World Nutrition Journal

Breastfeeding and complementary feeding practices and management of wasting of the young children

Judhiastuty Februhartanty — 2024-08-30

Human milk is the standard for infant nutrition and growth. World Breastfeeding Week (WBW) is essential in raising awareness, providing support, and advocating for breastfeeding, which leads to healthier communities. Over recent decades, there has been a significant increase in breastfeeding rates, a broader acknowledgment of human milk as the primary food for infants, and a deeper understanding of breastfeeding's role in human development, ushering in a new era for breastfeeding

Effect of vitamin D supplementation on lung function in chronic obstructive pulmonary disease patients

Annisa Nurul Kirana — 2024-08-30

Background: Chronic obstructive pulmonary disease (COPD) is characterized by progressive and persistent airflow obstruction together with an increased chronic inflammatory response, primarily caused by environmental exposure and smoking habit. Vitamin D deficiency is associated with increased rates of exacerbation and hospitalization in COPD patients. Recent studies have indicated a direct correlation between vitamin D deficiency and the severity of COPD, suggesting that acute exacerbation could be prevented with vitamin D supplementation. Some studies propose that correcting the serum vitamin D level may improve the prognosis for COPD patients experiencing respiratory tract infections.

Objective: The aim of this study was to determine the effect of vitamin D supplementation for lung function in COPD patient.

Methods: Literature search was carried out by advanced searching on Pubmed, Cochrane Library, and Scopus using a combination of MeSH Terms and Title/Abstract. Following screening for duplications, the literature obtained then screened according to predetermined eligibility criteria. The appropriate literatures were critically reviewed and the level of evidence in accordance with the Oxford Center for Evidence Based Medicine.

Results: One meta-analysis and three randomized controlled trial (RCT) met the PICO and eligibility criteria that had been set. Three studies concluded that vitamin D supplementation enhanced lung function in COPD patient. Vitamin D deficiency is common in COPD patients, so it is recommended to check vitamin D levels before vitamin D supplementation.

Conclusion: Vitamin D administration can improve lung function and prevent acute exacerbation in COPD patients.

Role of folic acid supplementation in level of c-reactive protein in metabolic syndrome

Anissa Syafitri Sjarkowi — 2024-08-30

Introduction: The prevalence of metabolic syndrome is increasing, its progression involves an inflammatory response that has an important impact on the initiation, progressivity, and complications of several diseases such as heart disease, stroke, type 2 diabetes mellitus, and cancer. C-reactive protein (CRP) is one of the inflammation markers increased in patients with metabolic syndrome. Folic acid has a role in metabolizing homocysteine and improving endothelial function. There have been many studies conducted, but the results are still inconsistent.

Method: Literature searching was conducted using PubMed, Cochrane Library, and Embase databases. MeSH terms, advanced search and eligibility criteria were used for title/abstract screening before journal review.

Results: One systematic review and meta-analysis (SR-MA) and one RCT met the PICO and eligibility criteria. The SR-MA found that folic acid administration can reduce CRP level (WMD -0.94 (95% CI -1.56 – 0.32; p=0.00) at a dose of 0.15 mg/day for 12 weeks to 10 mg/day for 2 weeks, while the RCT found an insignificant result.

Conclusion: Folic acid supplementation has a potential benefit to decrease CRP levels in metabolic syndrome.

The effect of vitamin D supplementation on increasing CD4 levels in human immunodeficiency virus

Dessy Suci Rachmawati — 2024-08-30

Introduction: Human immunodeficiency virus (HIV) is a retrovirus infection that attacks the immune system. According to world data in 2016, the number of HIV-infected patients reached 36.7 million, and 10 million people died due to acquired immunodeficiency syndrome (AIDS). Patients with HIV infection are susceptible to decreased levels of vitamin D (25(OH)D) by proinflammatory cytokines or as a result of the use of antiretroviral drugs. Vitamin D plays an important role in immune system, including reducing the production of pro-inflammatory cytokines and increasing the production of cathelicidin that inhibit viral replication. Oral vitamin D supplementation is an effort that can be made to increase vitamin D. To date, the relationship between vitamin D sufficiency and CD4 T cell count remains unclear, although most studies have shown a positive association. This study wanted to determine the effect of oral vitamin D supplementation on increasing CD4 levels in patients with HIV infection.

