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"A study to investigate the effect of iron supplementation program among underfive children in North Central 'Timor, East Nusa Tenggara, Indonesia was conducted. The study was comprised into two parts: a cross-sectional study to investigate the impact of the ongoing government of Indonesia iron supplementation program and a intervention trial aiming to investigate the effect of daily compared to weekly iron supplementation. Hemoglobin, weight, height and compliance assessment were performed.The cross-sectional study involved 127 underfive children from four health centers. The average of age, weight and height of the recruited subjects was 36.6 months, 10.4 kg and 84.5 cm respectively. The result of this study showed that the prevalence of anemia among 127 underfive children where iron supplementation program has been implemented was still high, (81.5%), although 75.6% of the subjects claimed to take all the iron syrup.The intervention study recruited 160 preschool children and were divided into two groups: for 10 week one group received a daily supplement of 30 mg Fe, while the other group received 30 mg Fe per week A complete data set was obtained from 75 children in the group supplemented daily and 73 children in the group supplemented weekly. Th average age, weight and height of the subjects for daily group were 43.7 months, 12.1 kg and 91.0 cm respectively while 41.8 months, 11.7 kg and 90.3 cm for the weekly group.The result of this study showed a significant hemoglobin increase in both groups (p<0.001) which reduced the prevalence of anemia from 42.3 to 7 % in daily group and from 55.9% to 27.9% in weekly group. Although the weekly group had higher compliance (100%) compared to daily group (42.1%), it is concluded that daily group resulted in a better effect in reducing anemia prevalence among the preschool children."

"Diarrheal diseases among children are still the problems of concern globally despite of much progress in primary health care, hygiene-sanitation and living condition. According to WHO estimation, in 1997 there were 4 billions episodes of diarrhea in the world that contributed up to nearly 2.5 millions deaths. The diarrheas were the leading causes of morbidity and the sixth causes of mortality of human in the world. In recent decades, with the discovery and utilization of Oral rehydration solution (ORS) as well as other Oral rehydration therapies (0RTs) and the promotion of appropriate feeding and caring practice at the community levels, the mortality due to diarrhea is reduced. However, diarrhea is still contributing up to 19% to child mortality in the developing world. Results from 276 surveys conducted in sixty countries between 1981 and 1986 indicated that children under five in developing countries suffered 3.5 diarrheal episodes each year. Incidence of diarrhea is higher in certain communities especially the rural poor. High diarrheal prevalence and mortality among young children lead to serious consequences in health and socio-economy fiom household to the world levels."

"Proporsi BBLR hasil Riskesdas 2018 adalah 6,3% dengan jumlah kasus terbanyak di Provinsi Jawa Barat. Kekurangan zat besi pada ibu hamil dapat menyebabkan pertumbuhan janin terhambat, kelahiran prematur atau BBLR. Program pemberian tablet tambah darah pada ibu hamil diberikan untuk memenuhi kebutuhan zat besi pada ibu hamil. Penelitian ini bertujuan untuk melihat hubungan antara kepatuhan konsumsi suplemen besi selama kehamilan dengan BBLR setelah mengendalikan seluruh variabel confounding. Metode yang digunakan pada penelitian ini adalah kasus kontrol dengan rasio 1:3. Sampel penelitian berasal dari data sekunder Riset Kesehatan Dasar tahun 2018 khusus Provinsi Jawa Barat. Jumlah kasus untuk penelitian ini adalah 180 sampel dan kontrol 540 sampel. Variabel kovariat dalam penelitian ini adalah usia bersalin, tingkat pendidikan, status bekerja, wilayah tempat tinggal, riwayat hipertensi, adanya komplikasi, status merokok, status merokok pasif dan usia gestasi saat melahirkan. Hubungan variabel dinilai dengan analisis bivariat dan multivariat. Hasil penelitian menunjukkan tidak terdapat hubungan bermakna (p>0,05) dengan peluang risiko 1,268 kali lebih besar pada ibu yang tidak patuh mengkonsumsi TTD untuk melahirkan bayi BBLR (OR= 1,268 95%CI 0,87-1,847) setelah dikontrol variabel kovariat.

