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"ABSTRAKStunting growth adalah pertumbuhan abnormal pada tinggi badan yang diklasifikasikan menurut standar pengukuran World Health Organization WHO yaitu tinggi badan menurut usia berada di bawah minus 2 SD. Defisiensi nutrisi yang umum terjadi pada stunting antara lain defisiensi besi. Besi merupakan salah satu komponen penyusun hemoglobin Hb . Hb mengisi eritrosit, dan mempengaruhi ukuran eritrosit MCV . Studi ini menilai hubungan kadar besi serum SI dengan MCV dan Hb. Di samping itu, studi ini juga menilai perbedaan kadar besi serum SI , Hb, MCV, dan TIBC pada kelompok stunting dan non stunting.Dalam pengolahan data, pertama-tama dilakukan uji normalitas Kolmogorov-Smirnov. Uji korelasi nilai SI dengan MCV dilakukan dengan uji korelasi Spearman, diperoleh hasil korelasi lemah dan bermakna secara statistik r = 0,361 dan p = 0,002 . Uji korelasi nilai SI dengan Hb dilakukan dengan uji korelasi Spearman, diperoleh hasil korelasi sedang dan bermakna secara statistik r = 0,559 dan p < 0.001 . Uji perbedaan nilai SI, nilai Hb, dan nilai MCV pada kelompok stunting dan non stunting dilakukan dengan uji Mann Whitney dan diperoleh hasil tidak terdapat perbedaan bermakna pada semua parameter antara kedua kelompok. SI p = 0,224 , Hb level p = 0,266 , MCV p = 0,576 , dan TIBC p = 0,266.

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ABSTRAKAccording to World Health Organization WHO , stunting is an impaired growth in children whose height for age below minus two standard deviations. Stunted children are most likely to also suffer malnutrition. One of the most common malnutrition is iron deficiency. Iron is the component of hemoglobin Hb and its presence can affect the size of the erythrocytes MCV . The aim of this study was to, 1 evaluate the relationship of serum iron SI and MCV also SI and Hb level 2 compare the differences between SI, Hb, MCV, and TIBC in stunting children and non stunting children.To asses the normality of the data, Kolmogorov Smirnov test for normality were performed. The correlation between SI and MCV was assessed using Spearman correlation and there was statistically significant weak correlation between SI and MCV r 0.361 p 0.002 . Spearman correlation test between SI and Hb level gave a statistically significant moderate correlation between SI and Hb level r 0.559 p 0.001 . Furthermore, the Mann Whitney comparison test of SI, Hb level, MCV and TIBC proved to be not significant between stunting children and non stunting children in each of the parameters SI p 0.224 , Hb level p 0.266 , MCV p 0.576 , and TIBC p 0.266 ."

"Stunting merupakan gangguan pertumbuhan dan perkembangan yang dialami anak akibat gizi buruk, infeksi berulang, dan stimulasi psikososial yang tidak memadai yang ditandai dengan indeks TB/U < -2 SD. Stunting dapat menghambat seorang anak dalam mencapai potensi fisik dan kognitifnya baik dalam jangka pendek maupun dalam jangka panjang. Survei Status Gizi Indonesia (SSGI) tahun 2022 mencatat penurunan prevalensi stunting sebesar 2,8% dari tahun 2021 menjadi 21,8%. Prevalensi stunting di Indonesia masih tergolong kategori tinggi. Sulawesi Barat merupakan provinsi dengan prevalensi stunting tertinggi kedua. Terdapat peningkatan prevalensi secara khusus pada kelompok usia 24-59 bulan. Oleh karena itu, penelitian ini bertujuan untuk mengetahui gambaran kejadian stunting dan faktor dominan kejadian stunting pada anak usia 24-59 bulan di Provinsi Sulawesi Barat tahun 2022. Penelitian ini merupakan penelitian kuantitatif dengan pendekatan cross-sectional. Jumlah sampel yang digunakan adalah 2479 sampel menggunakan total sampling. Penelitian ini menggunakan data sekunder SSGI tahun 2022 yang diperoleh sesuai prosedur yang berlaku. Hasil penelitian menunjukkan bahwa 34,8% anak usia 24-59 bulan di Provinsi Sulawesi Barat tergolong stunting. Analisis bivariat menunjukkan bahwa terdapat hubungan yang signifikan antara berat badan lahir (p <0,001; OR = 2,537), panjang badan lahir (p <0,001; OR = 2,355), jumlah anggota keluarga (p = 0,037; OR = 1,194), akses air minum (p = 0,004; OR = 1,382), akses sanitasi (p <0,001; OR = 1,942), dan wilayah tempat tinggal (p = 0,003; OR = 1,333) dengan kejadian stunting. Namun, tidak ditemukan adanya hubungan antara riwayat penyakit infeksi, jumlah anak umur 0-59 bulan, ketahanan pangan, status imunisasi dasar, pemanfaatan posyandu, suplementasi vitamin A, dan pemberian obat cacing dengan kejadian stunting. Penelitian ini menemukan bahwa faktor dominan kejadian stunting pada anak usia 24-59 bulan di Provinsi Sulawesi Barat adalah panjang badan lahir.

