Hasil Pencarian  ::  Simpan CSV :: Kembali

Abstrak :
Pemerintah di dunia sedang berkembang memberi semua ibu hamil mendapat antenatal care, memberi tablet besi dan asam folat (IFO) sedini mungkin dalam jumlah cukup. Lembaga Internasional di dunia mendorong pemberian suplemen mikronutrien multipel (MNM) pada ibu hamil, dimaksudkan memberi efek positip pada pertumbuhan fetus dalam umur gestasi cukup bulan. Pemberian MNM pada semua ibu hamil hasilnya inkonsisten. Penelitian ini bertujuan melihat efek MNM khusus pada ibu hamil tanpa komplikasi terhadap outcome kelahiran yaitu: pertumbuhan (berat lahir), perkembangan (lingkar kepala lahir) dan maturitas (umur gestasi) bayinya. Harapannya adalah setiap bayi lahir bisa dibekali dengan pertumbuhan, perkembangan dan maturitas yang optimal sebagai satu kesatuan hasil kelahiran. Masih diragukan apakah suplementasi MNM pada ibu hamil lebih baik jika dibandingkan dengan IFO untuk memperbaiki antropometri dan umur gestasi. Pertanyaan tersebut ingin dipecahkan melalui pemberian suplemen MNM pada ibu hamil tanpa komplikasi dibandingan IFO. Penelitian ini mengeluarkan faktor yang menyebabkan hambatan pertumbuhan fetus dari populasi studi, memanfaatkan data sekunder studi SUMMIT di Pulau Lombok 2001 ? 2004, desainnya randomized control trial double blind. Analisis data melihat efek MNM terhadap rata-rata tiga outcome dengan statistik MANOVA; terhadap masing-masing outcome secara tersendiri yaitu berat lahir di bawah normal, lingkar kepala di bawah normal dan umur gestasi di bawah normal; terhadap status gizi prahamil rendah dibanding status gizi prahamil baik. Suplementasi MNM meningkatkan rata-rata berat lahir 38,52g lebih tinggi dibanding IFO, secara statistik bermakna. Risiko terjadinya berat lahir <2.600 g pada suplementasi IFO ibu hamil tanpa komplikasi sebesar 1,2 kali dibanding MNM, apabila menggunakan batas α=0,10 secara statistik bermakna, 90%CI: 1,00-1,46. Jika pemberian IFO diganti dengan MNM, akan tercegah sebanyak 13/1.000 bayi dengan berat lahir <2.600 g. Kejadian berat lahir <2.600 g pada pemberian IFO bisa dikurangi 15,1% dari kejadian 83/1.000 bayi lahir bila diganti MNM. Risiko terjadinya berat lahir <2.600 g pada suplementasi IFO jika diganti dengan MNM lebih jelas pada IMT prahamil <18,50 sebesar 1,7 kali bila menggunakan batas α=0,10 secara statistik bermakna, 90%CI: 1,08-2,65. Jika pemberian IFO pada ibu hamil tanpa komplikasi dengan status gizi prahamil rendah diganti dengan MNM, akan tercegah sebanyak 70/1.000 bayi dengan berat lahir <2.600g. Kejadian berat lahir <2.600g pada pemberian IFO ibu hamil tanpa komplikasi dengan IMT prahamil <18,50 bisa dikurangi 40,7% dari kejadian 172/1.000 bayi lahir bila diganti MNM.

