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Jurnal Vol.9 No.2

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ARTIKEL - Oktober 2012, Vol.9, No.2

Durasi menyusu dan kejadian overweight pada remaja

Nurlaili Ramli1, Madarina Julia2, Toto Sudargo3

ABSTRACT

Background
: Statistic showed an increasing number of overweight incidences among children in Aceh Province. However, relationship between breastfeeding and risk of overweight and obesity is still controversial due to strong confounding factors. Hence, the relationship between breastfeeding and obesity is unclear. To reduce the confounding factors, siblings analysis can be undertaken as children live in the same environment.
Objective : To investigate the infl uence of siblings overweight status on breastfeeding duration and overweight incidence among adolescents and to explore other environmental and genetic factors related to overweight incidence in adolescents.
Method : This was an observational-analytical study with a matched case control design. There were 50 subjects for each group. Subjects in the case group were taken from existing cases, while the control group was selected by purposive sampling by matching in age and gender. Paired t test, McNemar test and conditional logistic regression were performed to analyse the data.
Result : Overweight adolescents have shorter breastfeeding duration than non-overweight adolescents. Multiple conditional logistic regression tests on overweight status in siblings showed that breastfeeding duration could reduce overweight incidence among adolescents (OR=0.81; 95%CI:0.69-0.96).
Conclusion : Overweight adolescents have shorter duration of breastfeeding than those who were not overweight. Factors that affect the risk of overweight among adolescents in this study were mother’s education, adolescent’s eating behavior, mother’s overweight status and sibling’s overweight status.

Key words : breastfeeding duration, overweight, adolescents, siblings

1 Korespondensi: Jurusan Kebidanan Politeknik Kesehatan Kementerian Kesehatan Aceh, Jl. Dr. T. Syarief Thayeb Lampriet, Banda Aceh, e-mail: This e-mail address is being protected from spambots. You need JavaScript enabled to view it
2 Bagian Ilmu Kesehatan Anak Rumah Sakit Umum Pusat Dr. Sardjito/Fakultas Kedokteran Universitas Gadjah Mada, Jl. Kesehatan No 1, Yogyakarta, e-mail: This e-mail address is being protected from spambots. You need JavaScript enabled to view it
3 Program Studi Gizi Kesehatan, Fakultas Kedokteran Universitas Gadjah Mada, Jl. Farmako, Sekip Utara, Yogyakarta 55281, e-mail: This e-mail address is being protected from spambots. You need JavaScript enabled to view it

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Asupan protein dan fosfor, rasio fosfor – protein, dan kadar fosfor darah pada pasien gagal ginjal kronis dengan hemodialisis

Ahmad Syauqy1, Susetyowati2, Suhardi3

ABSTRACT

Background
: Hyperphosphatemia has become one of the main causes of death in CKD patients on HD. Thus, correction and prevention of hyperphospatemia is a major component in the management of HD patients. High protein diet in HD patients may lead to increased serum phosphate level due to mineral metabolism disorder associated with decreased glomerular fi ltration rate. In addition, high protein intake often followed by high phosphate intake as high protein foods also contains high phosphate and may cause hyperphosphatemia. Meanwhile, reduction of protein intake to control phosphate level was associated with decreased health and nutritional status in CKD patients. Therefore, appropriate phosphate-protein ratio is essential to provide adequate protein intake and avoid hyperphosphatemia.
Objective : To investigate the association between protein and phosphate intake, phosphate-protein ratio and blood phosphate level in CKD patients on routine HD.
Method : The study used an analytic observational method with cross sectional design. There were 100 subjects involved in this study. Subject characteristics, protein and phosphate intake, phosphate-protein ratio and intake of phosphate binders were obtained through interview and 3 x24 hour food record. Serum phosphate level was analyzed by inorganic phosphorus quantifi cation method. Food processor was used to analyze the intake of protein and phosphate. Bivariate and multivariate tests with 95% confi dence interval were used to analyze the data.
Result : Adequate protein intake was observed among 38% subjects, while 46% of them have excess phosphate intake.High phosphate-protein ratio was found in 20% subjects. Most subjects did not take phosphate binders regularly (61%) and have hyperphosphatemia (66%). The average protein intake, phosphate intake, phosphate-protein ratio, and blood phosphate level were 1.1 g/kg/d, 13.5 mg/kg/d, 12.8 mg/g, and 5.6 mg/dl, respectively. Bivariate test showed that there was a signifi cant association between protein intake (p=0.037; RP=2.78), phosphate intake (p=0.005; RP=3.54), phosphate-protein ratio (p=0.045; RP=3.85), and blood phosphate level in CKD patients on routine HD. Multivariate analysis revealed that high phosphate intake and did not consume phosphate binders regularly were risk factors of hyperphosphatemia (p=0.000; OR=6.543; CI 95%:2.357-18.164 dan p=0.024; OR=3.413; CI 95%:1.179; R2=0.42).
Conclusion : Consumtion of low phosphate foods and phosphate binders may reduce the risk of hyperphosphatemia in CKD patients on routine HD.