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Stunting is a growth and development disorder experienced by children due to poor nutrition, recurrent infections, and inadequate psychosocial stimulation which is characterized by a HAZ index < -2 SD. Stunting can prevent a child from reaching his physical and cognitive potential, not only in the short but also in the long term. The 2022 Survei Status Gizi Indonesia (SSGI) recorded a reduction in stunting prevalence of 2.8% from 2021 to 21.8%. The prevalence of stunting in Indonesia is still in the high category. West Sulawesi is the province with the second-highest prevalence of stunting. There is a particular increase in prevalence in the 24-59 months age group. Therefore, this study aims to determine the description of stunting and the dominant factor in the incidence of stunting in children aged 24-59 months in West Sulawesi Province in 2022. This research is a quantitative study with a cross-sectional approach. The number of samples used was 2479 samples using total sampling. This research uses SSGI secondary data for 2022 which was obtained according to applicable procedures. The research results show that 34.8% of children aged 24-59 months in West Sulawesi Province are classified as stunted. Bivariate analysis showed that there was a significant relationship between birth weight (p < 0.001; OR = 2.537), birth length (p < 0.001; OR = 2.355), number of family members (p = 0.037; OR = 1.194), access to water (p = 0.004; OR = 1.382), access to sanitation (p < 0.001; OR = 1.942), and area of ​​residence (p = 0.003; OR = 1.333) with the incidence of stunting. However, no relationship was found between the history of infectious diseases, number of children aged 0-59 months, food security, basic immunization status, use of integrated service post (posyandu), vitamin A supplementation, and administration of deworming drug (p > 0,05) with the incidence of stunting. This research found that the dominant factor in the incidence of stunting in children aged 24-59 months in West Sulawesi Province is birth length."

"Stunting terjadi dimulai didalam Rahim dan berlanjut setidaknya selama 2 tahun pertama kehidupannya, menentukan potensi individu untuk kehidupan kedepan dalam hal risiko morbiditas dan mortalitas, prestasi sekolah, produktivitas kerja, kekuatan fisik, dan risiko penyakit kronis. Tujuan dari penelitian ini untuk Mengetahui Potret Anak Stunting di Desa Pangkalan, Kecamatan Teluk Naga, Kabupaten Tangerang Tahun 2017. Penelitian Kualitatif dengan Rapid Assessment Procedures (RAP), dilakukan kepada informan yang memiliki anak stunting usia < 23 bulan dan 24-59 bulan pada bulan Juni 2017. Penggalian informasi melalui Diskusi Kelompok Tearah, Wawancara mendalam serta observasi. Hasil penelitian menunjukkan, sebagian besar informan memiliki tinggi badan < 150 cm, usia antara 20-25 tahun dan jarak antar kehamilan > 3th, tinggal di wilayah yang sanitasinya kurang baik karena sebagian besar masih BAB di kali dan sampah keluarga yang dibakar disekitar rumah. Anggota keluarga lain selain ibu ikut terlibat dalam pengasuhan anak. Sebagian besar informan tidak melakukan IMD dan ASI Eksklusif. Pola asuh makan informan terhadap anaknya tergolong kurang baik karena anak sering diberikan makanan jajanan, saat anak sakit, makanan yang diberikan lebih sedikit, dan anak makan sambil jalan-jalan, untuk keanekaragaman makanan juga masih kurang dimana sayuran sebagian besar hanya diberikan kuahnya saja sementara buah jarang diberikan. Kemudahan akses terhadap pelayanan kesehatan tidak dimanfaatkan dengan baik terlihat sebagian besar informan hanya mengimunisasi anaknya 2-3 kali dan pengetahuan tentang gizi seimbang masih kurang, dan masih mengikuti budaya untuk memantang beberapa makanan selama hamil.

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Stunting takes place inside the uterus and continues for at least the first 2 years of life, determining the individual's potential for future life in terms of risk of morbidity and mortality, school performance, work productivity, physical strength, and chronic disease risk. The purpose of this research is to know the Portrait of Stunting Children in Pangkalan Village, Teluk Naga Subdistrict, Tangerang Regency Year 2017. Qualitative Research with Rapid Assessment Procedures (RAP), conducted to informants who have child stunting age <23 months and 24-59 months month June 2017. Excavation of information through

Focus Group Discussion, In-depth interview and observation. The results showed, most informants have a height <150 cm, age at the time od pregnancy between 20-25 years and distance between pregnancy> 3th, living in a poorly sanitary area because most are still defecate in the river and family trash burned around the house Family members other than mothers get involved in parenting. Most

informants do not do IMD and Exclusive Breast Milk. Feeding patterns of informants to their children are not good enough because children are often given food snacks, when children are sick, the food is given less, and children eat while walking, for the diversity of food is also still lacking where most vegetables are only given sauce only while the fruit Rarely given. Ease of access to health services is not well utilized seen most informants only immunize their children 2-3

times and knowledge about balanced nutrition is still lacking, and still follow the culture to challenge some food during pregnancy."