---

Government on developing countries care to all pregnant women for ANC access, give iron?folic acid (IFO) as soon as possible. International agencies on the world stimulate multiple micronutrients (MMN) suplement to pregnant women, that is aimed for giving good of fetal growth in appropriate gestation age. MMN distribution for all pregnant women still have inconsisten result. The purposes of this study look for MMN effect especially on pregnant women without complication for birth outcome: growth (birth weight), development (head circumference at birth) and maturity (gestation age). It is doubted that MMN suplementation on pregnant women is better than IFO for increasing anthropometry and gestation age. This research need specific care with restrict factors that delay fetal growth, using SUMMIT secondary data at Lombok Island 2001-2004 with RCT double blind design. Analyzing data was looking the MMN effect for three mean outcome values by MANOVA statistic, was looking the MMN effect for each outcome individually: birth weight below normal cut-off, head circumference at birth below normal cut-off and gestasion age below normal cut-off, was look at low prepregnancy BMI stratum comparing by normal prepregnancy BMI. MMN suplementation increases mean birth weight as 38,52g more than IFO with statistical significant. The risk of <2,600 g birth weight happened at IFO supplementation on pregnant women without complication were 1.2 time comparing with MNM. If it used at α=0.05 level, it was not statistical significant, but when it used at α=0.10 level, it was statistical significant with 90%CI: 1.00-1.46. If IFO supplementation on pregnant women without complication be replaced by MNM, it would prevent as 13/1,000 infant with <2,600 g birth weight. Incidence of <2.600 g birth weight at IFO supplementation on pregnant women without complication could be decreased 15.1% of 83/1,000 at birth babies happened if it were replaced by MNM. The risk of <2,600 g birth weight happened at IFO supplementation on pregnant women without complication if it be replaced by MNM were clearer on pregnant women without complication at <18.50 prepregnancy BMI stratum as 1.7 time. If it used at α=0.05 level, it was not statistical significant, but when it used at α=0.10 level, it was statistical significant with 90%CI:1.08-2.65. If IFO supplementation on pregnant women without complication at low nourish prepregnancy status were replace with MNM, it would be prevent as 70/1,000 infant with <2,600g birth weight. Incidence of <2,600g birth weight at IFO supplementation on pregnant women without complication at <18.50 prepregnancy BMI stratum could be decreased as 40,7% of 172/1,000 at birth babies happened if it were replaced by MNM.

Abstrak :
Anemia adalah kondisi dengan kadar hemoglobin rendah akibat defisiensi besi dan nutrisi. Suplemen darah komersial umumnya hanya mengandung zat besi dan kurang disukai karena rasa. Telah dikembangkan suplemen permen lunak dengan mikropartikel kitosan terdispersi yang mengandung besi(II) glukonat, vitamin (C, B2, B5, B6, B9, B12), dan seng (Zn). Tujuan penelitian ini adalah mengevaluasi efektivitas, waktu simpan, dan bioavailabilitas suplemen ini. Uji in vivo melibatkan 15 mencit yang dibagi dalam lima kelompok perlakuan berbeda. Hasil menunjukkan kenaikan kadar hemoglobin pada kontrol, mikropartikel dosis 300mg/kgBB, 600mg/kgBB, dan obat komersial berturut-turut sebesar 1,96 g/dl (SD: 4,8 g/dl), 3,5 g/dl (SD: 3,68 g/dl), 4,73 g/dl (SD: 2,02 g/dl), dan 4,7 g/dl (SD: 1,34 g/dl). Penurunan terjadi pada mikropartikel dosis 150mg/kgBB sebesar 0,43 g/dl (SD: 4,5 g/dl). Uji paired-t test menunjukkan peningkatan signifikan pada mikropartikel dosis 600mg/kgBB dan obat komersial (P < 0,05). Kenaikan hemoglobin tidak hanya dipengaruhi oleh besi(II) glukonat, tetapi juga oleh multivitamin dan zinc citrate. Formulasi disempurnakan dengan asam sitrat, kalium benzoat, dan kalium sitrat untuk meningkatkan rasa dan waktu simpan. Uji ICP-MS menunjukkan suplemen mengandung 3284,4 mg/kg elemen besi, dengan satu permen mengandung sekitar 11,5 mg besi, lebih tinggi dari rata-rata produk komersial. ......Anemia is a condition with hemoglobin levels below standard due to iron and nutrient deficiency. Commercial blood supplements generally contain only iron and are often disliked due to taste. This study developed a soft candy supplement with dispersed chitosan microparticles containing iron(II) gluconate, vitamins (C, B2, B5, B6, B9, B12), and zinc (Zn). The objective of this research was to evaluate the effectiveness, shelf life, and bioavailability of this supplement. In vivo tests involved 15 mice divided into five groups with different treatments. Results showed hemoglobin increases in the control, 300mg/kgBW microparticles, 600mg/kgBW microparticles, and commercial drug groups of 1.96 g/dl (SD: 4.8 g/dl), 3.5 g/dl (SD: 3.68 g/dl), 4.73 g/dl (SD: 2.02 g/dl), and 4.7 g/dl (SD: 1.34 g/dl), respectively. A decrease occurred in the 150mg/kgBW microparticle group by 0.43 g/dl (SD: 4.5 g/dl). Paired-t tests showed significant increases in the 600mg/kgBW microparticle and commercial drug groups (P < 0.05). Hemoglobin increases were influenced not only by iron(II) gluconate but also by the contained multivitamins and zinc citrate. The supplement formulation was improved by adding citric acid, potassium benzoate, and potassium citrate to enhance taste and shelf life. ICP-MS tests showed the fortified soft candy supplement contained 3284.4 mg/kg iron, with each candy containing approximately 11.5 mg iron, higher than the average commercial soft candy supplement.

