Institutional Research 2010

The review aims to create a systematic map of surveys and studies undertaken in Indonesia between January 2000 and April 2010 in the three areas relevant for developing national dietary guidelines for children under the age of five years: (1) eat variety of foods including water, (2) physical activities and healthy lifestyle, and (3) monitor nutritional status. This involved exploration of published and unpublished studies accessible from 46 health-nutrition related institutions in Jakarta, Banten, and Bandung, including 9 university’s libraries, 2 polytechnics, 12 government institutions, 3 UN agencies, and 20 NGOs.

In total 212 studies were identified: 18 publications in international journals, 101 publications in local journals, 59 dissertations/theses, and 34 reports. Most of the studies (n=104) were conducted in rural area, 63 studies in urban, and 45 studies in both rural and urban. The studies covered information from 27 (out of 33) provinces, 69 districts, 58 sub-districts, and 114 villages.

The review found that dietary diversity was of medium-low diversity (≤4 food groups) and was lower in infants; access to protected drinking water was still a problem in both rural and urban, especially urban slum; delayed developmental outcomes (mental and psychomotor) were identified in almost all of the reported studies to the higher level than BSID-II reference; poor practices related to food safety and food hygiene were observed with indication that practices were poorer as child got older and in urban poor community; complete immunization rate was still low in some areas; regular visits to growth monitoring facilities was done by only half (45%) of mothers/caregivers and was decreased starting from 12months (after last immunization); and anemia is problem with higher prevalence amongst under two. While stunting and wasting were of high public health problem, there was limited information on clinical outcomes related to nutritional status. Prevalence tends to be higher amongst boys, children from female-headed households, and from mothers with lower education level.

Several recommendations were made on messages which should be included in the health and nutrition guidelines for under fives; on further studies and on access to available data as public domain to serve in policy making.

Background

Although many studies have been conducted by various institutions throughout Indonesia, documentation of these documents nationally are lacking. This exercise is aimed to compile results related to Food Consumption, Physical Activity, Lifestyle, and Nutritional Status of studies conducted in Indonesia between 2000-April 2010. The data can be used to develop targeted nutrition guideline and observe trend.

Methods

Literature search was done using library visit, internet, and visit to universities and government institutions. Cities visited were Yogyakarta, Solo, Semarang, Jember, Magelang, Malang, and Denpasar. Subject of this study was elementary school children age 6-12 years. Studies with samples equal to and greater than 80 children, from non-intervention or control group, were included in the compilation. Data was systematically extracted and narrated.

Results

From 116 studies gathered, mostly (94%) were gathered from library visit, about one-third (36%) were publications in 2006 and 2008, about one-fourth (28%) was publications in national journal, and written in Indonesian language (94%). The studies covered 20 provinces, although about one-fourth (28%) was conducted in Central Java. Most studies were conducted at sub-district level (45%) covered urban setting (54%), and cross-sectional in design (75%).

Variability in nutrient adequacies compared to the Recommended Dietary Allowance (RDA; Ministry of Health 2004) was as follows: energy 55% to 98%, protein 61% to 137%, fat 32-50%, iron 28% to 73%, and vitamin-C 47% to 123%. Most (82-100%) children had regular breakfast. Meal frequency was mostly more than three times a day. Street foods were favored by almost all (68-74%) children. Most children (65%) consumed drinking water less than 1.5 liter per day. Most (54%) students choose cooked foods and wrapped snacks. Iodized salt consumption varied from 36% to 97%.

Result in studies of physical activity for this age group resulted in good (80% children in Surakarta) and in low (74% children in Semarang); with frequency of once a week or less (12%-62%) or once a week (28-29%). Washing hands before eating was found inconsistent (27-50%).

Based on various indicators, the percentage of well-nourished students varied from 19% to 82%. The highest prevalence of wasting (Weight-for-Height z-score <-2SD) was 59%, stunting (Height-for-Age z-score <-2SD) 42%, thinness (Weight-for-Age z-score <-2SD) 45% and obesity (Weight-for-Height z-score> 3SD) 40%. The proportion of students with anemia varied from 5% to 84%. Based on palpation, the prevalence of Iodine Deficiency Disorder varied from 2% to 52%.

