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Abstrak :
A cross sectional survey was conducted to determine the prevalence of heavy metal contamination and nutritional status of lactating women and children living in a low socio economic urban coastal community. The study was carried out in Kenjeran, Surabaya, East Java, Indonesia. Socio-economically-linked parameters and nutritional status were assessed using a standardized questionnaire. Anthropometric measurements were collected from all mothers and children, 94 venous blood and 86 breast milk samples were collected from the mothers and 10 blood samples were obtained from the children. Blood and breast milk samples were analyzed at BATAN1 in Jakarta, BLK2 in Surabaya and at SEAMED laboratory. The median age of the children was 15 months (range: 2-50 months). Median age of mothers and fathers was 26 and 30 years, respectively. The fathers? main occupation was in the private sector (33%) followed by fishermen (24%). Most mothers remained at home (80%). Stunting in children was 25.3% (HAZ<-2 SD), wasting was 9.9% (WHZ<-2 SD) and underweight was 30.8% (WAZ<-2 SD). Anemia was prevalent in 60% of the children (Hb<11g/dL) and 56.4% of the mothers (Hb<12g/dL). High levels of lead (71.3%), cadmium (33%) and mercury (8.5%) were found in the blood of the mothers and high levels of lead (94.2%), cadmium (77.9%) and mercury (34.9%) were found in the breast milk. Levels used to determine "high" Pb, Cd and Hg in blood were 300µg/L, 5gglL and 15µg/L, respectively. Levels used to determine "high" Pb, Cd and Hg in breast milk were 201.tg/L, 5 µgfL and 3.5 µg/L, respectively. Median levels of Pb-B, Cd-B and Hg-B were 416.7µg/L, 22.5 1411, and 6.3 µgfL, respectively. Median levels of Pb-M, Cd-M and Hg-M was 537.6 µg/L, 36µg/L and 0.7 µg/L, respectively. All children exceeded the level of concern for lead in blood recommended by the Centers for Disease Control (10µg/dL). High lead in breast milk was associated with low hemoglobin concentrations in the mothers' blood, and a high mercury concentration in blood was associated with the frequency of fresh fish intake. As a consequence of high heavy metal exposure in the environment, the population of Kenjeran is suffering from adverse health effects. Contaminated breast milk is a major public health concern for the future of the child's mental development and growth. Heavy metal contamination may endanger the health and well-being of the population, reduce work productivity and raise national health costs. Further studies are needed to monitor the extent of heavy metal contamination in coastal communities surrounding urban areas. Improving the micronutrient status of the population, raising public awareness on the negative health effects of metal toxicity, developing strategies to prevent further exposure, improving the quality of drinking water, identifying alternative sources of income and implementing industrial waste control laws are recommended. Notes : 1) BATAN : Badan Tenaga Atom National (National Institute for Atomic Energy) in Jakarta. 2) BLK : Balai Laboratorium Kesehatan (Laboratory of the Department of Health) in Surabay.

Abstrak :
Addressing public health problems of child malnutrition in Indonesia needs an appropriate integrated health and nutrition program. Positive Deviance Approach integrated with Posyandu TKA (Tumbuh Kembang Anak) offered an excellent opportunity to alleviate the health and malnutrition problem. A community trial study was conducted with a main objective to measure the effect of 3-month Positive Deviance Approach (PDA) integrated with posyandu TKA on growth of the children under five in Pandeglang District, Banten Province, Indonesia. This research report is divided into three parts. Part 1 includes comprehensive reviews on the background of the study, rationale of the study, literature review, conceptual framework, hypothesis, objectives and variable indicator matrix. Part 2 covers the manuscript for publication with a title of "The Effectiveness of 3-months Positive Deviance Approach (PDA) integrated with Posyandu TKA (Tumbuh KembangAnak) on Growth of Underweight Children 6-59 months in Pandeglang District, Banten Province, Indonesia". It is written and formatted in accordance with the instructions for author of The Journal of Nutrition. Part 3 shows the supporting documents including important results that are not included in the manuscript, detailed methodology, grant approval, curriculum vitae and list of references for this research. List of operational definition and abbreviation are also included as guide for the readers. It is hoped that the results of this study will serve as reference data and advocacy tool for intervention program to address under nutrition among children. It can also be use for planning and implementation of future programs especially for Posyandu Revitalization Program in Indonesia.

