Community Nutrition Research Articles

Health Communication Strategy in Changing Community Nutrition Behavior and Reducing Stunting Cases in South Konawe Regency, Southeast Sulawesi

This study aims to analyze the communication capacity of public health cadres in designing and implementing effective health communication campaigns and their impact on changing the nutritional behavior of rural communities and helping to reduce the number of stunting cases in Indonesia. This study uses a qualitative and case study approach focusing on health communication strategies implemented by community health cadres in South Konawe Regency, Southeast Sulawesi Province. Data collection used an in-depth interview method with public health cadres, which included evaluating their understanding of health communication, the use of social media in delivering health messages, and their ability to adapt nutrition messages to the local cultural context. Research findings show that most health cadres do not understand effective health communication. The use of social media in delivering health messages is still not optimal, and there are challenges in understanding and integrating local cultural contexts in nutrition counseling. The implications of this study suggest that enhancing the capacity of community health cadres in South Konawe Regency is imperative, particularly in proficient health communication through social media platforms and understanding the nuances of local cultural contexts. It is anticipated that implementing strategies aimed at augmenting the training and skill development of health cadres would significantly contribute to endeavors to mitigate the prevalence of stunting cases in rural Indonesian regions.

Increasing Community Nutrition Awareness through Balanced Nutrition Education Program


 Public health is a vital aspect in the development of a country. One of the key factors affecting health is balanced nutrition. Despite this, awareness of the importance of nutrition is often low in many societies, especially in developing countries. To overcome this challenge, balanced nutrition education programs have become one of the effective strategies. This program aims to increase public knowledge and awareness about the importance of balanced nutrition and encourage behavior change towards a healthier diet. Program implementation methods include identification of needs, development of appropriate educational materials, program implementation involving various related parties, periodic evaluation, and program adjustments as needed. The results of this program include increased knowledge of community nutrition, changes in healthier eating behaviors, and improved overall health and well-being of the community. The success of balanced nutrition education programs shows that this approach is effective in raising people's nutrition awareness and encouraging positive behavior change. However, sustainability and innovation development challenges still need to be addressed to achieve broader and sustainable impact in the long term. With strong commitment and cross-sector cooperation, balanced nutrition education programs have the potential to significantly improve the quality of life and welfare of the community

Evolution of the diagnosis of malnutrition in adults: a primer for clinicians.

During the last two decades, the definition, diagnosis, and management of malnutrition have significantly evolved. Malnutrition is generally defined as deficiencies, excesses, or imbalances in a person's intake of energy and/or nutrients. While malnutrition is associated with a significantly increased risk of morbidity, mortality, and healthcare cost, it is often underdiagnosed both in healthcare and community settings. One contributing factor is the lack of a consensus on its definition and appropriate diagnostic indicators. In the current article, we review the evolution of frameworks for the diagnosis of malnutrition. Recently published consensuses by prominent clinical nutrition societies have established a trajectory for the uniform global diagnosis of malnutrition. Limiting the use of body mass index (BMI) as a diagnostic criterion while emphasizing the use of muscle mass enables a more consistent and accurate diagnosis of malnutrition in the clinical setting. Guidance for the unified methodology and terminology for diagnosing malnutrition, such as the one proposed in the current article will enable policy makers to systematically address the two faces of malnutrition, starvation- and disease-related malnutrition applicable to both pediatric and adult populations. Policies and programs that could address issues of food insecurity and scarcity as well as early diagnosis and management of disease-related malnutrition will empower better care of community nutrition.

Relationship between food environment, social isolation and diet quality in Brazil