Introduction

Adolescence is a transition stage from childhood to adulthood, which is also often led to problem in their health and behavior. It is necessary to review nutrition conditions that exist in Indonesia, looking at the adolescent Food Consumption, Physical Activity, Lifestyle, and Nutritional Status to support the design of Nutritional Guidelines for this particular age group. This exercise is aimed to compile results of studies conducted in Indonesia between 2000-April 2010.

Methods

Literature search was done using library visit, internet, and visit to universities and government institutions. Cities visited were Yogyakarta, Solo, Semarang, Purwokerto, Jember, Magelang, Malang, Surabaya, and Denpasar. Subject of this study was adolescents age 13-18 years. Studies with samples equal to and greater than 80 adolescents, from non-intervention or control group, were included in the compilation. Data was systematically extracted and narrated.

Results

This review identified 130 studies, which was mostly (76%) gathered from library searched. The studies covered 17 provinces, of which one-third (31%) in Yogyakarta. Most studies (66%) were conducted at district level, covered urban setting (72%), and were cross-sectional in design (91%).

The percentage range of intake compared to the Recommended Daily Allowance (RDA) was as follows: energy 82% to 107% (1607 to 2249 kkal), protein 60% to 124% (37-91 g), carbohydrates 78% to 92% (234-257 g), fat 68% to 115% (37-83 g), iron 95% to 99%, and vitamin-A 875%. Consumption of other nutrients and nutrition related items that were available included fiber, folic acid, vitamin B1, C, calcium, zinc, iodized salt. More adolescents who live in rural areas consumed vegetables and fruits than their counterparts in urban areas (80% vs. 60% for vegetables and 61% vs. 45% for fruits respectively. Most adolescents (51%-69%) in Java had three meals per day, while 60% in Denpasar had two times per day. Adolescents who had breakfast (23%-94%) and consumed supplements (mostly vitamin-C) (5-65%) varied.

Popular physical exercises for adolescents were jogging (79%) and sport games (71%) such as badminton, soccer, volleyball, softball, and basketball. About three-fourth (71%) of adolescents were either at Risk of- or Had- Unhealthy lifestyle, measured by scoring of the 10 ways and habits in selecting and consuming food. From 30 studies that measured nutritional status using Body Mass Index (BMI), 23%-88% of adolescents were found normal, 0%-60% severe underweight, and 0%-13% obese. The prevalence of anemia was 2%-87%, while for goiter 31%-52%. Other information available was Iodine Concentration in Urine and Night Blindness.

Background

In developing evidence based Food Based Dietary Guidelines, reliable data on food pattern, nutrient intake, health and nutritional status are needed. The purpose of this study was to compile results of studies related to the above topic conducted in Indonesia between 2000 and 2010.

Methods

Literature search was done using library visit, internet, and visit to universities and government institutions. Eight cities were visited, namely Yogyakarta, Solo, Semarang, Jember, Magelang, Malang, and Denpasar. Subject of this study was adult age 20-54 years. Studies with samples equal to and greater than 80, from non-intervention or control group, were included in the compilation. Data was systematically extracted and narrated.

Results

In total, 142 studies were identified in the search. Most adults (52%-71%) consumed meals three times a day. Skipping breakfast was pretty common (6%-66%). Only 10% of adults could eat variety of food in each meal. Energy intake ranged from 1121 to 1883 kcal/day, with more adults consuming <80% of the Recommended Dietary Allowance (RDA). On the other hand, protein intake ranged from 40 to 79 g/day, with more adults consuming excess protein. Consumption of legumes was often, while the consumption of animal food was rare. The prevalence of adults that met recommendation of fruits and vegetables intake was very low (7%). Consumption of Iodized salt varied (23%-100%). Deficit and excess in fat intake were similarly found (both has prevalence of 20%-45%. Approximately 75% adults were deficit in micronutrients, especially calcium and iron.

The percentage of adults who lack physical activity, smoked, consumed alcohol, and consumed risky foods (sweet meals/drinks, salty food, fatty meals, innards, roasted and preserved food, caffeine, and flavoring) was greatly varied, i.e. 11%-20%, 7%-69%, 1%-63%, and 2%-78% respectively. Up to 50% adults suffered from chronic- energy deficiency (Body Mass Index-BMI <18.5) (range 1%-50%). Likewise, up to half (2%-51%) of the adults was overweight/obese (BMI>25). The percentage of hypercholesterolemia was 6%-51% and hypertension was 35%-65%. The prevalence of anemia was 8%-65% and iodine deficiency (IU<100 µg/L) was 3%-41%. On the contrary, excessive iodine (>200 µg/L) was also found (29%- 64%). Women were found to be more affected in malnutrition related diseases than men, i.e. prevalence of obesity (10% to 56% vs 6% to 12%), hypercholesterolemia (8% vs. 6%), hypertension (65% vs. 35%), and anemia (32% vs. 14%).

