IntroductionOptimizing dietary intake during pregnancy and lactation is crucial to the growth and... more IntroductionOptimizing dietary intake during pregnancy and lactation is crucial to the growth and development of children and their lifelong health. We performed a systematic review and meta-analysis to describe the nutrient intakes of pregnant and lactating women in Indonesia and Malaysia, countries that are experiencing rapid nutrition transition in Southeast Asia.MethodsWe screened 2,258 studies published between January 1980 and March 2021. The nutrient intakes of pregnant and lactating women were quantitatively analyzed to calculate the percentage of adequacy using national recommended daily allowances or nutrient intakes (RDA/RNI) and estimated average requirements (EAR) for micronutrients. Standardized mean differences (SMD) between dietary intake and RDA/RNI were determined for selected nutrients.ResultsFifty-three studies were included and showed that energy and macronutrient intakes among pregnant and lactating women in both countries were below the RDA/RNI. In addition, m...
Background Mobile applications such as personalized tracking tools and food choice aids may enhan... more Background Mobile applications such as personalized tracking tools and food choice aids may enhance weight loss programs. We developed and assessed client preferences for the content, user interface, graphics, and logic flow of a mobile application, and evaluated its validity for tracking compliance with weight control and making healthy and sustainable food choices. Methods Our four-stage study comprised formative research, application development, acceptance assessment, and validity. The formative research included literature reviews and six focus groups with 39 respondents aged 19–64 years at high risk for obesity. The development stage included programmer selection, defining application specifications, design, and user interface. Prototype acceptability was assessed with 53 respondents who graded 17 features of content, graphic design, and application flow (ranked as good, moderate, and poor). A feature was considered to have "good" acceptance if its mean response was ...
Pediatric Gastroenterology, Hepatology & Nutrition, 2021
Extensive studies have shown that breast milk is the best source of nutrition for infants, especi... more Extensive studies have shown that breast milk is the best source of nutrition for infants, especially during the first six months, because it fulfills almost all of their nutritional needs. Among the many functional building blocks in breast milk, human milk oligosaccharides (HMOs) have been receiving more attention recently. Furthermore, it is the third most common group of compounds in human milk, and studies have demonstrated the health benefits it provides for infants, including improved nutritional status. HMOs were previously known as the 'bifidus factor' due to their 'bifidogenic' or prebiotic effects, which enabled the nourishment of the gastrointestinal microbiota. Healthy gastrointestinal microbiota are intestinal health substrates that increase nutrient absorption and reduce the incidence of diarrhea. In addition, HMOs, directly and indirectly, protect infants against infections and strengthen their immune system, leading to a positive energy balance and promoting normal growth. Non-modifiable factors, such as genetics, and modifiable factors (e.g., maternal health, diet, nutritional status, environment) can influence the HMO profile. This review provides an overview of the current understanding of how HMOs can contribute to the prevention and treatment of nutritional issues during exclusive breastfeeding.
ObjectivesAffordable options for COVID-19 epidemiological surveillance are needed. Virus detectio... more ObjectivesAffordable options for COVID-19 epidemiological surveillance are needed. Virus detection by reverse transcription-PCR (RT-PCR) is sensitive but costly, and antigen-based rapid diagnostic tests (RDTs) are cheap but with reduced sensitivity; both detect current infection but not exposure. RDT-IgM/IgG antibodies to SARS-CoV-2 detect exposure but have poor sensitivity for current infection. We investigated if the integration of symptomatic, demographical and diet-related comorbidities data with antibody RDTs improves their potential to assess infection rates in addition to exposure, thereby broadening their utility for surveillance.DesignWe conducted a cross-sectional study using data from community surveillance for SARS-CoV-2. Health workers collected nasopharyngeal swabs for RT-PCR and RDT antigen assessments and venous blood for RDT-IgM/IgG from symptomatic and asymptomatic persons. Data on age, gender, contact history, symptoms (ie, fever, cough, runny nose, sore throat, h...
The aim of this study was to develop and evaluate the simple semi-quantitative food frequency que... more The aim of this study was to develop and evaluate the simple semi-quantitative food frequency questionnaire (FFQ) for assessing folate intake in women of reproductive age. We developed a 30-item FFQ, and tested the reliability and validity in 97 women aged between 20 and 39 yrs using the FFQs and 24-h recalls, which were carried out twice, respectively. Assessing the reliability, the correlation coefficients were 0.53 (Spearman's) and 0.49 (Pearson's) for folate. There was no significant difference of folate intake between FFQ1 and FFQ2. 36.1% subjects were classified into the same quartile and 83.5% into the same or adjacent quartile divided by folate intake. On determining the validity, the mean folate intake obtained from the FFQ (FFQ1) and 24h-recalls (2-d) were 306.6 ± 167.2 µg/d and 326.9 ± 103.3 µg/d, respectively. There was no significant difference between folate intakes from the two methods. The correlation coefficients for folate were 0.24 (Spearman's) and 0.26 (Pearson's). 39.2% of the subjects were categorized into the same quartile and 70.1% were into the same or adjacent quartile. In addition, sensitivity (64.3%) and specificity (62.3%) were estimated to evaluate the adequacy of folate intake. These results suggest that this FFQ would be a useful and a valuable instrument to assess the intake of folate among the Korean women of child-bearing age.