Introduction. The COVID-19 pandemic has impacted diet quality in differentways. In this context, community, organizational and consumer nutrition environments can influence the eating pattern. Objective. The purpose of this study was to identify how quarantine during the COVID-19 pandemic changed the diet in Brazil. Materials and methods. A natural experiment organized into experimental (social-isolated group - SIG) and control groups (non-isolated group - CG) was conducted with data collection from an online survey at the beginning of the pandemic (T0) and in the less restrictive period of 2020 (T1). Pre-post improvements in diet quality (IDQ) were determined for the SIG and CG. Intro-intergroup changes were tested using the Mann–Whitney and Wilcoxon signed rank tests. The intervention effect was estimated using crude and adjusted difference- indifference in multilevel regression analysis accounting for repeated measures. Results. A sample of 565 Brazilian adults answered the questionnaire at T0 and T1. IDQ was favored twice or more by attitudes such as buying food directly from farmers/street markets, reducing requests for food delivery, and increasing time spent on eating activities and the frequency of cooking. The isolated group had no IDQ at T1, whereas the no isolated group, who worsened diet quality (6.1%) at T0, improved it at T1 (4.8%). Conclusions. The restrictive quarantine forced the non-isolated population to have an experience comparable to a food desert, negatively affecting their diet.

Disturbance-diversity relationships of microbial communities change based on growth substrate.

Disturbance events can impact ecological community dynamics. Understanding how communities respond to disturbances and how those responses can vary is a challenge in microbial ecology. In this study, we grew a previously enriched specialized microbial community on either cellulose or glucose as a sole carbon source and subjected them to one of five different disturbance regimes of varying frequencies ranging from low to high. Using 16S rRNA gene amplicon sequencing, we show that the community structure is largely driven by substrate, but disturbance frequency affects community composition and successional dynamics. When grown on cellulose, bacteria in the genera Cellvibrio, Lacunisphaera, and Asticcacaulis are the most abundant microbes. However, Lacunisphaera is only abundant in the lower disturbance frequency treatments, while Asticcacaulis is more abundant in the highest disturbance frequency treatment. When grown on glucose, the most abundant microbes are two Pseudomonas sequence variants and a Cohnella sequence variant that is only abundant in the highest disturbance frequency treatment. Communities grown on cellulose exhibited a greater range of diversity (1.95-7.33 Hill 1 diversity) that peaks at the intermediate disturbance frequency treatment or one disturbance every 3 days. Communities grown on glucose, however, ranged from 1.63 to 5.19 Hill 1 diversity with peak diversity at the greatest disturbance frequency treatment. These results demonstrate that the dynamics of a microbial community can vary depending on substrate and the disturbance frequency and may potentially explain the variety of diversity-disturbance relationships observed in microbial systems.IMPORTANCEA generalizable diversity-disturbance relationship (DDR) of microbial communities remains a contentious topic. Various microbial systems have different DDRs. Rather than finding support or refuting specific DDRs, we investigated the underlying factors that lead to different DDRs. In this study, we measured a cellulose-enriched microbial community's response to a range of disturbance frequencies from high to low, across two different substrates: cellulose and glucose. We demonstrate that the community displays a unimodal DDR when grown on cellulose and a monotonically increasing DDR when grown on glucose. Our findings suggest that the same community can display different DDRs. These results suggest that the range of DDRs we observe across different microbial systems may be due to the nutritional resources microbial communities can access and the interactions between bacteria and their environment.

Integrated Electronic Medical Record Design With Nutritional Screening System at NCC’s Teaching Factory

One of Politeknik Negeri Jember's Teaching Factories (TEFA) that offers community nutrition services is the Nutrition Care Centre (NCC). The design of electronic medical records (EMRs) for continuous care patients, especially those with non-communicable diseases, is being studied in order to meet the ever-increasing needs of health care, assist patients who require continuous care, and improve the way that modern medical technology serves humans. The Waterfall framework concept is used in the research process, and an electronic medical record system is designed in accordance with the goals and the overall architecture of the system. Black-box testing and white-box testing are then conducted to evaluate the features, dependability, and stability of the designed electronic medical record system. Furthermore, when combined with other research findings, the design's viability is demonstrated. It is evident that the electronic medical record system created for the study's patients who require ongoing care is entirely workable. As electronic medical records continue to develop, there will be more opportunities to research and enhance this system, which will benefit patients and hospitals alike in the long run.

