Specific Nutritional Interventions Research Articles

Effect of non-pharmacological intervention on the nutritional status of patients with Prader Willi Syndrome

IntroductionObesity is highly prevalent in patients with Prader-Willi syndrome (PWS), particularly among adults. This condition, which can be morbid in many cases, is multifactorial and has a complex management. The purpose of our study was to describe the feasibility of achieving a better nutritional status, including normal weight in individuals diagnosed with PWS, through specific nutritional interventions within the framework of a transdisciplinary treatment and without resorting to pharmacological treatments or growth hormone (GH). MethodologyThis observational study included patients with confirmed genetic diagnosis of PWS, receiving transdisciplinary treatment in a specialized rare diseases institution. Patients under treatment with GH and those under pharmacological treatment with nutritional objectives were excluded from the study. All patients attended our institution regularly on a weekly or fortnightly basis. Anthropometric records, including weight, height, and body mass index (BMI) were evaluated in each visit from treatment onset until the last check-up. ResultsWe included 24 patients with confirmed genetic diagnosis of PWS. At baseline, 9 patients (38%) had obesity grade III, 1 (4%) of obesity grade II, 10 (42%) of obesity grade I, 2 (8%) of overweight, and 2 patients (8%) with normal baseline weight. After a median duration of 52 months (interquartile range 23 - 116 months) of transdisciplinary nutritional treatment, we identified a significant reduction in BMI (baseline 40.2±15.7 kg/m2 vs. follow-up 28.3±6.7 kg/m2, p<0.0001), without significant differences regarding height (baseline 1.45±0.1 meters vs. follow-up 1.48±0.1 meters, p=0.09). ConclusionIn this study, we demonstrated that nutritional nonpharmacologic interventions immersed in a transdisciplinary treatment enabled a consistent and sustainable improvement in BMI and nutritional status among patients with PWS.

THE EFFECT OF NUTRITION EDUCATION TO PROSPECTIVE BRIDE IN PREGNANCY NUTRITION PREPARATION TO PREVENT THE RISK OF STUNTING: STUDY LITERATURE REVIEW

The National Strategy Program in Indonesia for the Acceleration of Stunting Prevention targets specific nutrition interventions for Women of Reproductive Age. The government implemented a health examination program for prospective brides to prevent the risk of stunting. This study aims to describe the implementation of nutrition education for brides in Indonesia, and its effect on knowledge, attitudes, and consumption behavior of nutritious food as a preparation for a healthy pregnancy. The method of this research is Systematic Literature Review by screening articles using the PRISMA chart. The article sources used were Google Scholar and Garuda with article years 2020 to 2022, 333 articles were found, and 16 articles were required to be reviewed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses method. Description of research results is the locations used to provide education include the Office of Religious Affairs (Kantor Urusan Agama), Puskesmas, and local area halls. The educational media used are booklets, leaflets, digital applications, social media, and PowerPoint presentations. The nutrition materials given were 1000 HPK, preconception nutrition, and anemia prevention. The results of the study provided nutrition education had a significant impact on knowledge and attitudes, but education would have an impact on behavior if it was given at least 3 times. This study concludes that the nutrition education strategy needs to include factors that affect education acceptance such as educational background and social economy, and the impact assessment of education must also include the behavior of consuming nutritious food and changes in the body's nutritional status.

IMPLEMENTASI PROGRAM INTERVENSI GIZI SPESIFIK PADA REMAJA PUTRI DAN BALITA DI PUSKESMAS PATEAN KABUPATEN KENDAL

The scope of implementing specific nutrition intervention programs at the Patean Health Center for young women and toddlers in 2021 and 2022 was still not in line with the national target. This study aimed to analyze the implementation of a specific nutrition intervention program for girls and toddlers at the Patean Health Center. This research was a qualitative research with a descriptive approach through in-depth interviews conducted from January to July 2023. The data processing method used content analysis.The results showed that the implementation of the specific nutrition intervention program for young women and toddlers are not optimal. Obstacles in the activities of young women are caused by unclear communication, limited and inadequate support facilities and fragmentation that is not in accordance with policy. Obstacles in toddler activities are caused by limited quality of posyandu cadres, limited budget and inadequate supporting facilities. It can be concluded that the implementation of specific nutrition intervention programs for girls and toddlers at the Patean Public Health Center is not optimal because it is influenced by communication factors, resources, attitudes and bureaucratic structures