The purpose of the study was to estimate dietary intake of folate in two groups of women from dif... more The purpose of the study was to estimate dietary intake of folate in two groups of women from different economic backgrounds and to evaluate validity of the 5-day-weighed food registry (5-d-WFR) and Food Frequency Questionnaire (FFQ) using biological markers. A cross-sectional study was conducted in two samples of urban Mexican women: one represented the middle socioeconomic status (middle SES) and the other, low socioeconomic status (low SES). Middle SES included 34 women recruited from 1998 to 1999. Participants were between the ages of 18 and 32 years and were employed in the banking industry (middle SES) in the US-Mexican border city of Tijuana, Baja California. Low SES included 70 women between the ages of 18 and 35 years recruited during the year 2000. These women were receiving care at a primary health care center in Ensenada, Baja California Norte State, Mexico (low SES). Pearson correlations were calculated between folate intake among 5-day diet registry, FFQ, and biochemical indices. FFQ reproducibility was performed by Spearman correlation of each food item daily and of weekly intake. Average folate intake in middle SES from 5-d-WFR was 210 microg +/- 171. Fifty four percent of participants had intakes <200 microg/daily. Average folate intake from FFQ was 223 +/- 78 microg/day. Pearson correlation between log transformed and within individually adjusted 5-d-WFR folate intakes and serum folate was 0.40 (p=0.02). Mexican women of reproductive age living in the US-Mexican border State of Baja California are at very high risk of NTDs as a result of low folate intake and low serum folate and RBC folate concentrations.
Dietary changes during pregnancy (DP) and post-partum are essential for women’s nutrition status ... more Dietary changes during pregnancy (DP) and post-partum are essential for women’s nutrition status and the health of their offspring. We compared the diet quality DP and at 3-year post-partum (3YPP) and assessed the relationship between maternal diet quality and nutritional status using a prospective cohort design among women in East Jakarta. In total, 107 women were recruited from the study in 2014 and followed up at 3YPP in 2018. The mid-upper arm circumference (MUAC), weight, and height were evaluated. Food consumption data were collected from repeated 24-h recalls. The validated US Diet Quality Index-Pregnancy (DQI-P) scores with eight components were calculated using the food consumption data and compared between DP and 3YPP. Associations of the DQI-P score with the MUAC and weight gain DP and body mass index (BMI) at 3YPP were analyzed using multivariable linear and logistic regression. The median of the DQI-P score DP was significantly higher than at 3YPP [35 (27; 42) versus 27...
Supplemental Material, sj-pdf-5-fnb-10.1177_03795721211011136 for Associations of Knowledge, Atti... more Supplemental Material, sj-pdf-5-fnb-10.1177_03795721211011136 for Associations of Knowledge, Attitude, and Practices toward Anemia with Anemia Prevalence and Height-for-Age Z-Score among Indonesian Adolescent Girls by Rina Agustina, Fadila Wirawan, Arini A. Sadariskar, Ainanur A. Setianingsing, Khairun Nadiya, Erfi Prafiantini, Eriana K. Asri, Tutut S. Purwanti, Sri Kusyuniati, Elvina Karyadi and Manoj K. Raut in Food and Nutrition Bulletin
Background: Adolescent overweight and obesity (AOO) is a global public health problem and risk fo... more Background: Adolescent overweight and obesity (AOO) is a global public health problem and risk for noncommunicable diseases. Understanding context-specific risks is crucial for interventions. Objective: Determine the prevalence of AOO in the Indonesian National Health Survey (INHS) 2013, assess the 5-year trend from 2013 to 2018, and identify risks. Methods: We selected adolescents aged 10 to 19 years (n = 174 290) from the INHS 2013 and used hierarchical logistic regression to identify gender-specific risks for those aged 15 to 19 years (n = 77 534). Change in AOO was assessed by comparison to INHS 2018 reports. Results: The national AOO prevalence increased over 5 years by 48% in young adolescents (13-15 years) and 85% in older ones (16-18 years). High prevalence areas included the urban location of Jakarta (20.9%) and the remote rural region of Papua (19.4%). Overall, AOO risks were being sedentary, male, lower education, married, younger adolescent, and school enrollment, with u...
Background: Crucial gaps persist in knowledge, attitude, and practice (KAP) of adolescent girls t... more Background: Crucial gaps persist in knowledge, attitude, and practice (KAP) of adolescent girls that affect anemia and linear growth failure. Objective: To understand the role of KAP as a risk factor of anemia and linear growth problem in adolescent girls. Methods: We conducted a cross-sectional survey of 335 adolescent girls selected by clustered random sampling. The KAP questionnaire had 18 variables consisting of 9 knowledge, 3 attitude, and 6 practice components. Twelve variables addressed nutrition, dietary diversity, and health environments related to both anemia and stunting. The questionnaire was adapted from the 2014 Food and Agriculture Organization nutrition-related KAP guidelines for anemia. Dietary practice was evaluated from 2-day 24-hour recalls and a semi-quantitative food-frequency questionnaire. Associations between KAP and anemia, and height-for-age z-score (HAZ), were analyzed using multivariate logistic and linear regression models, respectively. Results: The me...