Abstrak :
Latar Belakang: Anemia maternal merupakan masalah kesehatan masyarakat utama yang memiliki efek merugikan pada hasil kehamilan dan kelahiran. Ancaman kerawanan pangan dan kekurangan gizi semakin meningkat akibat pandemi COVID-19. Tujuan penelitian ini adalah untuk mengetahui prevalensi dan faktor risiko anemia pada ibu hamil di Kabupaten Lombok Timur pada masa pandemi. Metode: Studi potong lintang ini merupakan bagian dari studi kohort observasional berjudul “UKRI-GCRF Action Against Stunting Hub (AASH)” di Lombok Timur. Data ibu hamil (usia 18-40 tahun) trimester ketiga dikumpulkan bulan Agustus 2021 hingga Februari 2022, meliputi LILA, wawancara kuesioner terstruktur, recall diet, perhitungan darah lengkap, dan metode Kato-Katz. Faktor yang berhubungan dengan anemia ditentukan menggunakan analisis regresi logistik. Hasil: Dari total 446 wanita hamil trimester ketiga, 40.8% mengalami anemia. Selama pandemi, 74,7% dan 28,9% ibu melaporkan penurunan pendapatan rumah tangga dan pengeluaran makanan. Strategi penanggulangan kerawanan pangan sedang dan tinggi dilaporkan oleh 47% responden. 6,5% ibu terinfeksi cacing usus (mayoritas cacing Trichuris trichiura), dan 19,1% memiliki ANC yang tidak memadai (<6 kunjungan) selama kehamilan. Anemia ditemukan secara signifikan berhubungan dengan KEK (AOR=1.87), tidak menggunakan kontrasepsi (AOR=1.60), dan rendahnya keragaman konsumsi pangan (AOR=1.59). Kesimpulan: KEK, tidak menggunakan metode KB, dan rendahnya keragaman konsumsi pangan merupakan kontributor utama anemia pada kehamilan. Pemangku kepentingan multisektoral dan praktisi kesehatan harus berkolaborasi untuk mengembangkan dan menerapkan kebijakan kesehatan masyarakat serta program intervensi untuk mengatasi anemia di Lombok Timur. ......Background: Maternal anemia is a major public health issue that has detrimental effects on pregnancy and birth outcomes. The threat of food insecurity and nutritional deficiencies is growing as a result of the COVID-19 pandemic. The aim of this study was to determine the prevalence and risk factors of anemia in pregnancy in East Lombok during the pandemic. Methods: This cross-sectional study is part of an observational cohort study entitled “UKRI-GCRF Action Against Stunting Hub (AASH)” in East Lombok, from August 2021 to February 2022. Data of pregnant women (aged 18-40 years) in their third trimester, including MUAC, structured questionnaires, dietary recall. The complete blood count and Kato-Katz method was performed. The factors associated with anemia were determined using logistic regression analysis. Results: Of the total 446 women in the third trimester, 40.8% had anemia. During the pandemic, 74.7% and 28.9% reported a decrease in household income and food expenditure, respectively. Medium to high coping strategies reported by 47%. About 6.5% of women were infected with intestinal helminth (mostly from Trichuris trichiura) and 19.1% had inadequate ANC (<6 visits) throughout pregnancy. Anemia was found to be significantly associated with CED (AOR=1.87), non-use of contraception (AOR=1.60), and inadequate dietary diversity (AOR=1.59). Conclusions: CED, non-use of contraception, and inadequate dietary diversity were major contributors to anemia in pregnancy. Multisectoral stakeholders and healthcare practitioners should collaborate to develop and implement public health policies and intervention programs to alleviate anemia in East Lombok.

