There is an established link between food promotions and children's food purchase and consumption. Children in developing countries may be more vulnerable to food promotions given the relative novelty of advertising in these markets. This study aimed to determine the scope of television food advertising to children across the Asia-Pacific to inform policies to restrict this marketing. Six sites were sampled, including from China, Indonesia, Malaysia and South Korea. At each site, 192 h of television were recorded (4 days, 16 h/day, three channels) from May to October 2012. Advertised foods were categorized as core/healthy, non-core/unhealthy or miscellaneous, and by product type. Twenty-seven percent of advertisements were for food/beverages, and the most frequently advertised product was sugar-sweetened drinks. Rates of non-core food advertising were highest during viewing times most popular with children, when between 3 (South Korea) and 15 (Indonesia) non-core food advertisements were broadcast each hour. Children in the Asia-Pacific are exposed to high volumes of unhealthy food/beverage television advertising. Different policy arrangements for food advertising are likely to contribute to regional variations in advertising patterns. Cities with the lowest advertising rates can be identified as exemplars of good policy practice.
High-dose vitamin A supplementation improves the linear growth of children with very low serum retinol and the effect is modified by age and breast-feeding.
The aim of the study was to identify determinants of exclusive breastfeeding (EBF) at the individual, family, community, and organizational level. This study was a secondary analysis of data from a multilevel promotion of EBF program in two rural public health centers (PHCs) in the Demak district, Central Java, Indonesia. The program was a quasi-experimental study with a pretest-posttest control group. A total of 599 participants were enrolled, consisting of 163 mother infant pairs, 163 fathers, 163 grandmothers, 82 community leaders, and 28 midwives. EBF duration and its determinants were measured and analyzed using Cox proportional-hazard model. Mothers with a high level of breastfeeding knowledge had the greatest EBF duration. Mothers who had a knowledge score >80 had a 73 % (HR 0.27, 95 % CI 0.15, 0.48) greater chance of EBF compared to mothers who had a knowledge score of <60. Factors which shortened EBF duration were grandmother's lack of support for EBF (HR 2.04, 95 % CI 1.33, 3.14), received formula samples at discharge (HR 1.99, 95 % CI 1.25, 3.16), and maternal experience of breast engorgement (HR 1.97, 95 % CI 1.32, 2.94). High maternal breastfeeding knowledge was the only factor associated with longer duration of EBF. Barriers to EBF were breast engorgement, receiving formula samples at discharge, and a grandmother's lack of support for EBF.
Obesity has become a significant problem for developing countries, including Indonesia. High duration of sedentary activity and high intake of unhealthy foods were associated with high risk of overweight and obesity. The objective of this study was to compare the distributions of sedentary activity and dietary behavior with overweight/obesity risks between urban and rural areas among children and adolescents aged 10–18 years in Indonesia. This is a cross-sectional study. Data from a national survey in 33 Indonesian provinces (Basic Health Research /Riskesdas 2013) were analyzed. Multiple logistic regression models were used to calculate the odds ratio (OR) adjusted with all variables, such as age, gender, residency, education level, physical activity, and food intake. An urban–rural residence difference was found in the factors related to obesity. Daily caffeinated soft drinks and energy drinks consumption (OR = 1.12, 95% CI: 1.01–1.23) were related to risk of overweight and obesity in urban areas. Daily grilled foods (OR = 1.32, 95% CI: 1.22–1.42) and salty food (OR = 1.09, 95% CI: 1.04–1.15) consumption were significantly associated with obesity in rural areas but not in urban areas. Furthermore, sedentary activity was correlated with overweight and obesity among those who lived in urban and rural areas. Our findings suggest that education, environmental, and policy interventions may need to specifically target urban settings, where access is high to a wide range of processed and traditional high-sugar, high-fat snack foods and beverages.