BACKGROUND Periconceptional folic acid reduces neural tube defect (NTD) risk. Red blood cell fola... more BACKGROUND Periconceptional folic acid reduces neural tube defect (NTD) risk. Red blood cell folate concentration is inversely associated with NTD risk. In many countries there is a lack of information on NTD rates. Red cell folate status in women of childbearing age may be a surrogate for NTD rates and may be helpful in identifying countries or regions most likely to benefit from improved folate status. OBJECTIVE To predict NTD rates using red cell folate concentrations in women of childbearing age living in three Asian cities Design: Cross-sectional convenience samples of non-pregnant women living in Beijing (n=220), Kuala Lumpur (n=389), and Jakarta (n=129). RESULTS Red cell folate concentrations were highest (p<0.001) in women from Jakarta at 872 nmol/L (95% CI; 833, 910) followed by Kuala Lumpur at 674 nmol/L (95% CI: 644, 704) and lowest in Beijing at 563 nmol/L (95% CI: 524, 601). Accordingly, predicted NTD rates were highest in Beijing at 30/10000 (95% CI: 27, 33), follow...
A randomized double blind clinical trial was conducted to assess the efficacy of a special infant... more A randomized double blind clinical trial was conducted to assess the efficacy of a special infant formula containing Lactobacillus rhamnosus LMG P-22799 (probiotic: 5 x 10(8) CFU/100mL), inulin (prebiotic: 0.15 g/100mL), dietary fiber (soy polysaccharides: 0.2 g/100mL) and increased amounts of zinc+iron (+0.4 and +0.6 mg/100mL, respectively) as active ingredients for the early dietary management of 58 Indonesian well-nourished male infants aged 3-12 months suffering from acute diarrhea with moderate dehydration. After adequate oral rehydration, the patients were randomly assigned to receive either a low lactose infant formula supplemented with added precooked rice (1.5 g/100mL) with the above active ingredients (study group) or a low lactose infant formula with added precooked rice without the above active ingredient supplement (control group). No antibiotic, anti-secretory drug or antiemetic was given at all. Both study and control groups showed similar outcomes for weight gain and...
Microbiota and its modification with specific probiotics in early life could provide long term he... more Microbiota and its modification with specific probiotics in early life could provide long term health benefits. Probiotics and calcium strengthen intestinal integrity and may support linear growth. This study investigated the long-term effects of childhood probiotics and calcium supplementation on growth in adolescence. We re-enrolled 238 adolescents aged 11–18 years from 494 children 10-years after 6-months of supplementation with either low-lactose milk fortified with low levels of calcium (LC, ∼50 mg/day, n = 53/124), with regular levels of calcium (RC, ∼440 mg/day, n = 70/126), or with regular calcium + 5 x 108 CFU/day Lactobacillus reuteri DSM 17938 (Reuteri, n = 55/124), or regular calcium + 5 x 108 CFU/day L. casei CRL 431 (Casei, n = 60/120). Changes in height-for-age z-score (HAZ) and body mass index-for-age z-score (BMIZ) were determined from the end of intervention to re-enrollment. General linear models were used to assess the effects on HAZ and BMIZ of group, gender, li...
Advanced glycation end products (AGEs) in foods are increased by heat processing, and high consum... more Advanced glycation end products (AGEs) in foods are increased by heat processing, and high consumption of these compounds could contribute to the pathogenesis of non-communicable disease. Yet, the information on carboxymethyl lysine (CML) content, as a part of AGEs, in dietary intakes with predominantly traditional foods with diverse food processing is lacking. We developed a database of Indonesian foods to facilitate studies involving the assessment of dietary and plasma CML concentration by liquid-chromatography-tandem-mass spectrometry. We estimated dietary CML values of 206 food items from 2-repeated 24-h recalls of 235 Indonesian women with the mean age of 36±8 years old in a cross-sectional study. All foods were listed and grouped according to the Indonesian food composition table, completed for cooking methods, amount of consumptions, and ingredients. CML values were obtained from published databases, analyzed with similar methods or calculated using other criteria. We search...
Background Stunting, an indicator of restricted linear growth, has become a primary measure of ch... more Background Stunting, an indicator of restricted linear growth, has become a primary measure of childhood undernutrition due to its persistent high prevalence globally, and importance for health and development. Although the etiology is recognized as complex, most analyses have focused on social and biomedical determinants, with limited attention on psychological factors affecting care and nurturing in the home. We assessed whether the psychological distress of parents is related to child linear growth and stunting, and documented the associated risk factors, and examined the relationship between parental distress and behavioral and other risk factors for stunting. Methods We used data from the Indonesia National Health Survey 2013, including 46,315 children 6–59 months of age. Multivariate linear, logistic, and multilevel multinomial logistic regression, using survey weights, were used to assess the relationship between parental distress, as assessed by the WHO Self Reporting Questi...
