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GIZI INDONESIA

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ISSN : 04360265 EISSN : 25285874 DOI : -

Core Subject : Health,

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Gizi Indonesia (Journal of The Indonesian Nutrition Association) is an open access, peer-reviewed and inter-disciplinary journal managed by The Indonesia Nutrition Association (PERSAGI). Gizi Indonesia (Journal of The Indonesian Nutrition Association) has been accredited by Indonesian Institute of Sciences since 2004. Gizi Indonesia aims to disseminate the information about nutrition, therefore it is expected that it can improve insight and knowledge in nutrition to all communities and academics. Gizi Indonesia (Journal of The Indonesian Nutrition Association) offers a specific forum for advancing scientific and professional knowledge of the nutrition field among practitioners as well as academics in public health and researchers

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BEBERAPA PERTIMBANGAN BEBERAPA INDIKATOR UNTUK MENENTUKAN KEBERHASILAN PROGRAM ELIMINASI GAKY DI INDONESIA Gorstein, Jonathan
GIZI INDONESIA Vol 28, No 2 (2005): September 2005
Publisher : PERSATUAN AHLI GIZI INDONESIA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36457/gizindo.v28i2.19

Pemeriksaan TGR (Tyroid Goiter Rate) yang dahulu dianjurkan oleh WHO (1993) kini sudah tidak dianjurkan lagi. Tulisan ini membahas mengapa TGR tidak diajurkan lagi dan Urine Iodium Exretion (UIE) terbukti merupakan indikator yang lebih akurat untuk menilai keberhasilan program yodisasi garam. Pemeriksaan TGR terutama melalui palpasi pada kelenjar tyroid di leher tidak akurat karena beberapa hal. Pertama, pemeriksaan melalui palpasi sangat bervariasi hasilnya karena sangat subjektif terutama pada petugas kesehatan yang kurang pengalaman dan latihan dalam melakukan palpasi. Kedua, karena terjadinya pembesaran kelenjar tyroid membutuhkan waktu yang cukup lama, dan kembalinya kelenjar tersebut kebentuk normal juga membutuhkan waktu pula, karena itu Totasl Goitre Rate (TGR) tidak mencerminkan status yodium saat ini tapi lebih mencerminkan kekurangan yodium di masa lampau. Pada beberapa kasus, perbesaran kelenjar tyroid bahkan tidak dapat kembali ke bentuk normal. Penilaian yodium melalui urin atau UIE dapat dijelaskan secara ilmiah dengan melihat data yang disajikan pada makalah ini. Penilaian UIE berarti menilai yodium yang berasal dari makanan dan minuman yang dikeluarkan memalui urin. Dengan demikian penilaian UIE mencerminkan keadaan yodium saat ini. Untuk individu, jumlah yodium di urin ditentukan oleh banyak faktor, karena itu penilaian UIE lebih baik untuk populasi dari pada individu. Pada populasi, UIE digunakan untuk memperkirakan konsumsi rata rata yodium yang berasal dari makanan. Bila UIE dari populasi cukup baik, maka dapat diperkirakan status yodium populasi cukup terjaga, sehingga penurunan IQ dapat dicegah. Bila kita korelasikan antara hasil penilaian melalui %TGR dan median UIE, maka keduanya tidak memiliki korelasi, karena keduanya mencermikan keadaan yodium yang berbeda dari segi waktu. Demikian juga korelasi antara %TGR dan % cakupan garam beryodium ditingkat provinsi. Namun bila kita korelasikan antara %cakupan garam beryodium dengan median UIE maka keduanya memilki korelasi yang cukup baik (r2=0.4727). Pemberian kapsul yodium ternyata tidak mempunyai korelasi baik dengan UIE maupun dengan persentasi cakupan garam beryodium. Hal ini disebabkan karena sifat kapsul yodium akan dibuang melalui urin pada minggu pertama setelah pemberian kapsul yodium kemudian sedikit demi sedikit menurun pada kurun waktu 6-9 bulan setelah pemberian. Sedangkan pengambilan data UIE adalah beberapa bulan setelah pemberian kapsul yodium. Perbedaan waktu tersebut menyebabkan tidak terdapatnya hubungan antara kedua variabel tersebut. Tulisan ini menguatkan bahwa untuk menilai cakupan garam beryodium dapat dicerminkan dengan penilaian menggunakan metoda yang tepat yaitu Urine Iodium Exretion (UIE) dan tidak lagi menggunakan TGR.(Jonathan, 2005)

