consumption of staple food, snacks, eggs, and fatty foods at the end of intervention.  Effect of FBR promotion on nutrient intake was observed through the significant changes in energy and carbohydrate intakes, percentage of energy from PUFA and MUFA, as well as PUFA to SAFA ratio in daily diet. However, intake of saturated fat remained unchanged. Marginal but significant improvements were observed in body weight, BMI, and waist circumference, but the prevalence of obesity was relatively not affected. There were no significant changes of blood lipid profile at the end of intervention.

CONCLUSIONS: Linear programming approach could be potentially used to develop an optimized food-based recommendation based on the identified problem nutrients and locally available nutrient dense foods. The FBRs promotion produced significant improvement in dietary practice, nutrient intakes, and nutritional status, but did not statistically affect blood lipid profile of Minangkabau WoRA with dyslipidemia. 

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"Latar Belakang. Sebuah pabrik tekstil “X” yang sebagian besar pekerjanya perempuan, mempunyai jam operasional yang mengharuskan pekerja menjalani sistem kerja gilir. Sistem kerja gilir mempengaruhi pola makan dan status gizi pekerja, kekurangan zat gizi memiliki potensi tinggi menyebabkan kelelahan sehingga diperlukan rekomendasi makanan tambaha serta edukasi gizi bagi kelompok pekerja ini. Pendekatan Linear Programming (LP) menghasilkan Food Based Recommendation (FBR) yang mempertimbangkan penggunaan bahan pangan lokal yang disesuaikan dengan pola makan pekerja dengan kerja gilir serta permasalahan gizi kelompok pekerja dengan mengoptimalkan kandungan nutrisi sehingga FBR yang dirumuskan dapat menjadi kebijakan bagi pemilik industri tekstil yang memperkerjakan perempuan pekerja dengan sistem kerja gilir.Objektif. Didapatkan rekomendasi makanan tambahan bagi perempuan pekerja dengan kerja gilir malam dalam menurunkan kejadian kelelahan.Metode. Penelitian dilakukan dalam dua fase, yaitu pra dan paska intervensi menggunakan desain quasi-eksperimental dengan uji pra dan paska dengan kelompok kontrol. Subjek penelitian dianalisis secara per protokol sehingga subjek berjumlah 100 perempuan pekerja. Data diet pekerja diperoleh dari penimbangan makanan yang diberikan saat kerja gilir malam, data dikombinasikan dengan 24 hours food recall serta 5 dFFQ (5-days food-frequency questionnaire). Kelelahan diukur dengan menggunakan kuesioner CIS (Checklist Individual Strength) 20R dan Reaction Time. Analisis LP menggunakan sistem Optifood yang merumuskan suatu rekomendasi makanan tambahan (FBR).Hasil. Berdasarkan hasil pemeriksaan kelelahan pada dua kelompok menunjukkan bahwa nilai rerata waktu reaksi pada kelompok intervensi pra intervensi sebesar 239,29±49,96 setelah dilakukan intervensi terjadi penurunan rerata waktu reaksi sebesar 12,97 millidetik. Penurunan rerata waktu reaksi kelompok intervensi mempunyai nilai p<0,05 (p=0,006) sehingga secara statistik nilai p bermakna pada rerata penurunan waktu reaksi kelompok intervensi paska intervensi. Pada kelompok kontrol pra intervensi rerata waktu reaksi sebesar 236,99±40,56 setelah dilakukan intervensi mengalami penurunan sebesar 3,56 millidetik. Sedangkan rerata waktu reaksi pra intervensi gabungan kedua kelompok sebesar 238,12±45,24 paska intervensi sebesar 229,94±27,34, beda rerata gabungan kedua kelompok sebesar 8,18 millidetik. Artinya ada penurunan kelelahan sebesar 8,18 millidetik paska intervensi. Secara satitistik penurunan rerata waktu reaksi gabungan kedua kelompok bermakna (p=0,007).Kesimpulan. Intervensi FBR cukup efektif dalam penurunan kelelahan bagi kedua kelompok penelitian, pada paska intervensi terdapat perbaikan kelelahan yang cukup baik.

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Introduction. Textile factory “X”, where most workers are women, has an operational system that requires its workers to work on shifts. The shift system affects the dietary patterns and nutritional status of workers. Malnutrition has a high potential in causing fatigue. Thus, additional food recommendations and nutritional education for this population are needed. A Linear Programming (LP) approach produced the Food Based Recommendation (FBR), which considers the use of local food ingredients adjusted to the dietary pattern of shift workers and the nutritional problem of those workers by optimizing nutritional content. Therefore, the formulated FBR can be used as a policy for textile industry owners who employ female workers with a shift system.

Objective. Obtaining additional food recommendations for female workers who work a night shift to reduce the incidence of fatigue.

Methods. This study was conducted in two phases, i.e., pre-and post-intervention, using a quasi-experimental design with pre-and post-test with the control group. The subjects were analyzed per the protocol and a total of 100 female workers was obtained. The data on the workers’ diet was obtained from weighing food given during the night shift. The data were combined with a 24-hour food recall and 5 RFQ (5-days food-frequency questionnaire). Fatigue was examined using a CIS (Checklist Individual Strength) 20R questionnaire and a Reaction Time Analysis LP using the Optifood system, which formulated a Food-Based Recommendation (FBR). Data were analyzed using univariate and bivariate analysis.

Results. Based on the results of the fatigue examination of the two groups, the mean value of pre-intervention reaction time in the intervention group was 239.29 ± 49.96. After the intervention, an average reduction of 12.97 milliseconds occurred in reaction time.The mean reduction of reaction time in the intervention group produced a p-value of < 0.05 (p = 0.006). Therefore, statistically, the p-value was significant to the mean reduction in reaction time in the intervention group after the intervention. In the pre-intervention period of the control group, the mean value of reaction time was 236.99 ± 40.56 and decreased by 3.56 milliseconds after the intervention. Meanwhile, the average pre-intervention reaction time between the combinations of the two groups was 8.18 milliseconds. This means that there is a decrease in fatigue by 8.18 milliseconds after the intervention. Statistically, the reduction of mean reaction time between the two groups was significant (p = 0.007).

Conclusion. Adequate energy intake will improve the health status of workers, especially to avoid physiological disturbances and fatigue. The additional food menu chosen as the FBR recommendation is the one with the highest nutritional content. The recommended FBR was quite effective in reducing reaction time for both study groups. In the pre-intervention group with the mean value (239.29±49.96) and the post-intervention mean value (226.32±31.19), there was a decrease in reaction time of 12.9 milliseconds. Recommendations for providing additional food menus and nutrition education can be used as recommendations for workers and company owners."