Background: The trend of unhealthy lifestyles is increasing among adolescents and has been associ... more Background: The trend of unhealthy lifestyles is increasing among adolescents and has been associated with the rising burden of noncommunicable diseases (NCDs). However, specific determinants of unhealthy lifestyles among adolescents in low- and middle-income countries remain limited. Objective: To investigate the relationships of child-, parents-, and environment-associated determinants with diet quality, physical activity, and smoking habits among low-socioeconomic urban adolescents. Methods: A cross-sectional study involving 238 adolescents aged 11 to 17 years was conducted in Jakarta, Indonesia. Adolescents and their parents were interviewed to assess the determinants of healthy lifestyles that included diet quality, physical activity, and smoking habits. Diet and physical activity were quantified using the Diet Quality Index for Adolescents (DQI-A) and Physical Activity Questionnaire for Older Children (PAQ-C), respectively. Multiple regression was used to determine the β coeff...
Background Poor diet is a risk factor for anemia, overweight, and obesity among adolescent girls.... more Background Poor diet is a risk factor for anemia, overweight, and obesity among adolescent girls. However, comprehensive assessment on dietary quality and habits in this population is limited. We assessed the association of meal patterning, dietary quality, and dietary diversity with both anemia and overweight-obesity. Methods We conducted a cross-sectional survey in 335 school-going adolescent girls aged 12-19 years from three districts in West Java using multi-stage cluster sampling. Meal patterning, Dietary Quality Index for Adolescents (DQI-A), and Dietary Diversity Score (DDS) were determined using 2-day 24-h recall. Results Of the girls, 45% were anemic and 17% overweight or obese. Eating occasions of 3-4 times (AOR 2.68, 95% CI 1.21-5.98) and >4 times (AOR 2.43, 95% CI 1.01-5.83) were associated with greater odds of developing anemia compared to eating occasions of <3 times. Adolescent girls who skipped dinner had greater odds of being overweight or obese (AOR 2.13, 95% CI 1.10-4.10) and were less likely to be anemic (AOR 0.56, 95%CI 0.33-0.95) compared to those who did not skip dinner. Difference in energy intake was found between girls who had dinner and skipped dinner (p = 0.05). Mean total DQI-A score was 44.4% ± 7.71% and DDS was 4.0 out of 9.0. DQI-A score was significantly higher in non-anemic compared to anemic girls. Moreover, each unit increment of 1% of total DQI-A score was associated with a 3.967 g/dL increases of hemoglobin after adjustment for confounders. We
Background: Analyses of correlates of SARS-CoV-2 infection or mortality have usually assessed ind... more Background: Analyses of correlates of SARS-CoV-2 infection or mortality have usually assessed individual predictors. This study aimed to determine if patterns of combined predictors may better identify risk of infection and mortality. Methods: For the period of March 2nd to 10th 2020, the first 9 days of the COVID-19 pandemic in Indonesia, we selected all 18 confirmed cases, of which 6 died, and all 60 suspected cases, of which 1 died; and 28 putatively negative patients with pneumonia and no travel history. We recorded data for travel, contact history, symptoms, haematology, comorbidities, and chest x-ray. Hierarchical cluster analyses (HCA) and principal component analyses (PCA) identified cluster and covariance patterns for symptoms or haematology which were analysed with other predictors of infection or mortality using logistic regression. Results: For univariate analyses, no significant association with infection was seen for fever, cough, dyspnoea, headache, runny nose, sore t...
Dietary and plasma carboxymethyl lysine (dCML, pCML) and plasma tumor necrosis factor-α (pTNF-α) ... more Dietary and plasma carboxymethyl lysine (dCML, pCML) and plasma tumor necrosis factor-α (pTNF-α) may be associated with obesity in affluent society. However, evidence in women from low-middle income countries with predominantly traditional diets is lacking. We investigated the mediator effects of dCML, pCML and pTNF-α on body mass index (BMI) and waist circumference (WC) among Indonesian women. A cross-sectional study was conducted among 235 non-diabetic, non-anemic and non-smoking women aged 19–50 years from selected mountainous and coastal areas of West Sumatra and West Java. Dietary CML, pCML, pTNF-α were obtained from 2 × 24-h recalls, ultra-performance liquid chromatography-tandem mass spectrometry and enzyme-linked immunosorbent assay, respectively. Between-group differences were analyzed by the Chi-square or Mann-Whitney test and mediator effects by Structural Equation Modeling. The medians and interquartile-ranges of dCML, pCML and pTNF-α were 2.2 (1.7–3.0) mg/day, 22.2 (17....
Background A high quality modern diet is associated with reduced risk of metabolic disease and di... more Background A high quality modern diet is associated with reduced risk of metabolic disease and diabetes. However, it remains unclear whether the quality of predominantly traditional ethnic diets is associated with such conditions. Moreover, the relationship between dietary quality and microbiota, a potential mediator of metabolic disease, has not been studied. Objective We investigated the relationship of dietary quality of traditional ethnic diets in Indonesia with fasting blood glucose (FBG), HbA1c, and the number of fecal Bifidobacterium. Design A cross-sectional study was conducted in selected districts with predominantly animal-or plant-based traditional diets of West Sumatera and West Java provinces, respectively. A total of 240 apparently healthy women aged 19-50 years were randomly selected from 360 women screened by a cluster sampling design. Dietary quality was assessed by 2-day repeated 24-hour food recall, and scored using the Healthy Eating Index (HEI) 2010. FBG was quantified with the enzymatic colorimetric method, and HbA1c by using hexokinase and high-performance liquid chromatography, and total fecal Bifidobacterium by real-time quantitative polymerase chain reaction.
