World Nutrition Journal (Indonesian Nutrition Association - INA)
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Medical Nutrition Therapy In Enterocutaneous Fistula: A Step-By-Step Approach
Get PDFEnterocutaneous fistula (ECF) management is a challenge that requires a multidisciplinary team approach in achieving optimal clinical output. Nutrition as a component of management plays a vital role in determining the prognosis, both as a predictor of morbidity and mortality. Malnutrition can also occurs as a preceeding situation or complication of ECF caused by the underlying disease, decreased food intake, increased protein requirements associated with systemic inflammation, and increased nutrient loss associated with the amount of fistula output. Thus, nutrition management can act as prevention, therapy, or both. Nutritional medical therapy in ECF cases aims to adequately estimate nutritional needs, maintain fluid and electrolyte balance, and stimulate spontaneous ECF closure whenever possible. To achieve optimal outcome, nutrition needs analysis must be done individually by considering the etiology, anatomical location of the fistula, and the amount of output. In the following article, we will discuss a comprehensive step-by-step nutrition treatment, both from the nutritional routes consideration, macronutrient and micronutrient requirements, specific nutrients, pharmacotherapy, and monitoring and evaluation that need to be done to achieve optimal clinical outcomes.
Probiotics administration as a prevention for postoperative infectious complications in colorectal cancer patients: A literature review
Get PDFBackground Colorectal cancer is the third leading cause of death from cancer in adults in the United States, with increasing prevalence in other countries. Radical resection is the gold standard of treatment in most cases of colorectal cancer, with a high rate of postoperative complications. Perioperative probiotics can improve the immune response and the postoperative intestinal microbiota environment. Although several studies have shown the benefits of probiotics in preventing postoperative complications of infection, the administration of perioperative probiotics in colorectal cancer patients is still controversial.
Objective. The purpose of this critical appraisal is to know the effectiveness of administering probiotics to prevent infectious complications in colorectal cancer patients.
Methods. Literature research using Pubmed, Cochrane, and EBSCOhost was carried out and 2 articles were obtained in the form of meta-analysis using STATA v11 and Revman v5.2 that was critically examined using the FAITH method. A comprehensive search for all studies was done to find all relevant studies using both MeSH terms and text words. The article should describe the assessment of quality and criteria used in method section, also provide information on the quality of individual studies in result section to minimize bias. The result section should state whether heterogeneity exists and mention possible reasons.
Results. Based on 2 meta-analyses that have been critically examined, which each consisting of 13 and 7 studies, giving probiotics can reduce the overall infection rate after colorectal cancer surgery. One meta-analysis showed an odds ratio (OR) of 0.51 (95% CI: 0.38 – 0.68, p = 0.00). Probiotics, such as Lactobacillus acidophilus and Bifidobacterium longum can also reduce the incidence of surgical site infections (OR = 0.59, 95% CI 0.39 – 0.88, p = 0.01) and pneumonia (OR = 0.56, 95% CI 0.32 – 0.98, p = 0.04). Probiotics did not provide statistically significant benefits in preventing urinary tract infections, leakage of anastomosis, and duration of postoperative pyrexia compared to the control group. Seven articles analyzed in the second meta-analysis showed probiotics to be useful in preventing postoperative infections with OR 0.5388 (95% CI, 0.4058-0.7154, P <0.0001).
Conclusions. Combination of more than one strain of probiotics such as Lactobacillus and Bifidobacterium is promising for the prevention of infections in patients undergoing colorectal cancer surgery
The effect of dietary fiber on insulin resistance in obesity: A literature review
Get PDFIntroduction Obesity has become a significant public health problem in developing countries such as Indonesia. According to WHO, 13% of adults aged 18 years and over were obese in 2016. In Indonesia, 21.8% of adults were obese. In obesity, the body's resistance to insulin will develop. Some studies showed a probable link between dietary fiber and insulin resistance. This research aims to investigate the role of the dietary fiber on insulin resistance in obesity.
Methods: This study is a literature study to determine the effect of dietary fiber on insulin resistance in obesity with sources from scientific publications 10 years back. The databases were PubMed and Google Scholar. The search term used was using the explode function for subgroup terms with operators (“and,” or) for “dietary fiber”, “obesity”, “insulin resistance”. Hand-searching was used to identify further potential eligible studies. There were no language restrictions, however only publications with full texts available were included. Total 138 publications titles and abstract were screened for their relevance to this literature review.
