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Luh Ade Ari Wiradnyani
"Probiotics, product containing viable, defined and sufficient microorganisms that beneficially alfects the host, has shown cholesterol-lowering effect in in vitro, animal and human studies. However, studies in human showed inconclusive findings.
A randomized double-blind two-way cross-over study was conducted to investigate whether daily supplementation of yoghurt enriched with Lactobacillus acidophilus improves lipid profile in hypercholesterolemic Indonesian adult males. Each period of treatment was 4 wk, separated by a 2 wk washout period. During both treatment periods, subjects consumed daily either yoghurt enriched with Lacidophilus FNCCI I6 (test yoghurt) or traditional yoghurt (control yoghurt).
By the end of the first period, serum total cholesterol concentration of subjects in test group was significantly lower (p<0.05) compared to those in control group (21 0.4 kurang lebih 8.3 vs 226.8 kurang lebih 4.5 mg/dL); and the concentration in both groups was significantly lower compared to baseline. The reduction, however, was not significantly different between groups (-6.0 kurang lebih 2.0 vs -5.9 kurang lebih 2.1 %). There were no significant differences between groups on other lipid profile variables i.e serum LDL-C, HDL-C, tryglicerides, and LDL/HDL ratio, after supplementation. No significant differences on all lipid profile variables between groups were observed after supplementation at the second treatment period and when the treatment period was combined. However, there was a tendency that test group had better lipid profile, except for triglycerides, than control group (p<0.05 for LDL/HDL ratio; p=0.053 for LDL-C).
This cross-over study showed that daily supplementation of yoghurt enriched with Lacidophilus FNCCI 16 showed hypocholesterolemic effect only at the first period, but not at the second and the combined periods.
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Jakarta: Fakultas Kedokteran Universitas Indonesia, 2003
T12495
UI - Tesis Membership  Universitas Indonesia Library
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Luh Ade Ari Wiradnyani
"LATAR BELAKANG. Prevalensi stunting di Indonesia masih tinggi. Di lain pihak, pemerintah telah menjalankan program nasional gizi ibu dan anak pada 1000 hari pertama kehidupan/HPK anak yang merupakan periode emas untuk mencegah/menurunkan kejadian stunting.Studi menunjukkan bahwa untuk mendapatkan dampak yang diharapkan,diperlukan kepatuhan ibu menjalankan rekomendasi program gizi tersebut. Studi ini bertujuan untuk mengukur faktor yang berhubungan dengan praktek ibu dalam menjalankan rekomendasi program gizi nasional pada 1000 HPK, serta hubungannya dengan prevalensi stunting pada anak usia 6-23 bulan.
METODE. Studi ini menganalisis data sekunder dari Survei Nasional (SDKI 2002, 2007 dan 2012, dan Riskesdas 2010) dan pendekatan kualitatif untuk melengkapi hasil analisisagar mendapat gambaran yang utuh tentang faktor yang berhubungan dengan praktek ibu tersebut. Program gizi nasional yang diukur adalah suplementasi tablet besi-folat/TBF, pemberian ASI lanjutan, pemberian makanan pendamping ASI/MP-ASI, dan suplementasi kapsul vitamin A.
HASIL. Kepatuhan ibu menjalankan program sebagai komposit program tidak berhubungan secara bermakna dengan resiko stunting pada anak. Namun, analisis program secara individu menunjukkan bahwa kepatuhan minum TBFberhubungan bermakna dengan risiko severestunting, dan praktik MP-ASI berhubungan dengan risiko stunting pada anak usia 6-11 bulan. Pada keluarga dengan ekonomi rendah, anak yang masih menerima ASI memiliki risiko stunting yang lebih tinggi dibandingkan pada anak yang sudah disapih. Hal ini berhubungan dengan MP-ASI yang lebih buruk pada anak yang masih menyusu. Faktor lain yang berhubungan dengan risiko stunting adalah tinggi badan ibu, berat lahir serta jenis kelamin dan umur anak.Paparan informasi serta dukungan suami/keluarga berhubungan secara bermakna dengan praktek ibu. Ditemukan empat mispersepsi yang umum pada ibu, yaitu TBF dapat menyebabkan tekanan darah tinggi, TBF lebih untuk pengobatan daripada pencegahan, ASI dapat menggantikan kebutuhan energi dan zat gizi anak yang seharusnya diperoleh dari MP-ASI, serta makanan lunak untuk anak usia 6-8 bulan yg baik adalah bubur susu siap saji.
KESIMPULAN. Kepatuhan ibu pada program prenatal, serta faktor sebelum dan selama kehamilan berhubungan dengan resiko stunting pada anak. Hal ini menekankan kembali pentingnya status gizi wanita sebelum dan selama hamil. Paparan informasi dan dukungan suami/keluarga sangat berperan dalam praktek ibu. Memaksimalkan kunjungan antenatal dan pemantauan pertumbuhan balita sebagai media untuk memberi ibu paparan informasi menjadi sangat penting. Memberdayakan bidan dan kader Posyandu adalah keharusan. Pendekatan ibu-ayah diusulkan sebagai salah satu cara karena diharapkan dapat memberi hasil yang lebih baik dibandingkan pendekatan pada ibu sebagai satu-satunya target program gizi ibu dan anak.

BACKGROUND. Stunting in Indonesia remains highly prevalent despite the availability of national maternal and child nutrition/MCN programs for the period known to be window of opportunity for stunting prevention/reduction, i.e. the first 1000 days of child's life. Studies confirm that good adherence towards the program recommendations is required to ensure the program's impact. The study aims to assess factors associated with adherence of mothers towards national MCN programs within the first 1000 days of child's life and its association with prevalence of stunting among children aged 6-23 months.
METHODS. The study analyzed national surveys data (Indonesian DHS 2002, 2007 and 2012 and Riskesdas 2010), complemented witha qualitative approach exploring factors associated with the mother's adherence in order to provide the more complete pictures. The MCN programs cover iron-folic acid supplementation/IFAS, continued breastfeeding, complementary feeding/CF practices, and vitamin A capsule supplementation.
RESULTS. Adherence towards MCN programs as a composite program is not associated with risk of stunting in children. However,good adherence towards IFAS program is associated with significant lower risk of severe stunting.The CF practices shows significant association with risk of stunting in 6-11 months old children. On the contrary, risk of stunting of children from poor family was higher among breastfed than non-breastfed ones, which was associated with their poorerCF practices. Other predictors of stunting were maternal height, child's birthweight, sex and age. Good exposures towards information and support from husband/family were associated with good mother's adherence towards the MCN program. Four misleading perceptions were revealed from the qualitative study, i.e. IFA tablets may cause high blood pressure,IFAS was more for curative than preventive, breastmilk can substitute energy and nutrient needs for the children that should be obtained from foods, and instant baby milk porridges were referred as most appropriate 'soft food' for 6-8 months old children.
CONCLUSION. Adherence towards prenatal program, maternal height and child's birthweight were significant predictors of child stunting. It reinforces the needs to put good nutrition of women before and during pregnancy as priority. Good CF practices have to be emphasized more, especially during the transition period. Exposure towards information and support from husband were significant factors of the mother's adherence. Making optimal use of ANC and posyandu visit to expose mothers with information is highly crucial. Thus, empowering midwife andposyandu cadres is a must.Mother-father based approach is proposed to be more beneficial rather than mothers as single target of the MCN programs for pregnancy and child care."
Depok: Universitas Indonesia, 2015
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UI - Disertasi Membership  Universitas Indonesia Library