"Latar Belakang: Stunting merupakan salah satu bentuk dari malnutrisi dengan prevalensi paling tinggi. Kondisi ini terjadi di berbagai negara salah satunya di Indonesia dengan prevalensi terbesar berada di NTT. Dampak dari stunting bermacam-macam seperti meningkatkan resiko penyakit non-communicable pada saat dewasa, serta meningkatkan resiko obesitas pada saat dewasa. Pertumbuhan dipengaruhi oleh berbagai hormon, salah satunya adalah leptin. Leptin dapat diproduksi dalam jumlah sedikit pada kelenjar saliva mayor. Namun, penelitian yang menunjukan hubungan stunting dengan kadar leptin masih terbatas khususnya dalam penelitian yang menggunakan saliva sebagai sampel. Tujuan: Menganalisis perbedaan kadar leptin pada saliva anak usia 6-8 tahun pada anak-anak berkategori stunting dan non-stunting serta menganalisis korelasinya. Metode: Penelitian ini menggunakan 84 sampel saliva anak usia 6-8 tahun di NTT yang dikategorikan menjadi stunting dan non-stunting. Saliva diteliti menggunakan BioEnzy© ELISA kit untuk melihat kadar leptin lalu dilakukan kuantifikasi menggunakan ELISA reader dengan panjang gelombang 450 nm. Dari pembacaan tersebut didapatkan nilai absorbance dan konsenterasi sampel saliva. Selanjutnya konsenterasi leptin sampel saliva dianalisis secara statistik menggunakan SPSS untuk mengetahui nilai komparasi dan korelasi dengan status stunting dan non-stunting. Hasil: Rata-rata kadar leptin saliva anak-anak 6-8 tahun stunting ditemukan lebih tinggi daripada anak-anak non-stunting. Terdapat hubungan linear negatif sedang yang bermakna antara kadar leptin saliva anak 6-8 tahun dengan status stunting (r = -0,287, p < 0,05). Kesimpulan: Terdapat perbedaan dan hubungan antara kadar leptin pada saliva anak usia 6-8 tahun dengan status stunting dan non-stunting. Hal ini dapat terlihat dari rata-rata kadar leptin pada saliva yang lebih tinggi pada anak-anak berstatus stunting daripada non-stunting.

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Background: Stunting is a form of malnutrition with the highest prevalence. This condition occurs in various countries, one of which is Indonesia, with the greatest prevalence in NTT. The impact of stunting varies, such as increasing the risk of non-communicable diseases as adults and increasing the risk of obesity as adults. Growth is influenced by various hormones, one of which is leptin. Leptin can be produced in small amounts in the major salivary glands. However, research showing the relationship between stunting and leptin levels is still limited, especially in studies using saliva as a sample. Objectives: Analyzing the differences between salivary leptin levels in children aged 6-8 years in the stunting and non-stunting groups and analyzing the correlation between salivary leptin levels in children aged 6-8 years with stunting. Method: This study used 84 saliva samples of children aged 6-8 years in NTT who were categorized as stunting and non-stunting. Saliva was examined using the BioEnzy© ELISA kit to see leptin levels and then quantified using an ELISA reader with a wavelength of 450 nm. From the readings, the absorbance and concentration values of the saliva samples were obtained. Furthermore, the leptin concentration of saliva samples was analyzed statistically using SPSS. Results: The average salivary leptin level of stunted children aged 6-8 years was found to be higher than the non-stunted children. There was a significant negative linear correlation between salivary leptin levels in children aged 6-8 years and stunting status (r = -0.287, p <0.05). Conclusion: There is a significant difference between leptin levels in the saliva of children aged 6-8 years with stunting and non-stunting status. There is also a significant correlation between leptin levels in the saliva of children aged 6-8 years with stunting and non-stunting status. This can be seen from the average leptin level in saliva which is higher in stunted children than non-stunted children."

