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"ABSTRACTLatar belakang. Prevalens alergi makanan meningkat dalam dekade terakhir, namun belum ada data prevalens alergi makanan di Indonesia. Alergi makanan paling banyak ditemukan pada anak berusia kurang dari 3 tahun. Perolehan data prevalens dapat dilakukan dengan survei berbasis web yang memiliki hasil sebaik survei langsung.Tujuan. Mengetahui prevalens alergi makanan pada anak usia kurang dari 3 tahun di Jakarta berbasis survei dalam jaringan (daring). Mengetahui angka penegakan diagnosis alergi makanan dari terduga alergi makanan, manifestasi klinis keluhan orangtua yang menandakan anaknya alergi makanan, jenis makanan penyebab, dan sebaran alergi makanan berdasarkan gambaran pemberian makan dan kejadian alergi keluarga.Metode. Studi ini adalah deskriptif potong lintang menggunakan survei daring selama Januari 2011-Oktober 2013. Orangtua anak usia <3 tahun di Jakarta yang mampu mengakses internet dengan keluhan kecurigaan alergi makanan pada anaknya, melakukan log masuk di www.alergianakku.com. Kuesioner daring yang terisi kemudian diseleksi sesuai inklusi. Konfirmasi diagnosis didapatkan dengan menanyakan ulang informasi alergi, termasuk melalui pemanggilan dan pemeriksaan langsung. Hasil. Sebanyak 286 subjek yang memenuhi kriteria inklusi; terdapat 100 subjek (35%) dengan terduga alergi makanan dan 30 subjek dari 100 subjek ditetapkan memiliki alergi makanan. Karakteristik subjek adalah mayoritas lelaki (60%) dan kelompok usia >12-36 bulan (48%). Pada kelompok alergi makanan, usia terbanyak >6-12 bulan (11/30). Gejala alergi makanan tersering adalah reaksi kulit (26/30). Makanan penyebab alergi tersering adalah susu sapi. Mayoritas subjek dengan alergi makanan mendapatkan ASI hingga usia 12 bulan (13/30); ASI eksklusif diberikan <6 bulan (23/30), dan makanan pendamping diberikan saat usia 2-4 bulan (13/30). Riwayat alergi pada keluarga (27/30) tersering adalah asma (12/30) dengan hubungan keluarga tersering ibu kandung (15/30). Simpulan. Prevalens alergi makanan pada anak usia kurang dari 3 tahun di Jakarta berbasis survei daring adalah 10,5%. Diagnosis alergi makanan dari terduga alergi makanan adalah 30%. Keluhan tersering yang menandakan alergi makanan adalah reaksi kulit. Jenis makanan tersering penyebab alergi adalah susu sapi. Mayoritas subjek dengan alergi makanan mendapatkan ASI hingga usia 12 bulan, ASI eksklusif diberikan kurang dari 6 bulan, diberikan makanan pendamping dini, dan sebagian besar memiliki riwayat alergi keluarga dengan hubungan tersering ibu kandung dan penyakit alergi keluarga tersering adalah asma.

