Diana Sunardi
Departemen Ilmu Gizi Fakultas Kedokteran Universitas Indonesia Indonesian Hydration Working Group - FKUI

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The roles of growing up milk on growth and anemia prevention in children under 5 years of age Sunardi, Diana; Budiati Sutanto, Luciana; Chandra, Dian Novita; Shabrina, Arifah; Ratih, Mia Puspita
World Nutrition Journal Vol. 8 No. i1 (2024): Volume 08 Issue 1, August 2024
Publisher : Indonesian Nutrition Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25220/WNJ.V08.i1.0016

Abstract

Background: Adequate nutrition during the early years of life is necessary for good growth, development, and long-term health outcomes. The first 1000 days of life are a critical time for nutrition. Aims: This literature review aimed to evaluate the role of growing up milk on growth, stunting, and anemia prevention of under-five children. Methodology: This study used a literature review approach, searching three databases: PubMed, Google Scholar, and Cochrane. The inclusion criteria in this literature review were 1) randomized clinical trials, systematic review, and meta-analysis, 2) studies conducted over the last 10 years, 3) available in full text, 4) written in Indonesian or English, and 5) Research studies conducted in humans. Result: We identified 3 publications, that matched the inclusion criteria and research aims, including 2 original articles from Lovell AL, et al and Cervo MCM, et al, and 1 meta-analysis by Brooker PG et al. Fortified milk (GUM) consumption significantly had a positive impact on nutritional status, especially growth and hemoglobin status (anemia). Conclusion: Fortified milk (GUM) consumption is a solution to macro-micronutrient adequacy in under five children. More efforts are needed to conduct studies in Indonesia on GUM and address specific nutrients that may promote linear growth, reverse stunting and anemia in children.
Sarkopenia sebagai Faktor Risiko Varises Esofagus Risiko Tinggi berdasarkan Stratifikasi Child-Pugh Pasien Sirosis Hati Sepmeitutu, Iwandheny; Kurniawan, Juferdy; Maulahela, Hasan; Rinaldi, Ikhwan; Shatri, Hamzah; Pramana, Triyanta Yuli; Makmun, Dadang; Lesmana, Cosmas Rinaldi A; Hidayat, Rudy; Laksmi, Purwita Wijaya; Sunardi, Diana
Jurnal Penyakit Dalam Indonesia Vol. 11, No. 3
Publisher : UI Scholars Hub

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Background The high prevalence of sarcopenia in chronic liver disease negatively impacts the quality of life and increases the risk of various complications of cirrhosis, one of which is the development of esophageal varices. The aim of this study was to determine the prevalence of sarcopenia in cirrhosis patients based on the severity of liver cirrhosis and to explore the association of sarcopenia with high-risk esophageal varices stratified by Child-Pugh. Methods This observational cross-sectional study involved patients with liver cirrhosis at Cipto Mangunkusumo Hospital between January and September 2023. Sarcopenia was defined as a reduction in muscle mass accompanied by decreased grip strength or walking speed, according to the AWGS 2019 criteria (Asian Working Group for Sarcopenia). Multivariate logistic regression analysis was conducted to evaluate the association between sarcopenia and high-risk esophageal varices. Results A total of 155 patients with liver cirrhosis were included in this study. The majority of liver cirrhosis patients were males, with hepatitis B being the most commonly found etiology. The prevalence of sarcopenia was found in 40.0% of Child-Pugh A patients, 53.8% of Child-Pugh B patients, and 50.0% of Child-Pugh C patients with a p-value of 0.411. The high-risk of esophageal varices was found more frequently in Child-Pugh B (53.8%) and Child-Pugh C (50.0%) compared to Child-Pugh A (25.6%) with a p-value of 0.013. Bivariate analysis showed that the presence of sarcopenia in liver cirrhosis patients has a statistically significant association with an increased risk of high-risk esophageal varices, especially in the Child-Pugh B and C subgroups of liver cirrhosis patients (OR = 7.50 (95% CI: 1.48 – 37.91, p<0.030)). However, no association was found between sarcopenia and high-risk esophageal varices in the Child-Pugh A subgroup (OR = 1.46 (95% CI: 0.65 – 3.29, p<0.477)). Conclusion Sarcopenia significantly increases the risk of high-risk esophageal varices in liver cirrhosis, especially in those with Child-Pugh B and C classification.
Effect of Vitamin D3 on Changes in Muscle Mass in the Elderly in Nursing Homes: Double-Blind Controlled Randomized Trial Prajna Adhityarani; Diana Sunardi; Esthika Dewiasty
Contagion: Scientific Periodical Journal of Public Health and Coastal Health Vol 6, No 1 (2024): CONTAGION
Publisher : Universitas Islam Negeri Sumatera Utara, Medan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30829/contagion.v6i1.19030