Determining the Role of Exclusive Breastfeeding and Nutritional Status in Stunting Prevention: A Literature Review

Stunting among children is a serious global concern including Indonesia since it has a negative impact on children's growth and development. Globally, more than 148 million children are affected by stunting. In Indonesia, the prevalence of stunting was 21.6% in 2022, which reflected a serious problem that needs to be addressed. This study aims to explore the correlation between exclusive breastfeeding, nutritional status and stunting among under-five children in Indonesia. The current study explored the correlation between exclusive breastfeeding (EBF) and nutritional status with the incidence of stunting among under-five. The inclusion criteria consisted of original articles, open access, written in English/Indonesian, 2020-2023, discussed EBF, nutritional status, and stunting. Databases involved ScienceDirect, PubMed, BMC journals, Google Scholar. Article selection used keywords and MeSH, and the results were presented in a PRISMA diagram. It was conducted an analysis of 10 articles, which were grouped in a matrix based on author, year, journal name, title, methods, and results. The results revealed that exclusive breastfeeding practice was correlated with a 3.1-fold reduction in the risk of stunting (CI 95%=1.5–6.4). Factors such as good nutrition and breastfeeding for at least 6 months provided protection from the risk of stunting. In conclusion, exclusive breastfeeding and good nutritional status were required, along with strengthening education and promotion regarding nutritional fulfilment patterns. Integration of the study findings should be made in child health guidelines, which may further guide policy and practice, support concrete steps to reduce the prevalence of stunting, and ensure optimal growth of children. Recommendations in this study include improvement in maternal education, nutritional support, and child health policy advocacy. For next steps, in-depth research is needed to evaluate the impact of specific nutritional interventions, understand the social and cultural factors that influence nutritional practices, and assess the effectiveness of cross-sector programs in reducing the prevalence of stunting.

Pendampingan Pencegahan Stunting melalui Intervensi Gizi Spesifik di Desa Mekar Sari Kecamatan Tatah Makmur Kabupaten Banjar

Purpose: The aim of this community service is to prevent the occurrence and increase of stunting through assistance with specific nutritional interventions in Mekar Sari Village, Tatah Makmur District, Banjar Regency. Methodology: Prevention assistance was carried out through counseling and providing education and information to pregnant women, breastfeeding mothers, and mothers with toddlers. The implementation of activities was also carried out in stages, including on September 22, 2023, counseling was given and provision of nutritious food and vegetables, continuously on October 4, 2023, was carried out at the same time as Posyandu activities by providing counseling and intake of vitamins and protein (milk and eggs). Results: The results of community service showed that participants knew and understood stunting and the factors that caused it; however, prevention methods that were not implemented led to an increase in the stunting rate in Mekar Sari Village, reaching 11 children from examination data until October 2023. The results of this activity also showed an increase in participants’ understanding. Protein and vitamin intake is one way to prevent stunting. Limitations: This activity was carried out on only 32 target people, including pregnant women, breastfeeding mothers, and mothers with toddlers. Contribution: The counseling and assistance activities for the Mekar Sari Village community need to be carried out consistently because they contribute to increased awareness of health problems, especially stunting prevention, in order to reduce the stunting rate.

Family Roles and Support in Preventing Stunting: A Systematic Review

Background: Stunting is inadequacy in physical growth. Stunting can be detrimental to children under five as it causes low intelligence, decreased endurance, and inhibited growth and development. This will increase risk of infections and non-communicable diseases in adulthood. The optimal implementation of family roles supports the improvement of nutritional status in toddlers so it can reduce the incidence of stunting.Method: This systematic review is written in accordance to the PRISMA guidelines. The process includes analysis on online articles from databases of ScienceDirect, PubMed, and Google Scholar for the past five years the period from 2019 with the keywords "stunting and parents or family".Results: There are researches from eight articles related to the role and support of families in preventing stunting. Based on several syntheses reviewed, it was determined that culture can be an inhibiting factor in preventing stunting. Still, with local wisdom, it can also be a catalyst in reducing stunting itself. Culture is one of the specific nutrition interventions that can reduce the prevalence of stunting by emphasizing aspects of a mother as the “center of life”, family roles and support, and the role of fathers in preventing stunting. Families have an important role to play in preventing and managing the problem of stunting. Families play an important role in preventing stunting at every stage of life from fetus in the womb, to newborn, toddler, teenager, married, pregnant, and so on. Therefore, efforts to empower families are necessary.