"Stunting adalah masalah gizi kurang yang terjadi selama periode 1000 Hari Pertama Kehidupan HPK namun memiliki dampak kepada penurunan kualitas hidup seseorang kedepannya. Penelitian ini bertujuan untuk melihat faktor-faktor yang mempengaruhi kejadian stunting pada anak usia 6-23 bulan di Jakarta Selatan tahun 2017. Penelitian ini menggunakan data primer dengan desain studi cross-sectional yang dilakukan selama bulan April-Juli 2017. Pengumpulan data dilakukan melalui wawancara kuesioner dan didapatkan sampel sebesar 221 anak dari 19 posyandu terpilih yang terdapat pada 6 wilayah puskesmas terpilih di Jakarta Selatan. Hasil penelitian menunjukan prevalensi stunting pada anak usia 6-23 bulan di Jakarta Selatan sebesar 13,1. Hasil analisis bivariat mendapat terdapat hubungan yang bermakna antara riwayat penyakit infeksi OR=2,249, suplementasi vitamin A OR=5,304, tingkat pendidikan ibu OR=2,446, tingkat pendapatan keluarga OR=2,298, jumlah anggota keluarga OR=2,649, dan urutan kelahiran anak OR=3,125. Selain itu, hasil analisis regresi menemukan bahwa suplementasi vitamin A pada 6 bulan terakhir OR=5,744 merupakan faktor dominan kejadian stunting pada anak usia 6-23 bulan di Jakarta Selatan tahun 2017 setelah di kontrol variabel minimum meal frequency, riwayat penyakit infeksi, tingkat pendidikan ibu, tingkat pendapatan keluarga, dan urutan kelahiran anak. Peneliti menyarankan pemerintah untuk meningkatkan cakupan imunisasi dan suplementasi vitamin A serta mengedukasi orang tua mengenai praktik pemberian ASI dan MP-ASI yang benar dan lebih mempromosikan mengenai program keluarga berencana.

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Stunting is a malnutrition that occurs during the first 1000 days periode but has an impact to the decline in the quality of human life in the future. This research was aimed to analyze the risk factors of Stunting in children aged 6 ndash 23 months in South Jakarta in 2017. This research used primary data with cross sectional study design conducted during April July 2017. Data were analyzed by chi square test and logistic binary regression. Data collection was done through the Questionnaire interview and obtained a sample of 221 children from 19 selected posyandu in 6 regions selected health centers in South Jakarta.

The results showed the prevalence of stunting in children aged 6 23 months in South Jakarta is 13.1. The study found that the risk factors for stunting in children aged 6 ndash 23 months in South Jakarta is infectious disease OR 2,249, vitamin A supplementation OR 5,304, mother rsquo s education OR 2,446, family income OR 2,298, family size OR 2,649, and birth order OR 3,125. In addition, the results of regression analysis found that vitamin A supplementation in the last 6 months OR 5,744 was the dominant factor of the incidence of stunting in children aged 6 23 months in South Jakarta in 2017 after being controlled with minimum meal frequency, infectious disease, mother education, family income, and the order of child birth. Researchers recommend the government to increase coverage of immunization and vitamin A supplementation and to educate parents about breastfeeding practices and proper weaning food and also to promote more about family planning programs. "

"Stunting adalah gangguan pertumbuhan dan perkembangan pada anak yang terjadi sebagai akibat dari buruknya asupan makan anak, kejadian infeksi yang berulang, dan tidak adekuatnya stimulasi psikosoial. Tujuan dari penelitian ini adalah untuk mengetahui faktor dominan yang berhubungan dengan kejadian stunting pada anak usia 6-23 bulan di Jakarta Barat tahun 2017. Penelitian dilakukan dengan desain cross sectional, menggunakan data primer dengan jumlah sampel sebanyak 210 anak yang diambil dengan teknik multistage random sampling dari 12 Posyandu pada 6 kelurahan dari 3 kecamatan di Jakarta Barat. Pengumpulan data dilakukan dengan cara melakukan pengukuran panjang badan anak dan melakukan wawancara dengan responden. Hasil penelitian memperlihatkan bahwa sebanyak 16,2 anak usia 6-23 bulan di Jakarta Barat mengalami stunting. Hasil analisis bivariat dengan uji chi-square menemukan bahwa faktor-faktor yang berhubungan secara bermakna dengan kejadian stunting pada anak usia 6-23 bulan di Jakarta Barat adalah suplementasi vitamin A OR=3,62; 90 CI 1,144-8,939 dan tingkat pendidikan ibu OR=2,40; 90 CI 1,167-4,885. Hasil analisis multivariat dengan analisis regresi logistik ganda menemukan bahwa suplementasi vitamin A merupakan faktor dominan dari kejadian stunting pada anak usia 6-23 bulan di Jakarta Barat tahun 2017 setelah dikontrol oleh variabel capaian MAD, praktik pemberian kolostrum, dan tingkat pendidikan ibu OR=4,00; 90 CI 1,402-11,436. Berdasarkan hasil penelitian, saran untuk pihak Suku Dinas Kota Administrasi Jakarta Barat adalah perlu dilakukan assessment untuk mengetahui mengapa anak yang masih berusia kurang dari 6 bulan sudah diberikan susu formula, cakupan mendapatkan suplementasi vitamin A harus ditingkatkan hingga mencapai 100, perlu dilakukan penyediaan alat antropometri panjang badan yang baku untuk setiap Puskesmas dan Posyandu, dan perlu dilakukan pelatihan mengenai prosedur yang baik dan benar dalam mengukur panjang badan anak; saran untuk pihak Puskesmas dan Posyandu adalah perlu dilakukan pemantauan status gizi berdasarkan indeks PB/U setiap 3 bulan sekali, perlu dilakukan pelatihan prosedur panjang badan kepada kader, perlu dilakukan edukasi kepada masyarakat mengenai praktik pemberian makan yang tepat dan pemanfaatan pelayanan kesehatan bagi anak; saran untuk peneliti lain adalah penelitian perlu dilakukan pada skala yang lebih besar baik dari sisi jumlah sampel maupun wilayah, penggunaan variabel capaian minimum dietary diversity, minimum meal frequency, dan minimum acceptable diet sebaiknya digunakan secara berhati-hati dan pengukurannya dilakukan 2-3 kali pada hari yang berbeda, serta perlu dilakukan 24-hour dietary recall untuk mengetahui keadekuatan asupan makan anak.