Sedentary behaviors and dietary intake are independently associated with obesity risk. In the literature, only a few studies have investigated gender differences for such associations. The present study aims to assess the association of sedentary behaviors and unhealthy foods intake with obesity in men and women in a comparative manner. The analysis presented in this study was based on the data from a population-based, cross-sectional, nationally representative survey (Indonesian Basic Health Research 2013/RISKESDAS 2013). In total, 222,650 men and 248,590 women aged 19–55 years were enrolled. A validated questionnaire, physical activity card, and food card were used for the assessments. The results showed that the prevalence of obesity (body mass index of ≥27.5 kg/m2) was higher in women (18.71%) than in men (8.67%). The mean body mass index in women tended to be higher than in men. After adjusting for age and education, the gender effect on obesity persisted in women and was more significant than in men. There was also a positive and significant effect on obesity of sedentary behaviors and unhealthy foods intake. Moreover, fatty and fried foods displayed a positive multiplicative interaction, increasing obesity risk in women more than in men and indicating a possible dietary risk in in women in relation to obesity. The study suggests that the implementation of educational programs on nutrition and physical activity is particularly important for promoting a healthy body weight among Indonesian women.
Sebagai negara yang sedang berkembang dan sedang membangun, bangsa Indonesia masih memiliki beberapa ketertinggalan dan kekurangan jika dibandingkan negara lain yang sudah lebih maju. Di bidang kesehatan, bangsa Indonesia masih harus berjuang memerangi berbagai macam penyakit infeksi dan kurang gizi yang saling berinteraksi satu sama lain menjadikan tingkat kesehatan masyarakat Indonesia tidak kunjung meningkat secara signifikan. Ironisnya, di beberapa daerah lain atau pada sekelompok masyarakat Indonesia yang lain terutama di kota-kota besar, masalah kesehatan masyarakat utama justru dipicu dengan adanya kelebihan gizi; meledaknya kejadian obesitas di beberapa daerah di Indonesia akan mendatangkan masalah baru yang mempunyai konsekuensi- konsekuensi serius bagi pembangunan bangsa Indonesia khususnya di bidang kesehatan. Pendek kata, masih tingginya prevalensi kurang gizi di beberapa daerah dan meningkatnya prevalensi obesitas yang dramatis di beberapa daerah yang lain akan menambah beban yang lebih kompleks dan harus dibayar mahal oleh bangsa Indonesia dalam upaya pembangunan bidang kesehatan, sumber daya manusia dan ekonomi.
<p><strong>ABSTRACT</strong></p><p><em><strong>Background</strong>: Stunting in children is one of public health problem in Indonesia. Stunting is a serious problem because it is linked with the quality of human capital in future. </em></p><p><em><strong>Objectives</strong>: To determine the association between exclusive breastfeeding practice and stunting in young children 6 – 23 months in Indonesia.</em></p><p><em><strong>Methods</strong>: This study used a cross-sectional design. Data was obtained from Basic Health Research (Riskesdas) 2013. Riskesdas 2013 used multistage cluster sampling. Subject in this study was 6.956 young children 6 – 23 months in Indonesia which was selected purposively. Data was analyzed by using descriptive analysis, chi-square, and multiple logistic regression by adjusting the sampling weight for survey analysis.</em></p><p><em><strong>Results</strong>: Exclusive breastfeeding was protective against stunting, but the result was not significant both for exclusive breastfeeding >6 months (OR=0,99, 95% CI: 0,63–1,59) and exclusive breastfeeding 4-<6 bulan (OR=0,93, 95% CI: 0,63–1,39). Young children with low birth weight history had higher risk to become stunting (OR=1,77, 95% CI: 1,33–2,37). Household economic status which were very poor (OR=1,96, CI: 1,53–2,52), poor (OR=1,62, 95% CI:1,30–2,03) and middle (OR=1,32, 95% CI: 1,06–1,64) were also associated with the risk of stunting.