Diet as an epigenetic factor in inflammatory bowel disease

Inflammatory bowel disease (IBD) has as a main characteristic the exacerbation of the immune system against enterocytes, compromising the individual’s intestinal microbiota. This inflammatory cascade causes several nutritional deficiencies, which further compromise immunological functioning and, as a result, worsen the prognosis. This vicious cycle can be interrupted as the patient’s dietary pattern meets their needs according to their clinical condition, acting directly on the inflammatory process of IBD through the interaction of food, intestinal microbiota, and epigenome. Specific nutritional intervention for IBD has a crucial role in preventing and managing disease activity. This review addresses epigenetic modifications through dietary compounds as a mechanism for modulating the intestinal microbiota of patients with IBD.

Long-term efficacy and predictors of pembrolizumab-based regimens in patients with advanced esophageal cancer in the real world

Inflammatory bowel disease (IBD) has as a main characteristic the exacerbation of the immune system against enterocytes, compromising the individual’s intestinal microbiota. This inflammatory cascade causes several nutritional deficiencies, which further compromise immunological functioning and, as a result, worsen the prognosis. This vicious cycle can be interrupted as the patient’s dietary pattern meets their needs according to their clinical condition, acting directly on the inflammatory process of IBD through the interaction of food, intestinal microbiota, and epigenome. Specific nutritional intervention for IBD has a crucial role in preventing and managing disease activity. This review addresses epigenetic modifications through dietary compounds as a mechanism for modulating the intestinal microbiota of patients with IBD.

Colorectal motility patterns and psychiatric traits in functional constipation and constipation-predominant irritable bowel syndrome: A study from China

Inflammatory bowel disease (IBD) has as a main characteristic the exacerbation of the immune system against enterocytes, compromising the individual’s intestinal microbiota. This inflammatory cascade causes several nutritional deficiencies, which further compromise immunological functioning and, as a result, worsen the prognosis. This vicious cycle can be interrupted as the patient’s dietary pattern meets their needs according to their clinical condition, acting directly on the inflammatory process of IBD through the interaction of food, intestinal microbiota, and epigenome. Specific nutritional intervention for IBD has a crucial role in preventing and managing disease activity. This review addresses epigenetic modifications through dietary compounds as a mechanism for modulating the intestinal microbiota of patients with IBD.

Inflammatory bowel diseases patients suffer from significant low levels and barriers to physical activity: The “BE-FIT-IBD” study

Inflammatory bowel disease (IBD) has as a main characteristic the exacerbation of the immune system against enterocytes, compromising the individual’s intestinal microbiota. This inflammatory cascade causes several nutritional deficiencies, which further compromise immunological functioning and, as a result, worsen the prognosis. This vicious cycle can be interrupted as the patient’s dietary pattern meets their needs according to their clinical condition, acting directly on the inflammatory process of IBD through the interaction of food, intestinal microbiota, and epigenome. Specific nutritional intervention for IBD has a crucial role in preventing and managing disease activity. This review addresses epigenetic modifications through dietary compounds as a mechanism for modulating the intestinal microbiota of patients with IBD.

First report on establishment and characterization of the extrahepatic cholangiocarcinoma sarcoma cell line CBC2T-2

Inflammatory bowel disease (IBD) has as a main characteristic the exacerbation of the immune system against enterocytes, compromising the individual’s intestinal microbiota. This inflammatory cascade causes several nutritional deficiencies, which further compromise immunological functioning and, as a result, worsen the prognosis. This vicious cycle can be interrupted as the patient’s dietary pattern meets their needs according to their clinical condition, acting directly on the inflammatory process of IBD through the interaction of food, intestinal microbiota, and epigenome. Specific nutritional intervention for IBD has a crucial role in preventing and managing disease activity. This review addresses epigenetic modifications through dietary compounds as a mechanism for modulating the intestinal microbiota of patients with IBD.