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The decline in muscle mass and strength begins at the age of 30 years by 40% within 30 years, then will decrease by 40% every ten years after the age of 60 years. Loss of muscle mass and strength in older people causes weakness and reduced muscle function, which can lead to a decrease in the ability to perform activities of daily living and an increased risk of falls. In addition, older people are prone to malnutrition; this condition will be accompanied by micronutrient deficiencies both in older people who are undernourished and overnourished. Giving vitamin D3 to increase muscle mass and ability and reduce fat mass in older people also has pros and cons. So, this study aims to explore the effect of giving Vitamin D3 on changes in muscle mass in older adults. The study will also examine changes in upper arm muscle strength and evaluate the impact of Vitamin D3 on changes in muscle mass. This research is a study with an Experimental Randomised Control Trial (RCT) research design. The population was elderly who were deficient in vitamin D, while the study sample amounted to 26 control subjects and 26 action subjects. Samples are taken by consecutive sampling technique. Based on research findings, most older adults (60–69 years) suffer from vitamin D deficiency and deficiency. However, vitamin D3 supplementation increases the muscle mass of older adults in nursing homes, especially in the muscles of the upper and lower extremities. However, the supplement weakens muscle mass and causes bruising and bleeding but does not weaken arm muscle mass. Keywords: Elderly,  Muscle Mass,  Panti Werdha, Vitamin D3
Optimizing nutrients intake of children in Indonesia: Dietary modelling approach Sunardi, Diana; Wibowo, Yulianti
World Nutrition Journal Vol. 8 No. S1 (2024): Selected conference proceedings of the Nutri Symposium 2024
Publisher : Indonesian Nutrition Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25220/WNJ.V08.S1.0012

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The prevalence of obesity is rising in high-income countries, while low-income populations face the triple burden of malnutrition. Improving dietary intake is crucial in addressing these issues. Diet optimization or diet modelling have emerged as valuable tools for identifying the optimal combination of foods that meet daily nutritional requirements by incorporating nutrient-dense options into the diet.
Effective use of semi-elemental diet in managing anastomotic leakage after surgery for esophageal stricture: A case report Afifa, Nadhira Nuraini; Sonia, Steffi; Sunardi, Diana; Lestari, Wiji
World Nutrition Journal Vol. 8 No. S1 (2024): Selected conference proceedings of the Nutri Symposium 2024
Publisher : Indonesian Nutrition Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25220/WNJ.V08.S1.0027

Abstract

Anastomotic leakage occurs in ±10% of patients after surgery for esophageal stricture. Management often requires re-surgery, which increases morbidity and mortality. This case report shows successful conservative management of anastomotic leakage with semi-elemental diet.
The Role of Eicosapentaenoic Acid Supplementation on Muscle Mass in Malnutrition Patients with Squamous Cell Carcinoma of the Tongue: Case Report Kirana, Annisa Nurul; Sunardi, Diana; Manikam, Nurul Ratna Mutu; Rasyid, Nurhayati M
Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education Research Institute Vol. 7 No. - (2023): Proceedings Book of International Conference and Exhibition on The Indonesian M
Publisher : Writing Center IMERI FMUI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69951/proceedingsbookoficeonimeri.v7i-.195