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ABSTRACTBackground. Prevalence of food allergy is increasing in last decade; however there is no data from Indonesia yet. Food allergy is mostly found in children below 3 years of age. Web-based surveys can be used for obtaining prevalence data as well as direct surveys.Objectives. To know the prevalence of food allergy in children less than 3 years old in Jakarta based on online survey. To know the confirmed food allergy diagnosis from suspected food allergy, clinical manifestation of childhood food allergy based on the parent’s complaint, food etiology, and food allergy distribution based on feeding model and family allergic history.Methods. A cross-sectional descriptive study with online survey during January 2011-October 2013. Parents, who have children <3 years old in Jakarta with suspected food allergy complaint and have access to internet, log in to www.alergianakku.com. The filled online questionnaire was selected by inclusion criteria. Confirmation of diagnosis was made by convincing allergic history, asking the subject to come and by direct examination. Results. Total 286 subjects fulfilled the inclusion criteria; 100 subjects (35%) were suspected food allergy, and 30 out of 100 were diagnosed food allergy. The majority characteristics of subjects were male (60%) and >12-36 months age group (48%). The majority of food allergy subjects were >6-12 months age group (11/30). The most frequent food allergy symptom was skin reaction (26/30). The most frequent food etiology was cow’s milk. The food allergy subjects were breastfed until the age of 12 months (13/30); were given exclusive breastfeeding less than 6 months (23/30) and complementary food at age 2-4 months (13/30). Most of them had family allergic history (27/30), with asthma (12/30) as the most frequent disease, and the most frequent relationship was mother (15/30). Conclusions. Prevalence of food allergy in children less than 3 years old in Jakarta based on online survey is 10.5%. The confirmed food allergy diagnosis from suspected food allergy is 30%. The most frequent clinical manifestation of childhood food allergy is skin reaction. The most frequent food etiology is cow’s milk. The food allergy subjects were breastfed until the age of 12 months; were given exclusive breastfeeding less than 6 months and complementary food at age 2-4 months. Most of them have family allergic history, the disease is asthma, and the relationship is mother"

"ABSTRAKPenelitian ini bertujuan untuk mengembangkan dan menentukan efek programgaya hidup sehat (HLP) berdasarkan teori kognitif sosial (SCT) pada remajadengan kelebihan berat badan di Kota Makassar. Studi ini terdiri dari tiga tahap.Tahap pertama bertujuan untuk mengembangkan HLP. Tahap selanjutnyabertujuan untuk mengembangkan dan memvalidasi instrument untuk mengukurefek HLP. Tahap akhir dari studi ini bertujuan untuk menilai efek HLP terhadapefikasi diri remaja untuk berperilaku sehat, efikasi diri orang tua, perilaku remajadan indeks anthropometri dengan menggunakan desain uji kluster acak terkontrol.Sebanyak delapan (8) sekolah menengah pertama (SMP) diramndomisasi untukmenentukan sekolah intervensi dan kontrol. Total 238 remaja dengan kelebihanberat dan orang tuanya diikutsertakan dalam penelitian ini. Perubahan outcomedianalisis dengan menggunakan uji ANCOVA dengan pendekatan intention totreat. HLP adalah sebuah program yangh terdiri atas dua belas (12) sesipendidikan yang menerapkan beberapa strategi perubahan perilaku dari SCTantara lain penguatan positif, monitoring diri, penentuan tujuan dan keterlibatanorang tua yang disampaikan sekali seminggu oleh para fasilitator terlatih melaluisesi kelompok. HLP berkontribusi dalam meningkatkan efikasi diri remaja untukmempraktikkan perilaku sehat, menurunkan kebiasaan cemilan, dan perubahanpada BMI Z-score menurut umur dan lingkar pinggang.

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ABSTRACTThe study aimed to develop and determine the effect of healthy lifestyle program(HLP) based on Social Cognitive Theory (SCT) among overweight adolescents inMakassar City. It consisted of three stages. Stage one was to develop HLP. Nextstage was to develop and validate the instruments for measuring the effect ofHLP. The last was to measure the effects of HLP on adolescents? self-efficacy onhealthy behaviors, parents? self-efficacy, adolescents? behaviors, andanthropometry indices using cluster randomized controlled trial design. EightSMP were randomly assigned to intervention and control schools. A total of 238overweight adolescents and their parents were involved. Changes in outcomeswere analyzed using ANCOVA on an intention to treat basis. HLP is twelvesessions of education applied behavior change strategies from SCT includingpositive reinforcement, self-monitoring, goal setting and parents? involvementdelivered by trained facilitators through weekly group sessions. HLP contributedin increasing adolescents? self-efficacy for practicing healthy behavior, reducingsnacking habit, and changing BMI for age Z-score and waist circumference"