What if gastrointestinal complications in endurance athletes were gut injuries in response to a high consumption of ultra-processed foods? Please take care of your bugs if you want to improve endurance performance: a narrative review.

To improve performance and recovery faster, athletes are advised to eat more often than usual and consume higher doses of simple carbohydrates, during and after exercise. Sports energetic supplements contain food additives, such as artificial sweeteners, emulsifiers, acidity regulators, preservatives, and salts, which could be harmful to the gut microbiota and impair the intestinal barrier function. The intestinal barrier plays a critical function in bidirectionally regulation of the selective transfer of nutrients, water, and electrolytes, while preventing at the same time, the entrance of harmful substances (selective permeability). The gut microbiota helps to the host to regulate intestinal homeostasis through metabolic, protective, and immune functions. Globally, the gut health is essential to maintain systemic homeostasis in athletes, and to ensure proper digestion, metabolization, and substrate absorption. Gastrointestinal complaints are an important cause of underperformance and dropout during endurance events. These complications are directly related to the loss of gut equilibrium, mainly linked to microbiota dysbiosis and leaky gut. In summary, athletes must be cautious with the elevated intake of ultra-processed foods and specifically those contained on sports nutrition supplements. This review points out the specific nutritional interventions that should be implemented and/or discontinued depending on individual gut functionality.

Medical nutrition therapy in patients receiving extracorporeal membrane oxygenation: knowledge in progress.

Nutritional support in adult patients receiving extracorporeal membrane oxygenation (ECMO) therapy is controversial. Although there are guidelines for the NS (Nutritional support) in pediatric patients with ECMO, in adults these guidelines are not available for the use, type, route and timing of nutritional therapy. In critically ill patients it is well known that early enteral nutrition is beneficial, however there is the possibility that in patients with ECMO early enteral nutrition leads to gastrointestinal complications. Likewise, there have not been established caloric targets, proteins and doses or types of micronutrients to use for this specific population being a challenge for the clinician. In addition, patients with ECMO are some of the most seriously ill in intensive care units, where malnutrition is associated with increased morbidity and mortality. Regarding the use of parenteral nutrition (NP) it has not been described if it implies a risk of circuit failure at the time of introducing lipids to the oxygenator. Therefore, a correct evaluation and specific nutritional intervention by experts in the field is imperative to improve the prognosis and quality of life in this population, which is a primary goal in the care of adult patients receiving extracorporeal membrane oxygen.

Study on the impact of the COVID-19 pandemic on stunting program implementation (sensitive and specific programs) in Sleman Regency

The COVID-19 pandemic is a new challenge for the implementation of stunting intervention in Indonesia. Therefore, monitoring the stunting program implementation during a pandemic is crucial to achieving the target of stunting reduction. This research aims to examine the pandemic’s impacts on the implementation of specific and sensitive programs, especially posyandu, iron supplementation, PMT, and Sustainable Food Program(SFG). Method, qualitative research uses a Case-Study with 17 informants selected by purposive sampling, including the stakeholders and program’s target in the working area of Tempel 2 Health Center. Data in the form of interview transcripts and other documents were collected using in-depth interviews and documentation studies in November-December 2021 and were analyzed in 3 stages: reduction, presentation, and conclusion. Result, the COVID-19 pandemic has affected specific nutrition interventions, especially in the planning, implementation, and scope of activities. It relates to social difficulties and concerns over the spread of COVID-19. In the implementation of SFG program, the pandemic does not have a significant impact. It can be interpreted that COVID-19 pandemic affects several aspect of the stunting program’s implementation. This study suggests the stakelhoders and communities to optimize the implementation of stunting intervention so it can run sustainably to reduce stunting prevalences.