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Based on Riskesdas 2018, the proportion of LBW in Indonesia is 6.3% with the highest number of cases in West Java Province. Iron deficiency in pregnant women can cause restricted fetal growth, prematur birth or LBW. This study aims to look at the relationship between compliance with iron supplement consumption during pregnancy with LBW after controlling for all confounding variables. The method used in this study is case control with a ratio of 1: 3. The research sample is derived from secondary data used from the 2018 Basic Health Research in West Java Province. The number of cases for this study were 180 samples and 540 controls. The covariate variables in this study were maternal age during pregnancy, education level, work status, area of residence, history of hypertension, complications, smoking status, passive smoking status and gestational age at delivery. The relationship of variables was assessed by bivariate and multivariate analysis. The results showed no significant relationship (p> 0.05) with a 1.268 times greater chance of risk for mothers who consumed less iron supplements than 90 tablets to deliver LBW babies (OR = 1.268 95% CI 0.87-1.847) after covariate controlled variable."

"This randomized double-blind placebo-controlled trial aimed to compare the efficacy of daily iron supplementation and multi-micronutrient supplementation both daily and weekly basis on increasing iron status among 284 apparently healthy Indonesian infants aged 6-12 mo. Infants were randomly assigned to receive either daily 1 RDA multi micronutrient supplement (n = 72), weekly 2 RDA multi micronutrient supplement (n = 70), daily ferrous sulphate 10 mg (n = 72), or placebo (n = 70) for wk. Blood hemoglobin, plasma ferritin, plasma zinc, and plasma C-reactive protein concentrations were measured prior to intervention and after 23 wk of supplementation. At baseline, 58.1% of subjects were anemic, 28.2% were iron deficient, and 11.2% were zinc deficient. After 23 wk of supplementation, both daily 1 RDA multi micronutrient and iron supplemented groups had significantly increased blood hemoglobin and plasma ferritin concentration, furthermore reducing the percentage of anemia and iron deficiency. However, the changes of hemoglobin were not significantly different among the treatment groups. Changes of hemoglobin were significantly higher in daily 1 RDA multi micronutrient group than in placebo group when initial blood hemoglobin was low. The change of plasma ferritin concentration in both daily 1 RDA multi micronutrient and iron groups was significantly higher than in other groups. Hemoglobin and ferritin concentrations of weekly 2 RDA multi micronutrient group were not significantly increase, but there were significantly increased in the subjects with low concentration of blood hemoglobin or plasma ferritin. Proportion of infants with zinc deficiency was increased significantly in iron group Daily I RDA multi micronutrient and daily iron supplementation are efficacious in improving the concentration of blood hemoglobin and plasma ferritin and reducing the percentage of infants with anemia and iron deficiency of Indonesian infants aged 6-12 months in a rural community. However, there was an increasing proportion of infants with zinc deficiency in daily iron supplementation. The efficacy of daily 1 RDA multi micronutrient supplementation was higher among the children with blood hemoglobin < 110 g/L Efficacy of weekly 2 RDA multi micronutrient supplementation on the concentration of blood hemoglobin and plasma ferritin of all subjects was not found, but it affected in children with low concentration of blood hemoglobin or plasma ferritin."

"An adequate calcium calcium is an important aspect in maternal and fetal psyciology during pregency. ...."