Results: A total of 25 publications were finally included. There are cross-sectional studies, randomized clinical trial, cohort studies, and article review. Some studies showed that dietary fiber had an effect on improve insulin resistance, but other studies did not find this effect.
Conclusion: The studies of dietary fiber effect on insulin resistance have inconsistent results. In the future, further studies are required for better understanding about the effect of dietary fiber on insulin resistance in obesit
Investing in adult nutrition to reduce mobility problems in ageing population
Get PDFAs people age, most body organs deteriorate. Osteoporosis, arthritis, sarcopenia, muscle aches, low back pain and neuropathy are common mobility issues in the elderly. Body mass index (BMI), physical inactivity, and having comorbidities increase the likelihood to have mobility health problems. One in every ten adults over the age of 45 years in Indonesia develops these mobility problems, and one in every fifteen adults has difficulty in walking/stepping before entering the elderly age. Nutrition has been reported to have important role in controlling weight and physical locomotive organs. Generally, 46% adults in Indonesia have vitamin A deficiency, 70% vitamin C deficiency, 77% vitamin E deficiency, and inadequate calcium intake. Low nutrition intake can result in increasing mobility problems that lead to health issues in the aging population. Dietary strategies are necessary to achieve healthy ageing. Currently, no standardized guideline has been developed for preventing mobility health problems in Indonesia. This calls for urgent need to hinder poor quality of life in elderly population
Energy target achievement and its determinants in critically ill COVID-19 patients in Indonesia
Get PDFIntroduction. Achievement of energy target in critically ill Covid-19 patients in Intensive Care Unit (ICU) is challenging. This study was aimed to depict the possibility of achieving energy target and its determinants in critically ill Covid-19 patients.
Methods. A cross sectional study was conducted in ICU of dr. Kariadi Hospital Semarang, Indonesia. Secondary data were obtained from Covid-19 patients who were in ICU for minimum 3 days, from March to December 2020. Data collected included age, sex, Body Mass Index (BMI), comorbidities, Modified Nutrition Risk in Critically Ill (mNUTRIC) score, energy intake, route of nutrition delivery (enteral or combination of enteral and parenteral nutrition), lactate status, ICU length of stay (LOS), duration of mechanical ventilator and mortality. Risk Prevalence calculations were conducted to measure risks. Variables with significant associations and p< 0.25 were included in multiple logistic regression.
Results. A total of 188 subjects were included in the analysis. Most patients were male (62.8%) and obese (61.8%). As much as 56.9% patients were able to achieve energy target of 20 kcal/kgBW on day 3 of ICU stay. Those with low risk mNUTRIC score and nutrition delivery was through enteral and parenteral route were more likely to achieve target energy of 20 kcal/kgBW in the first 3 days in the ICU.
Conclusions. Achieving energy target of 20 kcal on day 3 of ICU stay for critically ill Covid-19 patients is feasible. Low mNutric score and nutrition delivery through enteral and parenteral route were two determinants for the achievement
Low Dietary Omega-6 to Omega-3 Fatty Acid Intake Ratio Enhances Adiponectin Level in Obesity
Get PDFEvery year around the world, the prevalence of obesity is increasing. Obesity and its associated diseases have become some of the most pressing health problems in developed and developing countries. In its development, adipocytes dysfunction and chronic low-grade inflammation occur in obesity will stimulate diseases at higher risk including type 2 diabetes mellitus (T2DM), atherosclerosis, hypertension, and metabolic syndrome. Western diet and sedentary lifestyle are thought to have significantly contributed to the increase in obesity recently. Diet modification is a sound method to prevent obesity and its complications. Nevertheless, the concern lies in the ratio of omega-6 towards omega-3 fatty acids intake, which in its current state indicates an imparity. Omega-3 and omega-6 are two essential fatty acids that emerge as dominant factors in obesity through adiponectin. Adiponectin refers to a protein hormone conceived by adipocytes to prevent obesity and its subsequent complications by increasing insulin sensitivity, fatty acid oxidation, anti-inflammatory, and antiaterogenic. This study aims to determine the mechanism and the role of fatty acids in omega-6 towards those within omega-3 by using adiponectin as the indicator of advancement to obesity and its underlying diseases
Food avoidance behaviour among children aged 2 – 6 years in North Jakarta and its correlation with weight and energy intake