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Stunting is the impaired growth and development that children experience as the result of poor nutrition, repeated infection, and inadequate psychosocial stimulation. The objective of this research is to determine the dominant factor related with stunting occurrence among children aged 6 23 months in West Jakarta Region in 2017. This research was descriptive study with cross sectional design that using primary data and included 210 children taken with a multistage random sampling technique from 12 Posyandu on 6 administrative villages of 3 sub districts of West Jakarta region. Data collection was done by measuring children's length and conduct interviews with respondents.

The result showed prevalence of stunting was 16,2. The Chi Square analysis showes that vitamin A supplementation OR 3,62 90 CI 1,144 8,939 and mother's education level have a significant association with stunting OR 2,40 90 CI 1,167 4,885. Furthermore, binomial logistic regression shows that vitamin A supplementation as a dominant factor of stunting occurrence among children aged 6 23 months in West Jakarta Region in 2017 after controlled by other variables minimum acceptable diet, colostrum feeding, and mother's education OR 4,00 90 CI 1,402 11,436.

Based on this research, the recommendations for Suku Dinas Kesehatan in West Jakarta region are to conduct an assessment on why children aged less than 6 months already given the formula milk, to increase the scope of vitamin A supplementation up to 100, to provide a golden standard anthropometric measurements for each Puskesmas and Posyandu, and to train Puskesmas workers on how to measure children's length with proper dan right procedure second, the suggestions for Puskesmas and Posyandu in West Jakarta are to monitor children's nutrition status based on indices height for age every 3 months, to train Posyandu workers about how to measure children's length with proper dan right procedure, and to educate the community about appropriate feeding practice and child health care finally, the advice for researchers are research needs to be done on a larger scale both in the number of samples and research location, the use of minimum dietary diversity, minimum meal frequency, and minimum acceptable diet as independent variables should be used in a careful way and the measurement of these variables need to be done 2 3 times on the different days in addition, 24 hour dietary recall method need to be done to assess children's dietary intake adequacy."

"Menurut data WHO 2018, angka kejadian stunted mencapai 21,9% yang berarti sekitar 140 juta anak di dunia mengalami kejadian stunted. Prevalensi stunted di Indonesia pada tahun 2018 mencapai 30,8%. Artinya, kejadian stunted diderita oleh sekitar 7,3 juta anak Indonesia. Pandemi Covid 19 yang terjadi sejak 2020 menyebabkan banyak perubahan pola kondisi sosial ekonomi pada masyarakat, yang tentu saja mempengaruhi kemampuan orang tua menyediakan makanan yang bergizi untuk memenuhi kebutuhan asupan nutrisi anak. Jika kecukupan zat gizi inadekuat, proses metabolisme tubuh dapat terganggu dan akan menyebabkan terhambatnya proses pembentukan sel atau jaringan dalam tubuh yang selanjutnya menjadi stunted. Salah satu nutrisi yang harus tercukupi adalah zat besi. Tujuan penelitian ini adalah untuk mengetahui perbedaan asupan dan status besi pada anak stunted dan non stunted pada anak usia 24 – 35 bulan pada masa pandemi Covid-19 di Jakarta. Metode penelitian yang digunakan adalah potong lintang komparatif menggunakan data sekunder dari 77 anak usia 24 – 35 bulan di Puskesmas Kampung Melayu, Jakarta Timur pada bulan September sampai dengan Oktober 2020. Data karakteristik subjek diambil dengan kuesioner. Data asupan zat besi, kalori dan protein didapat dengan metode semikuantitatif Food Frequency Questionnaire. Dilakukan pemeriksaan antropometri dan laboratorium untuk kadar hemoglobin, ferritin dan hs–CRP. Analisis bivariat t tidak berpasangan digunakan untuk mengetahui perbedaan kadar Hb antara anak stunted dan non-stunted, dan uji Mann-Whitney untuk mengetahui perbedaan asupan besi dan kadar ferritin antara anak stunted dan non-stunted, dengan batas kemaknaan p<0,05. Didapatkan perbedaan rerata yang bermakna kadar Hb (9,91±1,93 g/dL kelompok stunted dan 12,18±1,20 g/dL kelompok non-stunted, p<0,001) dan kadar ferritin (4,9 (1,5 - 67,4) μg/L kelompok stunted dan (26,8 (1,6 - 91,1) μg/Lkelompok non-stunted, p<0,001). Asupan besi tidak terdapat perbedaan bermakna di antara kedua kelompok (8,85 (1,5 -74) mg kelompok stunted dan 11,1 (1,9 - 118,6) mg kelompok non-stunted, p = 0,676). Hasil analisis menemukan Kadar Hb dan ferritin anak stunted lebih rendah dibandingkan pada anak non-stunted.