"Kejadian malnutrisi pada balita menjadi perhatian besar karena menyangkut investasi sumber daya manusia. Indonesia menghadapi triple burden status gizi balita yang menjadi beban negara. Berbagaiupaya dilakukan untuk menurunkan prevalensi kurang gizi balita. Growth faltering sebagai indikatorawal risiko terjadinya stunting menjadi titik awal intervensi intensif dilakukan untuk mencegah stunting. Upaya mengatasi growth faltering dilakukan melalui intervensi spesifik terutama pemberian makan bayi dan anak pada baduta. Penelitian ini bertujuan untuk mengidentifikasi efektivitas brief intervention terhadap praktik pemberian makan responsif pada bayi growth faltering usia 6-23 bulan. Desain penelitian ini adalah pre-experimental study dengan sampel 33 responden di kelompok kontrol (mendapatkan intervensi konseling pemberian makan bayi dan anak/PMBA dan kelompok intervensi (mendapatkan intervensi konseling PMBA dan brief intervention). Hasil penelitian ini menunjukkan bahwa kelompok yang mendapatkan intervensi cenderung meningkatkan skor total pemberian makan responsif dan skor active feeding, meskipun tidak ditemukan signifikansi (pValue > 0,05); sedangkan pad kelompok kontrol selisih skor menunjukkan penurunan. Hasil ini menunjukkan bahwa tidak adaperbedaan bermakna antara kelompok yang mendapat intervensi konseling PMBA dengan kelompok yang mendapatkan intervensi PMBA dan brief intervention “Mentari”. Rekomendasi pelayanan menunjukkan bahwa konseling PMBA tetap dapat menjadi intervensi mengubah praktik pemberian makan.

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The incidence of malnutrition in children under five is a big concern because it involves investing in human resources. Indonesia faces a triple burden on the nutritional status of children under five. Various efforts were made to reduce the prevalence of malnutrition. Growth faltering as an early indicator of the risk of stunting is the starting point for intensive interventions to prevent stunting. Efforts to overcome growth faltering are carried out through specific interventions, especially infant and young child feeding practices. This study aims to identify the effectiveness of the brief intervention on responsive feeding practices in growth-faltering infants aged 6-23 months. The design of this study was a pre-experimental study with a sample of 33 respondents in the control group (getting infant and young child feeding counselling interventions/IYCF and intervention groups (getting IYCF counselling interventions and brief intervention). The results of this study showed that the group that received the intervention tended to improve the total responsive feeding score and active feeding score, although no significance was found (pValue > 0.05); Meanwhile, in the control group, the difference in scores

showed a decrease. These results showed no significant difference between the group that received IYCF counselling intervention and the group that received IYCF intervention and brief intervention. Service recommendations suggest that IYCF counselling can still be an intervention to change feeding practices."

"Kejadian malnutrisi pada balita menjadi perhatian besar karena menyangkut investasi sumber daya manusia. Indonesia menghadapi triple burden status gizi balita yang menjadi beban negara. Berbagai upaya dilakukan untuk menurunkan prevalensi kurang gizi balita. Growth faltering sebagai indikator awal risiko terjadinya stunting menjadi titik awal intervensi intensif dilakukan untuk mencegah stunting. Upaya mengatasi growth faltering dilakukan melalui intervensi spesifik terutama pemberian makan bayi dan anak pada baduta. Penelitian ini bertujuan untuk mengidentifikasi efektivitas brief intervention terhadap praktik pemberian makan responsif pada bayi growth faltering usia 6-23 bulan. Desain penelitian ini adalah pre-experimental study dengan sampel 29 responden di kelompok kontrol (mendapatkan intervensi konseling pemberian makan bayi dan anak/PMBA dan 27 responden kelompok intervensi (mendapatkan intervensi konseling PMBA dan brief intervention). Hasil penelitian ini menunjukkan bahwa kelompok yang mendapatkan intervensi cenderung meningkatkan skor total pemberian makan responsif dan skor active feeding, meskipun tidak ditemukan signifikansi (pValue > 0,05); sedangkan pada kelompok kontrol selisih skor menunjukkan penurunan. Hasil ini menunjukkan bahwa tidak ada perbedaan bermakna antara kelompok yang mendapat intervensi konseling PMBA dengan kelompok yang mendapatkan intervensi PMBA dan brief intervention “Mentari”. Rekomendasi pelayanan menunjukkan bahwa konseling PMBA tetap dapat menjadi intervensi mengubah praktik pemberian makan.