Key words : hyperphosphatemia, protein intake, phosphor intake, phosphate-protein ratio, chronic renal failure, hemodialysis

1 Korespondensi: Program Studi Ilmu Gizi, Fakultas Kedokteran Universitas Diponegoro, Jl. dr. Sutomo No. 14, Semarang Jawa Tengah, e-mail: This e-mail address is being protected from spambots. You need JavaScript enabled to view it
2 Program Studi Gizi Kesehatan, Fakultas Kedokteran Universitas Gadjah Mada, Jl. Farmako, Sekip Utara, Yogyakarta 55281, e-mail: This e-mail address is being protected from spambots. You need JavaScript enabled to view it
3 Instalasi Hemodialisis Rumah Sakit Umum Pusat Dr. Sardjito, Jl. Kesehatan No 1, Sekip, Yogyakarta

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Peningkatan aktivitas fagositosis dan produksi nitrit oksida pada makrofag peritoneum tikus Sprague Dawley yang diberi Lactobacillus plantarum Mut7 dan ekstrak serat ubi jalar

Lily Arsanti Lestari1, Marsetyawan Heparis Nur Ekandaru Soesatyo2, Susi Iravati3, Eni Harmayani4

ABSTRACT

Background
: Macrophages play an important role as part of the innate immune response in the gut and they represent one of the fi rst lines of nonspecifi c defense against bacterial invasion. Previous studies indicated that probiotics and prebiotics may act as an immunomodulator agents. Nevertheless, research on the immunomodulatory effect of local materials has never been performed.
Objective : To study the effects of Lactobacillus plantarum Mut7 and sweet potato fi ber on the activity and Nitric Oxide (NO) production of peritoneal macrophages of Sprague Dawley rats.
Method : Ninety six Sprague Dawley rats aged 8 weeks were divided into two groups; A (not infected with Salmonella typhimurium) and B (infected with S. typhimurium). Each group was divided into 4 subgroups and assigned to standard AIN-93M diet (KON), 109 CFU/ml of L. plantarum Mut7 (PRO), modifi ed AIN-93M diet with sweet potato fi ber (PRE), and both component (SIN). After 3 weeks of treatment, 6 rats of each subgroup were sacrifi ced and the peritoneal macrophages were isolated and analysed for its activity and NO production. The rest of the rats continued the treatments for another 2 weeks. At the end of the experiment, they were sacrifi ced and the peritoneal macrophage were isolated and analysed for its activity and NO production.
Result : Oral administration of L. plantarum Mut7, sweet potato fi ber, or both improve phagocytic activity of peritoneal macrophage which was indicated by an increase in the percentage of macrophages that phagocyte latex particles (p<0.05) and an increase in the number of latex particles engulfed by macrophages either after 3 or 5 weeks of treatment (p<0.05). Oral administration of L. plantarum Mut7, sweet potato fi ber, or both were unable to increase the nitric oxide production after 3 weeks of treatment (p>0.05), but after 5 weeks of treatment the production of NO was signifi cantly increased (p<0.05).
Conclusion : L. plantarum Mut7, sweet potato fi ber, or both increase the non specifi c immune response as they could improve the activity and NO production of peritoneal macrophages.