IntroductionOptimizing dietary intake during pregnancy and lactation is crucial to the growth and... more IntroductionOptimizing dietary intake during pregnancy and lactation is crucial to the growth and development of children and their lifelong health. We performed a systematic review and meta-analysis to describe the nutrient intakes of pregnant and lactating women in Indonesia and Malaysia, countries that are experiencing rapid nutrition transition in Southeast Asia.MethodsWe screened 2,258 studies published between January 1980 and March 2021. The nutrient intakes of pregnant and lactating women were quantitatively analyzed to calculate the percentage of adequacy using national recommended daily allowances or nutrient intakes (RDA/RNI) and estimated average requirements (EAR) for micronutrients. Standardized mean differences (SMD) between dietary intake and RDA/RNI were determined for selected nutrients.ResultsFifty-three studies were included and showed that energy and macronutrient intakes among pregnant and lactating women in both countries were below the RDA/RNI. In addition, m...
Background Mobile applications such as personalized tracking tools and food choice aids may enhan... more Background Mobile applications such as personalized tracking tools and food choice aids may enhance weight loss programs. We developed and assessed client preferences for the content, user interface, graphics, and logic flow of a mobile application, and evaluated its validity for tracking compliance with weight control and making healthy and sustainable food choices. Methods Our four-stage study comprised formative research, application development, acceptance assessment, and validity. The formative research included literature reviews and six focus groups with 39 respondents aged 19–64 years at high risk for obesity. The development stage included programmer selection, defining application specifications, design, and user interface. Prototype acceptability was assessed with 53 respondents who graded 17 features of content, graphic design, and application flow (ranked as good, moderate, and poor). A feature was considered to have "good" acceptance if its mean response was ...
Pediatric Gastroenterology, Hepatology & Nutrition, 2021
Extensive studies have shown that breast milk is the best source of nutrition for infants, especi... more Extensive studies have shown that breast milk is the best source of nutrition for infants, especially during the first six months, because it fulfills almost all of their nutritional needs. Among the many functional building blocks in breast milk, human milk oligosaccharides (HMOs) have been receiving more attention recently. Furthermore, it is the third most common group of compounds in human milk, and studies have demonstrated the health benefits it provides for infants, including improved nutritional status. HMOs were previously known as the 'bifidus factor' due to their 'bifidogenic' or prebiotic effects, which enabled the nourishment of the gastrointestinal microbiota. Healthy gastrointestinal microbiota are intestinal health substrates that increase nutrient absorption and reduce the incidence of diarrhea. In addition, HMOs, directly and indirectly, protect infants against infections and strengthen their immune system, leading to a positive energy balance and promoting normal growth. Non-modifiable factors, such as genetics, and modifiable factors (e.g., maternal health, diet, nutritional status, environment) can influence the HMO profile. This review provides an overview of the current understanding of how HMOs can contribute to the prevention and treatment of nutritional issues during exclusive breastfeeding.
ObjectivesAffordable options for COVID-19 epidemiological surveillance are needed. Virus detectio... more ObjectivesAffordable options for COVID-19 epidemiological surveillance are needed. Virus detection by reverse transcription-PCR (RT-PCR) is sensitive but costly, and antigen-based rapid diagnostic tests (RDTs) are cheap but with reduced sensitivity; both detect current infection but not exposure. RDT-IgM/IgG antibodies to SARS-CoV-2 detect exposure but have poor sensitivity for current infection. We investigated if the integration of symptomatic, demographical and diet-related comorbidities data with antibody RDTs improves their potential to assess infection rates in addition to exposure, thereby broadening their utility for surveillance.DesignWe conducted a cross-sectional study using data from community surveillance for SARS-CoV-2. Health workers collected nasopharyngeal swabs for RT-PCR and RDT antigen assessments and venous blood for RDT-IgM/IgG from symptomatic and asymptomatic persons. Data on age, gender, contact history, symptoms (ie, fever, cough, runny nose, sore throat, h...
The aim of this study was to develop and evaluate the simple semi-quantitative food frequency que... more The aim of this study was to develop and evaluate the simple semi-quantitative food frequency questionnaire (FFQ) for assessing folate intake in women of reproductive age. We developed a 30-item FFQ, and tested the reliability and validity in 97 women aged between 20 and 39 yrs using the FFQs and 24-h recalls, which were carried out twice, respectively. Assessing the reliability, the correlation coefficients were 0.53 (Spearman's) and 0.49 (Pearson's) for folate. There was no significant difference of folate intake between FFQ1 and FFQ2. 36.1% subjects were classified into the same quartile and 83.5% into the same or adjacent quartile divided by folate intake. On determining the validity, the mean folate intake obtained from the FFQ (FFQ1) and 24h-recalls (2-d) were 306.6 ± 167.2 µg/d and 326.9 ± 103.3 µg/d, respectively. There was no significant difference between folate intakes from the two methods. The correlation coefficients for folate were 0.24 (Spearman's) and 0.26 (Pearson's). 39.2% of the subjects were categorized into the same quartile and 70.1% were into the same or adjacent quartile. In addition, sensitivity (64.3%) and specificity (62.3%) were estimated to evaluate the adequacy of folate intake. These results suggest that this FFQ would be a useful and a valuable instrument to assess the intake of folate among the Korean women of child-bearing age.
