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Abstrak :
ABSTRACT Goiter in school children is one of the symptoms of iodine deficiency for a long period. This condition will have a wide spectrum of mental, psychomotor and growth abnormalities if there is no correction immediately. According to many studies, there is an interaction between selenium, vitamin A and iodine. Indonesia has a program of iodine supplementation to eradicate IDD; however, there is still prevalence of IDD in endemic areas. It can be suspected that goiter is not only caused by low intake of iodine but also by other cause, trace elements such as selenium, calcium and other heavy metals. In Indonesia, the study of trace elements is still needed. Therefore, this study has the main objective to assess the effect of selenium and vitamin A supplementation on the goiter size among school children in Central Java. The study was conducted in Cimanggu sub-district, Cilacap district, Central Java Province, Indonesia from November 1997 till January 1998. School children age 8 - 12 years with palpable goiter was allocated randomly into 2 groups? treatment and control. First group receive once 400 mg iodine capsule and vitamin A (200,000 [ti); Selenium (200p.gram) twice/week for 8 weeks. Second group receive once 400 mg iodine capsule and vitamin A (200,000 IU); placebo. At the beginning and the end of the study, serum selenium, goiter size, UIE, weight and height were measured. The prevalence of goiter based on palpation was 40.5%. By using ultrasound, the subjects with palpable goiter were 57.3% in treatment and 46.7% in control who positively suffering from goiter. Mean of selenium status of both groups was low (29.lpgll in treatment and 30.1 pgll in control) compared with normal value (86-99 µgI1). After two-month supplementation, serum selenium was increased in treatment group (29.1 to 44.1µg11), but decreased in control group (30.1 to 23.2 p,gll). Median of Urinary Iodine Excretion before supplementation was already high, the prevalence of U1 E < 100 ggll was 5.3% in treatment and 6.7% in control. After supplementation the mean of UIE was increased significantly. The change of UlE was not different between treatment and control. Thyroid volume of both groups was decreased significantly (p

Abstrak :
Nowadays, many children in developing countries are suffering from micro nutrient deficiencies (Lartey et at., 2000b; Zhao et al., 1998; van Stuijvenberg et al, 1999; Sempertegui et at, 1995). And the most prevalent ones are VAD (Vitamin A Deficiency), IDA (Iron Deficiency Anemia), IDD (Iodine Deficiency Disorder), and lately is zinc deficiency (Sandstead, 1991). The causes of micro nutrient deficiencies are varied and include inadequate dietary intakes (Robert et al, 2000), repeated infections (Khanum et al, 1998) and poor bioavailability from foods due to the presence of inhibitors or inadequate intake of dietary enhancers (Berdanier, 1998; Lunnerdal, 2000; de Pee et al, 1998; Donnen et al, 1996; Lartey et al, 2000a). Due to the roles of micronutrients in metabolic process, immune competence and taste acuity (Golden, 1995), previous findings showed that micronutrient deficiencies might impaired growth (Allen, 1994b; Rosado, 1999; Krieger et al, 1986; Simondon et al, 1996; Hambidge, 2000; Golden & Golden, 1981) and immune system (Black, 1998; Khanum et al, 1998; Semba et al, 1993). The reversibility of impairments caused by micronutrient deficiencies depends on the severity, duration, and stage of development. In some cases, micronutrient supplementation can correct the impairment right after a certain period of supplementation. Ninh et al (1996) stated that zinc deficiency among nutritionally deprived children may limit growth because the growth stimulating effects of zinc might be mediated through changes in circulating insulin-like growth factor (IGF). And after 5 months supplementation with daily-10 mg zinc, weight and height of growth-retarded children in supplemented group significantly increased compared to those of placebo group. In Uganda, zinc supplementation had a short-term effect (within 3 months) on weight gain and MUAC increment only among children from the school with the highest socioeconomic status (Kikafunda et al, 1998). Clinical vitamin A deficiency has been associated with poor child growth (Tarwotjo et al, 1992). Study in Zaire among moderately malnourished preschoolers found that high dose vitamin A supplementation (60 mg of oily solution of retinal palmitate, 30 mg if aged <12 months) increased MUAC and weight significantly compared to control group although without deforming at baseline (Donnen et al, 1998). In Indonesia, the intervention using vitamin A-monosodium glutamate did not merely result on increment of serum vitamin A level, but it also increased the linear growth of supplemented children compared to children in control group at every age (Muhilal et al, 1988). Similar with zinc and vitamin A, iron deficiency may also lead to slowing of growth in regarding to the increment of iron demands during periods of rapid growth and the adverse effects of morbidity.

Abstrak :
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.

Abstrak :
Salt, is a potential vehicle and has extensively been used for delivery of iodine to the population, as an iodized salt. Many methods for assessing intake of salt have been applied in several studies in Indonesia, but all those methods were suspected to be relatively inaccurate. More precise method needed to define the amount of discretionary salt intake, which is salt added during cooking and at the table. Lithjum.marker technique is a relatively new method, has been established as a suitable, safe and biological reference for tracking the actual intake of individual salt. This method has been treated as a ?gold standard? method for assessing the discretionary salt intake. This result report deals with three methods: lithium-labeled salt technique, 24-hour salt recall and salt weighing, for assessing discretionary salt intake among children and mothers in an iodine deficient area of East Java-Indonesia. The research report has been organized under three major parts. The first part, the introduction, consists ofbackground, problem statement and rationale ofthe study, literature review, conceptual framework of research, objectives and variable and indicator matrix. Part two, the manuscript for publication to International Journal of Food Science and Nutrition. This part provides the abstract, introduction, subjects and methods, result, discussion, conclusion, and references. Part three is the last part of this report, the appendices, consists of questionnaires, detailed of the methodologies, detailed of the results, ethic application and ethical clearance, grand approval, references and curriculum vitae.