Key words: L. plantarum Mut7, sweet potato fi ber, peritoneal macrophage, nitric oxide

1 Korespondensi: Program Studi Gizi Kesehatan, Fakultas Kedokteran Universitas Gadjah Mada, Jl. Farmako, Sekip Utara, Yogyakarta 55281, e-mail: This e-mail address is being protected from spambots. You need JavaScript enabled to view it
2 Bagian Histologi dan Biologi Sel, Fakultas Kedokteran Universitas Gadjah Mada, Jl. Farmako, Sekip Utara, Yogyakarta 55281
3 Bagian Mikrobiologi, Fakultas Kedokteran Universitas Gadjah Mada, Jl. Farmako, Sekip Utara, Yogyakarta 55281
4 Jurusan Teknologi Pengolahan Hasil Pertanian, Fakultas Teknologi Pertanian Universitas Gadjah Mada, Jl. Flora No. 1, Bulaksumur, Yogyakarta 55281

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Pemanfaatan tepung daun kelor (Moringa oleifera Lamk) dengan pretreatment asam dan tepung ikan lele terhadap pemulihan anemia secara in vivo

Ayutha Wijiindyah1, Syaiful Anwar1, Sri Hetty Susetyorini1

ABSTRACT

Background
: It is estimated more than 50% of the cases of anemia in the world is caused by iron (Fe) defi ciency, it needs alternative sources local food that rarely used but cheap.
Objective : This monofactorial experiment was done to fi nd out whether kelor leaves powder resulted from acid pretreatment and addition of catfi sh powder can support the recovery of iron defi ciency anemia, based on an in vivo study with iron (Fe) and hemoglobin (Hb) measurements.
Method : The experiment was a trial of anemia recovery by providing 42 wistar rats with no iron-containing feeding for 7 days, then continued for 14 days with either one of six kinds of feeding: standard feeding of AIN-93 M, kelor leaves powder or catfi sh powder (as control), kelor leaves powder with 0.5% citric acid pretreatment, kelor leaves powder with 0.5% citric acid pretreatment and catfi sh powder (1:1), kelor leaves powder with 0.5% lime pretreatment, or kelor leaves powder with 0.5% lime pretreatment and catfi sh powder (1:1). Criteria of anemia recovery was Fe value > 80 ?g/dl and Hb > 10 g/dl. Statistical analysis was performed by using ANCOVA and LSD test.
Result : The in vivo study showed that feeding rats with kelor leaves powder (respective Fe and Hb value was 101.22 ?g/dl and 11.17 ?g/dl), with 0.5% citric acid pretreatment (respective Fe and Hb value was 90.36 ?g/dl and 10.68 ?g/dl), with 0.5% lime pretreatment (respective Fe and Hb value was 115.51 ?g/dl and 12.12 ?g/dl), with 0.5% lime pretreatment and catfi sh powder (1:1) (respective Fe and Hb value was 107.29 ?g/dl and 11.25 ?g/dl), can be used in anemia recovery.
Conclusion : The best result for anemia recovery was obtained from feeding of kelor powder leaves with 0.5% lime pretreatment.

Key words : iron defi ciency anemia, iron, haemoglobin, acid pretreatment, Moringa oleifera Lamk

1 Korespondensi: Program Studi Ilmu Gizi, Fakultas Kedokteran Universitas Diponegoro, Jl. dr. Sutomo No. 14, Semarang, Jawa Tengah, e-mail: This e-mail address is being protected from spambots. You need JavaScript enabled to view it

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Derajat keparahan infeksi Soil Transmitted Helminths terhadap status gizi dan anemia pada anak sekolah dasar

Farissa Fatimah1, Sri Sumarni2, Muhammad Juffrie3

ABSTRACT

Background
: Indonesia as a tropical country with high humidity, has good environment for worm breeding particularly Soil Transmitted Helminths (STH). The prevalence of worm infestation in Indonesia is still relatively high, about 60% of 220 million Indonesian population, 21% of them are elementary school-age children. STH intensity greatly affects the nutritional status of patients, in wich more severe infection leads to poorer nutrition condition.
Objective : To identify severity of STH infection in elementary school student at the working area of Kokap I Health Center of Kulonprogo and its correlation with nutritional status and anemia.
Methods : The study was undertaken in 25 elementary schools at the working area of Kokap I Health Center of Kulonprogo. Samples were all students of grade I as many as 241 students. Worm examination was done by using Kato-Katz method, assessment of nutrition status was based on body weight according to height (weight/height), anemia status was assessed from Hb level using Cyanmethaemoglobin method.
Result : The results of the study showed that most of students (83,6%) were well nourished and were non anemic (84,9%). No student belonged to severe anemic category, 3 students (1,3%) had anemia at medium category and 31 students (13,8%) were slightly anemic. Out of 51 students that positively got STH infection, 16 students (31.4%) had light infection of A. lumbricoides, 36 students (70,6%) had T. trichiura and 4 students (5,9%) had hookworm. A. lumbricoides infected 7 student (13,7%) and T. trichiura infected 8 student (15,7%) both at medium criteria. There was no infection at severe criteria. The result of Somers’ D analysis showed that there was no signifi cant correlation between the two variables (p>0,05).
Conclusion : There was no correlation between severity of STH infections with nutrition status and anemia in elementary school student.