Background

The improvement of health care system bring into the increasing of population of elderly in the last decade. In order to make the program policy feasible and applicable in the community, data on Food Consumption, Physical Activity, Lifestyle, and Nutritional Status are needed. Although many studies have been conducted by various institutions throughout Indonesia, documentation of these data nationally are lacking. This exercise is aimed to compile results related to the above topics from studies conducted in Indonesia between 2000-April 2010. The data can be used by the government to improve its commitment in developing adequate nutrition related policies. In addition, the data can be used to develop targeted nutrition guideline and for comparison to current data.

Methods

Literature search was done using internet, library visit, visit to universities and government institutions, and personal communication. Cities visited were Yogyakarta, Solo, Semarang, Jember, Magelang, Malang, and Denpasar. Subject of this study was elderly population age 55 years and above. Studies with samples equal to and greater than 80, from non-intervention or control group, focus on relatively healthy subject, were included in the analysis. Data was systematically extracted and narrated. Data collection was done between March and April 2010.

Result

From visits to 38 Libraries of 27 institutions, 224 references were found, however, only 58 eligible references were included for analysis. From those, mostly (53%) came from national journals and some (10%) was obtained from the internet. The studies covered 4 provinces, mostly conducted at district level (47%) and in urban setting (.66%). Most literatures stated that elderly eat variety of food, with rice as the staple food and tofu, tempe, vegetables, and fruits as side dish, although in small portion. The macronutrients intake was below the nutrient requirements (less than or equal to 75% of the Recommended Daily Allowance (RDA)), while the micronutrients intake was mostly sufficient (vitamin-A and C). About 50% of the elderly exercised 1-2 times weekly and spent less than 30 minutes per exercise. Anthrophometry was a method widely used to monitor nutritional status of elderly. Nutritional problems such as underweight (range 6%-30%), overweight (range 3%-22%), obesity (5%-22%), and Iron Deficiency Anemia (IDA) were still present among the elderly.

Introduction

Many studies on food consumption, physical activity, lifestyle, and nutritional status have been conducted in Indonesia. However, there is an absence of a systematic review to bring together all the studies which have been carried out in Indonesia and provide a complete picture on evidences of food consumption during pregnancy and lactation.

Objective

This study aimed to review studies on food consumption, nutritional status and physical activity among pregnant and lactating mothers conducted by several institutions and researchers in Indonesia.

Methods

We searched all identifiable research papers including printed or electronically published journals, dissertations, thesis, and reports of all studies conducted in Indonesia. Inclusion criteria are those which report food consumption, physical activity and healthy lifestyle, and nutritional status of pregnant and lactating mothers.

Results

From 398 papers which were relevant to our search criteria only 91 papers were eligible for analysis. We found that pregnant mothers tended to increase their macronutrient intake during pregnancy. Their iron intake was low compared to current recommendation (Angka Kecukupan Gizi - AKG). Several studies revealed that iron and vitamin C intake of pregnant mothers in rural area were lower than those in urban area. Several pregnant mothers still practiced some risky eating behavior including ngapii (reduce intake for easier labor). Body weight increments were observed to be lowest on the fourth month of pregnancy, and highest on the ninth. In contrast to studies on pregnant mothers, studies on lactating mothers are still limited. A study had showed that protein, iron and vitamin C intake of lactating mothers were lower than current recommendation. Reports on energy intake varied greatly between studies. One study reported that 52% lactating mothers in the study population were anemic.

Conclusion

Our findings suggest that nutrient intake of pregnant and lactating mothers in several areas were lower than recommendation. Nutrition status had been monitored for years but our review revealed that there is still found a significant number of anemia and low nutritional status in pregnant and lactating mothers. Our study only described several studies in particular areas in Java Island, further research is needed to cover the other areas in Indonesia.