</em></p><p><em><strong>Conclusions</strong>: Exclusive breastfeeding is not the only factor contributing to stunting in children. Optimal complementary feeding practice should also be the focus of intervention. Improvement in nutritional status since the preconception and during the pregnancy, and household economy status may reduce stunting problem in children.</em></p><p><strong>KEYWORDS</strong>: <em>stunting, exclusive breastfeeding, feeding practice, growth</em></p><p> </p><p><strong>ABSTRAK</strong></p><p><strong></strong><em><strong>Latar belakang</strong>: Stunting pada anak-anak merupakan salah satu masalah kesehatan masyarakat yang utama di Indonesia. Stunting menjadi masalah yang serius karena dikaitkan dengan kualitas sumber daya manusia di kemudian hari.</em></p><p><em><strong>Tujuan</strong>: Untuk mengetahui hubungan antara praktik pemberian ASI eksklusif dan stunting pada anak usia 6 – 23 bulan di Indonesia.</em></p><p><em><strong>Metode</strong>: Desain penelitian ini adalah cross-sectional. Data didapatkan dari hasil riset kesehatan dasar (Riskesdas) 2013. Teknik pengambilan sampel pada Riskesdas 2013 adalah multistage cluster sampling. Subjek pada penelitian ini berjumlah 6.956 anak usia 6 – 23 bulan di Indonesia yang dipilih secara purposive. Data dianalisis dengan menggunakan analisis deskriptif, chi-square dan regresi logistik berganda dengan mempertimbangkan sampling weight untuk analisis survei.</em></p><p><em><strong>Hasil</strong>: ASI eksklusif bersifat protektif terhadap kejadian stunting pada anak, namun hasilnya tidak signifikan, baik untuk ASI eksklusif >6 bulan (OR=0,99, 95% CI 0,63–1,59) maupun ASI eksklusif 4-<6 bulan OR=0,93, 95% CI: 0,63–1,39). Anak yang lahir dengan berat badan lahir rendah (BBLR) memiliki risiko yang lebih tinggi untuk menjadi anak yang stunting (OR=1,77, 95% CI: 1,33–2,37). Status ekonomi rumah tangga sangat miskin (OR=1,96, 95% CI: 1,53–2,52), miskin (OR=1,62, 95% CI: 1,30–2,03) dan</em><br /><em>menengah (OR=1,32, 95% CI: 1,06–1,64) masing-masing berkontribusi terhadap peningkatan risiko stunting pada anak.</em></p><p><em><strong>Kesimpulan</strong>: ASI eksklusif bukanlah satu-satunya faktor yang berkontribusi terhadap kejadian stunting pada anak. Pemberian MPASI yang optimal juga harus diperhatikan. Perbaikan status gizi sejak masa prekonsepsi dan selama kehamilan, serta status ekonomi rumah tangga diharapkan mampu menurunkan kejadian stunting pada anak.</em></p><p><strong>KATA KUNCI</strong><em>: stunting, ASI eksklusif, praktik makan, pertumbuhan</em></p>
Obesity is a major contributor to the global burden of chronic disease and disability. In developing countries like Indonesia, obesity often co-exists with undernutrition. Data from national basic health research 2007 showed that overnutrition was found among all age groups, on a double digit scale, with similar magnitude in urban and rural areas and higher prevalence in adult female. In contrary to 14% undernourished children under the age of 5 years, 12% of their counterparts were overnourished; for 6-14 years 10% vs. 6%; and for 15 years and above 15% vs. 19%. The purpose of the review is to raise awareness on the increasing obesity problem and to set recommendations to prevent obesity. Stunted adults in developing countries are 1.2 times more likely to be overweight than non-stunted adults. Approaches to overcoming obesity in adulthood emphasize dietary changes, increasing physical activity and behaviour modification. It is important for Indonesia to target nutrition intervention for female adolescents, pregnant woman to first 2 years of life, initiate nutrition education for school-age children and disseminate Holistic Healthy Framework Approach with key message 'Initiate healthier food choices'. Prompt Nutrition Guidelines and the use of lower body mass index cut-off should be considered.
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