The purpose of the study was to estimate dietary intake of folate in two groups of women from dif... more The purpose of the study was to estimate dietary intake of folate in two groups of women from different economic backgrounds and to evaluate validity of the 5-day-weighed food registry (5-d-WFR) and Food Frequency Questionnaire (FFQ) using biological markers. A cross-sectional study was conducted in two samples of urban Mexican women: one represented the middle socioeconomic status (middle SES) and the other, low socioeconomic status (low SES). Middle SES included 34 women recruited from 1998 to 1999. Participants were between the ages of 18 and 32 years and were employed in the banking industry (middle SES) in the US-Mexican border city of Tijuana, Baja California. Low SES included 70 women between the ages of 18 and 35 years recruited during the year 2000. These women were receiving care at a primary health care center in Ensenada, Baja California Norte State, Mexico (low SES). Pearson correlations were calculated between folate intake among 5-day diet registry, FFQ, and biochemical indices. FFQ reproducibility was performed by Spearman correlation of each food item daily and of weekly intake. Average folate intake in middle SES from 5-d-WFR was 210 microg +/- 171. Fifty four percent of participants had intakes &amp;amp;amp;amp;amp;amp;amp;amp;lt;200 microg/daily. Average folate intake from FFQ was 223 +/- 78 microg/day. Pearson correlation between log transformed and within individually adjusted 5-d-WFR folate intakes and serum folate was 0.40 (p=0.02). Mexican women of reproductive age living in the US-Mexican border State of Baja California are at very high risk of NTDs as a result of low folate intake and low serum folate and RBC folate concentrations.
Dietary changes during pregnancy (DP) and post-partum are essential for women’s nutrition status ... more Dietary changes during pregnancy (DP) and post-partum are essential for women’s nutrition status and the health of their offspring. We compared the diet quality DP and at 3-year post-partum (3YPP) and assessed the relationship between maternal diet quality and nutritional status using a prospective cohort design among women in East Jakarta. In total, 107 women were recruited from the study in 2014 and followed up at 3YPP in 2018. The mid-upper arm circumference (MUAC), weight, and height were evaluated. Food consumption data were collected from repeated 24-h recalls. The validated US Diet Quality Index-Pregnancy (DQI-P) scores with eight components were calculated using the food consumption data and compared between DP and 3YPP. Associations of the DQI-P score with the MUAC and weight gain DP and body mass index (BMI) at 3YPP were analyzed using multivariable linear and logistic regression. The median of the DQI-P score DP was significantly higher than at 3YPP [35 (27; 42) versus 27...
Supplemental Material, sj-pdf-5-fnb-10.1177_03795721211011136 for Associations of Knowledge, Atti... more Supplemental Material, sj-pdf-5-fnb-10.1177_03795721211011136 for Associations of Knowledge, Attitude, and Practices toward Anemia with Anemia Prevalence and Height-for-Age Z-Score among Indonesian Adolescent Girls by Rina Agustina, Fadila Wirawan, Arini A. Sadariskar, Ainanur A. Setianingsing, Khairun Nadiya, Erfi Prafiantini, Eriana K. Asri, Tutut S. Purwanti, Sri Kusyuniati, Elvina Karyadi and Manoj K. Raut in Food and Nutrition Bulletin
Background: Adolescent overweight and obesity (AOO) is a global public health problem and risk fo... more Background: Adolescent overweight and obesity (AOO) is a global public health problem and risk for noncommunicable diseases. Understanding context-specific risks is crucial for interventions. Objective: Determine the prevalence of AOO in the Indonesian National Health Survey (INHS) 2013, assess the 5-year trend from 2013 to 2018, and identify risks. Methods: We selected adolescents aged 10 to 19 years (n = 174 290) from the INHS 2013 and used hierarchical logistic regression to identify gender-specific risks for those aged 15 to 19 years (n = 77 534). Change in AOO was assessed by comparison to INHS 2018 reports. Results: The national AOO prevalence increased over 5 years by 48% in young adolescents (13-15 years) and 85% in older ones (16-18 years). High prevalence areas included the urban location of Jakarta (20.9%) and the remote rural region of Papua (19.4%). Overall, AOO risks were being sedentary, male, lower education, married, younger adolescent, and school enrollment, with u...
Background: Crucial gaps persist in knowledge, attitude, and practice (KAP) of adolescent girls t... more Background: Crucial gaps persist in knowledge, attitude, and practice (KAP) of adolescent girls that affect anemia and linear growth failure. Objective: To understand the role of KAP as a risk factor of anemia and linear growth problem in adolescent girls. Methods: We conducted a cross-sectional survey of 335 adolescent girls selected by clustered random sampling. The KAP questionnaire had 18 variables consisting of 9 knowledge, 3 attitude, and 6 practice components. Twelve variables addressed nutrition, dietary diversity, and health environments related to both anemia and stunting. The questionnaire was adapted from the 2014 Food and Agriculture Organization nutrition-related KAP guidelines for anemia. Dietary practice was evaluated from 2-day 24-hour recalls and a semi-quantitative food-frequency questionnaire. Associations between KAP and anemia, and height-for-age z-score (HAZ), were analyzed using multivariate logistic and linear regression models, respectively. Results: The me...