Nutritional Avocado Intervention Improves Physical Activity Measures in Hispanic/Latino Families: A Cluster RCT

Nutrition and physical activity are key components for the prevention of cardiovascular disease. There remains a paucity of trial data on the effect of specific nutritional interventions on physical activity and sedentary time. One question is how a common nutrient-dense food such as avocado may impact physical activity and sedentary time in Hispanic/Latino families, a group that reports the lowest levels of physical activity. This is a 6-month clustered RCT. Seventy-two families (235 individuals) who identified as Hispanic/Latino were enrolled through the San Ysidro Health Center (San Diego, CA) between April 2017 and June 2018. After a 2-week run-in period, 35 families were randomized to the intervention arm (14 avocados/family/week), and 37 families were assigned to the control arm (3 avocados/family/week). Linear mixed-effects models were used to assess changes in physical activity (MET minutes per week) between the groups during the 6-month trial. Secondary outcomes included sedentary time (minutes/week), BMI, and systolic and diastolic blood pressures. An adherence goal of >80% was achieved for both arms. Total mean physical activity increased by 2,197 MET minutes per week more in the intervention group (p<0.01) than in the control group, driven by between-group differences in moderate (p<0.01) versus vigorous (p=0.06) physical activity. After accounting for longitudinal repeated measures per participant and nested family effects, total adult physical activity remained significantly higher in the intervention than in the control group (+1,163 MET minutes per week on average per participant), with a significant intervention interaction term (p<0.01). There were no significant changes in sedentary time, BMI, or blood pressure. Higher allocation of avocados was associated with significantly higher physical activity and no adverse changes in BMI or blood pressure, suggesting that this nutritional intervention may have beneficial pleiotropic effects.Trial registration: This study is registered at www.clinicaltrials.gov as NCT02903433.

Risk factors for 6-to-24-month-old toddlers in district of Tanara: survey of hygiene sectors, worm infection, and complementary feeding to reduce stunting

Background: Children in Indonesia still struggle against being stunted, wasted, and underweight. In 2018, 30.8 % of children under five years old were stunted, in 2022, it had decreased to 21.6%. The stunting rate in Pandeglang Regency in 2019 was 41.6%, whereas the incidence in Banten Province was 24.1%. This study aims to determine factors that influence the occurrence of stunting in children aged 6–24 months in Tanara District, Serang Regency, Indonesia. Methods: A cross-sectional approach was used on a sample consisting of 40 mothers with children aged 6–24 months in September 2020, selected using consecutive sampling from nine subdistricts. Results: Of the total respondents, 21 (52.5%) have stunted children aged 6–24 months, 28 (70%) children had completed exclusive breastfeeding, and 65% had poor knowledge of complementary feeding. Findings reveal a relationship between the incidence of stunting and the history of infectious disease, a lack of complementary feeding knowledge, and a lack of a healthy life attitude. Conclusions: The most influential factor in stunting in children aged 6–24 months was the history of infectious disease and the attitude toward a healthy life. A lower history of infectious disease in children under five will give a low incidence of stunting; conversely, a higher attitude toward healthy living lowers the incidence of stunting. In this study, the specific nutrition intervention programs required are learning classes for mothers, whether they are mothers of infants/toddlers or pregnant women. Moreover, the improvement of sensitive intervention programs for environmental hygiene needs to be encouraged, which is conducted by the local government and the community. The need to integrate nutrition-specific and sensitive interventions into efforts to improve children’s health should be met so that the handling of nutritional problems can be sustainable.

Analisis Peran Kader Posyandu dalam Pencegahan Stunting di Kelurahan Margoagung, Kapanewon Seyegan, Kabupaten Sleman

The prevalence of stunting in Margoagung Village reached 10.14%, making it the Village with the highest prevalence rate in Kapanewon Seyegan. As a result, a stunting prevention program is required, and it is inextricably linked to the role of cadres, because cadres can influence the success of the Posyandu program, particularly in monitoring the growth and development of toddlers. Based on this, the purpose of this study is to examine the role of Posyandu cadres in preventing stunting in Margoagung Village. The method used in this study is descriptive qualitative with data collection techniques through interviews, observation and documentation. This study involved 12 respondents, namely representatives of community cadres in the Margoagung Village. The findings of this study show that the Posyandu cadres in Margoagung Village have made a positive contribution to the local community in terms of health because they have carried out their duties well. It has also been demonstrated that the community feels the benefits of regularly visiting the Posyandu, one of which is that the community, particularly mothers of toddlers, can detect early and pay more attention to the health of their respective toddlers. Furthermore, despite not carrying out the program optimally, the cadres have successfully implemented a stunting prevention program through specific and sensitive nutrition interventions. According to the study's findings, several barriers to implementation were discovered, including cadres' lack of knowledge about nutrition and toddler health, so they relied on health workers at the Puskesmas

