World Nutrition Journal

The role of Artificial Intelligence in nutritional assessment in clinical practice

Pittara Pansawira — 2025-02-28

Nutrition plays a crucial role in clinical practice, impacting immune function, disease prevention, and treatment. However, assessing a patient’s nutritional status remains challenging due to individual differences and the limitations of traditional methods like dietary recalls and food diaries, which can be subjective and time-consuming.

Artificial Intelligence (AI), particularly machine learning, is emerging as a powerful tool to enhance nutritional assessments. AI can quickly and accurately analyze large datasets, enabling both patients and clinicians to track and manage dietary intake, blood sugar levels, and other health metrics through apps and wearable devices.

Despite its promise, AI in nutrition faces challenges such as data accuracy, potential misdiagnoses, and ethical concerns related to data privacy and security. Nonetheless, as technology advances, AI is set to play an increasingly significant role in nutrition diagnostics and healthcare, offering new possibilities for personalized and efficient nutritional management.

A scoping review : Potential nutraceutical values of bioactive compounds and antioxidant activity in durian seed – An exotic tropical plant

Siti Aisyah — 2025-02-28

Background: Durian is a tropical fruit with a unique flavour and intense aroma. All parts of durian are reported to have many health benefits, especially the seeds. The seeds are known to have higher antioxidant activity and phytochemical compound than the pulp. Durian seeds are food waste that has the potential to be reused in the food and health industry.

Objective: This article provides information on the presence of bioactive compounds, antioxidant activity, and the potential use of durian seeds as therapeutic agents.

Methods: The study used a scoping review with four databases: Google Scholar, PubMed, DOAJ, and ScienceDirect. Scoping is needed to complete the article, summarize scientific data, and as a future reference regarding the nutraceutical potential of durian seeds.

Results: A total of 6 articles were reviewed based on the screening results. The bioactive compounds found in these articles are phenolics, flavonoids, α-tocopherol, terpenoids, saponins, anthraquinones, and several flavonoid classes such as catechin, rutin, isoquercitrin, quercitrin. Total phenolic content (TPC) and antioxidant activity were highest in the Chanee durian seed cultivar compared to the Monthong type and various other cultivars from several countries.

Conclusion: Durian seeds as food waste seem to have potential as a nutraceutical. Known as food waste that is rarely utilized, based on several studies, durian seeds have several benefits, one of which is to overcome various diseases. Further research needs to be done to prove that durian seeds can be helpful in the food industry as well as in pharmaceutical and cosmetic applications.

Effect of omega−3 fatty acdid supplementation on reduce body weight and body fat mass in obesity

Lidya Anissa — 2025-02-28

Background: Obesity is a public health problem, especially in developing countries. Providing Omega−3 supplementation has benefits to reduce body weight and body fat mass.

Objective: This study aims to determine the effect of omega−3 supplementation on weight loss and body fat mass in obesity.

Methods: This study used a literature search using advanced queries in the databases PubMed, Scopus, ProQuest, Cochrane Library, and combined MeSH terms with Title/Abstract. The collected literature is discarded if there are duplicates, then literature that meets the eligibility criteria is filtered. We used the Oxford Center for Evidence-Based Medicine as a means of critical appraisal and determining the level of evidence of the selected literature.

Results: Four chosen study were selected. The first study involved 39 adults with obesity, there was a weight loss of 6.04 kg in the group given omega−3 supplementation of 6 g/day for 8 weeks compared to the placebo group 5.4 kg and there was a decreased in body fat mass in the intervention group. The second study did not show a significant result. The third study on 65 women showed a weight loss of 3.07 kg in the group given omega−3 consisting of 1.08 g EPA and 0.72 g DHA compared to 1.16 kg in the placebo group for 12 weeks. In the fourth study, a systematic review study, there was no conclusive result.

Conclusion: Omega−3 fatty acid supplementation could be beneficial in reducing weight in obese patients with dietary modification.

Effect of magnesium supplementation on glycemic control in type 2 diabetes mellitus

Anita Janetthe Apriyanti G — 2025-02-28

Background: Diabetes mellitus is one of the most serious and common chronic diseases, leading to life-threatening, disabling and costly complications, and reducing life expectancy. Poor intracellular magnesium concentration may contribute to insulin resistance, whereas higher magnesium levels are associated with increased insulin sensitivity. This study aimed to investigate the effect of magnesium supplementation on glycemic control in patients with type 2 diabetes.

Objective: This study aimed to investigate the effect of magnesium supplementation on glycemic control in patients with type 2 diabetes.