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The Indonesian prevalence of lip and oral cavity cancer in 2020 was 14,913, with 5,780 new cases. Head and neck cancer patients are very vulnerable to malnutrition; about 50% are malnourished, and 80% experience unwanted weight loss. Studies showed a significant effect of EPA as an anti-inflammatory substance. A 56-year-old female patient with a diagnosis of tongue squamous cell carcinoma (SCC) presents with the tumor removed along with some teeth. She is experiencing difficulty chewing food and had a weight loss of 8 kg (17%) in the last six months. The patient's muscle mass was 25.5% (low). Patients were given protein intake in the 1.1-1.8 g/kgbw/day range and EPA supplementation of 1.1 g/day. After one month, the BIA measurement showed that her muscle mass had increased to 26.2% and was in the normal category. Omega 3, especially EPA, improved body weight and lean body mass in cancer patients by modulating circulating inflammatory markers, demonstrating an inhibitory effect on inflammatory parameters related to muscle atrophy and lipolysis.Adequate protein intake and supplementation of 1.1 g/day EPA increased muscle mass in malnourished patients and enhanced the effectiveness of cancer therapy.
Pengaruh Pemberian Probiotik terhadap Penurunan Gejala Enteritis pada Pasien Karsinoma Sel Skuamosa Serviks dalam Terapi Radiasi: studi kasus dengan pendekatan berbasis bukti Witjaksono, Firisha Virgidewi; Sunardi, Diana
Jurnal Ilmu Kesehatan Indonesia Vol. 6 No. 1 (2025): Maret 2025
Publisher : Fakultas Kedokteran, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jikesi.v6i1.1493

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Latar Belakang: Kanker serviks adalah salah satu jenis kanker yang paling umum pada wanita di negara berkembang. Radioterapi merupakan salah satu terapi utama, namun dapat menyebabkan efek samping, salah satunya adalah enteritis terkait radiasi. Probiotik diketahui dapat membantu mengurangi gejala enteritis terkait radiasi dengan memperbaiki keseimbangan mikrobiota usus dan mengurangi peradangan. Hasil penelitian yang beragam dan belum konklusif mendorong perlunya penelitian lebih lanjut untuk mengevaluasi efektivitas probiotik dalam mengurangi gejala enteritis pada pasien karsinoma sel skuamosa serviks. Objektif: Mengetahui efek pemberian probiotik terhadap penurunan gejala enteritis terkait radiasi pada pasien karsinoma sel skuamosa serviks. Metode: Penelusuran literatur dilakukan pada empat pangkalan data, yaitu PubMed, Cochrane, dan Embase, menggunakan kata kunci MeSH terms. Penyeleksian artikel dilakukan dengan penapisan judul atau abstrak, telaah teks lengkap, dan menentukan terpenuhinya kriteria inklusi dan eksklusi. Dilakukan telaah kritis pada dua studi kajian literatur sistemik/meta-analisis dari uji acak terkontrol berdasarkan telaah validity, importance, dan applicability. Hasil: Tiga literatur dipilih secara kritis. Artikel pertama menunjukkan bahwa tidak ada pengurangan RID yang signifikan secara statistik (RR = 0,52, 95% CI = 0,14, 1,91) yang diamati pada analisis subkelompok pada pasien yang menerima terapi radiasi dan kemoterapi. Namun, pasien yang hanya menerima terapi radiasi menunjukkan manfaat yang signifikan (RR = 0,61, 95% CI = 0,48, 0,78). Artikel kedua menunjukkan bahwa jumlah rata-rata tinja cair dengan Bristol tipe 6 dan 7 tidak berkurang secara signifikan dalam kelompok probiotik, namun terdapat pengurangan yang signifikan pada kelompok yang jumlah rata-rata buang air besar dengan lebih dari 1 kali tinja cair yaitu 15,04 ± 8,92 hari dalam plasebo dan 8,65 ± 5,93 hari dalam kelompok probiotik dosis tinggi (P = 0,014). Artikel ketiga menunjukkan bahwa insiden diare berkurang pada kelompok probiotik dibandingkan kelompok plasebo (53,8 dan 82,1%, p < 0,05). Diare ringan hingga sedang dan berat berkurang secara signifikan pada kelompok probiotik (p < 0,05). Kesimpulan: Pemberian probiotik dapat menurunkan gejala RID pada pasien kanker serviks.
Asupan Serat Pangan dan Hubungannya dengan Keluhan Konstipasi pada Kelompok Dewasa Muda di Indonesia Saptawati Bardosono; Iwan Surjadi Handoko; Ruth Audy Alexander; Diana Sunardi; Almira Devina
Cermin Dunia Kedokteran Vol 47 No 10 (2020): Dermatologi
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v47i10.553