"Defisiensi seng (Zn) mempunyai peran yang besar pada proses tumbuh-kembang. Hal ini terutama akan berdampak pada anak-anak kekurangan gizi. Zn penting dalam kekebalan tubuh baik yang bersifat lokal maupun sistemik. Tujuan penelitian ini adalah untuk menilai dampak suplementasi Zn pada sitokin TNF-a dan diare pada balita dengan malnutrisi berat dari keluarga berpendapatan rendah. Desain penelitian adalah jenis controlled randomized double blind pre-test post-test pada kelompok anak berusia 12-59 bulan. Anak-anak diberi makanan biasa dan dibagi menjadi 2, kelompok kontrol (n+60) dan kelompok intervensi yang diberikan makanan mengandung 15mg/ml Zn. Kadar Zn diukur menggunakan atomic absorption spectrophotometer (AAS), sedangkan TNF-a menggunakan ELISA. Data masukan makanan dikumpulkan melalui cara wawancara makanan dalam 24-jam. Hasil penelitian menunjukkan adanya peningkatan kadar Zn serum yang bermakna dan penurunan kadar TNF-a serta penurunan lama dan frekuensi diare setelah intervensi. Kadar Zn meningkat 87,0% pada kelompok intervensi, sedangkan pada kelompok kontrol peningkatan hanya sebesar 19,6%. Selain itu, terdapat penurunan bermakna baik pada kadar TNF-a serum maupun feses setelah intervensi (p<0.05). Beratnya gejala maupun lamanya diare berkurang secara bermakna pada kelompok intervensi (p<0.001). Dari hasil penelitian ini dapat disimpulkan bahwa pemberian suplemen Zn dapat mengurangi lama dan beratnya diare melalui peningkatan kekebalan tubuh, terutama imunitas lokal yang menggunakan TNF- a sebagai biomarker. (Med J Indones 2003; 12: 247-51)

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Zinc deficiency has a great impact on growth and development, especially in malnourished children. Zinc is important in both local and systemic immunity. The aim of this study was to assess the impact of zinc supplementation on the cytokine, tumor necrosis factor a (TNF-a), and diarrhea in severely undernourished under-five children of low-income families. A randomized double blind pre-test post-test controlled design was selected. A group of 12-59 month-old children were given local food, and treated as control group (n=60), and another group (n=60) were given local food with 15 mg/5 ml zinc as intervention group. Zinc concentration was measured by atomic absorption spectrophotometer (AAS), and TNF-a concentration was determined by ELISA. Data on nutrient intakes were collected using 24-hour food recall method. The result of the study showed that after zinc intervention, zinc serum increased significantly, and TNF-a concentration decreased along with reduction of the duration and frequency of diarrhea. Zinc concentration increased 87.0% in the intervention group, while in the control group the increase was only 19.6%. There was a significant reduction of both serum and fecal TNF-a concentration after intervention (p<0.05). Severity and duration of diarrhea were reduced significantly in the intervention group compared to the control group (p<0.001). It was concluded that zinc intervention reduced the duration and severity of diarrhea through improvement of immunity, especially local immunity with TNF-a as biomarker. (Med J Indones 2003; 12: 247-51)"

"Diarrheal disease remains an important public health problem in developing countries (Black, 1993) and is enormously associated with one-fourth of all deaths in children less than 5 years in developing countries (Richards et. at, 1993). Despite a remarkable declining in mortality rate, the morbidity rate of acute diarrhea of under five children is still fairly high (Murray, 1992). Alarcon et. al. (1991) reported that each year, diarrheal disease causes approximately more than 1 billion episodes of illness. Therefore, the reported attack rates range from 1 to 12 episodes per child per year with a global average of 3 episodes per child (Richards et. al, 1993) and nearly 5 millions deaths worldwide in children less than 5 years (Shamir, 1998). In Indonesia, the incidence of diarrhea is accounted for up to 200-400 per 1000 population per year; 60-80% of them are under five, mostly infants (Lubis, 1992). Rotavirus is the most common cause of acute diarrheal disease in infants. It is the most commonly identified enter pathogens for infants who admitted to hospital in the USA and many other countries (Saavedra et. al., 1994) included Indonesia, (Soenarto, 1997). In USA accounts for up to 50% of the cases of children hospitalized with diarrhea and dehydration (Cohen, 1991) and is responsible for approximately 1 million cases of severe infantile diarrhea and up to 150 deaths annually (Guarino et.al.,1994). In Indonesia accounts for up to 16% of childhood diarrhea in urban area of North Jakarta and 19-40% of chldhood diarrhea age 0-36 months in Bandung, West Java (Yuwono, 1993). The incidence of diarrheal disease is higher and the severity of the illness is greater in infants than in older children and adults. Several major factors become predisposed to an increased frequency of diarrheal diseases in infants are increased fecal-oral contamination and infants have a relatively unchallenged immune system that has not previously been exposed to many pathogens and has not acquired protective antibodies. Immune system tolerance of life to some polysaccharide antigens in the first year may diminish the infant's ability to defend against intestinal infections (Cohen, 1991). Non-breastfed infants are at greater age of experiencing diarrhea than those who are partially breast-fed, however infants who are partially breast-fed are at greater risk than those who are exclusively breast-fed (Lubis, 1992). The global diarrheal disease control programs have concentrated almost exclusively on the prevention and treatment of dehydration by promoting appropriate fluid and electrolyte therapy, such as increased of oral rehydration solution-ORS (Alarcon, et. al, 1991). ORS has been considered by World Health Organization as the cornerstone of global efforts to reduce mortality from acute diarrhea (Richards et. al, 1993; Behrens, 1993). Until recently, however, more attention has been directed to the nutritional complications of diarrhea (Alarcon, et. al, 1991)."