Beyond Conventional Medical Treatment of HIV/AIDS in Anambra State: Approaches to Enhancing Overall Well-Being

The Anambra State HIV/AIDS epidemic is a complicated issue that goes beyond standard medical therapy. Despite advances in ART and clinical care, people continue to experience stigma, discrimination, mental health difficulties, socioeconomic inequality, and limited access to comprehensive support services. Thus, the purpose of this project is to examine nutritional approach, naturopathic approach, community involvement and peer support approaches to improving the well-being of HIV/AIDS patients in Anambra State. Three research questions guided the study. This study adopted a causal comparative research design. The study was carried out in Awka South Local Government Area of Anambra State. The population of this study comprised of all healthcare providers in the 91 health centres in Awka South LGA of Anambra State. The multi-stage sampling procedure was used to draw 40 healthcare providers from four communities in Awka South LGA. A structured questionnaire titled “Beyond Conventional Medical Treatment Questionnaire” (BCMTQ) was developed by the researcher. Descriptive statistics of mean was used to analyze data to answer the research questions. The findings found that healthcare practitioners in Anambra State agree on nutritional approaches, naturopathic approach and community involvement and peer support approaches to improving the wellness of HIV/AIDS patients. Based on the findings, healthcare professionals were advised to regularly sensitize community engagement initiatives, peer-led programs, and support networks in order to foster connections, reduce stigma, improve social support, and empower people living with HIV/AIDS to actively participate in their care and community life.

Promoting responsive care and early learning practices in Northern Ghana: results from a counselling intervention within nutrition and health services.

This study assesses change in caregiver practices after integrating responsive care and early learning (RCEL) in nutrition and health services and community platforms in northern Ghana. We trained health facility workers and community health volunteers to deliver RCEL counselling to caregivers of children under 2 years of age through existing health facilities and community groups. We assessed changes in caregivers' RCEL practices before and after the intervention with a household questionnaire and caregiver-child observations. The study took place in Sagnarigu, Gushegu, Wa East and Mamprugu-Moagduri districts from April 2022 to March 2023. Study sites included seventy-nine child welfare clinics (CWC) at Ghana Health Service facilities and eighty village savings and loan association (VSLA) groups. We enrolled 211 adult caregivers in the study sites who had children 0-23 months at baseline and were enrolled in a CWC or a VSLA. We observed improvements in RCEL and infant and young child feeding practices, opportunities for early learning (e.g. access to books and playthings) in the home environment and reductions in parental stress. This study demonstrates the effectiveness of integrating RCEL content into existing nutrition and health services. The findings can be used to develop, enhance and advocate for policies integrating RCEL into existing services and platforms in Ghana. Future research may explore the relationship between positive changes in caregiver behaviour and improvements in child development outcomes as well as strategies for enhancing paternal engagement in care practices, improving child supervision and ensuring an enabling environment.

Pemberdayaan masyarakat melalui inovasi pembuatan permen Madu Trigona dan Nira desa Sigar Penjalin

Stunting remains an unresolved issue in North Lombok, NTB, Indonesia. One of the government's efforts to reduce stunting rates involves ensuring nutritional fulfillment for mothers and expectant mothers, which can be obtained from local food sources. Nira (palm sap) and Trigona honey are local commodities available in Tanjung, North Lombok. Unfortunately, these commodities have not been optimally utilized for nutritional fulfillment or as income sources. Typically, Nira is only sold as fresh sap, fermented beverage (tuak), or palm sugar, which have relatively low market values. Combining Nira and Trigona honey to create high-value candy products represents an opportunity. This community service project aimed to improve welfare and nutrition in Sigar Penjalin Village by assisting in the production of hard candy from Trigona honey and Nira Aren as a potential local delicacy to combat stunting and enhance local income. The implementation involved 16 community members organized by UMKM Rangsot Kreatif. The training used ingredients like brown sugar, granulated sugar, glucose syrup, Trigona honey, and water. The training stages included preparation, material delivery, hands-on practice, and evaluation through pretests and posttests to measure participants' knowledge, skills, and interests. The pretest results showed a total score of 627 out of 960 (65.31%), indicating a moderate level of understanding. After the training, the posttest showed a significant improvement, with a total score of 829 out of 960 (86.35%), indicating a very high level of understanding. This activity highlights the importance of technological support and the utilization of local resources in developing nutritious and economical snack products, supporting improvements in community nutrition and economy, and providing alternative solutions in local product processing