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The incidence of malnutrition in children under five is a big concern because it involves investing in human resources. Indonesia faces a triple burden on the nutritional status of children under five. Various efforts were made to reduce the prevalence of malnutrition. Growth faltering as an early indicator of the risk of stunting is the starting point for intensive interventions to prevent stunting. Efforts to overcome growth faltering are carried out through specific interventions, especially infant and young child feeding practices. This study aims to identify the effectiveness of the brief intervention on responsive feeding practices in growth-faltering infants aged 6-23 months. The design of this study was a pre-experimental study with a sample of 29 respondents in the control group (getting infant and young child feeding counselling interventions/IYCF and 27 respondents in the intervention groups (getting IYCF counselling interventions and brief intervention). The results of this study showed that the group that received the intervention tended to improve the total responsive feeding score and active feeding score, although no significance was found (pValue > 0.05); Meanwhile, in the control group, the difference in scores showed a decrease. These results showed no significant difference between the group that received IYCF counselling intervention and the group that received IYCF intervention and brief intervention. Service recommendations suggest that IYCF counselling can still be an intervention to change feeding practices."

"Anak sakit kritis terutama sepsis mengalami degradasi protein yang tinggi, yang memperburuk luaran bila masukan nutrisi tidak adekuat. Kiraan jumlah kebutuhan protein yang ada saat ini ternyata dalam praktiknya kurang dari 90 memenuhi target kebutuhan. Di lain sisi, variasi genetik individu juga memengaruhi luaran. Polimorfisme gen TNF?-308 berhubungan dengan luaran yang buruk berbagai penyakit infeksi dan inflamasi, walaupun hasil yang diperoleh berbeda-beda.Penelitian ini bertujuan mengetahui hubungan nutrisi tinggi protein terhadap prognosis pasien sepsis skor PELOD , lama rawat dan lama pemakaian ventilator, serta menganalisis peran pelbagai faktor yang berperan terhadap skor PELOD, termasuk polimorfisme gen TNF?-308.Penelitian ini merupakan uji klinis randomisasi pada 80 anak sepsis di 4 rumah sakit. Intervensi diberikan asam amino parenteral, yaitu Aminosteril infant 6 untuk usia < 1 tahun dan Aminofusin pediatric 5 untuk usia ge; 1 tahun. Kelompok eksperimental diberikan asam amino 4 g/KgBB/hari, sedangkan kelompok kontrol menerima 2 g/KgBB/hari selama tiga hari, kemudian dilakukan pencatatan skor PELOD pada hari ke-1,2 dan 3, lama hari rawat dan lama pemakaian ventilator. Dilakukan pemeriksaan keseimbangan nitrogen selama tiga hari, pemeriksaan kadar prealbumin hari ke-1 dan ke-3, pemeriksaan kadar TNF-? dan IL-10. Pemeriksaan polimorfisme dengan metode PCR polymerase chain reaction ndash; RFLP restriction fragment length polymorphism . Pada kelompok kontrol, diperoleh rerata skor PELOD pada hari ke-1 20,5 10,6 , hari ke-2 19,8 13,8 dan hari ke-3 19,8 15,4 ; median lama rawat 7 hari 3 ndash;19 dan median lama pemakaian ventilator 5 hari 1 ndash;14 . Pada kelompok eksperimental, diperoleh rerata skor PELOD berturut-turut 22,4 10,8 ; 20,5 13,9 ; 18,8 14,5 ; median lama rawat 7 hari 4 ndash;27 dan median lama pemakaian ventilator 4 hari 1 ndash;27 . Tidak ditemukan perbedaan bermakna skor PELOD, lama rawat dan lama pemakaian ventilator antara 2 kelompok. Diperoleh perbedaan bermakna secara statistik pada keseimbangan nitrogen baik hari ke-1,2, dan 3 p = 0,003; p = 0,016; p = 0,046 . Dari 80 subjek, 6 subjek 7,5 dengan polimorfisme gen TNF?-308 G/A atau heterozigot dan tidak ditemukan homozigot.Tidak ditemukan peran usia, jenis kelamin, status gizi, pemberian nutrisi tinggi protein dan polimorfisme gen TNF?-308 terhadap skor PELOD. Kata kunci: polimorfisme gen TNF?-308, protein tinggi, sepsis