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According to WHO 2018 data, the stunted incidence rate reached 21.9%, which means that around 140 million children in the world experienced stunted events. The prevalence of stunted in Indonesia in 2018 reached 30.8%. This means that around 7.3 million Indonesian children are stunted. Since 2020, the Covid 19 pandemi has caused many changes in the pattern of socioeconomic conditions in society, which, of course, affects parents' ability to provide nutritious food to meet the nutritional needs of their children. If nutrients are insufficient, the body's metabolic processes will be disrupted, and the process of forming cells or tissues in the body will be inhibited, causing growth to be stunted. Iron is one of the nutrients that must be met. The goal of this study was to see if there were any differences in iron intake and status between stunted and non-stunted children aged 24-35 months during the Covid-19 pandemi in Jakarta. From September to October 2020, 77 children aged 24-35 months were studied in a cross-sectional comparative study using secondary data at the Kampung Melayu Health Center in East Jakarta. A questionnaire was used to collect data on the subjects' characteristics. Data on iron, calorie and protein intake were taken using the semi-quantitative Food Frequency Questionnaire method. Anthropometric and laboratory examinations were performed for hemoglobin, ferritin and hs-CRP levels. Independent sample t-test was used to determine differences in Hb levels between stunted and non-stunted children, and the Mann-Whitney test to determine differences in iron intake and ferritin levels between stunted and non-stunted children, using a significance limit of p < 0.05. There was a significant difference in Hb levels (9.91±1.93 g/dL in the stunted group and 12.18±1.20 g/dL in the non-stunted group, p<0.001) and ferritin levels (4.9 (1.5 - 67.4) μg/L in the stunted group and (26.8 (1.6 -91.1) μg/L in the non-stunted group, p<0.001) There was no significant difference in iron intake between the two groups (8.85 (1.5-74) mg in the stunted group and 11.1 (1.9 - 118.6) mg in the non-stunted group, p = 0.676. The results of the analysis found Hb and ferritin levels in stunted children were lower than in non-stunted children"

"Varian gen TMPRSS6 berasosiasi dengan status besi diplasma, tetapi efek tersebut belum dijelaskan pada anak Indonesia. Penelitian ini bertujuan menganalasis apakah SNP rs855791 (G>A) dan rs4820268 (A>G) gen TMPRSS6 berhubungan dengan status besi dan hemoglobin yang rendah dengan mengontrol asupan zat besi pada anak baduta suku Sasak. Studi crossectional ini mengeksplorasi baseline data dari randomized trial di Kabupaten Lombok Timur, sebanyak 121 subyek memenuhi syarat dalam penelitian ini. Real Time PCR, metode Taqman Assay digunakan untuk menganalisis genotip. Hasil Penelitian menunjukkan bahwa varian TMPRSS6 secara signifikan berhubungan dengan feritin, tetapi asupan zat besi lebih berkontribusi terhadap feritin dibandingkan genotipe.

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Variants in TMPRSS6 were associated with plasma iron, but their effects in Indonesian children remain elucidated. This study aim to analyze whether the TMPRSS6 SNPs rs855791 (G>A) and rs4820268 (A>G) were associated with low iron status and hemoglobin controlling for iron intake among Sasaknese. A crossectional study explored the baseline of a randomized trial in East Lombok district, 121 subjects were eligible in the study. Real Time PCR using Taqman-assay method was used for analysis of SNPs genotype. The researcher suggests that TMPRSS6 variants were significantly associated with plasma ferritin, but iron intake still more contribute to ferritin than genotype."