PENGGUNAAN BERBAGAI CUT-OFF INDEKS MASSA TUBUH SEBAGAI INDIKATOR OBESITAS TERKAIT PENYAKIT DEGENERATIF DI INDONESIA Heryudarini Harahap; Yekti Widodo; Sri Mulyati
GIZI INDONESIA Vol 28, No 2 (2005): September 2005
Publisher : PERSATUAN AHLI GIZI INDONESIA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36457/gizindo.v28i2.20

DETERMINING CUT-OFF POINTS OF BODY MASS INDEX FOR OBESITY ASSOCIATED WITH DEGENERATIVE DISEASES IN INDONESIAObesity now is recognized as a public health problem. Changing diets and decreasing physical activity explain the increasing prevalence of obesity. Method that is commonly used for indentifying obesity is Body Mass Index (BMI). At present, there has been a growing debate on different BMI cut-off points for different ethnic groups, in particular for Asian population. A different cut-off point is needed due to evidence associated with BMI, percentage of body fat, and body fat distribution that differ across population. Therefore, health risks may incrase even below the cutoff point of 25 kg/m2 that now categorized as overweight. The objective of the study was to determine BMI cut-off points and their relationship with degenerative diseases. Data was originally taken from Health National Household Health Survei (SKRT) in 2004. The population were those who were aged 25 to 65 years old. The variable analysed statistically were age, sex, blood pressure, total cholesterol, and Diabetes Mellitus (DM). The analysis used in this study was univariate and bivariate tables to answer the objective. Based on WHO cut-off point, obesity was in BMI =25 kg/m2, and the prevalence of being hypertension, DM and hyperkolestrolemia as risks were 52.3%, 12,7% and 1,6% respectively. However, based on International Obesity Task Force (IOTF) cut-off in which pre obesity was started on BMI 23 kg/m2, the prevalence of each risk was consecutively 40,1%; 11,4% and 0,6%. Respectively cut-off used by Ministry of Health in obesity was 25 kg/m2 with prevalence for each risk was 50.2%, 11.8% and 1.5% respectively. Sensitivity (Se) and Specificity (Sp) were around 22.0-23.0 for all subjects based on sex, age, and education. The highest Se and Sp was found on hypercholesterol. Logistic regresion analysis showed that the increasing of BMI cut-off of 23 to 25 would be followed by the increase of the risk of hypercholesterol up to 0.6 points. On the other hand, decreasing BMI from 25 to 25 in USA may reduce 13% co-morbidity disease associated to obesity. In conclusion this study showed that on BMI =23.5 was related to degenerative diseases. However, the cut-off point still need to be examined in relation to the incidence of degenative diseases.Key Word: body mass index, cut-off point, degenerative diseases

PREVALENSI GIZI LEBIH DAN OBESITAS PENDUDUK DEWASA DI INDONESIA Sandjaja Sandjaja; Sudikno Sudikno
GIZI INDONESIA Vol 28, No 2 (2005): September 2005
Publisher : PERSATUAN AHLI GIZI INDONESIA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36457/gizindo.v28i2.21