Methods: Literature search was carried out by advanced searching on Pubmed, Cochrane Library, and Science Direct using eligibility criteria determined by the authors.

Result: One systematic review and three randomized controlled trials (RCT) met the PICO and eligibility criteria that had been set. Three studies concluded that vitamin D supplementation can increase CD4 levels. One study shows that vitamin D supplementation dose of 5,000 IU daily could not increase CD4 levels.

Conclusion: Providing vitamin D supplementation at appropriate dose can increase serum vitamin D levels so that it can increase CD4 levels.

Intermittent fasting-induced improving insulin resistance in healthy obese adults

Nyono Dedi Prabowo — 2024-08-30

Background: Obesity is a severe global public health problem linked to chronic noncommunicable disease and increased mortality. It has harmful effects on metabolic disorders via the insulin resistance pathway. Available guidelines recommend caloric reduction via intermittent fasting for obesity management. However, the available literature is less focused on the benefits of intermittent fasting on improved insulin resistance in healthy obese adults, especially related to an accumulation of free fatty acids. Therefore, a scoping review is necessary.

Objective: This review aims to collect evidence on the benefits of intermittent fasting on improved insulin resistance in healthy obese adults.

Methods: This scoping review followed the 5-step Arksey and O'Malley framework and was submitted following PRISMA ScR. Five electronic databases were thoroughly searched. Papers are included if they are eligible. The result was a synthesis of descriptive and narrative elements.

Results: 1117 papers were collected in total. Nine randomized controlled trial studies met the review's inclusion criteria. The papers included are sourced from reputable, relevant sources. As a whole, intermittent fasting appears to benefit improved insulin resistance in healthy obese adults. Intermittent fasting has been shown to reduce insulin levels while increasing insulin sensitivity, therefore improving insulin resistance.

Conclusion: Evidence suggests that intermittent fasting can help improve insulin resistance in healthy obese adults.

Effect of probiotic administration in adult atopic dermatitis patients

Dewita Nina Paramita Paramita — 2024-08-30

Introduction: Atopic dermatitis (AD) is a chronic skin disease characterized by abnormal skin barrier function and heightened immunologic sensitization. Its incidence has surged recently, with approximately 60% of cases diagnosed within the first year of life. AD can persist or recur, significantly deteriorating the quality of life due to persistent itching and sleep disturbances. Individuals with AD are at increased risk of developing other atopic disorders like asthma and allergic rhinitis. Various dietary approaches, including low carbohydrate, calorie, and fat diets, have been associated with enhanced quality of life by regulating immune responses. Probiotics have been used as adjuvant therapy in allergic conditions, though their effectiveness varies due to the complex nature of allergies.

Method: A literature search was conducted using PubMed, Cochrane Library, and Google Scholar. MeSH terms, advanced search strategies, and predefined eligibility criteria were employed to identify relevant studies. Duplicate studies were excluded, and critical assessment tools and levels of evidence were defined per Oxford Center for Evidence-based Medicine standards.

Results: One systematic review and meta-analysis of randomized controlled trials (RCTs) met the PICO and eligibility criteria. The meta-analysis demonstrated that probiotics significantly decreased AD severity in adults, enhancing their overall quality of life. Other meta-analyses and systematic reviews supported that probiotics reduce clinical severity and improve life quality in adult AD patients.

Conclusion: Probiotic supplementation is a viable option to improve the quality of life for adult AD patients, offering potential therapeutic benefits in managing this condition.