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Walaupun sampai saat ini konstipasi fungsional masih beragam definisinya, gejalanya sering dikeluhkan karena dirasakan mengganggu kualitas hidup khususnya, pada kelompok dewasa muda, dan bila tidak ditangani dengan baik akan berdampak negatif bagi kesehatan. Asupan serat yang memadai merupakan salah satu alternatif yang efektif untuk mengatasi masalah tersebut, namun asupan sayur dan buah masyarakat di Indonesia masih jauh dari angka kecukupan yang dianjurkan; jumlah asupan serat harian pekerja dewasa muda di Jakarta bervariasi antara 3,3-27,4 g. Tambahan serat pangan dalam diet sehari-hari diharapkan dapat meningkatkan asupan serat sehingga dapat bermanfaat untuk mengatasi keluhan konstipasi. Although until now functional constipation still has various definitions, the symptoms are often interfering with quality of life, especially in young adults. If not managed properly, it may have a serious negative impact on health. Adequate fiber intake is an effective alternative to overcome this problem, but vegetables and fruits intake in Indonesia is still far from adequate. A recent pilot study found that the daily fiber intake among young adult workers in Jakarta is varied between 3.3–27.4 g. Additional dietary fiber in daily diet is expected to increase fiber intake so that it can be useful for dealing with complaints of constipation.
Optimizing nutritional status with nutritional therapy in malnourished patient post whipple’s procedure: A case report Stefani, Shiela; Sunardi, Diana; Sonia, Steffi
Jurnal Prima Medika Sains Vol. 7 No. 1 (2025): June
Publisher : Program Studi Magister Kesehatan Masyarakat Universitas Prima Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.34012/jpms.v7i1.6235

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The prevalence of malnutrition is considerably high among patients with pancreatic cancer and that Whipple procedure is associated with high morbidity and mortality rates. Post-Whipple procedure nutritional therapy can help to preserve nutritional status, accelerate recovery of functional capacity, and improve patient’s quality of life. A 65-year-old malnourished woman underwent Whipple procedure for adenocarcinoma of ampulla of Vater. Oral pre-operative nutrition was given in the form of normal food and oral nutritional supplement (ONS). Eight hours before surgery, the patient received ONS containing 30 g carbohydrate. The patient was given early enteral nutrition at <48 hours post-operatively and was given oral nutrition as soon as she regained consciousness. The patient experienced post-operative pancreatic fistula (POPF) grade A. Post-operative in-hospital and homecare nutritional therapy included supply of energy, macronutrients, micronutrients, and nutritional education adjusted to the patient’s clinical condition and intake tolerance. Energy intake during hospitalization attained 109% of the estimated total energy requirement that consisted of up to 1.9 g/kg/day protein. Homecare nutritional intake reached almost 2 times basal energy requirement with 2.2 g/kg/day protein intake. The patient experienced improvement of clinical symptoms, POPF, intake tolerance, glycemic control, and functional capacity. The patient was allowed to be discharged and treated in the outpatient clinic, without readmission in the next 2 months. Adequate hospital and homecare medical nutritional therapy in post-Whipple procedure may improve nutritional status and functional capacity, improve clinical outcome, and prevent readmission of patients.
The role of nutritional management in preventing stroke and improving clinical outcomes Mauluddy, Anggita Citra Resmi; Sunardi, Diana
World Nutrition Journal Vol. 9 No. i1 (2025): Volume 09 Issue 1, August 2025
Publisher : Indonesian Nutrition Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25220/WNJ.V09.i1.0002