There is a trend that the prevalence of overweight and obesity is increasing in Indonesia in the last decade. Overweight and obesity has been shown to increase risk of several degenerative diseases. Using data from household health survey (SKRT), data analysis of 20.137 adults was done, comprised of 9.390 men and 10.747 women from urban and rural areas. Overweight and obesity was defined for body mass index (BMI) 25.0 – 27.0, while obesity was defined for BMI 27.0. The study found that the prevalence of overweight was 7.2% among men and 10.4% among women. The prevalence of overweight was higher in urban areas (10.8%) than in rural areas (7.5%). The prevalence of obesity among women was more than twice (13.3%) than among men (5.3%), higher in urban areas (12.8%) than rural areas (7.1%). The peak of overweight and obesity was found at the age range of 45 – 49 years old. In conclusion, the prevalence of overweight and obesity was higher in both aspects, among women than men and in urban areas than in rural areas. The higher prevalence was found at the age of 45-49 years old.

GANGGUAN PERTUMBUHAN DAN DEFISIT BERAT BADAN PADA BALITA DI PERKOTAAN DAN PEDESAAN Sri Muljati; Dwi Hapsari; Basuki Budiman
GIZI INDONESIA Vol 28, No 2 (2005): September 2005
Publisher : PERSATUAN AHLI GIZI INDONESIA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36457/gizindo.v28i2.22

GROWTH FAILURE AND BODY WEIGHT DEFICIT OF UNDERFIVE CHILDREN IN URBAN AND RURAL AREASThe prevalence of malnutrition in Indonesia in 2003 is 19 percents; three percents of them are severe malnutrition. Study on the age beginning deviation of growth failure and the extent of the deficit in body weight of underfive children in Indonesia is scarce. We analysed 1694 records of children underfive year old from National Household Survey (SKRT) having complete data in weight, height and age. The study revealed that 42.9% children underfives suffered from growth failure, in which the magnitude was greater in rural than urban e.i. 53.8% and 46.2% respectively growth failure started. In the age 4 months, infant begins deficit his her body weight and the peak of the deficit is infant in six months e.i 21.05%. This analysis supports international finding that deviation in growth failure begin at 4 month for Indonesian children should be consideredKeywords: under five year children, growth

IRON-ZINC SUPPLEMENTATION AMONG ADOLESCENT GIRLS AT ELEMENTARY SCHOOL IN KUPANG CITY, EAST TIMOR PROVINCE. Indriastuti Kurniawan, Yustina Anie; Muslimatun, Siti
GIZI INDONESIA Vol 28, No 2 (2005): September 2005
Publisher : PERSATUAN AHLI GIZI INDONESIA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36457/gizindo.v28i2.17

Anemia is the main micronutrient deficiency problem among adolescent girls in Indonesia. Anemia due to iron deficiency often coexists with zinc deficiency. Both iron deficiency anemia and zinc deficiency can increase the risk of obstetric complications among pregnant women i.e. bleeding during labor and post-partum hemorrhage. Iron-folate supplementation among pregnant women had been conducting since long time ago throughout this country; however, effort to improve the nutritional status particularly among adolescent girls prior to pregnancy is still lack behind. Iron and zinc have antagonistic interaction. Therefore it was challenging to alleviate anemia problem among adolescent girls with appropriate ratio of iron-zinc supplementation, and will give a benefit to improve their nutritional status. This study was aimed to investigate the different ratios of ironzinc supplementation on reducing the prevalence of anemia as improving the nutritional status of adolescent school girls.A female elementary school students age 10-12 years old (n= 137) were screened in rural area of Kupang City, East Timor Province. Subjects were assigned randomly to one of the three groups for daily iron-zinc supplementation for 12 weeks; Group 1 (iron; 60 mg/day), Group 2 (iron and zinc; 30 mg and 15 mg/day), Group 3 (iron and zinc; 60 mg and 15 mg/day). Hemoglobin concentration was measured by cyanmethemoglobin method (Hemocue) to determine the prevalence of anemia (Hb level 120 g/L), while anthropometric assessment was conducted for measuring weight and height to determine the nutritional status. General characteristics was assessed through interview. At base line, 29.1% of subjects suffered from anemia and in general, the prevalence was reduced to around 13.1% after they took iron supplements with or without zinc. Hemoglobin concentration was significantly increased among all subjects euther suffered from anemia or not. The result of this study showed that subject who received iron/zinc supplement with ratio 4: 1 for 12 weeks asa “blanket approach” significantly increased hemoglobin conc. higher than to who received iron alone. Similar result occurred when supplement was received to anemic adolescent. Although there were significantly increased of weight, height and BMI for age among all groups, the percentage of subjects were underweight, stunted and wasted remains high after supplementation that 54.6%, 36.9% and 39.2% respectively. Anemia seems to be a health problem among adolescent school girls in Kupang City, East Timor Province and iron-zinc supplementation with appropriate ratio is promising to increase hemoglobin level. A large scale of cohort study was recommended for female student, to investigate the effect iron/zinc supplementation with ratio 2: 1 on iron, zinc status and growth performance among adolescent girls.Key Words: Iron, Zinc, Adolescent, Girls