Key words : Soil Transmitted Helminths infection, nutrition status, anemia

1 Korespondensi: Progam Studi Ilmu Gizi, Fakultas Ilmu Kesehatan Universitas Respati Yogyakarta, Jl. Laksda Adisucipto Km 6,3 Depok, Sleman, Yogyakarta, e-mail: This e-mail address is being protected from spambots. You need JavaScript enabled to view it
2 Bagian Parasitologi, Fakultas Kedokteran Universitas Gadjah Mada, Jl. Farmako Sekip Utara, Yogyakarta 55281
3 Bagian Ilmu Kesehatan Anak, RSUP Dr. Sardjito/Fakultas Kedokteran Universitas Gadjah Mada, Jl. Farmako Sekip Utara, Yogyakarta 55281

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Pendidikan gizi dan pesan gizi melalui short message service terhadap pengetahuan, perilaku, dan kepatuhan ibu hamil minum tablet besi

Mars Khendra Kusfriyadi1, Hamam Hadi2, Anis Fuad3

ABSTRACT

Background
: Low compliance as one cause of high prevalence of anemia in Indonesia is mainly due to forgetfulness. Nutrition education and short message service (SMS) are expected to become media to send nutrition message and remind pregnant mothers of taking iron tablet.
Objectives : To identify impact of nutrition education and nutrition message through SMS to knowledge, behavior and compliance of pregnant mothers with taking iron tablet.
Methods : The study was a quasi experiment that used pre and post test control/non equivalent control group design involving 3 groups of experiment, i.e. nutrition education only, nutrition education and SMS, and control as comparator. Subject of the study consisted of 121 pregnant mothers. The study was carried out from November 2009 to April 2010 at Palangka Raya Municipality in Pahandut, Kayon and Tangkiling Health Centers. Statistical analysis was performed by using paired t-test, ANOVA, Tukey test, and multivariate test.
Results : Pregnant mothers that got nutrition education and SMS intervention signifi cantly improved their knowledge and behavior (p<0.05). Pregnant mothers that got nutrition education and SMS had knowledge 18 point higher (coef=18.26), behavior 4 point better (coef=4.07) and probability 4 times more compliant than the control group (OR=3.79; p=0.03). Nutrition education and SMS intervention could increase compliance and signifi cantly affect increase of hemoglobin (Hb) level up to 1.3g/dl (p<0.05). Increase of Hb level went in line with increase of compliance (dose-response) in pregnant mothers with preliminary Hb level <11g/dl. Meanwhile in pregnant mothers with preliminary Hb level >11g/dl, increase of Hb level was statistically signifi cant when compliance reached >90%.
Conclusion : Pregnant mothers that got nutrition education and SMS had better knowledge, behavior and compliance with taking iron tablet than those that only got nutrition education and the control group. High compliance could signifi cantly increase Hb level.

Key words : anemia, pregnant mothers, knowledge, behavior, compliance, hemoglobin level, SMS, nutrition education

1 Korespondensi: Politeknik Kesehatan Kementerian Kesehatan Palangkaraya Jurusan Gizi, Jl. George Obos No. 30, Palangkaraya, e-mail: This e-mail address is being protected from spambots. You need JavaScript enabled to view it
2 Minat Utama Gizi Kesehatan, Program Studi S2 Ilmu Kesehatan Masyakarat, Fakultas Kedokteran Universitas Gadjah Mada, Jl. Farmako, Sekip Utara, Yogyakarta 55281, e-mail: This e-mail address is being protected from spambots. You need JavaScript enabled to view it
3Minat Utama Sistem Informasi Manajemen Kesehatan, Program Studi S2 Ilmu Kesehatan Masyakarat, Fakultas Kedokteran Universitas Gadjah Mada, Jl. Farmako, Sekip Utara, Yogyakarta 55281

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