Methods: A literature search was conducted using three major databases: PubMed, Cochrane Library, and EBSCOhost. MeSH terms, advanced search, and eligibility criteria were used for title and abstract screening after removing duplicates. Critical assessment tools and levels of evidence of the final articles are based on the Oxford Center for Evidence-Based Medicine.

Results: A meta-analysis and two RCTs met the PICO and eligibility criteria. One meta-analysis found that magnesium supplementation significantly reduced fasting blood glucose and HbA1c. One RCT reported that magnesium supplementation significantly improved HbA1c, insulin levels, and HOMA-IR. Another RCT found that there were no differences in HbA1C and continuous glucose monitoring.

Conclusion: Magnesium supplementation may have a beneficial effect on glycemic control in patients with type 2 diabetes. However, further research is needed to establish optimal dosage and the most effective form of magnesium supplementation.

Relationship between protein intake and nutritional status with response therapy of intensive phase in pulmonary tuberculosis patients in Dili and Oecusse

Merita Marques Lafo — 2025-02-28

Background: Tuberculosis (TB) infection triggers a decrease in appetite and disrupts protein metabolism. Protein provides the main source of amino acids for immune system formation and tissue repair, both of which are impaired in tuberculosis patients. Intensive phase anti-tuberculosis therapy aims to boost immunity, reduce bacterial load, and improve nutritional status. Pulmonary TB is the leading cause of death in Timor Leste (94% mortality rate by 2021), yet few studies have explored the relationship between nutrition and treatment response. This study investigated the relationship between protein intake, nutritional status, and treatment response in pulmonary TB patients undergoing intensive therapy in Dili and Oecusse.

Method: Using a cross-sectional study design, 104 participants were recruited using consecutive sampling. Data collection included both primary and secondary data. Analyses were conducted using the independent samples t-test, Mann-Whitney, and Fisher's Exact Test.

Results: There are 66.3% at risk of malnutrition based on upper arm circumference, a mean body mass index of 17.86 kg/m². The median daily protein intake was 1.07 g/kgBW/day, with lower intake of animal protein compared to plant protein (0.44 g/kgBW/day vs. 0.59 g/kgBW/day). The study found no significant relationship between protein intake and nutritional status in response to the intensive phase therapy (p>0.05).

Conclusion: There is no significant relationship between protein intake and nutritional status in response to the intensive phase therapy. Further research with a case-control study design is needed to confirm findings and evaluate factors affecting unbalanced therapy response.

Leucine-included liquid diet as medical nutrition therapy improved handgrip strength and mid-upper circumference in clinically malnourished pulmonary tuberculosis patient with high neutrophil lymphocyte ratio

Anna Maurina Singal — 2025-02-28

Background and objectives: Muscle weakness delays clinical improvement in pulmonary tuberculosis patients. Higher neutrophil lymphocyte ratio, low handgrip strength, mid-upper arm circumference indicates bad clinical outcome. Weight loss must be managed from the start of treatment. Good muscle condition has benefits to the recovery rate. Leucine provides benefits in increasing the synthesis of muscle mass so as the clinical conditions. Unfortunately, leucine has not been the routine part of medical nutrition therapy in tuberculosis patients.

Methods: This is a case report of a female patient with body weight 42 kg and height 150 cm, admitted to Universitas Indonesia Hospital, with lung tuberculosis. Leucine given, started from 1.95 g/day to the maximum amount of 7,34 g/day through the hospital tailored-made liquid food. There was an improvement of clinical signs and symptoms during 14 days of hospitalization. Mid-upper arm circumferences at day 1, 8, and 15 were 21.1, 21.4, and 12.9 21.9 cm in a row. The right and left handgrip strength at day 1, 8, and 15 were 9.7 kg and 8.1 kg, 10.9 kg and 8.9 kg, 15.1 kg and 13.4 kg, respectively. While the neutrophil lymphocyte ratio at day 0, 6, and 9 were increasing, at 6.89, 6.89, and 13.8, in a row.

Conclusions: Leucine 1.95–7.34 g/day, in tailored-made liquid food, as part of tuberculosis management therapy, though the NLR 13.8, can improve the mid-upper arm circumference, handgrip strength, clinical signs and symptoms in 14 days of hospitalization.

Evaluation of the prevalence, and relationship between nutritional status, malnutrition, and quality of life in cancer patients undergoing chemotherapy in Mashhad, Iran in 2023

Ali Zeyghami — 2025-02-28

Introduction: Cancer patients face high risks of malnutrition, low muscle mass, and sarcopenia due to decreased intake and treatment side effects. This malnutrition can lead to longer hospital stays, higher mortality, lower quality of life, and poor treatment tolerance. The purpose of this study is to evaluate the prevalence and relationship between nutritional status, malnutrition and quality of life in cancer patients undergoing chemotherapy in Mashhad, Iran in 2023.