INDONESIAN NUTRITIONAL STATUS OF CHILDREN 1989-2005: POVERTY AND HOUSEHOLD FOOD SECURITY, DIETARY DIVERSITY AND INFECTION: WHICH IS THE MOST IMPORTANT RISK? -, Atmarita; L. Tilden, Robert; Nur, Noor Nasry; Ghani, Ascobat; Widjajanto, RM
GIZI INDONESIA Vol 28, No 2 (2005): September 2005
Publisher : PERSATUAN AHLI GIZI INDONESIA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36457/gizindo.v28i2.18

STATUS GIZI ANAK INDONESIA 1989-2005 DAN FAKTOR RISIKO TERPENTINGIndonesia berhasil mengendalikan masalah gizi-mikro, kurang vitamin A (KVA) dan Gangguan Akibat Kurang Iodium (GAKI), dengan mengembangkan program-program yang berbasis komunitas. Namun demikian, kurang energi protein masih masalah. Walaupun besar masalah gizi berkurang cukup bermakna selama 25 tahun terakhir, namun risiko gagal tumbuh pada usia penyapihan berdampak pada semua sektor ekonomi dan menjadi kendala pertumbuhan ekonomi dan kualitas hidup. Makalah ini mengupas risiko faktor kemiskinan, keamanan pangan keluarga, keanekaragaman pangan dan infeksi penyakit terhadap gagal tumbuh anak Indonesia. Sumber data adalah hasil Survei Sosial Ekonomi Nasional (SUSENAS) 1989-2005. Data yang diolah meliputi konsumsi rumahtangga, data kesehatan individu dari modul gizi. Status gizi diukur menurut Z-skor yang mengacu pada rujukan internasional, NCHS. Pengolahan menggunakan alat bantu komputer. Selama 10 tahun terakhir, status gizi anak Indonesia tidak berubah secara bermakna dan rendahnya cakupan ASI eksklusif merupakan penyebab penting. Proporsi ibu yang mengaku menyusui sampai 12 bulan sebesar 75 persen, tetapi makanan pendamping telah diperkenalkan terlalu dini. Ibu yang menyusui bayinya secara eksklusif hingga enam bulan sebesar 12 persen dan rendahnya berperan terhadap gagal tumbuh bayi pada bulan ke 4 sampai ke 18. Penyebab utama gagal tumbuh anak-anak tersebut adalah infeksi penyakit dan rendahnya konsumsi makanan padat energi. Pola dasar penyebab gagal tumbuh anak ini dijumpai pada semua kelompok ekonomi. Anak-anak kelompok kuintil ekonomi terbawah yang terbanyak anak yang gagal tumbuh, namun tiga kelompok di atasnya tidak jauh berbeda. Anak dalam kelompok ekonomi teratas, berhasil mengurangi risiko gagal tumbuh walau masih dalam pola umum gagal tumbuh dan dalam rentang satu simpang baku di bawah baku internasional. Sementara kelompok lain berada dalam rentang 1,5 simpang baku di bawah baku internasional. Masalah ekonomi bersama-sama dengan faktor sanitasi lingkungan, akses kepada air bersih dan pendidikan yang rendah merupakan penyebab yang dominan. Pergeseran prioritas pengeluaran sedikit saja akan berdampak pada status gizi karena hampir 70 persen pendapatan penduduk Indonesia di bawah satu dolar per orang per hari. Sejak program gizi dilimpahkan kepada kewenangan pemerintah daerah, penanganan masalah gizi menghadapi kendala keterbatasan jumlah dan ketrampilan tenaga pelaksana. Gagal tumbuh pada anak usia penyapihan menjadi tantangan yang berat bagi perbaikan gizi masyarakat di Indonesia. Kerjasama pemerintah, keterlibatan masyarakat dalam perencanaan, lembaga-lembaga non pemerintah, lembaga-lembaga donatur non pemerintah akan sangat berarti dalam menurunkan masalah ini.Katakunci: gagal-tumbuh, anak usia penyapihan, gizi masyarakat, kemiskinan.