Strengthening Nutrition Sources Based on Local Food as an Effort to Prevent Stunting

This short study aims to illustrate how the power of local food as a source of community nutrition is very adequate. This study focuses on the sexy national issue of stunting in children who should be experiencing perfect growth and development. The research method in this study is a discourse search and analysis with a content analysis approach of a scientific work. The study will be described with a narrative that has been qualitatively analysis based on certain categories. Data sources are various scientific journals, reference books and other sources considered compatible with this study. The use of local food potential to be empowered into processed food is very likely to be used as food to prevent stunting symptoms in infant growth. From this study, it can be concluded that various studies confirm how the contribution of local resources in terms of food is very significant in helping the stunting reduction program in the community. The nutritional content contained in corn, sweet potatoes, taro, carrots, tubers and so on are very contributive alternative ingredients. As an example, children who are lacking in vitamin C will have difficulty in forming protein and collagen, which will inhibit their growth and development. Normal children's protein intake was mostly from animal-source foods such as eggs, but the protein intake of stunted children was primarily sourced from legumes

Ecological Analysis of Stunting Toddlers in East Nusa Tenggara Province 2021

<p><em>Stunting is a chronic condition that results in stunted growth of children under five due to malnutrition for a long time. The objective of this study is to analyze the factors associated with the occurrence of stunting in East Nusa Tenggara Province in the year 2021. An ecological approach is employed in this study, utilizing secondary data obtained from the 2021 East Nusa Tenggara Province Health Profile report. This research was conducted from January to March 2023. Analysis was carried out on a total of 22 districts/cities, with a population of 388,760 toddlers which included the entire sample size, namely toddlers with stunting incidents totaling 81,354 toddlers. The main variable predicted is the proportion of stunted toddlers. Predictor variables consist of the percentage of ANC visits, the proportion of LBW history and the percentage of exclusive breastfeeding. Bivariate analysis involved the utilization of cross-tabulation to examine the relationships between variables. The results of the study show that the prevalence of stunting status in toddlers is in the moderate category (16.04-24.07%). This happened as the coverage of ANC visits in districts/cities was in the low category (40.0-61.6%), history of LBW in districts/cities was in the low category (3.0-6.6%) and breastfeeding exclusively in districts/cities that are in the high category (65.67-93.0%). Stunting among toddlers in the province of East Nusa Tenggara in 2021 is in the moderate category along with ANC visits in districts/cities which are in the low category, history of LBW in districts/cities is in the low category and exclusive breastfeeding in districts/cities is also in the low category. To accelerate stunting prevention in Indonesia, it is essential to have synchronized efforts in planning, implementation, and monitoring at all government levels, including villages. The active involvement of all stakeholders is crucial in achieving this goal.</em></p><p><em> </em></p><p><em></em><strong><em>Keyword: </em></strong><strong><em>Community nutrition, Ecological analysis, Secondary data, Stuned</em></strong></p>

Optimizing the Role of Posyandu through Nutrition Huts in the Context of Prevention and Accelerating the Reduction of Stunting at the Rural Level

Reducing the stunting rate has been declared a national priority program. The government continues to move to organize the tools for accelerating stunting prevention and formulating the 2018-2024 National Strategy for the Acceleration of Stunting Prevention. Community nutrition counseling is one of the strategic steps that can be taken to improve health status and optimize the role of Posyandu as a health service facility for the community at the grassroots level. Participants in this activity were community health cadres, community leaders and communities with children under five who have stunting risk factors in Bulurejo Village, Diwek District, Jombang Regency. The implementation method includes the preparation, implementation, and evaluation stages. The results of community service activities were that more than half of the respondents (53%) were aged 20-25 years, all respondents were female, the education level of most of the respondents (83%) was high school/equivalent and most (75%) of the respondents had jobs as Housewife. Referring to the requirements for cadres, the ability to read and write is one of the requirements to become a cadre so that the elementary education level meets the cadre requirements. In addition, the type of work most cadres are housewives (87.5%). Knowledge about stunting and nutrition huts before being given training more than half had poor knowledge (56%), knowledge about stunting and nutrition huts after being given training most had good knowledge (63%). This community service program has initiated the formation of a nutrition hut at the toddler posyandu in Bulurejo Village, Diwek District . In addition, there has been an increase in the knowledge and skills of cadres to carry out early detection of stunting using a Z score.