Method: In a cross-sectional study, we evaluated 237 cancer patients from Razavi, Nazeran, Qhaem, and Omid Hospitals using the Patient-Generated Subjective Global Assessment (PG-SGA). Data analysis was conducted with SPSS version 21.

Results: Among the 237 patients assessed, 61.6% were identified as female. The PG-SGA scores indicated that the prevalence of malnutrition and the risk of malnutrition were 89.9% (n=213) and 7.2% (n=17), respectively. Our findings revealed significant differences in physical function, role function, and emotional status dimensions between the malnourished group and the normal/at-risk malnutrition group (P < 0.001). In contrast, no significant differences were found in cognitive function and social function. Furthermore, there were significant variations in fatigue, pain, and appetite levels between the malnourished group and the normal/at-risk malnutrition group, as assessed by the QoL questionnaire.

Conclusion: It was determined that 89.9% of cancer patients across all treatment modalities were malnourished and required immediate care. Gastrointestinal cancer was found to have the highest malnutrition rates when compared to other cancer types.

Correlation of energy and protein intake with nitrogen balance changes in late acute phase critically ill patients

Githa Putri Puspita Sari — 2025-02-28

Background: The hypercatabolic process due to metabolic stress in critically ill patients, especially in the acute phase, is very high, causing protein degradation. Inadequate intake and high protein losses will result in a negative nitrogen balance.

Objective: To analyze the correlation of energy and protein intake in the late acute phase with nitrogen balance changes.

Methods: This study’s method was cross−sectional with consecutive sampling, conducted in the ICU of the university of Indonesia hospital. Energy and protein intake were assessed for 7 days. On days 3 and 7 of treatment, 24−hour urine urea nitrogen levels and nitrogen balance (NB) were assessed. Twenty three subjects participants in this study.

Results: There was a positive correlation between energy and protein intake with NB on day 3 (r=0.5, p=0.01 ;r=0.6, p=0.003). The mean nitrogen balance changes was positive, namely 3.8 g. There was a significant correlation between energy and protein intake with NB changes (p>0.01)

Conclusion: Energy and protein intake were positively correlated with nitrogen balance in the early acute phase. The results show that the administration of energy and protein starting at low intake in the early acute phase and gradually reaching the target intake during the late acute phase leads to an improvement in nitrogen balance.

Correlation between body mass index and 25(OH)D levels in pregnant women

Verawati Sudarma — 2025-02-28

Background: Vitamin D is a vitamin that has a positive effect on maternal and infant health. The mother's nutritional status affects vitamin D levels, where one of nutritional status is expressed in body mass index (BMI). It has been assumed that BMI has the potential to influence the mother's vitamin D levels.

Objective: This study analyzes the correlation between BMI and 25(OH)D levels in pregnant women.

Methods: This observational analytical study examines data from the medical records of pregnant women who underwent antenatal examinations at the AMS Clinic Kemang from January 2022 to December 2023. The data analyzed were maternal age, gestational age at the time of vitamin D examination, gestational age at delivery, 25(OH)D levels, and maternal BMI. The Pearson correlation or Spearman Rank test was used in bivariate analysis, with a significance level of p<0.05.

Results: The mean maternal age was 33.45±6.24 years, with the median gestational age at the time of vitamin D examination being 6.5 mg. The median gestational age at birth was 39 weeks, with vitamin D levels of 20.8 ± 7.8, and a median BMI of 24.22 kg/m2. Based on the results of the Spearman statistical test analysis, there is a strong negative significant correlation between body mass index and levels of 25(OH)D in pregnant women (r -0.747; p=0.008).

Conclusion: Pregnant women's body mass index correlates negatively with levels 25 (OH)D. Therefore, it is recommended that pregnant women maintain a BMI within the normal range.

Socio-demographic, exercise, and anthropometric profiles of adults participating in fitness exercise programs in Vhembe district, Limpopo province, South Africa

Rendani Raymond Ramashidzha — 2025-02-28

Introduction Adults in Vhembe district participate in fitness exercise programs for optimal health. However, the nutritional profiles of these participants remain unknown.

Aim: To assess the socio-demography, calculate BMI and measure WC of adults participating in fitness exercise programs around Vhembe district, Limpopo Province.