Abstrak :
Konsumsi gula yang meningkat merupakan suatu keprihatinan global, karena terkait dengan berbagai masalah kesehatan. Indonesia merupakan konsumen gula terbesar ketiga di dunia, dengan konsumsi gula meningkat menjadi 7.15 juta metric ton (MMT) pada tahun 2019/20 dari 7.05 MMT pada tahun 2018/19, dan diperkirakan akan naik menjadi 7.2 MMT pada tahun 2021. Pemerintah telah mengambil beberapa langkah untuk mengurangi konsumsi gula, salah satunya dengan menggunakan label pada makanan kemasan. Namun, terdapat beberapa faktor yang dapat mendorong orang untuk menggunakan dan membaca label, termasuk usia, pendapatan, pendidikan, jenis kelamin, status pekerjaan, pengetahuan tentang gizi dan label makanan, pendapatan orang tua dan pentingnya rasa dan nutrisi. Peneliti ingin menyelidiki hubungan antara pengetahun dan sikap pada label informasi nilai gizi terhadap asupan gula pada remaja. Penelitian ini merupakan studi potong lintang yang menggunakan kuesioner online untuk remaja di Indonesia dengan rentang usia 15-18 tahun. Pada penelitian ini menunjukkan bahwa usia median responden adalah 17 tahun dan mayoritas responden adalah perempuan (90%), serta rata-rata pendidikan orang tua responden kurang dari 12 tahun bersekolah. Uang saku dan uang saku untuk makanan dan minuman dalam sebulan berada dalam kategori dibawah median, yaitu Rp 300.000 untuk uang saku dan Rp 200.000 untuk uang saku makanan dan minuman. Dalam studi ini menunjukkan bahwa lebih dari setengah responden memiliki pengetahuan yang baik (51.7%) dan memiliki sikap yang baik terhadap label informasi nilai gizi (53.5%). Analisis bivariate menunjukkan hubungan yang signifikan antara pengetahuan tentang informasi nilai gizi dan media massa dengan konsumsi gula, namun tidak terdapat hubungan yang signifikan antara sikap terhadap informasi nilai gizi dan konsumsi gula. Analisis multivariat menunjukkan hubungan yang signifikan antara pendidikan ibu dan konsumsi gula pada remaja. Temuan dari penelitian menyatakan bahwa baik pengetahuan maupun pendidikan ibu memiliki peran penting dalam konsumsi gula pada remaja. Sehingga disarankan untuk meningkatkan pengetahuan terkait label informasi nilai gizi pada remaja maupun ibu, agar nantinya dapat memilih dan mengonsumsi makanan yang tepat.  ......Increased sugar consumption is a global concern, as it has been linked to a variety of health problems. Indonesia is the third-largest sugar consuming in Indonesia increased to 7.15 million metric tons (MMT) in 2019/20 from 7.05 MMT in 2018/19, and is expected to rise to 7.2 MMT in 2021. The government has taken several ways to reduce sugar intake, one of which is by using labels on packaged food. However, there are several factors that can encourage people to use and read labels include age, income, education, gender, employment status, knowledge of nutrition and food labels, parent’s income, and the importance of flavor and nutrients. The researchers want to investigate what knowledge and attitudes adolescent have about sugar intake based on the nutrition fact panel. This research was a cross-sectional study using an online questionnaire for adolescent in Indonesia with age range between 15-18 years old. Finding of this study that the respondent median age was 17 and attended by more women (90%) and the average education of the respondent’s parent was less than 12 years of schooling. Pocket money and pocket money for food and drink in a month are in the category below the median cut off 300.000 for pocket money and 200.000 for pocket money for food and drink. This study also showed that more than half respondents had good knowledge (51.7%) and had positive attitude of NFP (60.8%). The majority of respondents have high sugar intake (53.5%). The results of the bivariate analysis indicated a significant relationship between knowledge of NFP and mass media with sugar intake, and there is no significant relationship between attitudes of NFP with sugar intake. Multivariate analysis revealed a significant relationship between mother education and sugar intake. The findings of this study suggest that both knowledge and mother education play a significant role in influencing sugar intake among adolescents. As a result, it is advisable to enhance the understanding of NFP among both adolescents and mothers, in order to enable them to make informed decisions and select appropriate dietary options.  