Vitamin D deficiency and risk of myasthenia gravis

Nadiyah Wijayanthie — 2024-08-30

Background: An autoimmune condition known as myasthenia gravis (MG) targets the receptors for neurotransmitter acetylcholine at the neuromuscular junction, resulting in inhibition of muscle contraction. This results in muscle weakness resulting in a decrease in quality of life. Immunoregulation and muscle contractility are known to play a role in vitamin D. Literature on how vitamin D affects myasthenia gravis risk has not been widely carried out and the results are still controversial.
Objective: To evaluate the association between vitamin D and MG risk.
Methods: The search of the literature was conducted from PubMed, Cochrane Library, Embase, and EBSCOhost with the eligibility criteria determined by the authors. The literature search was using MeSH Term, text word, and title/abstract.
Results: Two articles were selected and critically appraised. The first article shows an odds ratio of 3.96 (CI95 1.26 to 12.52), which means that myasthenia gravis has vitamin D levels almost 4 times lower than healthy population. A case-control study that followed described a comparison of mean levels of vitamin D (25(OH)D) in myasthenia gravis (mean, 18.8±8.4 ng/mL) compared to healthy controls (26.3±6.1). ng/mL) (p <0.05). Both studies revealed a strong interaction between MG and vitamin D inadequacy. Conclusion: Both studies above support the theory that vitamin D deficiency is associated with the risk of developing MG.

Validity test of the Global Leadership Initiative on Malnutrition (GLIM) diagnostic criteria compared with the American Society for Parenteral and Enteral Nutrition (ASPEN) criteria in inpatients at Dr. Cipto Mangunkusumo hospital

Oki Yonatan Oentiono — 2024-08-30

Background: Malnutrition experienced by numerous inpatients is linked to various complications. The Global Leadership Initiative on Malnutrition (GLIM), which established the latest malnutrition criteria, recommends a two-step methodology for diagnosing malnutrition in adult inpatients. This study aims to evaluate the validity of the GLIM criteria for the diagnosis of malnutrition in hospitalized patients at Cipto Mangunkusomo Hospital Jakarta by comparing them with the ASPEN criteria.

Methods: This cross-sectional study was conducted at Cipto Mangunkusomo Hospital, Jakarta. Secondary data was taken from 100 inpatients from October 2021 to February 2022 selected by consecutive sampling technique. The diagnosis of malnutrition in the patients applied the ASPEN and GLIM criteria. Furthermore, data were analyzed using Cohen's Kappa and chi-square tests.

Results: Of 100 inpatients, 63% were diagnosed with malnutrition according to the GLIM diagnostic criteria. Meanwhile, 48% of them were found to be malnourished according to the ASPEN criteria. The GLIM criteria have a specificity of 69.2%, a sensitivity of 97.9%, a PPV of 74.6%, and an NPV of 97.3%.

Conclusion: The GLIM diagnostic criteria are valid as an instrument for diagnosing malnutrition but require further research to assess the severity of malnutrition.

A review of anticaking agents in the realm of digital food printing

SONY JOSEPH MALIYIL — 2024-08-30

Background: Various food additives including anticaking agents have been in use since the second half of last century and digital printing of food is in practice. Concerns on food borne disease transmission following COVID-19 accelerated research in the direction of 3D printing. Objective: 3D printing of food depends on the rheological property of the dough. In addition to enhance the flow, anticaking agents which have other properties too can be exploited in 3D printing. Artificial intelligence (AI) assisted printing, targeting sustainability and customizability is in progress which needs data of food additives. The review has been done to consolidate data of the authorised anticaking agents used in food.

Methods:Using terms according to the criteria, a literature search was conducted with the data bases: Google Scholar, PubMed, ScienceDirect and Web of Science. Literature for full text analysis were selected from abstracts of 420 papers and books resulted on search, eliminating those prior to 2014, which were out of scope of the journal

Results:Consolidated literature about the anticaking agents authorised in Codex, is made discussing the deficiencies in the existing evaluation and highlighting the use of anticaking agents in 3D food printing. Promising application of the anticaking agents in AI assisted food printing has been observed.

Conclusion:This review being the first of its kind, consolidates the data of the anticaking agents including the current utility in 3D printing. It may instigate further research in this regard.

Lipid profile and anthropometry indices of franchised fast-food consumers in South Western states in Nigeria

Yewande Uthman-Akinhanmi — 2024-08-30

Background: Franchised fast foods are known for their unique tastes as it contains a number of spices that makes it delicious. Daily busy schedules have made consumption of franchised fast foods (FFFs) an easy option and control of our food choices even at home.

Objective: This research investigated the lipid profile and anthropometric indices of consumers of franchised fast foods (FFFs) in South-Western States in Nigeria.