Abstrak :
Latar belakang: Kegagalan pertumbuhan sering terjadi pada pasien talasemia mayor (TM). Tata laksana nutrisi merupakan salah satu aspek penting untuk mengoptimalkan hasil luaran klinis. Penilaian komposisi tubuh berupa persentase massa otot, persentase masa lemak dan densitas massa tulang (DMT) menjadi komponen penting dalam mengevaluasi status gizi. Hingga saat ini belum ada penelitian di Indonesia yang mengevaluasi hubungan antara asupan makronutrien dan mikronutrien terhadap komposisi tubuh pada pasien TM remaja serta hubungannya dengan berbagai parameter antropometri. Metode: Penelitian dengan desain studi potong lintang melibatkan 55 pasien TM remaja, berusia 10-18 tahun di Pusat Talasemia RSUPN Cipto Mangunkusumo. Status gizi dievaluasi disertai pengukuran lingkar lengan atas (LILA), triceps skin thicknes (TSK), dan mid-upper arm muscle circumference (MUAMC). Asupan makronutrien dan mikronutrien diperoleh melalui food record selama tiga hari. Persentase massa otot, massa lemak, dan DMT dinilai menggunakan dual-energy X-ray absorptiometry (DXA). Kadar vitamin D diperiksa melalui metode enzyme-linked immunosorbent assay (ELISA). Data dianalisis menggunakan korelasi Pearson dan Spearman sesuai dengan pola distribusi normalitas. Hasil penelitian: Gizi kurang dijumpai pada 58,2% subjek dan gizi buruk pada 9,1% subjek. Rerata dan median asupan zat gizi harian dibandingkan dengan kebutuhannya pada subyek lelaki yakni asupan energi 85,6 % (SB 20,19), protein 55% (SB 14,19), lemak 112,4% (SB 35,48), karbohidrat 85,5 % (SB 23,31), vitamin D 29% (RIK 15,68-40,80), vitamin E 34,1% (SB 14,77), kalsium 37% (RIK 16,63-43,45), dan asam folat 32,98% (SB 14,6), sedangkan pada subyek perempuan asupan energi 93,6 % (SB 18,61), protein 59% (RIK 51-63), lemak 112,4% (RIK 105-142,5), karbohidrat 93,3 % (SB 25,5), vitamin D 22% (RIK 13,65-43), vitamin E 24% (RIK 21,65-39,7), kalsium 35,7% (RIK 20,45-55,6), dan asam folat 26,3% (RIK 16,2-41,15). Terdapat korelasi  ringan antara asupan energi dengan persentase massa lemak pada subyek lelaki dan perempuan (r= 0,25, p= 0,017; r= 0,38, p= 0,02). Tidak terdapat korelasi antara asupan karbohidrat, lemak, dan protein, vitamin D, vitamin E, kalsium, dan asam folat terhadap persentase massa otot, persentase massa lemak dan DMT. Kadar vitamin D tidak berkorelasi dengan komposisi tubuh. Terdapat korelasi kuat antara LILA dan MUAMC dengan persentase massa otot (r= 0,54, p<0,001; r= 0,68, p<0,001) dan massa lemak (r=0,77, p<0,001; r= 0,61, p<0,001). Kesimpulan: Lebih dari separuh remaja talasemia mengalami malnutrisi dan kekurangan asupan protein. Komposisi tubuh berkorelasi dengan jumlah asupan energi, tetapi tidak dengan yang lainnya. Kadar vitamin D tidak berkorelasi dengan komposisi tubuh. Lingkar lengan atas (LILA) dan MUAMC berkorelasi dengan persentase massa otot dan massa