PENGGUNAAN BERBAGAI CUT-OFF INDEKS MASSA TUBUH SEBAGAI INDIKATOR OBESITAS TERKAIT PENYAKIT DEGENERATIF DI INDONESIA Harahap, Heryudarini; Widodo, Yekti; Mulyati, Sri
GIZI INDONESIA Vol 28, No 2 (2005): September 2005
Publisher : PERSATUAN AHLI GIZI INDONESIA

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (163.853 KB)

DETERMINING CUT-OFF POINTS OF BODY MASS INDEX FOR OBESITY ASSOCIATED WITH DEGENERATIVE DISEASES IN INDONESIAObesity now is recognized as a public health problem. Changing diets and decreasing physical activity explain the increasing prevalence of obesity. Method that is commonly used for indentifying obesity is Body Mass Index (BMI). At present, there has been a growing debate on different BMI cut-off points for different ethnic groups, in particular for Asian population. A different cut-off point is needed due to evidence associated with BMI, percentage of body fat, and body fat distribution that differ across population. Therefore, health risks may incrase even below the cutoff point of 25 kg/m2 that now categorized as overweight. The objective of the study was to determine BMI cut-off points and their relationship with degenerative diseases. Data was originally taken from Health National Household Health Survei (SKRT) in 2004. The population were those who were aged 25 to 65 years old. The variable analysed statistically were age, sex, blood pressure, total cholesterol, and Diabetes Mellitus (DM). The analysis used in this study was univariate and bivariate tables to answer the objective. Based on WHO cut-off point, obesity was in BMI =25 kg/m2, and the prevalence of being hypertension, DM and hyperkolestrolemia as risks were 52.3%, 12,7% and 1,6% respectively. However, based on International Obesity Task Force (IOTF) cut-off in which pre obesity was started on BMI 23 kg/m2, the prevalence of each risk was consecutively 40,1%; 11,4% and 0,6%. Respectively cut-off used by Ministry of Health in obesity was 25 kg/m2 with prevalence for each risk was 50.2%, 11.8% and 1.5% respectively. Sensitivity (Se) and Specificity (Sp) were around 22.0-23.0 for all subjects based on sex, age, and education. The highest Se and Sp was found on hypercholesterol. Logistic regresion analysis showed that the increasing of BMI cut-off of 23 to 25 would be followed by the increase of the risk of hypercholesterol up to 0.6 points. On the other hand, decreasing BMI from > 25 to < 25 in USA may reduce 13% co-morbidity disease associated to obesity. In conclusion this study showed that on BMI =23.5 was related to degenerative diseases. However, the cut-off point still need to be examined in relation to the incidence of degenative diseases.Key Word: body mass index, cut-off point, degenerative diseases

PREVALENSI GIZI LEBIH DAN OBESITAS PENDUDUK DEWASA DI INDONESIA ., Sandjaja; ., Sudikno
GIZI INDONESIA Vol 28, No 2 (2005): September 2005
Publisher : PERSATUAN AHLI GIZI INDONESIA