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Background: Stroke is a leading cause of global morbidity, mortality, and substantial economic burden. Modifiable stroke risk factors, including hypertension, dyslipidemia, obesity, and diabetes mellitus, can be effectively managed through targeted nutritional interventions. Nutritional management also supports neurological recovery and contributes to improved clinical outcomes in stroke survivors. Methods: A literature review was conducted using PubMed, MEDLINE, and EMBASE databases from the last ten years, focusing on nutritional management for stroke prevention, clinical outcomes, dietary patterns, and nutrient supplementation during post-stroke recovery. Results: Dietary strategies, including Dietary Approaches to Stop Hypertension (DASH), high intake of dietary fiber, and omega-3 fatty acids, significantly reduce stroke risk by improving cardiovascular health and decreasing inflammation. Supplementation with micronutrients such as B vitamins supports neurological and vascular function. Post-stroke nutritional issues such as dysphagia, malnutrition, sarcopenia, and pressure injuries commonly impair patient recovery. Targeted nutritional intervention, particularly adequate protein and branched-chain amino acid (BCAA) supplementation, help preserve muscle mass, enhance functional recovery, and optimize rehabilitation outcomes. Conclusions: Nutritional management plays a crucial role in both preventing stroke and improving clinical outcomes following stroke. Implementing effective nutritional strategies, together with patient education on healthy dietary practices, is fundamental for reducing stroke risk, accelerating recovery, and enhancing quality of life.
Co-Authors Achmad Mulawarman Jayusman Adelina Haryono Afifa, Nadhira Nuraini Ali Sungkar Ali Sungkar Almira Devina Anak Agung Eka Widya Saraswati Andry Kelvianto Angelia, Wella Anin Ika Rosa Ardesy Melizah Kurniati arieska felicia Audy Alexander, Ruth Ayu Andin Wardani, Mutia Ayu Diandra Sari Ayu Diandra Sari Badriul Hegar Bernie Endyarni Medise Budi Wiweko Budiati Sutanto, Luciana C Rinaldi A Lesmana Chandra, Dian Novita Christy, Sarah claresta diella Dadang Makmun Devina, Almira Dewi Friska Dian Araminta Ramadhania Dian Araminta Ramadhania Dian Sarah Mutiara Dian Sarah Mutiara Dian Sarah Mutiara Dian Sarah Mutiara Dian Sarah Mutiara Diyah Eka Andayani Diyah Eka Andayani Diyah Eka Andayani Dwi Nastiti Iswarawanti Dyah Arum Kusumaningtyas E. Mudjaddid A. Siswanto Deddy N.W.Achadiono Hamzah Shatri Erfi Prafiantini Ervira Wahyuni Esthika Dewiasty Esthika Dewiasty Esthika Dewiasty Evania Astella Setiawan Evania Astella Setiawan Fadilah Fadilah, Fadilah Fransisca Olivia Gabriella Nurahmani Putri Gloriana Seran Godong, Bernardine Handayani Eka Puspita Sari Hasan Maulahela Helda Khusun Ikhwan Rinaldi Iwan Surjadi Handoko Jessica Ferdi Juferdy Kurniawan Karin Wiradarma Kirana, Annisa Nurul Krisadelfa Sutanto Krisadelfa Sutanto Luana Lidwina Maggie Nathania Marvin Marino Mauluddy, Anggita Citra Resmi Melyarna Putri Mulianah Daya Muningtya Philiyanisa Alam Neng Tine Kartinah Almuktabar Ninik Mudjihartini Noorwati Sutandyo Novi Silvia Hardiany Nurhayati M Rasyid Nurul Ratna Manikam Nurul Ratna Mutu Manikam Patricia Amanda Pauline Octaviani Prajna Adhityarani Purwita Wijaya Laksmi Putri Novia Choiri Insani Rachmawati, Dessy Suci Rahmita, Kartika Soka Raphael Kosasih Rasyid, Nurhayati M Ratih, Mia Puspita Ratnayani Reisa Melisa Wijaya Rini Sekartini Rizki Yusrini Pohan Rudy Hidayat Ruth Audy Alexander Saptawati Bardosono Saptawati Bardosono Saptawati Bardosono Saptawati Bardosono Saptawati Bardosono Sepmeitutu, Iwandheny Shabrina, Arifah Sheena R. Angelia Stefani, Shiela Steffi Sonia Surjadi Handoko, Iwan Tiara Aninditha Titis Prawitasari, Titis Triyanta Yuli Pramana Wella Angelia Wicaksari, Sifa Aulia Wiji Lestari Wiji Lestari Wina Sinaga Winarsa, Jessica Witjaksono, Firisha Virgidewi Yosua Y Kristian Yosua Yan Kristian Yulhasri Yulhasri Yulianti Wibowo, Yulianti