BACKGROUND Periconceptional folic acid reduces neural tube defect (NTD) risk. Red blood cell fola... more BACKGROUND Periconceptional folic acid reduces neural tube defect (NTD) risk. Red blood cell folate concentration is inversely associated with NTD risk. In many countries there is a lack of information on NTD rates. Red cell folate status in women of childbearing age may be a surrogate for NTD rates and may be helpful in identifying countries or regions most likely to benefit from improved folate status. OBJECTIVE To predict NTD rates using red cell folate concentrations in women of childbearing age living in three Asian cities Design: Cross-sectional convenience samples of non-pregnant women living in Beijing (n=220), Kuala Lumpur (n=389), and Jakarta (n=129). RESULTS Red cell folate concentrations were highest (p<0.001) in women from Jakarta at 872 nmol/L (95% CI; 833, 910) followed by Kuala Lumpur at 674 nmol/L (95% CI: 644, 704) and lowest in Beijing at 563 nmol/L (95% CI: 524, 601). Accordingly, predicted NTD rates were highest in Beijing at 30/10000 (95% CI: 27, 33), follow...
A randomized double blind clinical trial was conducted to assess the efficacy of a special infant... more A randomized double blind clinical trial was conducted to assess the efficacy of a special infant formula containing Lactobacillus rhamnosus LMG P-22799 (probiotic: 5 x 10(8) CFU/100mL), inulin (prebiotic: 0.15 g/100mL), dietary fiber (soy polysaccharides: 0.2 g/100mL) and increased amounts of zinc+iron (+0.4 and +0.6 mg/100mL, respectively) as active ingredients for the early dietary management of 58 Indonesian well-nourished male infants aged 3-12 months suffering from acute diarrhea with moderate dehydration. After adequate oral rehydration, the patients were randomly assigned to receive either a low lactose infant formula supplemented with added precooked rice (1.5 g/100mL) with the above active ingredients (study group) or a low lactose infant formula with added precooked rice without the above active ingredient supplement (control group). No antibiotic, anti-secretory drug or antiemetic was given at all. Both study and control groups showed similar outcomes for weight gain and...
Microbiota and its modification with specific probiotics in early life could provide long term he... more Microbiota and its modification with specific probiotics in early life could provide long term health benefits. Probiotics and calcium strengthen intestinal integrity and may support linear growth. This study investigated the long-term effects of childhood probiotics and calcium supplementation on growth in adolescence. We re-enrolled 238 adolescents aged 11–18 years from 494 children 10-years after 6-months of supplementation with either low-lactose milk fortified with low levels of calcium (LC, ∼50 mg/day, n = 53/124), with regular levels of calcium (RC, ∼440 mg/day, n = 70/126), or with regular calcium + 5 x 108 CFU/day Lactobacillus reuteri DSM 17938 (Reuteri, n = 55/124), or regular calcium + 5 x 108 CFU/day L. casei CRL 431 (Casei, n = 60/120). Changes in height-for-age z-score (HAZ) and body mass index-for-age z-score (BMIZ) were determined from the end of intervention to re-enrollment. General linear models were used to assess the effects on HAZ and BMIZ of group, gender, li...
Advanced glycation end products (AGEs) in foods are increased by heat processing, and high consum... more Advanced glycation end products (AGEs) in foods are increased by heat processing, and high consumption of these compounds could contribute to the pathogenesis of non-communicable disease. Yet, the information on carboxymethyl lysine (CML) content, as a part of AGEs, in dietary intakes with predominantly traditional foods with diverse food processing is lacking. We developed a database of Indonesian foods to facilitate studies involving the assessment of dietary and plasma CML concentration by liquid-chromatography-tandem-mass spectrometry. We estimated dietary CML values of 206 food items from 2-repeated 24-h recalls of 235 Indonesian women with the mean age of 36±8 years old in a cross-sectional study. All foods were listed and grouped according to the Indonesian food composition table, completed for cooking methods, amount of consumptions, and ingredients. CML values were obtained from published databases, analyzed with similar methods or calculated using other criteria. We search...
Background Stunting, an indicator of restricted linear growth, has become a primary measure of ch... more Background Stunting, an indicator of restricted linear growth, has become a primary measure of childhood undernutrition due to its persistent high prevalence globally, and importance for health and development. Although the etiology is recognized as complex, most analyses have focused on social and biomedical determinants, with limited attention on psychological factors affecting care and nurturing in the home. We assessed whether the psychological distress of parents is related to child linear growth and stunting, and documented the associated risk factors, and examined the relationship between parental distress and behavioral and other risk factors for stunting. Methods We used data from the Indonesia National Health Survey 2013, including 46,315 children 6–59 months of age. Multivariate linear, logistic, and multilevel multinomial logistic regression, using survey weights, were used to assess the relationship between parental distress, as assessed by the WHO Self Reporting Questi...