Methods: This was a cross-sectional study in South-West Nigeria and comprised three states: Lagos, Oyo, and Ogun. 300 respondents were recruited from ten (10) purposively selected fast-food outlets in Ikeja, Abeokuta and Ibadan cities, Nigeria. Standardized method for assessing plasma lipid profile was used. A well-structured and pretested questionnaire was used for the survey. The statistical analysis was done using 95% confidence interval and an error percentage of 5%.

Results: The major consumers of FFFs are single, younger adults, educated, and relatively high-income earners. Majority of male (39% and 23%) and females (33% and 41%) have excellent and good health status respectively. Significant association was observed between BMI and HDL-C (p=0.009) of male, and Significant differences existed among the BMI and all lipid profiles of female respondents (p<0.050).

Conclusion: The study conclude that both genders are at risk of age-related NCDs in the future due to inadequate physical activity and dependence on FFFs. The consumption of FFFs is common among young people, high-income earners and educated people.

Relation between nutrition intake, prediabetes, and central obesity with handgrip strength in Indonesian medical student

Annisa Afifah — 2024-08-30

Background: Muscles are crucial in creating movement, stabilising body posture, and regulating body temperature. Muscle strength can be assessed using handgrip strength. Handgrip strength can predict muscle function, nutritional status, diabetes risk, and the risk of metabolic syndrome. Handgrip strength can be influenced by muscle mass, nutritional intake, fat mass, physical activity level, and metabolic syndrome.

Objective: This research is to find relationship between handgrip strength and nutritional intake, muscle mass, and central obesity.

Methods: The research was conducted as a cross-sectional study using observational analytical methods. The sample consisted of 53 individuals selected through purposive sampling. Handgrip strength can be measured using a hand dynamometer, nutritional intake using a 2x24 hour food recall, muscle mass using a body composition analyzer, central obesity using waist to hip ratio, and fasting blood sugar using a glucometer. Statistical data analysis employed the chi-square test and independent T-test.

Results: The results indicated a relationship between central obesity and handgrip strength (p = 0.006). Researchers are interested in studying muscle strength and its predictors concerning central obesity, prediabetes, and nutritional status in medical students. The results indicated a relationship between handgrip strength and central obesity (p = 0.006), but no relationship was found between handgrip strength and energy intake (p = 0.235), protein intake (p = 0.524), and prediabetes (p = 0.272).

Conclusion: There is a relationship between central obesity and handgrip strength. Future researchers are encouraged to consider additional factors, including physical activity, muscle mass index, and comorbidities.

High blood pressure is correlated with anthropometric status in adults in Gribig district, Central Java, Indonesia

emmanuela Anandita Anughrayasa — 2024-08-30

Background: More than 17 million deaths worldwide are caused by cardiovascular disease due to high blood pressure. According to the World Health Organization (WHO), around 1.3 billion adults will have high blood pressure in 2021. Obesity is a significant factor influencing blood pressure. Waist circumference measurements and body mass index (BMI) can be used to identify obesity issues.

Objective: The aim was to analyze the correlation between BMI, waist circumference, and blood pressure among adults at Primary Health Care in Kudus, Central Java, Indonesia.

Methods: This cross-sectional study evaluated BMI, waist circumference, blood pressure, and questionnaire. Men and women aged 18-59 (healthcare staff, patient caregivers, and patients) who agreed to become study subjects were included. Participants with a history of diseases, current conditions, medication intake that affects blood pressure, and pregnancy were excluded. Samples were taken using purposive sampling and the Pearson test as a statistical analysis.

Results: The analysis showed a significant correlation between the BMI of patients with systolic blood pressure (p=0.000) and diastolic blood pressure (p=0.000). A moderate relationship was found between BMI and systolic blood pressure(r=0.473) and diastolic blood pressure (r=0.439). Moreover, waist circumference was significantly correlated with systolic blood pressure (p=0.000) and diastolic blood pressure (p=0.000).

Conclusion: A significant correlation exists between BMI and waist circumference with blood pressure among adults at the Primary Health Care in Kudus, Central Java, Indonesia.