Abstrak :
Peningkatan kompetensi kader dalam penyuluhan gizi sudah banyak dilakukan, namun studi pengembangan model pelatihan dengan menggunakan alat yang sistematis dan ilmiah masih sangat terbatas. Karena itu perlu dilakukan penelitian dengan tujuan untuk mengkaji dampak pelatihan yang dikembangkan dengan alat yang sistematis dan ilmiah terhadap kompetensi kognitif, afektif dan psikimotor kader dalam mengkomunikasikan MP-ASI kepada pengasuh anak 6-24 bulan. Studi ini terdiri dari 2 fase. Fase 1 adalah fase formatif dimana materi pelatihan seperti misalnya buku pegangan pelatih, buku peserta/kader, buku latihan, brosur yang dapat dibawa pulang, poster dan video dikembangkan dengan menggunakan elemen model Kemp. Fase ke dua studi menggunakan rancangan penelitian tidak setara dengan menggunakan pra-paska intervensi dengan menggunakan kelompok pembanding (non- equivalent pre-post test control group). Studi dilakukan di Kota Bekasi, dengan jumlah subyek 70 kader di kelompok intervensi yang menerima pelatihan 3 hari dan 68 kader di kelompok pembanding yang menerima seminar setengah hari. Training model yang telah dikembangkan terbukti efektif meningkatkan kompetensi kader dalam mengkomunikasikan MP-ASI yang tepat dan aman kepada pengasuh. ......Improving cadres competency in nutrition advice through training is well known. However, there is limited information on training model development which use a systematic and scientific tool. This study's objective is to assess the effect of training on cognitive, affective and psychomotor competencies of cadres in communicating safe complementary feeding to caregivers of children 6-24 months of age. This study consisted of 2 phases. Phase 1 was the formative phase during which training materials such as trainer's handbook, participant's handbook, workbook, booklet, take-home brochure, posters and videos were developed using Kemp's model intructional design. Phase 2 was the intervention phase using training material developed in phase 1. The non-equivalent pre-post test control group design was used in the second phase of the study. The study was conducted in Bekasi municipality; with sample of 70 cadres in the intervention and 68 cadres in the comparison groups. The intervention group received a 3-day training, while the comparison group received a half day seminar. The developed training model using the Kemp's elements as the instructional design was proven to be effective in improving the competencies of the cadres in communicating safe complementary feeding to caregivers.

Abstrak :
Penelitian ini bertujuan untuk mengetahui perubahan pengetahuan tentang gizi seimbang pada siswa kelas V SD setelah diberikan intervensi dengan menggunakan media leaflet dan video. Desain penelitian yang digunakan adalah quasi eksperimen dengan dua kelompok perlakuan. Penelitian ini dilakukan kepada 46 siswa kelas V di SDN terpilih. Kelompok leaflet berjumlah 24 siswa dan kelompok video berjumlah 22 siswa. Pengambilan data penelitian dilakukan sebanyak 4 kali, yang terdiri dari 1 kali pre test dan 3 kali post test untuk melihat retensi pengetahuannya. Uji statistik yang digunakan yaitu t berpasangan untuk menganalisi perubahan di dalam masing-masing kelompok dan uji t independen untuk melihat perbedaan antara kelompok serta hubungan karakteristik responden dengan tingkat pengetahuan. Hasil penelitian ini menunjukkan adanya perubahan pengetahuan dan penurunan retensi pada masing-masing kelompok (p<0,05), dengan penurunan retensi pengetahuan yang paling sedikit yaitu pada kelompok video dibandingkan kelompok leaflet. ......The Purpose of this research is to understand the change of knowledge nutrition among studenst class 5 in elementary public school after being given tha intervention by using leaflet and video media. Design study that is used is quasy experiment with two treatment group. This research is aplicated to 46 students of the 5th grade in several Elementary School in Bekasi City. Leaflet group consists of 24 students and video group consists of 22 students. Tha data is taken 4 times in each group, included 1 pre test and 3 post test to observe the knowledge retention. The statistic test that is used is t test dependent to analyze the retention scor change within group and t independent to analyze the differences scor between groups and the relationship of characteristics of respondents to the level of knowledge. The result of this research shows the change of knowledge retention in each group (p<0,05), with decreased retention of knowledge is in video group compared to leaflet group.