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (98.382 KB)

There is a trend that the prevalence of overweight and obesity is increasing in Indonesia in the last decade. Overweight and obesity has been shown to increase risk of several degenerative diseases. Using data from household health survey (SKRT), data analysis of 20.137 adults was done, comprised of 9.390 men and 10.747 women from urban and rural areas. Overweight and obesity was defined for body mass index (BMI) > 25.0 – 27.0, while obesity was defined for BMI > 27.0. The study found that the prevalence of overweight was 7.2% among men and 10.4% among women. The prevalence of overweight was higher in urban areas (10.8%) than in rural areas (7.5%). The prevalence of obesity among women was more than twice (13.3%) than among men (5.3%), higher in urban areas (12.8%) than rural areas (7.1%). The peak of overweight and obesity was found at the age range of 45 – 49 years old. In conclusion, the prevalence of overweight and obesity was higher in both aspects, among women than men and in urban areas than in rural areas. The higher prevalence was found at the age of 45-49 years old.Keywords: overweight, obesity, body mass index

GANGGUAN PERTUMBUHAN DAN DEFISIT BERAT BADAN PADA BALITA DI PERKOTAAN DAN PEDESAAN Muljati, Sri; Hapsari, Dwi; Budiman, Basuki
GIZI INDONESIA Vol 28, No 2 (2005): September 2005
Publisher : PERSATUAN AHLI GIZI INDONESIA

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (131.831 KB)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (149.778 KB)

Anemia is the main micronutrient deficiency problem among adolescent girls in Indonesia. Anemia due to iron deficiency often coexists with zinc deficiency. Both iron deficiency anemia and zinc deficiency can increase the risk of obstetric complications among pregnant women i.e. bleeding during labor and post-partum hemorrhage. Iron-folate supplementation among pregnant women had been conducting since long time ago throughout this country; however, effort to improve the nutritional status particularly among adolescent girls prior to pregnancy is still lack behind. Iron and zinc have antagonistic interaction. Therefore it was challenging to alleviate anemia problem among adolescent girls with appropriate ratio of iron-zinc supplementation, and will give a benefit to improve their nutritional status. This study was aimed to investigate the different ratios of ironzinc supplementation on reducing the prevalence of anemia as improving the nutritional status of adolescent school girls.A female elementary school students age 10-12 years old (n= 137) were screened in rural area of Kupang City, East Timor Province. Subjects were assigned randomly to one of the three groups for daily iron-zinc supplementation for 12 weeks; Group 1 (iron; 60 mg/day), Group 2 (iron and zinc; 30 mg and 15 mg/day), Group 3 (iron and zinc; 60 mg and 15 mg/day). Hemoglobin concentration was measured by cyanmethemoglobin method (Hemocue) to determine the prevalence of anemia (Hb level < 120 g/L), while anthropometric assessment was conducted for measuring weight and height to determine the nutritional status. General characteristics was assessed through interview. At base line, 29.1% of subjects suffered from anemia and in general, the prevalence was reduced to around 13.1% after they took iron supplements with or without zinc. Hemoglobin concentration was significantly increased among all subjects euther suffered from anemia or not. The result of this study showed that subject who received iron/zinc supplement with ratio 4: 1 for 12 weeks asa “blanket approach” significantly increased hemoglobin conc. higher than to who received iron alone. Similar result occurred when supplement was received to anemic adolescent. Although there were significantly increased of weight, height and BMI for age among all groups, the percentage of subjects were underweight, stunted and wasted remains high after supplementation that 54.6%, 36.9% and 39.2% respectively. Anemia seems to be a health problem among adolescent school girls in Kupang City, East Timor Province and iron-zinc supplementation with appropriate ratio is promising to increase hemoglobin level. A large scale of cohort study was recommended for female student, to investigate the effect iron/zinc supplementation with ratio 2: 1 on iron, zinc status and growth performance among adolescent girls.Key Words: Iron, Zinc, Adolescent, Girls

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