lemak. ......Background:Growth failure is common in thalassemia major (TM) patients. Nutritional management is an imperative aspect to optimize the clinical outcome. Measurement of muscle mass percentage, fat mass percentage, and bone mass density (BMD) on body composition is important component in assessing the nutritional status. There has been no study in Indonesia for the correlation between macronutrient and micronutrient intake on body composition in adolescents with thalassemia major. Methods: This cross-sectional study involved 55 adolescent TM patients aged 10-18 years old taken through concecutive sampling at the Thalassemia Center dr. Cipto Mangunkusumo National Hospital Jakarta. Nutritional status was evaluated and anthropometric measurements was performed including  mid-upper arm circumference (MUAC), triceps skin thickness (TSK), and mid-upper arm muscle circumference (MUAMC). Macronutrient and micronutrient intake was obtained through a three-day food record. Muscle mass percentage, fat mass percentage, and BMD were assessed by dual-energy X-ray absorptiometry (DXA). The enzyme-linked immunosorbent assay (ELISA) method was used to examine vitamin D levels. The data was analyzed by Pearson and Spearman correlation depending on the type of distribution. Result: Moderate malnourish occurred in 58.2% subjects and severe malnourish in 9,1% subjects. The mean and median daily nutrient intake compared to their needs in male subjects were energy intake 85.6% (SD 20.19), protein 55% (SD 14.19), fat 112.4% (SD 35.48), carbohydrates 85.5% (SD 23.31), vitamin D 29% (IQR 15.68-40.80), vitamin E 34.1% (SD 14.77), calcium 37% (IQR 16.63-43, 45), and folic acid 32.98% (SD 14.6), while in female subjects, energy intake were 93.6% (SD 18.61), protein 59% (IQR 51-63), fat 112.4% (IQR 105-142.5), carbohydrates 93.3% (SD 25.5), vitamin D 22% (IQR 13.65-43), vitamin E 24% (IQR 21.65-39.7), calcium 35 .7% (IQR 20.45-55.6), and folic acid 26.3% (IQR 16.2-41.15). There was a mild correlation between energy intake and fat mass percentage in male and female subjects (r= 0,25, p= 0,017; r= 0,38, p= 0,02). There was no correlation between carbohydrate, fat, and proteis, vitamin D, vitamin E, calcium, and folic acid on the proportion of muscle mass percentage, fat mass percentage, and BMD. Vitamin D levels were not correlated with body composition. There were strong correlation between MUAC and MUAMC with the percentage of muscle mass (r= 0.54, p<0.001; r= 0.68, p <0.001) and fat mass (r=0.77, p<0.001; r= 0.61 , p < 0.001). Conclusion: More than half of adolescent TM patients are malnourished and lack protein intake. Body composition correlates with total calorie intake, but not with anything else. Vitamin D levels are not correlated with body composition. Mid-upper arm circumference and MUAMC correlate with the percentage of muscle mass and fat mass.