The synergy of the religious role in supporting the accelerated reduction of stunting in Kutaraja District, Banda Aceh

Background: Stunting is a condition of chronic malnutrition caused by a lack of nutritional intake in the long term, resulting in a decline in the optimal growth and development of a child. In general, the incidence of stunting starts from inadequate nutritional intake during pregnancy until two years of age or more, commonly referred to as the golden period. Therefore, support from community leaders is needed to accelerate the reduction of stunting, a religious role model for the community.Objective: This study aimed to analyze the synergy of the role of religion in accelerating stunting reduction in Kutaraja District, Banda Aceh City.Methods: This was a qualitative study with a descriptive design. The informants in this study were religious and active in the Kutaraja sub-district of Banda Aceh City, with a total of 10 religions, and were selected based on specific criteria. Data were collected for two months through an in-depth interview method using a document study and questionnaires designed by the authors. Instrument validity was tested using the triangulation technique. Thematic data analysis was performed.Result: Religiosity has promoted studies related to parenting, a balanced diet, and a healthy lifestyle by directly becoming speakers in integrated service post activities, being involved in community empowerment activities called village nutrition houses, and being active as marriage counsellors in the office of religious affairs for the bride and groom.Conclusion: The synergy of religion in community activities can support the accelerated reduction of stunting, which the improvement of community participation in nutritional community empowerment activities can see.

The development of a method for the global health community to assess the proportion of food and beverage companies’ sales that are derived from unhealthy foods

ContextCorporate engagement with food and beverage companies who produce food associated with health harms is a divisive topic in the global nutrition community, with high-profile cases of conflict of interest increasingly coming under scrutiny. There is a need for an agreed method to support health organizations in deciding whether and how to engage with large food and beverage manufacturers.AimThe aim of this study was to develop a method to quantify the proportion of sales from food and beverage companies that are derived from unhealthy foods to support organizations in determining which companies might be considered high-risk for engagement.MethodsThe 2015 WHO Euro nutrient profile model was applied to 35,550 products from 1294 brands manufactured by the top 20 global food and beverage companies from seven countries (Australia, Brazil, China, India, South Africa, UK and USA). For the purpose of this study, products that met the WHO Euro criteria were classified as “healthier” and those that failed were classified as “unhealthy”. Products were grouped by brand and weighted by the brand’s value sales for 2020. The primary outcome was the proportion of each company’s sales that were classified as unhealthy and healthier by company and category.ResultsOverall, 89% of the top 20 companies’ brand sales were classified as unhealthy. For every USD$10 spent on the top 20 companies’ brands, only $1.10 was spent on products considered healthier. All companies saw the majority of their sales come from unhealthy foods, including soft drinks, confectionery and snacks. None of Red Bull or Ferrero’s sales were classified as healthier and less than 5% of total sales were healthier for Mondelēz, Mars, and PepsiCo. Some companies had higher proportions of sales deriving from healthier products, including Grupo Bimbo (48%), Danone (34%) and Conagra (32%), although the majority of their sales were still derived from unhealthy foods.DiscussionThe results presented in this study highlight the reliance the leading food and beverage companies have on sales of unhealthy products that are contributing to diet-related disease globally. The method and steps we have laid out here could be used by organizations in the global health community to identify companies that have conflicts of interest when it comes to engaging with governments, international organizations and public health bodies on issues of policy and regulation.