Method: A cross–sectional study design was conducted to assess socio-demographic and anthropometric profiles of 112 adults participating in fitness exercise programs around Vhembe district, Limpopo Province. Ethical clearance was obtained from TREC and written consent by the participants. Socio-demographic profile included, for example, age, education status, duration and frequency of training. Anthropometry included weight and height to calculate BMI, and waist circumference. Data were analyzed using SPSS (v29). The Chi-square test, with a p-value of <0.05, was used to determine the association among variables.

Results: Males were aged 36.3±9.3 and females 32.1±8.7 years; training three times per week for two hours in aerobics and bodybuilding programs. Most participants had bachelor’s degrees (males, 35.5%; females, 29.8%) and diplomas (males, 32.3%; females, 27.7%). Unemployment was higher (57.4%) among females compared to males (38.5%). Aerobic participants were overweight (males, 27.8±4.7; females 28.8±4.8 kg/m²) whereas those in bodybuilding were obese (31.0±16.9, males and 37.5±0.0 kg/m², females). Participants in both programs had optimal waist circumferences (<102 cm, males and <88 cm, females). Anthropometry was associated (p<0.05) to demography among the aerobic exercise participants.

Conclusion: Participants trained once per day, three times a week for two hours. The majority had higher education qualifications, however, unemployed. Participants were overweight with acceptable waist circumference values

Association between mother’s purchase intention of iron-fortified infant cereal and iron intake among children aged 6-23 months in Tangerang, Indonesia

Yustina Rossa Simatupang — 2025-02-28

Background: Iron deficiency can lead to anemia, negatively impacting children's cognitive and physical development. Mothers' knowledge of iron and the benefits of fortified complementary foods may have influenced their purchase intentions and decisions.

Objective: This study aimed to investigate the association between mothers' purchase intentions, actual purchases of iron-fortified infant cereals, and iron intake in children aged 6–23 months in Tangerang, Indonesia. Research on this topic remained limited, emphasizing the need for further studies to strengthen the existing evidence.

Methods: This study employed a cross-sectional design involving 162 mothers in pairs with their children aged 6–23 months, recruited consecutively. Data were collected using validated questionnaires. Data analysis was performed using the non-parametric Mann-Whitney test to compare groups and Spearman's correlation test to assess the strength of relationships between variables. A p-value < 0.05 was considered statistically significant.

Results: Mothers showed positive attitudes and intentions towards purchasing iron-fortified cereals, with a notable 51.9% having made recent purchases. While these purchase intentions correlate with actual purchases, they did not directly influence children's iron intake. Instead, factors such as mother’s education, occupation, and household income played significant roles in determining iron intake levels.

Conclusion: Purchase intentions were associated with actual purchase intention; however, factors such as gender, mother’s education, occupation, and household income did not exhibit a direct relationship with children's iron intake. This study indicates that while mother’s purchase intentions are associated with actual purchases, they do not directly impact children's iron intake.

The implementation and challenges of breastfeeding counselling program in Majene district, West Sulawesi: A qualitative study among health workers

Dyah Febriyanti — 2025-02-28

Background: Inadequate breastfeeding practices increase the risk of malnutrition, infant deaths, and other related developmental problems. Counselling on breastfeeding promotion is one of the most effective ways to improve breastfeeding practices. Nevertheless, challenges in implementing the counselling hinder its effectiveness. Using the logic model framework, this study examines the implementation and challenges of breastfeeding counselling programs in Majene District, West Sulawesi

Objective: This study aims to gain an in-depth understanding of experiences and perspectives regarding the implementation of the breastfeeding counselling program using the Logic Model among health workers in Majene District.

Methods: From January to June 2024, a qualitative phenomenological approach was employed. Data collection included in-depth interviews with 12 trained breastfeeding counsellors, eight key informants, and focus group discussions with 24 mothers. Thematic analysis using NVivo 12, guided by the Logic Model framework, which grouped breastfeeding counselling into input, process, outputs, and outcomes aspects.

Results: Key challenges included a shortage of trained counsellors, limited infrastructure, and budget constraints. Health workers adapted by integrating counselling into maternal health services, conducting home visits, and collaborating with Posyandu cadres. Exclusive breastfeeding rates showed slight improvements but remained below national targets. Beneficiaries expressed satisfaction but highlighted the need for longer and more frequent counselling sessions.

Conclusions: The program faced significant resource challenges, including a shortage of skilled counsellors, budget constraints, and limited facilities. However, adaptive strategies by health workers crucial for overcoming logistical and resource constraints resulted in beneficiaries’ satisfaction and positive developments in breastfeeding rates.