"Forty-eight male weanling rats (91 g) were utilized to study the nutritional adequacy of cooked polished white rice. Ratswere individually housed, and allowed ad libitum access to one of six treatment diets. Treatment diets were 1) polishedwhite rice plus 10% casein and 0.18% methionine, CAS, 2) polished white rice, WHR, 3) polished white rice plus0.45% lysine, LYS, 4) polished white rice plus0.40% methionine, MET, 5) polished white rice plus 0.30% threonine,THR, 6) polished white rice plus 0.45% lysine, 0.40% methionine, and 0.40% threonine, COM. Rice was cooked priordiet formulation using a 3 to 1 ratio of water to rice. Vitamins (AIN-76) and AIN minerals were added to all diets tomeet NRC (1978) requirements. Rats fed CAS diets were significantly heavier on d 21 (P<0.05) than rats on COM,LYS, MET, THR, or WHR diets, (219.9 vs. 171.6, 153.2, 153.2, 148.3, or 155.4 g respectively). Supplementation of themost deficient essential amino acids, lysine (LYS) or methionine (MET) did not improve (P>0.05) rat performance overWHR fed rats, Average daily gain (ADG) for CAS was 6.1 g/d and ADG for LYS and MET was 3.0 g/d. The additionof threonine (THR) significantly (P<0.05) reduced ADG when compared to WHR diets (2.7 vs. 3.0 g/d). When ratswere fed to COM diet significant (P<0.05) improvement in ADG was observed compared to WHR fed rats (4.8 vs. 3.0g/d). The increased gains achieved with COM diet and the poor gains observed with the single amino acid diets (LYS,MET, or THR) would suggest that polished white rice is limiting in more than one essential amino acid."

"ABSTRAKToddler period, especially the first two years of life is considered as golden age for children because of their rapid growth and development. Therefore, the occurrence of nutritional disorders in the period can be permanent and irreversible. This study tried to assess correlation between early initiation of breastfeeding and vitamin A with nutritional status. The total of samples analyzed in this study was 1,592 toddlers aged 6-59 months that were drawn from 2015 Indonesia Nutritional Status Monitoring Survey in Bengkulu. Data including age, sex, early initiation of breastfeeding, birth length, birth weight, vitamin A supplementation were collected by using questionnaire. Weight and height of children were obtained through anthropometric measurements. More than half of the toddlers (54.6%) did not get early initiation of breastfeeding. Based on multivariate analysis results, most dominant variables related to weight/age, height/age and weight/height indicators were early initiation of breastfeeding and Vitamin A supplementation. Toddlers who did not get early initiation of breastfeeding are at risk of 1.555 times stunting compared to toddlers who got early initiation of breastfeeding. The most dominant variable related to height/age is vitamin A supplementation. Children who do not get vitamin A supplementation are at risk of stunting 2.402 times compared to children who get vitamin A supplementation."