Produksi Ikan Nila Dengan Kolam Terpal di Desa Kramajaya, Lombok Barat Untuk Mencegah Stunting

Kramajaya Village is one of the stunting loci in Narmada District, West Lombok Regency. Stunting is a problem of chronic malnutrition caused by inadequate nutritional intake over a long period of time due to providing food that is not in accordance with nutritional needs. The way to overcome and prevent stunting from a food perspective is to provide nutritious food to pregnant women, breastfeeding mothers and toddlers. These nutritious foods can include eggs, beef, chicken, seawater fish or freshwater fish. Tilapia is a fish that has high nutritional value and is classified as a fish that is low in cholesterol so it is healthy to consume. The results of discussions with the Mandiri Jaya Youth Organization, Kramajaya Village, Narmada District, West Lombok Regency, has abundant water sources. Apart from that, in Kramajaya hamlet there are many yards of residents' houses that have not been utilized optimally. There are no residents who know that the yard can be used to produce tilapia due to lack of knowledge about the technology of cultivating tilapia using tarpaulin ponds. Therefore, there is a need for knowledge transfer and assistance so that village residents, especially the Mandiri Jaya Youth Organization, Kramajaya Village, can produce tilapia fish in tarpaulin ponds to fulfill community nutrition, especially to prevent stunting and help improve the family economy. This counseling will be carried out using the Focus Group Discussion (FGD) method. Tilapia fish production using tarpaulin ponds in Kramajaya Village, West Lombok, is an effective solution in preventing stunting and improving community nutrition

THE EFFECTIVENESS OF WOMEN'S EMPOWERMENT ON THE SUCCESS OF THE FAMILY PLANNING PROGRAM IN MUARA KAMAN ULU VILLAGE IN 2023

Family planning is a government program that aims to regulate child birth, reduce child mortality, improve maternal welfare, quality of health services and community nutrition. Family planning programs can be implemented through health promotion using the media because the media can assist in conveying information and can reduce misunderstandings. The aim of this study is to find out the effectiveness of women's empowerment on the success of the family planning program for couples of childbearing with lower middle income in Muara Kaman Ulu Village, Muara Kaman District in 2023. This type of research is pre-experimental with one group pretest-posttest. The population in this study were all couples of childbearing with middle to lower income in Muara Kaman Ulu Kaman Village, a total of 101 people, while a sample of 41 respondents was taken using a purposive sampling technique. The data analysis technique uses the Wilcoxon test. There is an influence of Women's Empowerment on the Success of the Family Planning Program for couples of childbearing who have middle to lower incomes in Muara Kaman Ulu Village, Muara Kaman District in 2023. Women's empowerment is a strategy to increase women's access to family planning in order to increase the interest of couples of childbearing to participate in family planning and increasing the knowledge of couples of childbearing regarding family planning. Empowerment of women has an influence on the interest of couples of childbearing in using family planning and affects the level of knowledge of couples of childbearing regarding family planning

Foraging Wild Edibles: Dietary Diversity in Expanded Food Systems.

Human food foraging in community forests offers extensive and expandable sources of food and high-quality nutrition that support chronic disease prevention and management and are underrepresented in US diets. Despite severe gaps in non-commercial "wild food" data, research in Syracuse, NY, identified substantial amounts of five key antioxidant phytochemicals in locally available, forageable foods with the potential to augment local dietary diversity and quality. Findings endorse the need for micro- and macro-nutrient research on an expanded range of forageable foods, community nutrition education on those foods, an expanded study on antioxidant phytochemical function, and the inclusion of forageables in the food system definition.

The FINDING-Food Intervention: A Mixed-Methods Feasibility Study Addressing Food Insecurity

Food insecurity is an economic and social condition involving limited or uncertain access to food. The problem of food insecurity in communities is influenced by economic conditions, food deserts, and barriers to accessing healthy food. Individuals experiencing food insecurity often endure concurrent problems of financial instability, hunger, and poor mental and physical health. Public and non-profit services in the U.S., such as the federally supported Supplemental Nutrition Assistance Program (SNAP) and community food banks, provide food-related assistance to individuals who are at a high risk of experiencing food insecurity. Unfortunately, many individuals who qualify for these services still experience food insecurity due to barriers preventing them from accessing food. Effective approaches for removing barriers that prevent individuals from accessing food are needed to mitigate the increased risk of chronic disease among vulnerable populations. This study tested a novel food insecurity intervention called FINDING-Food, which stands for Frequent Informational Nudges Directing Individuals to Needed Goods. Informational nudges were used to promote food security through the removal of information barriers to accessing food. The intervention used in this mixed-methods feasibility study consisted of informational nudges in the form of weekly text messages that were sent to food pantry clients experiencing food insecurity (n = 24). The study aims were to test the efficacy and acceptability of the intervention by examining whether the informational nudges could enhance food pantry utilization, increase SNAP registration, and promote food security. Quantitative study results showed a lower prevalence of food insecurity in the intervention group than the control group at the end of the study. Qualitative findings revealed how intervention group participants who completed the study (n = 9) found the text messages to be helpful and informative. These study findings can enhance future food insecurity interventions aiming to eliminate barriers that prevent individuals who are food insecure from accessing healthy food.