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Critically ill children, particularly with sepsis, have high protein degradation which worsens outcome if nutritional intake are inadequate. Currently, the estimated protein requirement is less than 90 target requirement. In addition, individual genetic variation also affects the outcome of these population. Tumor necrosis factor TNF 308 gene polymorphism is associated with poorer outcome of several infectious disease and inflammation, although the results are conflicting.This study aimed to determine the association between high protein nutrition intervention with prognosis of sepsis which is measured by PELOD score, length of stay, and duration of mechanical ventilation use. We also analyze the role of TNF 308 gene polymorphism which contribute to PELOD score.This was a randomized clinical trial in 80 children with sepsis in four hospitals. The interventions were parenteral amino acid, which includes Aminosteril infant 6 for subjects aged below one year and Aminofusin pediatric 5 for subjects aged above one year. Subjects in the experimental group were provided with amino acid 4 g KgBW day while those in the control group were provided with amino acid 2 g KgBW day for three consecutive days. PELOD scores in day 1, 2, 3, length of stay, and duration of mechanical ventilation use, were recorded. Nitrogen balance was measured for three days and prealbumin levels were measured in day 1 and 3. TNF and IL 10 levels were also measured. Polymorphism was measured using polymerase chain reaction PCR ndash restriction fragment length polymorphism RFLP .In the control group, the mean PELOD score on day 1, 2, 3 were 20.5 10.6 , 19.8 13.8 , and 19.8 15.4 , respectively. Median length of stay was 7 3 ndash 19 days and median duration of mechanical ventilation was 5 1 ndash 14 days. In the experimental group, obtained mean PELOD score was 22.4 10.8 20.5 13.9 18.8 14.5 consecutively median length of stay was 7 days 4 ndash 27 and median duration of ventilator use was 4 days 1 ndash 27 . There was no significant difference in PELOD score, length of stay, and duration of mechanical ventilation use between both groups. There was a significant difference in nitrogen balance on day 1, 2, and 3 p 0.003, p 0.016, and p 0.046, respectively . Of the 80 subjects, 6 7.5 subjects with TNF 308 G A gene polymorphism or heterozygotes, and no homozygote was found.Age, gender, nutritional status, provision of high protein nutrients, and TNF 308 gene polymorphism have no significant role in PELOD score. Keywords high protein, sepsis, TNF 308 gene polymorphism."