Get PDFBackground: Children generally facing food avoidance or food refusal behaviour and it may affect their food consumption. But there is limited information on food avoidance behaviour among Indonesian children. Therefore, this study aimed to assess whether energy intake and body weight are influenced by food avoidance behaviour in children aged 2-6 years in North Jakarta.Methods: Participants (N=168) were recruited between February – March 2020. Data collection was obtained via interviews with the mother or caregiver of the children. Food avoidance behaviour consisting of satiety responsiveness, slowness in eating, emotional under-eating, and food fussiness was measured with the Child Eating Behaviour Questionnaire. The child’s weight and dietary intake were assessed using a digital weighing scale and 2 x 24 hours food recall. Spearman test was performed to analyse the correlation between these variables. Multivariate analysis was done using linear regression to determine predictors of a child’s body weight and energy intake.Results: Energy intake among children was below the recommendation, and it was significantly correlated with the child’s body weight. Satiety responsiveness was negatively correlated with the child’s body weight (r = -0.166; p-value < 0.05) and energy intake (r = -0.210; p-value < 0.05). After running a linear regression test, we found that satiety responsiveness along with family income and child’s age was a significant predictor of energy intake among children.Conclusions: Children who are more responsive to satiety had lower body weight and energy intake. Understanding the child’s food avoidance behaviour is useful for designing intervention programs related to optimizing intake in children and malnutrition
The importance of school snacks for primary school-aged children nutritional support as the foundation of Sekolah Generasi Maju in Indonesia
Get PDFAs a developing country, Indonesia is still burdened with high prevalence of child malnutrition including those in primary school. One of the main factors affecting nutritional status of children is snack consumption in school. School snacks are expected to be able to contribute to nutritional requirements. This narrative review is written to collect information and knowledge regarding nutritional status, nutritional requirements, factors determining nutritional status of primary school children and, lastly, recommended school snacks. This review also acts as a basic information for school snacks program establishment
Known facts: iron deficiency in Indonesia
No full textMore than half cases of anemia are due to iron deficiency. Anemia is a major and global public health problem that affects maternal and child mortality, child cognitive development and eventually productivity. Infancy, adolescence, and pregnancy are particularly at risk. Indonesia is a low middle country with the prevalence of anemia as high as 48.9% in pregnant women and 38.5% in children under 5 years old. It is even higher among adolescents aged 12-18 years, especially in rural areas. Low income and level of education seem to also contribute to iron deficiency. Indonesia government aims to prevent anemia in young and pregnant women by providing iron pills. Still, the etiology of anemia in Indonesia is various and many elements are preventing Indonesia women to consume pills and/or iron-rich foods. We aim to review the prevalence, risk factors associated with iron deficiency especially among women of reproductive age in Indonesia, including the socio-determinant influence on iron deficiency. We will also discuss the management of iron deficiency in Indonesia in comparison with international guideline to identify the potential gaps
The Effect of Vitamin D Supplementation During Pregnancy on The Risk of Having Preterm Birth: An Evidence-based Case Report
Get PDFIntroduction: Preterm birth (PTB) is a major cause of neonatal morbidity and mortality. Pregnant women is one of the most vulnerable groups for vitamin D deficiency, that increase the risk of PTB. Vitamin D has the role of immunomodulator, anti-inflammatory, and transcription of genes involved in placental function. Research results on the correlation between vitamin D supplementation and PTB risk are still inconsistent.Objective: To observe the effect of oral vitamin D supplementation during pregnancy on the risk of PTBMethods: Advanced search for relevant literatures in PubMed, Cochrane, and Willey was conducted. After assessing the relevancy and eligibility, articles were selected and critically appraised.Results: There were three articles that relevant with the eligibility criteria and clinical questions, they were randomized controlled trial, meta-analysis and systematic review. Three studies found that oral vitamin D supplementation in the form of cholecalciferol during pregnancy had a significant reduction on the risk of PTB. A systematic review found that supplementation with combination of cholecalciferol and calcium carbonate may increase the risk of PTB. The different dosages, frequencies, and time of initiation limit the generalizations for efficacy and safety doses.Conclusion: Oral cholecalciferol supplementation during pregnancy reduces the risk of PTB. While supplementation with combination of cholecalciferol and calcium carbonate requires consideration. Further research is needed to find out about the dose, frequency, time of initiation, adverse events and effects of vitamin D when combined with other vitamins and minerals. Keywords: Pregnancy, vitamin D, vitamin D3, cholecalciferol, preterm birth, preterm labor