"ABSTRAKLatar belakang: Anemia defisiensi besi ADB pada usia 9-12 bulan dapat berdampak pada kualitas hidup anak di masa depan. Asupan zat besi, pemacu dan penghambat absorpsi besi memengaruhi kadar besi tubuh. Penelitian mengenai status zat besi dan hubungannya dengan zat pemacu dan penghambat absoprsi dalam asupan diet pada bayi usia 9 ndash;12 bulan yang disertakan dengan analisis asupan diet belum banyak dilakukan di Indonesia. Tujuan: Mengetahui prevalens gangguan status besi dan mengetahui hubungan status gizi dan kecukupan asupan besi harian terhadap kejadian defisiensi besi pada bayi usia 9-12 bulan. Metode: Studi potong lintang pada Juli 2017-Januari 2018 di Posyandu kecamatan Tanah Abang dan Jatinegara. Asupan zat besi, pemacu absorpsi besi dan penghambat absorpsi besi dinilai dengan metode food record dan diolah dengan program NutriSurvey . Subyek menjalani pengukuran antropometri dan pengambilan sampel darah darah perifer lengkap, LED, dan feritin serum . Data diolah dengan uji Pearson Chi Square dan kejadian gangguan status besi ditampilkan dalam prevalens. Hasil: Terdapat 82 subyek usia 9-12 bulan berpartisipasi dalam penelitian. Prevalens defisiensi besi sebesar 12,2 , dan ADB sebesar 26,8 . Tidak terbukti ada hubungan antara kecukupan asupan besi harian dengan gangguan status besi [p=0,064; PR=2,1 0,193-1,178 ] dan status gizi kurang dengan gangguan status besi [p=0,444; PR=0,729 0,307-1,731 ]. Terdapat perbedaan bermakna antara asupan harian besi total p=0,002 , besi heme 0,017 , kalsium p=0,006 , dan seng p=0,042 antara kelompok defisiensi besi dan non-defisiensi besi.Simpulan: Prevalens defisiensi besi dan ADB pada bayi usia 9-12 bulan berturut-turut adalah 12,2 dan 26,8 . Tidak terbukti ada hubungan antara status gizi dan kecukupan asupan besi harian dengan gangguan status besi, namun terdapat perbedaan bermakna antara asupan harian besi total, besi heme, kalsium, dan seng antara kelompok defisiensi dan non-defisiensi besi pada populasi bayi usia 9-12 bulan.

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ABSTRACTBackground Iron deficiency anemia IDA in 9 12 month old babies could affect their quality of life. Intake of iron containing food, enhancer and inhibitor of iron absorption affects iron body level. Study about iron profile and its correlation with enhancers and inhibitors of iron absorption in baby rsquo s daily dietary intake whose analyzed by food record method is still infrequent in Indonesia. Aim To measure the prevalence of iron deficiency and IDA and to know the correlation of nutritional status and adequacy of daily iron intake with iron deficiency status in 9 12 month old babies. Methods A cross sectional study was conducted on July 2017 January 2018 in Posyandu in Tanah Abang and Jatinegara district. Dietary iron intake, enhancer and inhibitor were obtained using a 3 day food record method and analyzed with NutriSurvey program. Subjects underwent anthropometry measurement. Complete blood count, ESR, and ferritin serum were also examined. Results A total of 82 babies aged 9 12 months were studied. Prevalence of iron deficiency and IDA were 12,2 and 26,8 . There were no evidence of relationship between adequacy of daily iron intake p 0,064 and undernourished condition p 0,444 with iron deficiency status. There were statistically significant differences in total iron p 0,002 , heme iron p 0,017 , calcium p 0,006 , and zinc p 0,042 daily intakes between iron deficiency group and non iron deficiency group.Conclusion The prevalence of iron deficiency and IDA were 12,2 and 26,8 . There were no evidence of relationship between adequacy of daily iron intake nor undernourished condition with iron deficiency status. There were statistically significant differences in total iron, heme iron, calcium, and zinc daily intakes between iron deficiency group and non iron deficiency group in 9 12 month old babies."