Abstrak :
ABSTRAK Prevalensi obesitas sentral global meningkat pesat beberapa dekade belakangan. Obesitas sentral, yang diukur melalui lingkar pinggang, merupakan tipe obesitas paling berbahaya karena berhubungan erat dengan penyakit kronis, komplikasi metabolik, dan tingginya tingkat infeksi COVID-19. Tujuan penelitian ini adalah mengetahui faktor dominan yang berhubungan dengan kejadian obesitas sentral pada populasi dewasa. Penelitian ini menggunakan data sekunder dari studi potong lintang tahun 2017 di Puskesmas Bojong Gede, Kabupaten Bogor. 85 orang pria dan wanita berusia 25-64 tahun yang dipilih secara purposif diikutsertakan sebagai sampel. Asosiasi antara faktor risiko dan obesitas sentral diukur dengan analisis bivariat chi square dan multivariat regresi logistik ganda pada aplikasi IBM SPSS versi 22. Sebanyak 70,6% responden mengalami obesitas sentral. Variabel jenis kelamin (perempuan), kadar kolesterol darah (hiperkolesterolemia), asupan energi, protein, lemak, dan karbohidrat (>110% kebutuhan gizi personal) berhubungan signifikan dengan obesitas sentral (p value <0,05). Hiperkolesterolemia merupakan faktor dominan yang berhubungan dengan obesitas sentral (p-value= 0,032; OR=.4,21; 95% CI= 1,131-15,667) setelah dilakukan kontrol terhadap variabel perancu.

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ABSTRACT The prevalence of central obesity has been increasing rapidly since the last few decades. Central obesity, measured by waist circumference, is the most dangerous type of obesity since it closely related to chronic diseases, metabolic complications, and high COVID-19 infection rates. The objective of this study was to identify the dominant factor of central obesity among the adult population. The study used secondary data from a 2017 cross-sectional study conducted at Bojong Gede Public Health Center, Bogor District. A total of 85 men and women aged 25-64 years old were selected by purposive sampling and included in the analysis. The association between risk factors and central obesity were measured using chi-square bivariate analysis and multiple logistic regression multivariate analysis in IBM SPSS application version 22. The prevalence of central obesity was 70,6%. The result showed that sex (women), total blood cholesterol level (hypercholesterolemia), energy, protein, fat, and carbohydrate intake (>110% personal nutritional needs) were significantly associated with central obesity (p-value <0,05). Hypercholesterolemia was the most dominant risk factor for central obesity (p value= 0,032; OR=.4,21; 95% CI= 1,131-15,667) adjusted for confounders.

Abstrak :
Sarapan merupakan waktu penting untuk menjaga kecukupan gizi tubuh selama beraktivitas. Melewatkan sarapan dapat menyebabkan tubuh kekurangan energi dan akan mengakibatkan tubuh menjadi lemas, lesu, mengantuk, pusing, kesulitan berkonsentrasi, penurunan prestasi akademik, serta dapat mengganggu tumbuh kembang fisik dan seksual pada remaja. Penelitian ini bertujuan untuk mengetahui gambaran dan perbedaan proporsi kebiasaan sarapan dengan faktor-faktor yang memengaruhinya pada siswa/i SMA Budhi Warman 2 Jakarta Tahun 2020. Penelitian ini menggunakan desain studi cross sectional dengan jumlah responden 152 siswa yang berasal dari kelas X dan XI. Data dikumpulkan dengan menggunakan kuesioner dan SQ-FFQ yang diisi secara mandiri oleh responden. Hasil penelitian menunjukkan sebanyak 54,5 % siswa memiliki kebiasaan sarapan yang tidak baik. Terdapat perbedaan proporsi yang signifikan pada kebiasaan sarapan berdasarkan pengetahuan gizi (p-value=0,032), kebiasaan jajan (p-value=0,007), ketersediaan sarapan (p-value=0,006), pekerjaan ibu (p-value=0,037), dan pengaruh orang tua (p-value=0,037). Peneliti menyarankan untuk diberikannya promosi dan pendidikan gizi mengenai sarapan agar siswa menyadari pentingnya sarapan. ...... Breakfast is an important meal to maintain adequate body nutrition during the activity. Skipping breakfast can cause the body to lack energy and will cause the body to become weak, lethargic, drowsy, dizzy, difficulty concentrating, decreased academic achievement, and can interfere with physical and sexual development in adolescents. This study aims to determine the description and differences in the proportion of breakfast habits with the factors that influence it on high school students at SMA Budhi Warman 2 Jakarta 2020. This study used cross sectional study design with a total 152 students that were taken from class X and XI as respondents. Data were collected using a questionnaire and SQ-FFQ that were filled in independently by respondents. The results showed that 54,5 % of students had poor breakfast habits. There is a significant difference in the proportion of breakfast habits based on nutritional knowledge (pvalue=0,032), snacking habits (p-value=0,007), availability of breakfast (pvalue=0,006), mother’s job (p-value=0,037), and parental influence (p-value=0,045). The researcher suggests that nutrition promotion and education about breakfast can be given so that students will be more aware of the importance of breakfast.