Qualitative Study of Utilization of Local Food for the Nutritional Needs of Stunted Children in Indonesia

Introduction: Stunting is a national problem in Indonesia due to an imbalance in children's nutritional intake. Diversity in balanced food consumption is one of the efforts to prevent stunting. Objectives: Exploring the potential of various types of food ingredients, utilization, equipment, capabilities, and expectations of the community in utilizing local food to fulfill stunting children's nutrition. Methods: Qualitative studies use a phenomenological approach. Research informants 15 people. Data were collected through Focus Group Discussion activities. ATLAS.Ti22 software is used to analyze data from focus group discussions. Results: It was found that the theme of ability and expectation has the highest co-occurrence value of 0.76, meaning that hope is very strongly related to the ability of the community. The theme of ability and availability of food ingredients has a co-occurrence value of 0.58, meaning that the ability to process local food ingredients is strongly related to the availability of food ingredients. Utilization and ability co-occurrence value of 0.16 means that the use of local food ingredients is weakly related to the ability to process food. Conclusion: Diversity in food consumption is related to food availability, utilization, and ability to process food. Suggestion: local food processing assistance is needed for the stunting target group to increase the community's ability to process local food. Inter-agency collaboration is needed in specific nutrition intervention programs by utilizing local food ingredients.

Evaluation of Integrated Nutritional Intervention in Cases of Stunting with Chronic Skin Infections

One in four toddlers in Indonesia is stunted, so the government is trying to reduce stunting by implementing integrated nutrition interventions. This case report aims to follow up on the results of the Stunting Case Audit (AKS) conducted by the Department of Health and across sectors by identifying risk factors for stunting, optimizing the role of Primary Health Care in clinically treating patients, and evaluating the implementation of integrated nutrition interventions that have been implemented. The patient is a toddler aged 25 months, weight 9.0 kg and height 78 cm, so the nutritional status according to the indicators of weight for age and height of age results in underweight and severe stunting. There are internal risks in patients, namely poor nutrition, poor personal hygiene, and chronic skin infections. In contrast, the external risks are the lack of parental income, a crowded home environment, and the mother's lack of knowledge about nutrition and health behavior. Forms of specific nutrition interventions include: handling skin infections and education on the practice of providing nutrition, while sensitive nutrition interventions include education on improving personal hygiene, providing PKH assistance, and building livable houses. The intervention and evaluation activities were carried out within 3 months. They resulted in improvements in providing nutrition, skin complaints, personal hygiene, and the implementation of PHBS in homes that were livable even though weight gain had not run optimally.

The Role of Health Care Workers of Kedungrejo Public Health Center in Stunting Reduction Strategy

Introduction: Banyuwangi Regency experienced the increase of stunting number as many as 8,2% from 2019. Stunting is not only affecting toddlers’ health, but also obstructing the development and the progress of a nation in the future. This case relates to the role of the health human resources in solving stunting. The role of health human resources towards stunting reduction strategy is crucial, in which using specific and sensitive nutritional intervention strategies. The current study aims to analyse the role of health human resources towards stunting reduction strategy.&#x0D; Methods: The study performed an analitical observational research with a cross sectional approach. The sample was 55 mothers possessing 0-23-month toddlers taken by clustered random sampling. The research variable was the basic role of the health human resources with some indicators applying specific and sensitive nutritional intervention. The data were analysed using descriptive method and logistic regression test.&#x0D; Results: The role of the communicator was mostly in a good category (61.8%), the motivator was mostly in good category (80%), the facilitator was mostly in not really good category (54.4%), the counselor was mostly in good category (76.4%). The communicator and the motivator influenced the specific nutritional intervention. The motivator and the facilitator influenced the sensitive nutritional intervention.&#x0D; Conclusion: The role of the communicator and motivator influenced the specific nutritional intervention as the stunting reduction strategy. Also, the motivator and facilitator influenced sensitive nutritional intervention.