"Anak di bawah dua tahun berisiko tinggi untuk defisiensi zat gizi mikro khususnya defisiensi zat besi, sebagian dikarenakan praktek pemberian makanan tambahan yang salah. Untuk meningkatkan kualitas pemberian makanan tambahan, rekomendasi makanan tambahan (Complementary Feeding Recommendation - CFR) berbasis pangan lokal dibutuhkan. Suplementasi zat besi digunakan secara luas untuk menanggulangi defisiensi zat besi di negara berkembang; namun, efek dari suplementasi tersebut pada mikronutrien lain dan pertumbuhan menjadi perhatian tersendiri. Fortifikasi zat besi telah menunjukkan dampak negatif pada mikrobiota usus melalui peningkatan pertumbuhan bakteri patogen pada usus dikarenakan peningkatan besi yang diserap dan suplementasi zat besi mungkin memiliki dampak yang serupa pada mikrobiota usus tetapi masih belum pernah diteliti. Sebaliknya, jika suplementasi zat besi diberikan dengan optimalisasi diet menggunakan CFR, status gizi anak-anak akan meningkat dengan efek samping yang lebih kecil pada mikronutrien lain dan pertumbuhan. Studi ini meneliti efek dari suplementasi zat besi; dengan atau tanpa diet optimal; pada status mikronutrien, mikrobiota usus dan pertumbuhan anak-anak Myanmar yang berusia di bawah 2 tahun. Sebuah percobaan acak terkontrol (NCT01758159) dilaksanakan selama 24 minggu pada anak usia 12-23 bulan di Ayeyarwady, Myanmar. Optimalisasi CFR berbasis pangan lokal dikembangkan dengan pendekatan Linear Programming. Pengacakan berdasarkan Desa untuk CFR dan non-CFR dan berdasarkan anak (n=433) untuk suplemen besi atau placebo, menghasilkan: 1. kelompok CFR+Fe (n=112); 2. kelompok CFR (n=112); 3. kelompok Fe (n=105); or 4. kelompok pembanding (plasebo) (n=104). Ibu dari kelompok CFR menerima pendidikan CFR dan anak-anak dari kelompok Fe menerima 15 mg Ferric NaEDTA setiap hari. Serum Feritin, Transferin receptor (sTfR), Zinc, retinol-binding-protein (RBP), C-reactive protein dan α-1 acid glycoprotein; feces untuk melihat mikrobiota usus (Bifidobacteria, Lactobacilli, Enterobacteriaceae, E.coli, EPEC, EAEC dan ETEC) diukur pada awal dan akhir penelitian. Di awal penelitian, 88.4% anak mengalami anemia (Hb<110g/L); setelah dikontrol dengan infeksi, 74.4% mengalami defisiensi zat besi (SF<12μg/L dan/ atau sTfR>8.3mg/L) dan 68.9% mengalami anemia gizi besi (AGB) (Hb<110g/L and ID), 41.3% mempunyai kadar serum Send rendah (serum send <10.7µmol/L). Suplementasi besi menurunkan anemia, defisiensi zat besi dan AGB dengan atau tanpa pemberian diet optimal. Namun, suplementasi besi meningkatkan risiko serum Send rendah dan pendek (stunting) bila diberikan tanpa penambahan diet optimal. Efek samping ini tidak terlihat saat suplementasi tablet besi diberikan bersama dengan diet yang optimal. Tidak ada perbedaan yang nyata pada komposisi mikrobiota usus diantara semua kelompok. Suplementasi zat besi harus diberikan bersama dengan diet optimal untuk mengurangi efek samping baik pada kadar zat gizi mikro lainnya di dalam tubuh maupun pertumbuhan anak.

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Children under 2-years of age are at high risk of micronutrient deficiencies especially iron deficiency (ID), partly due to poor complementary feeding practices. To improve feeding practices, local food-based complementary feeding recommendations (CFR) are needed. Iron supplementation is widely used to treat ID in developing countries; however, its potential effects on other micronutrients and growth are of concern. Iron fortification had shown negative impact on gut microbiota with increased growth of gut pathogens due to increased unabsorbed iron. It was assumed that iron supplementation may have similar impact on gut microbiota but has not yet been explored. On the other hand, if iron supplementation is given with optimized diet using CFRs, nutritional status of children would be improved with less adverse effects on other micronutrients status and growth.

The study investigated the effect of iron supplementation; given with or without optimized diet; on micronutrient status, gut microbiota and growth of under 2-year Myanmar children. A randomizedcontrolled trial (NCT01758159) was conducted for 24 weeks among 12-23 month old children from Ayeyarwady, Myanmar. Optimized CFRs based on locally available foods were developed by Linear Programming approach. Randomization by village for CFRs or non-CFRs and by child (n=433) for iron supplements or placebo, created: 1.CFR+Fe (n=112); 2.CFR-alone (n=112); 3.Fe-alone (n=105); or 4.Placebo (n=104) groups. Mothers from CFR-groups received education on CFRs and children from Fe groups received 15mg Ferric NaEDTA daily.

Serum for ferritin (SF), transferrinreceptor (sTfR), zinc, retinol-binding-protein (RBP), C-reactive protein and α-1 acid glycoprotein; stool for gut microbiota (Bifidobacteria, Lactobacilli, Enterobacteriaceae, E.coli, EPEC, EAEC and ETEC) were measured at baseline and endline. At baseline, 88.4% of children were anemic (Hb<110g/L); after adjusting for infection, 74.4% had ID (SF<12μg/L and/or sTfR>8.3mg/L) 68.9% had irondeficiency- anemia (IDA) (Hb<110g/L and ID), and 41.3% had low serum zinc status (serum zinc <10.7μmol/L).

Iron supplementation reduced anemia, ID and IDA whether or not it was given with optimized diet. However, iron supplementation increased the risk of low serum zinc and stunting when it is given without optimized diet. These adverse effects were not seen when iron supplementation was given with optimized diet. No significant difference was found in gut microbiota composition among groups. In conclusion, iron supplementation should be given together with optimized diet to reduce its adverse effect on other micronutrients status and growth to best improve nutritional status of these children."