Development of a sports nutrition knowledge questionnaire for elite track and field athletes

Kalani Weerasinghe — 2024-08-30

Background: Satisfactory nutrition knowledge among athletes is important to encourage proper dietary habits to overcome deficiencies and enhance sports performance. Identifying knowledge gaps in sports nutrition is essential for improving athletes' understanding through a tool that evaluates both general nutrition knowledge (GNK) and sports nutrition knowledge (SNK). This study aims to develop the Athletic Sports Nutrition Knowledge Questionnaire (A-SNKQ) specifically for Sri Lankan track and field athletes.

Methods: The development of the A-SNKQ followed an extensive step-wise approach. Firstly, a systematic literature review was conducted on existing SNK questionnaires for athletes. Secondly, sports nutrition guidelines were incorporated into the questionnaire. Thirdly, information from local literature was gathered to ensure contextual relevance. Lastly, a qualitative study involving key athletic stakeholders was conducted to gain cultural insights.

Results: The final version of the questionnaire consists of 32 questions in 12 sub-sections under two main sections: GNK section covers macronutrients, micronutrients, energy balance, hydration, and weight management, SNK section addresses carbohydrate loading, pre-training, training and post-training meals, sports supplements, supplement label reading, isotonic drinks, doping, and relative energy deficiency syndrome in sports.

Conclusions: The GNK section addresses the fundamental nutritional concepts, while SNK focuses on the knowledge associated with the sporting performance of athletes.

Child rearing workplace policy for working mothers

Fadhila Iswi Deandra — 2024-08-30

Introduction: Straddling work and childcare harms working moms' health, potentially their children too. To address this, child rearing workplace policies are needed. These would promote work-life balance and ensure both mothers' and children's well-being, ultimately protecting pregnant and parenting women at work.

Objective: This study aims to explore the gaps between available child rearing workplace policy for working mothers and the implementation on the field while taking its implications into account.

Methods: We reviewed literature from PubMed electronic database. Predefined keywords were developed and chosen. Relevant articles were filtered according to the inclusion and exclusion criteria. Furthermore, all articles were reviewed independently and those that match were included and charted through Microsoft Excel based on each articles’ characteristics.

Results: There are 13 workplace policies related to childcare for working mothers in the included articles. The most common policy was paid maternity leave. Other frequently mentioned policies included lactation support and facilities, flexible work arrangements, and daycare facilities. All policies have different implementation rates and implications to both working mothers and their children.

Conclusion: Supportive child rearing policies at work benefit everyone: employers, employees, and their families, leading to a better nutritional and health status, hence increase overall quality of life.

Impact of an oral nutritional supplement on nutritional status in older adults with malnutrition: A randomized controlled trial

Ranil Jayawardena — 2024-08-30

Background: The aging population is expanding at an unprecedented rate, leading to a significant increase in the prevalence of malnutrition among older adults. Oral Nutritional Supplements (ONS) have emerged as a widely accepted strategy to address the nutritional needs of this demographic.

Objective: This study aimed to evaluate the impact of an ONS on the nutritional status of malnourished older adults.

Methods: This was an open-label, randomized-controlled, parallel-group, single-centered study. Recruitment criteria were age ≥60 years, and mini nutrition assessment-short form (MNA-SF) score ≤11. A total of 50 participants were randomly assigned to the intervention (IG) and control (CG) groups (1:1 ratio). The IG received 200 mL of ONS as a bedtime drink for 12 weeks, while the CG received 200 mL of water. Nutrition status, biochemical analysis, and dietary assessment were performed at the beginning and end of the study.

Results: Forty-two participants (IG: n=20, and CG: n=22) completed the study. After 12 weeks, the IG showed a significant improvement in the MNA-SF score (p<0.001) compared to the CG (p=0.118). The IG experienced a substantial increment in the vitamin D level (p=0.002). No significant improvements were found in the serum albumin and haemoglobin levels in either group. The intervention led to significant increases in daily intake of energy (p<0.001), carbohydrate (p=0.013), protein (p<0.001), and fat (p<0.001) in comparison to the control group.

Conclusion: Supplementing with an ONS, along with a regular diet, significantly improved nutritional status, some biochemical parameters, and daily intake of energy and macronutrients in older adults with malnutrition.