"Pendahuluan. Inflamasi yang dapat ditandai dengan peningkatan high sensitivity c-reactive protein dapat meningkatkan resiko penyakit degeneratif pada remaja. Hs-CRP dipengaruhi oleh berbagai faktor termasuk diet dan obesitas. Penelitian ini bertujuan untuk menginvestigasi hubungan kualitas diet, lingkar pinggang dan rasio lingkar pinggang-panggul terhadap high-sensitivity protein pada remaja.Metode. Penelitian potong lintang yang melibatkan 219 remaja berusia 12-17 tahun yang tinggal di Surabaya dilaksanakan pada Bulan Januari – Agustus 2023. Kualitas diet dinilai dengan Healthy Eating Index (HEI) 2015 yang dihitung berdasarkan recall 24 jam selama 2 hari yang tidak berurutan. Lingkar pinggang dan lingkar panggul diukur menggunakan pita pengukur SECA® tapeline dengan akurasi 0,1 cm, sementara hs-CRP menggunakan particle-enhanced immunoturbidimetric assay. Regresi linier berganda digunakan untuk menganalisis hubungan kualitas diet, lingkar pinggang, rasio lingkar pinggang-panggul terhadap hs-CRP dengan mengontrol beberapa faktor perancu. Structural Equation Modelling (SEM) digunakan untuk analisis jalur efek berbagai variabel terhadap hs-CRP.Hasil. Rata-rata skor HEI 2015 subjek adalah 48.8± 10.3. Sebanyak 57.1% subjek memiliki kualitas diet yang buruk. Proporsi remaja dengan obesitas sentral dan obesitas abdominal sebanyak 25,1% dan 32,9%. Rata-rata hs-CRP adalah 1.71 ± 2.53 mg/L. Lingkar pinggang berhubungan dengan kadar hs-CRP (adjusted β=0.450; 95% CI = 0.444 - 0.456), namun rasio lingkar pinggang-panggul (adjusted β = 0.274; 95% CI =-0.929 - 1.476) dan kualitas diet (β=-0.017; 95% CI =-0.050 - 0.016) tidak berhubungan dengan hs-CRP walaupun telah dikontrol dengan faktor perancu. Analisis jalur menunjukkan bahwa ada pengaruh efek lingkar pinggang dengan arah positif terhadap kadar hs-CRP pada remaja.Kesimpulan dan Saran. Lingkar pinggang lebih memiliki efek dengan kadar hs-CRP jika dibandingkan dengan kualitas diet dan rasio lingkar pinggang-panggul. Pengukuran lingkar pinggang secara rutin perlu dilakukan untuk skrining dini risiko inflamasi pada remaja.

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Inflammation can be characterized by an increasing level of highsensitivity C-reactive protein (Hs-CRP), which can promote the risk of noncommunicable disease in adolescents. Hs-CRP is affected by various factors, including diet and obesity. We investigated the associations of dietary quality score, waist circumference, and waist-to-hip ratio profile with hs-CRP. Methods. A cross-sectional study involving 219 school-going adolescents aged 12-17 years, living in Surabaya was conducted from January to August 2023. Diet quality was assessed by the Healthy Eating Index (HEI) 2015, calculated from two non-consecutive days of 24 hours recalls. Waist and hip circumference were measured by SECA® tapeline with an accuracy of 0.1 cm. Hs-CRP was assessed by using a particle-enhanced immunoturbidimetric assay. Multiple linear regression was used to analyze the association of dietary quality, waist circumference, and waist-hip ratio (WHR) with HsCRP while controlling for confounding factors. Structural Equation Modelling (SEM) was used to determine the pathways of the mediator's effect on hs-CRP. Results. Most of the subject was female, in the 15-17 years age group, the puberty stage based on breast or genital development was stage 4. Most adolescents had low physical activity and poor sleep quality. The average HEI 2015 score was 48.8± 10.3. The majority of subjects had poor diet quality. The mean of hs-CRP was 1.71 ± 2.53 mg/L. The proportion of adolescents with central and abdominal obesity were 25.1% and 32.9%, respectively. Waist circumference was associated with hs-CRP (adjusted β=0.450; 95% CI = 0.444 - 0.456). However, the waist-to-hip ratio (adjusted β = 0.274; 95% CI =-0.929 - 1.476) and HEI 2015 score (β=-0.017; 95% CI =-0.050 - 0.016) were not associated with hs-CRP, even after accounting for confounding factors. The pathway analysis showed that the waist circumference variable has a positive significant effect on hs-CRP. Conclusion and Recommendation. Waist circumference is a mediator of hs-CRP compared to the waist-to-hip ratio and diet quality score. Routine waist circumference measurement as a screening tool for inflammation risk must be conducted in adolescents"