The Importance of Biomarkers in the Diagnosis and Follow-Up of the Celiac Disease

Aim: In the present study, the purpose was to investigate the clinical significance, diagnostic capabilities, relationships, and correlations of inflammation-based biomarkers before and after treatment in children with Celiac Disease. Methods: The study was conducted by retrospectively evaluating the files of patients who were diagnosed and followed up in the Department of Pediatric Gastroenterology of Selçuk University between January 2011 and January 2023. The study was completed with 202 Celiac Disease patients who were diagnosed according to the criteria of the European Pediatric Gastroenterology, Hepatology, and Nutrition Community and 160 healthy follow-ups. In case of clinical or laboratory suspicion, serological tests such as positive Tissue Transglutaminase Antibody and Anti-Endomysium values and the histopathological examination of the endoscopic tissue sample findings consistent with Celiac Disease were evaluated. Results: There were 122 (56.7%) girls and 80 (54.4%) boys in the patient group and 93 (43.3%) girls and 67 (45.6%) boys in the control group. The most common intestinal complaint was abdominal pain in 49 (22.3%) patients. Gluten-free diet treatment was started after the diagnosis. The values of the patients at the time of diagnosis, in the 6th month after the diet, and the values of healthy control patients were compared. A weak and positive correlation was found between NLR, RPO, RLO levels, and age, body weight, and height in the correlation analysis. The ROC curve for hematological biomarkers was used to evaluate the level of additional diagnostic support in Celiac Disease patients. Conclusion: After a gluten-free diet, symptoms regress, and the development of more serious celiac-related damage can be prevented. This suggests that NLR, RLR, PLO, SII, HRO, and PNI formulas, which are used in many inflammatory conditions and obtained from routine hemogram parameters, can be used to determine dietary compliance in Celiac Disease patients during their follow-ups.

The Effect of Nutritional Education with Leaflet Media on Increasing Maternal Knowledge and Intake of Protein, Zink, Calcium in Stunting Children Aged 6 – 23 Months

Background: One of the nutritional problems in children is stunting where the index (PB/U) or (TB/U) is in the threshold (z-score) between (<-3 SD) very short TB/PB category and (-3 SD). SD)-(<-2 SD) short TB/PB category. The high prevalence is caused by many factors including mother's knowledge and child's food intake. Riskesdas (2019), The prevalence of very short and short toddlers is 30.8%. Meanwhile, in Demak Regency, the prevalence of stunting reached 26.1%, Guntur village with stunting toddlers was 15%. Objective: To determine the effect of providing nutrition education with leaflet media on increasing maternal knowledge and intake of protein, zinc, calcium in stunting children. Methods : This research is a research in the field of community nutrition. This type of research is quasi-experimental with one group pretest-posttest design. The number of samples is 18 stunting children and 18 respondents are mothers of stunted children. The data collected were mother's knowledge and food intake of stunting children by interview method and filling out questionnaires. Statistical analysis using Paired T test and Wilcoxon Signed Ranks Test. Research Results: Mother's knowledge score increased by 6.77 (from 7.56 to 14.33). The average protein intake increased by 118.04 points, zinc intake increased by 71.85 points, calcium intake increased by 122.52 points. There are differences in maternal knowledge and intake of protein, zinc, and calcium in stunted children before and after being given nutrition education using leaflet media. (p= 0.007) and (p=0.008 , p=0.028, and p=0.008). Conclusion: There is an effect of providing nutrition education with leaflet media on increasing mother's knowledge and intake of protein, zinc, calcium in stunting children.