The roles of growing up milk on growth and anemia prevention in children under 5 years of age

Diana Sunardi — 2024-08-30

Background: Adequate nutrition during the early years of life is necessary for good growth, development, and long-term health outcomes. The first 1000 days of life are a critical time for nutrition.

Aims: This literature review aimed to evaluate the role of growing up milk on growth, stunting, and anemia prevention of under-five children.

Methodology: This study used a literature review approach, searching three databases: PubMed, Google Scholar, and Cochrane. The inclusion criteria in this literature review were 1) randomized clinical trials, systematic review, and meta-analysis, 2) studies conducted over the last 10 years, 3) available in full text, 4) written in Indonesian or English, and 5) Research studies conducted in humans.

Result: We identified 3 publications, that matched the inclusion criteria and research aims, including 2 original articles from Lovell AL, et al and Cervo MCM, et al, and 1 meta-analysis by Brooker PG et al. Fortified milk (GUM) consumption significantly had a positive impact on nutritional status, especially growth and hemoglobin status (anemia).

Conclusion: Fortified milk (GUM) consumption is a solution to macro-micronutrient adequacy in under five children. More efforts are needed to conduct studies in Indonesia on GUM and address specific nutrients that may promote linear growth, reverse stunting and anemia in children.

Changes in nutritional status, risk factors and food intake in stroke subjects: cohort study analysis of non-communicable disease risk factors

Engelien Milannia Gigir — 2024-08-30

Background: Stroke is a major cause of death and disability worldwide, affecting 15 million people annually. In Indonesia, the prevalence is 10.9%. Major risk factors include high blood pressure, obesity, inactivity, poor diet, and smoking.

Objective: This study aims to analyze long-term trends in risk factors, nutritional status, and food intake among stroke patients from 2011-2021, assessing their impact on stroke incidence.

Methods: Data from a longitudinal cohort study of 5,329 subjects, including 215 stroke patients, were analyzed using Microsoft Excel 2019 and SAS software. ANOVA was used to assess annual changes in risk factors, nutritional status, and food intake. Survival analysis was conducted with SAS PROC LIFETEST and PROC LIFEREG.

Results: The cohort was primarily female (62.8%), aged 60 or older (57.2%), senior high school education (25.6%), civil servants (30.7%), and low income (57.2%). Significant changes were noted in BMI (p=0.037), fasting blood glucose (FBG) (p=0.001), HDL (p=0.049), abdominal circumference, smoking habits, physical activity (p<0.001), protein intake (p=0.026), and intake of energy, fat, carbohydrates, and sodium (p<0.001). Factors significantly associated with stroke included age, FBG, postprandial glucose, smoking (p<0.0001), LDL (p=0.0380), HDL (p=0.0126), physical activity (p=0.0455), energy intake (p=0.0002), fat intake (p=0.0007), and sodium intake (p=0.0012).

Conclusions: The study highlights significant changes in nutritional status, glucose levels, HDL cholesterol, physical activity, and smoking habits. These factors, along with age, cholesterol levels, and dietary intake, impact stroke incidence, underscoring the need for comprehensive stroke prevention strategies.

The Corelation Between Food Preferences and Nutritional Intake in Food Service at KH Mas Mansur Student Dormitory

Dwi Rakhmawati Rizqillah — 2024-08-30

Background

Having good nutritional knowledge is not enough to form a healthy diet in students, it needs to be supported by a good consumption environment, such as food service in dormitories. Providing healthy food and having good preferences needs to be conducted to increase students' food intake.

Objective

The purpose of this study was to see how the correlation of food preferences in the dormitory with the amount of nutrient intake in students who lived in the KH dormitory

Methods

This study used an analytic observational design with a cross sectional approach. The subjects of this study were students who lived in dormitories with a total population of 365 students. Data collection was carried out by direct interview method with a 24-hour recall form instrumen for 3 days.

Results

The results of the correlation test showed that food preferences in the dormitory were positively correlated with total energy (p=0.032) and protein (p=0.012) intake. There was no correlation between food preferences in the dormitory with intake of fat and carbohydrate.

Conclusions

The higher the students' preference for food in the dormitory, the higher their energy and protein intake. So in this case, it is important for food organizers in the dormitory to further improve food preferences in the dormitory to provide better nutritional intake for students.