Background: The trend of unhealthy lifestyles is increasing among adolescents and has been associ... more Background: The trend of unhealthy lifestyles is increasing among adolescents and has been associated with the rising burden of noncommunicable diseases (NCDs). However, specific determinants of unhealthy lifestyles among adolescents in low- and middle-income countries remain limited. Objective: To investigate the relationships of child-, parents-, and environment-associated determinants with diet quality, physical activity, and smoking habits among low-socioeconomic urban adolescents. Methods: A cross-sectional study involving 238 adolescents aged 11 to 17 years was conducted in Jakarta, Indonesia. Adolescents and their parents were interviewed to assess the determinants of healthy lifestyles that included diet quality, physical activity, and smoking habits. Diet and physical activity were quantified using the Diet Quality Index for Adolescents (DQI-A) and Physical Activity Questionnaire for Older Children (PAQ-C), respectively. Multiple regression was used to determine the β coeff...
Background Poor diet is a risk factor for anemia, overweight, and obesity among adolescent girls.... more Background Poor diet is a risk factor for anemia, overweight, and obesity among adolescent girls. However, comprehensive assessment on dietary quality and habits in this population is limited. We assessed the association of meal patterning, dietary quality, and dietary diversity with both anemia and overweight-obesity. Methods We conducted a cross-sectional survey in 335 school-going adolescent girls aged 12-19 years from three districts in West Java using multi-stage cluster sampling. Meal patterning, Dietary Quality Index for Adolescents (DQI-A), and Dietary Diversity Score (DDS) were determined using 2-day 24-h recall. Results Of the girls, 45% were anemic and 17% overweight or obese. Eating occasions of 3-4 times (AOR 2.68, 95% CI 1.21-5.98) and >4 times (AOR 2.43, 95% CI 1.01-5.83) were associated with greater odds of developing anemia compared to eating occasions of <3 times. Adolescent girls who skipped dinner had greater odds of being overweight or obese (AOR 2.13, 95% CI 1.10-4.10) and were less likely to be anemic (AOR 0.56, 95%CI 0.33-0.95) compared to those who did not skip dinner. Difference in energy intake was found between girls who had dinner and skipped dinner (p = 0.05). Mean total DQI-A score was 44.4% ± 7.71% and DDS was 4.0 out of 9.0. DQI-A score was significantly higher in non-anemic compared to anemic girls. Moreover, each unit increment of 1% of total DQI-A score was associated with a 3.967 g/dL increases of hemoglobin after adjustment for confounders. We
Background: Analyses of correlates of SARS-CoV-2 infection or mortality have usually assessed ind... more Background: Analyses of correlates of SARS-CoV-2 infection or mortality have usually assessed individual predictors. This study aimed to determine if patterns of combined predictors may better identify risk of infection and mortality. Methods: For the period of March 2nd to 10th 2020, the first 9 days of the COVID-19 pandemic in Indonesia, we selected all 18 confirmed cases, of which 6 died, and all 60 suspected cases, of which 1 died; and 28 putatively negative patients with pneumonia and no travel history. We recorded data for travel, contact history, symptoms, haematology, comorbidities, and chest x-ray. Hierarchical cluster analyses (HCA) and principal component analyses (PCA) identified cluster and covariance patterns for symptoms or haematology which were analysed with other predictors of infection or mortality using logistic regression. Results: For univariate analyses, no significant association with infection was seen for fever, cough, dyspnoea, headache, runny nose, sore t...
Dietary and plasma carboxymethyl lysine (dCML, pCML) and plasma tumor necrosis factor-α (pTNF-α) ... more Dietary and plasma carboxymethyl lysine (dCML, pCML) and plasma tumor necrosis factor-α (pTNF-α) may be associated with obesity in affluent society. However, evidence in women from low-middle income countries with predominantly traditional diets is lacking. We investigated the mediator effects of dCML, pCML and pTNF-α on body mass index (BMI) and waist circumference (WC) among Indonesian women. A cross-sectional study was conducted among 235 non-diabetic, non-anemic and non-smoking women aged 19–50 years from selected mountainous and coastal areas of West Sumatra and West Java. Dietary CML, pCML, pTNF-α were obtained from 2 × 24-h recalls, ultra-performance liquid chromatography-tandem mass spectrometry and enzyme-linked immunosorbent assay, respectively. Between-group differences were analyzed by the Chi-square or Mann-Whitney test and mediator effects by Structural Equation Modeling. The medians and interquartile-ranges of dCML, pCML and pTNF-α were 2.2 (1.7–3.0) mg/day, 22.2 (17....
Background A high quality modern diet is associated with reduced risk of metabolic disease and di... more Background A high quality modern diet is associated with reduced risk of metabolic disease and diabetes. However, it remains unclear whether the quality of predominantly traditional ethnic diets is associated with such conditions. Moreover, the relationship between dietary quality and microbiota, a potential mediator of metabolic disease, has not been studied. Objective We investigated the relationship of dietary quality of traditional ethnic diets in Indonesia with fasting blood glucose (FBG), HbA1c, and the number of fecal Bifidobacterium. Design A cross-sectional study was conducted in selected districts with predominantly animal-or plant-based traditional diets of West Sumatera and West Java provinces, respectively. A total of 240 apparently healthy women aged 19-50 years were randomly selected from 360 women screened by a cluster sampling design. Dietary quality was assessed by 2-day repeated 24-hour food recall, and scored using the Healthy Eating Index (HEI) 2010. FBG was quantified with the enzymatic colorimetric method, and HbA1c by using hexokinase and high-performance liquid chromatography, and total fecal Bifidobacterium by real-time quantitative polymerase chain reaction.
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Papers by Rina Agustina