Abstrak :
Latar Belakang: Indonesia mempunyai prevalensi malnutrisi yang tinggi pada usia lanjut, yang dipengaruhi oleh inadekuasi asupan nutrien. Inadekuasi asupan nutrien pada usia lanjut di Indonesia merupakan masalah dengan prevalensi tinggi, high impact, dan menimbulkan beban ekonomi yang tinggi. Produk susu merupakan nutrient dense food yang potensial untuk intervensi masalah inadekuasi asupan nutrien. Produk susu dapat ditoleransi oleh usia lanjut di Indonesia, namun belum diteliti apakah berhubungan dengan asupan nutrien pada populasi usia lanjut Tujuan: Tujuan dari penelitian ini untuk mengetahui perbedaan rerata asupan energi dan nutrien, serta mengetahui hubungan antara konsumsi produk susu dengan adekuasi asupan nutrien pada kelompok dairy user dibandingkan non dairy user pada usia lanjut di Indonesia Metode: Penelitian ini merupakan bagian dari penelitian Indonesian Study of Lactose Intolerance in Elderly Population. Desain penelitian potong lintang. Waktu penelitian bulan Januari-Juli 2021 menggunakan data pasien di Unit Rawat Jalan Geriatri Terpadu RSCM Jakarta dengan sampling konsekutif. kriteria inklusi adalah usia 60 tahun atau lebih dan tinggal di komunitas bersama keluarga. Kriteria eksklusi adalah gangguan fungsi kognitif berat, kondisi klinis yang mempengaruhi hasil uji intoleransi laktosa, serta menolak berpartisipasi dalam penelitian. Analisis bivariat menggunakan uji t-test atau alternatifnya, chi-square atau alternatifnya, sesuai dengan jenis variabel yang diuji. Analisis multivariat untuk adjustment variabel perancu menggunakan regresi logistik. Hasil: Sebanyak 103 partisipan menjadi subjek penelitian ini. Terdapat perbedaan asupan protein (p=0.003), kalsium (p<0.001), vitamin D (p <0.001), vitamin B12 (p=0.002) pada kelompok dairy user dibandingkan non-dairy user. Tidak didapatkan kemaknaan statistik pada uji bivariat maupun multivariat yang menganalisis hubungan antara konsumsi produk susu dengan adekuasi asupan energi dan nutrien, namun didapatkan perbedaan proporsi inadekuasi asupan nutrien pada kedua kelompok. Kesimpulan: Tidak terdapat beda rerata asupan energi, karbohidrat, dan lemak pada kedua kelompok. Terdapat perbedaan rerata asupan protein, kalsium, vitamin D, dan vitamin B12 pada kedua kelompok. Belum dapat dibuktikan hubungan antara konsumsi produk susu dengan adekuasi asupan nutrien pada populasi orang usia lanjut di Indonesia, namun didapatkan perbedaan proporsi inadekuasi asupan nutrien yang bermakna secara klinis pada kelompok dairy user dibandingkan non- dairy user. ......Background: Indonesia is a country with high prevalence of malnutrition, which is strongly caused by inadequacy of nutrients intakes. The problem of inadequate intakes of nutrients in Indonesia older adults is a problem with a high prevalence, high impacts, and high economic burden. Dairy products as nutrient dense foods are beneficial to improve inadequacy of nutrients intakes, and well tolerated by older adults in Indonesia. Yet, lack of data on association between dairy products consumption and nutrients intakes in this population. Objectives: The aims of this study were to determine the difference in the mean intakes of energy and nutrients, as well as to investigate association between dairy products consumption and adequacy of nutrients intakes in the dairy user group compared with non-dairy users in Indonesian elderly population. Methods: A cross-sectional study, as a part of the Indonesian Study of Lactose Intolerance in Elderly Population was conducted in January-July 2021 using patients’ data at the Geriatric Outpatient Clinic, Cipto Mangunkusumo Hospital Jakarta, with consecutive sampling. Inclusion criteria were older adults (60 years or older) and community-dwelling. Exclusion criteria were subjects with severe cognitive impairment, having clinical conditions that affected the results of the lactose intolerance test, and unwillingness to participate in the study. Bivariate analysis used t-test or chi square, in concordance with the variables. Multivariate analysis using logistic regression was performed to assess the association between milk consumption and adequacy of energy and nutrients intake, adjusted by confounding variables. Results: A total of 103 participants enrolled as the subjects of this study. There were different mean intakes of protein (p=0.003), calcium (p<0.001), vitamin D (p<0.001), vitamin B12 (p=0.002) between dairy users and non-dairy users. There was no statistical significance in bivariate and multivariate analyses of association between dairy products consumption and adequate intake of energy and nutrients. Yet we found different proportions of nutrients inadequacies between dairy user (mild to moderate inadequacies) and non-dairy users (moderate to severe inadequacies). Conclusion: We found pronounced different mean intakes of protein, calcium, vitamin D, and vitamin B12 in dairy users compared with non-dairy users. Although association between consumption of dairy products and adequate intake of nutrients in Indonesian elderly population cannot be confirmed, yet we found clinically important difference proportions of nutrients inadequacies between dairy user and non-dairy users.