Gender, education, eating patterns, and nutritional status among high school students in the tourist area of Bukittinggi, Indonesia

Zuhrah Taufiqa — 2025-02-28

Background: The well-being of high school students in tourist shapes their eating habits and affects their nutritional status, leading to obesity and malnutrition.

Objective: This study aims to examine the association between gender, education, eating patterns, and nutritional status among high school students in tourism areas.

Methods: This cross-sectional study was conducted in October 2023 and included 118 students aged 12–18 years from junior and senior high schools in Bukittinggi, West Sumatra. Respondents were selected through multistage stratified clustered sampling. Data on gender, age, education, and eating patterns which assessed using a food frequency questionnaire classified according to the Guttman scale. Nutritional status was determined based on BMI-for-age WHO z-scores following the Indonesian Minister of Health Regulation. Data were collected via interviews using a questionnaire on the KoboToolbox application and analyzed using Chi-square tests.

Results: Most high school students (89.8%) had poor eating patterns, with 45.8% having a normal BMI-for-age, 34.7% undernourished, and 19.5% overweight or obese. Gender was significantly associated with nutritional status (p=0.007), with thinness more common in boys and normal BMI-for-age more prevalent in girls, while education and eating patterns showed no significant association. However, frequent consumption of sugary drinks was linked to higher rates of overweight and obesity.

Conclusion: There were gender differences in nutritional status among high school students in Bukittinggi, a tourist area, underscoring the need for targeted gender-focused nutrition interventions to address healthier eating patterns in tourism regions.

A qualitative study on the experiences of the prospective brides about nutritional preparation during the preconception period

Phellia Emirza — 2025-02-28

Background: Stunting is still a nutritional problem in Indonesia, where maternal malnutrition is one of the causes. Studies show that prospective brides and women of childbearing age in Indonesia are not physically and knowledgeably ready for pregnancy. Nutritional preparation is crucial during preconception, as preconception nutritional status can have cross-generational impacts, yet it is often overlooked.

Objective: This study aimed to explore the experiences of prospective brides regarding nutritional preparation during the preconception period.

Methods: This qualitative research was conducted in Bogor, Indonesia, using in-depth interviews and participatory methods. The main informants of this study were 20 prospective brides selected through convenience sampling. Additionally, 21 key informants were involved for triangulation. Data analysis was conducted by coding verbatim transcripts using NVivo12 software. The results of this study used a pre-determined theme aligned with the research objectives.

Result: Almost all informants agreed that preconception nutritional preparation was crucial before marriage. Several nutritional preparation activities carried out by prospective brides emerged from this study, such as pre-pregnancy weight management and eating nutritious and healthier foods. However, many prospective brides still did not perform these activities optimally.

Conclusion: Many prospective brides were already putting efforts to undertake nutritional preparation. However, knowledge gaps and misunderstandings among brides and grooms regarding nutritional preparation persist. There is a need to improve their awareness at preconception period and ensure government programs are accessible, equitable, and effective. This study offers new insights into nutritional preparation for brides, an area that is underexplored.

Association between maternal anemia and low birth weight among stunting children 12−23 months in Dili, Timor Leste

Da Costa Hornay Florencia Grifit Joiner — 2025-02-28

Background: Stunting is a chronic malnutrition problem primarily occurring during the first 1000 days of life. Iron deficiency anemia during pregnancy can threaten fetal growth and may affect the baby's birth weight and length. According to the Timor-Leste Food and Nutrition Survey 2020, stunting in Timor-Leste is 47.1%.

Objectives: To determine the relationship between a history of anemia during the third trimester of pregnancy and low birth weight with the incidence of stunting in children aged 12-23 months in Dili city.

Methods: This study was a case-control design conducted in five health centers in Dili City, Timor-Leste. The sample consists of 180 children aged 12-23 months, with 90 stunted cases and 90 controls selected consecutively. Data collected encompasses both child-related and maternal information.

Results: Anemia during the third trimester of pregnancy OR 95%CI 7.18 (3.38-15.23) and low birth weight OR 95%CI 5.39 (2.09 – 13.90) are significantly associated with the incidence of stunting (p < 0.01). Based on logistic regression analysis, anemia during pregnancy and low birth weight are not significantly associated with an increased risk of stunting. However, there are characteristics of the mother and child that are significantly associated with the risk of stunting.

Conclusion: Children with a history of low birth weight are 5.3 times more likely to experience stunting, and children whose mothers had anemia during pregnancy are 7.2 times more likely to experience stunting. The results show that low birth weight and maternal anemia are related to the incidence of stunting in Timor-Leste.