Abstrak :
Skripsi ini bertujuan untuk mengetahui gambaran umum karakteristik individu (usia, jenis kelamin, status pernikahan), status gizi (IMT, lingkar perut), kecukupan gizi (energi, kolesterol, karbohidrat, frekuensi konsumsi sayur & buah), dan gaya hidup (aktivitas fisik, aktivitas mengajar, durasi tidur), serta hubungannya dengan sindrom metabolik pada guru SD di Kecamatan Cilandak, Jakarta Selatan, Tahun 2013. Penelitian ini bersifat deskriptif analitik dengan menggunakan pendekatan cross sectional. Penelitian dilaksanakan pada bulan Maret-April 2013 di 18 SD di Kecamatan Cilandak, Jakarta Selatan. Sampel minimal yang dibutuhkan dalam penelitian ini yaitu 128 namun berhasil didapatkan sebanyak 138 responden. Hasil penelitian menunjukkan sebesar 24,6% guru sekolah dasar mengalami sindrom metabolik. Uji chi square menunjukkan adanya hubungan antara usia, status gizi, lingkar perut, aktivitas fisik, dan aktivitas mengajar terhadap sindrom metabolik. Uji statistik yang sama tidak menunjukkan adanya hubungan namun menunjukkan kecenderungan guru sekolah dasar yang menikah, kecukupan kolesterol >200 mg/hari, konsumsi karbohidrat >60% energi total, konsumsi frekuensi sayur <4x/minggu, dan durasi tidur ≤7 jam/hari lebih banyak mengalami sindrom metabolik. Sedangkan jenis kelamin, kecukupan energi, dan frekuensi konsumsi buah tidak menunjukkan hubungan maupun kecenderungan berdasarkan uji statistik. Hasil analisis multivariat menunjukkan status gizi merupakan faktor yang paling berhubungan dengan sindrom metabolik sehingga disarankan bagi guru SD untuk menjaga pola hidup demi menjaga status gizi normal. ......This thesis aims to describe the general characteristics of the individual (age, sex, marital status), nutritional status (BMI, waist circumference), nutrition adequacy (energy, cholesterol, carbohydrates, frequency of consumption of vegetables and fruit), and lifestyle (physical activity, teaching activity, sleep duration), also it?s relation with metabolic syndrome in elementary school teachers in the District Cilandak, South Jakarta, 2013. This is a analytical descriptive study with cross-sectional approach. The research was conducted in March-April 2013 in the 18 elementary schools in District Cilandak, South Jakarta. The minimum required sample in this study is 128, but in this study we?ve got 138 respondents. The results showed 24,6% of elementary school teachers have the metabolic syndrome. Chi square test showed a relationship between the age, nutritional status, waist circumference, physical activity, and teaching activities with metabolic syndrome. The same statistical test showed no relation but showed a tendency that married elementary school teacher, cholesterol intake >200 mg/day, carbohydrate intake >60% of total energy, the frequency of consumption of vegetables <4x/minggu, and sleep duration ≤ 7 hours/day more likely to have metabolic syndrome. Whereas sex, energy intake, and frequency of consumption of fruits showed no differences in the proportion nor tendency based on statistical tests. Multivariate analysis showed that the nutritional status is the most related factor with the metabolic syndrome, hence this study suggest the elementary school teachers to improve their lifestyle in order to maintain normal nutritional status.