The diet of Indonesian women of childbearing age is relatively poor, posing increased risk for suboptimal pregnancy outcome. In a cross-sectional study including 403 women in three economic quintiles (Q), we investigated differences in dietary intake and nutrition sufficiency according to economic status and whether regular dietary intakes of pregnant women (PW, n 203) differ from that of pre-pregnant women (PPW, n 200). Dietary intake data were collected using 2 × 24 h dietary recall and FFQ. Energy, protein, Fe, Ca, Zn, vitamin A and vitamin C intakes were calculated utilising Food Composition Tables and compared with Indonesian recommendations for adequacy. Energy and protein intakes <70 % and Fe, Ca, Zn, vitamin A and vitamin C intakes <77 % of the local recommendation were considered insufficient. A higher intake of milk/dairy products (Q3, Q4), fruits and vegetables (Q2) and snacks (Q3) in PW was observed compared with PPW, but insufficient to meet nutrient requirements. Nutrient intake calculations showed insufficiency in 26 % of PPW for protein and up to 70 % for Fe. Deficient nutrient intakes in PW were found in 49 % of the subjects for energy and up to 85 % for Fe. Energy and protein intakes decreased with decreasing economic quintiles in PPW and PW. Ca and vitamin A intakes were lower in Q2 compared with Q4. The proportion of animal protein in Q2-PW was low (31 %). Biochemical status parameters in a subset showed that anaemia and Fe and Zn deficiencies were prevalent among PPW and PW. Habitual diets in the study area did not meet the nutrient requirements for both PPW and PW across the investigated economic groups.Key words: Pregnant women: Pre-pregnant women: Food intakes: Nutrient intakes: Micronutrient intakes Maternal nutrition is a fundamental determinant of fetal growth, birth weight and infant morbidity; poor nutrition often leads to longterm, irreversible and detrimental consequences to the fetus (1) . Although government policies and programmes in Indonesia address nutrition among children (<5 years) and pregnant women (PW), 12·3 % of the Indonesian women are yet underweight (2) . The prevalence of anaemia and chronic energy deficiency in women (>15 years old) is 19·7 and 13·6 %, respectively (3) . Among Indonesian PW, anaemia and micronutrient deficiencies (folic acid, Zn, vitamin A, vitamin B 12 ) are quite high (40-50 %), which may lead to poor pregnancy outcomes. Earlier studies from Indonesia have shown an inadequate intake of food and several nutrients by PW (4)(5)(6) . Women are undernourished in the first trimester of the pregnancy and have an insufficient weight gain during pregnancy (79 %) (7) . Nutritional status during pregnancy not only puts the mother 'at risk' but is also a risk factor for the infant being born with low birth weight (LBW: 9-11 % in Indonesia) (8) .There are limited recent data on the nutritional status of women of reproductive age in Indonesia. Thus, the aim of the present cross-sectional study conducted in Bogor municipality, West Java, Indonesia, was ...

The way in which women accommodate for their increased nutritional needs during the lactation period is poorly investigated. In a crosssectional study involving 220 lactating women (LW), equally distributed in economic quintiles (Q2, Q3, Q4), we investigated whether habitual dietary intake of LW differed from that of 200 pre-pregnant women (PPW) studied using the same methodology. Differences in dietary intake and nutrition sufficiency according to economic status were also investigated. Dietary intake data were collected using 2 × 24-h dietary recalls and FFQ. Energy, protein, Fe, Ca, Zn and vitamins A and C intakes were calculated utilising local food composition tables and were compared against Indonesian recommendations for adequacy. Energy and protein intakes <70 % of the recommendation and Fe, Ca, Zn and vitamins A and C intakes <77 % of the recommendation were considered insufficient. Except for Zn, dietary intakes of all studied nutrients were higher in LW compared with PPW. However, for all studied nutrients, dietary intake was insufficient in >25 % of LW. For Q2-LW, this proportion was >50 %, except for protein. LW across all studied economic quintiles approximately doubled their vegetable intake, and 71 % of LW indicated a belief that this enhances lactation performance. Biochemical status parameters were analysed in a subset of forty-five women. Anaemia as well as Fe, Zn and Se deficiencies were prevalent among LW, supporting the nutrient intake deficiency data. Despite increasing intakes in LW compared with PPW, habitual diets in the study area do not provide for daily nutrient requirements in substantial proportions for both LW and PPW across all investigated economic groups. Key words: Lactating women: Food intakes: Vegetable intakes: Micronutrient intakesThe most vulnerable groups for malnutrition worldwide are infants, young children and pregnant and lactating women (LW). Among these groups, actual knowledge about nutritional status and potential nutrient insufficiencies in LW is hardly available. Although the literature on relevant physiological adjustments and additional nutritional requirements is extensive (1,2) , the number of dietary assessment studies in LW is limited (3)(4)(5)(6) . Thus, the question on whether and how women change their diet upon lactation is far from being answered and is surely also dependent on culture and socio-economic status.The constant denominator for the actual increased nutritional requirements for LW is the need to produce adequate amounts of breast milk. A variable contribution will be recovery from and replenishment of exhausted nutrient stores after pregnancy and delivery, or an intentional wish to decrease fat stores accumulated during pregnancy (7) . Owing to this variable contribution, several recommendation bodies have made different weightings depending on local or regional factors, and thus arrived at different quantifications of the additional nutrient requirements during lactation.In this contribution, we specifically report on the dietary ...

PurposeThe aim of this study was to identify the minimally meaningful dosage of inulin leading to a prebiotic effect in Indonesian infants.MethodsIn a randomized controlled double-blinded, parallel, 3-arm intervention study, 164 healthy formula-fed infants aged 3 to 5 months first obtained formula-A (without inulin) during a 4-week adaptation period. Subsequently, 142 subjects were subjected to a 4-week feeding period by administering either formula-A (no inulin), formula-B (0.2 g/100 mL inulin) or formula-C (0.4 g/100 mL inulin). The primary outcome parameter was %-bifidobacteria in faecal samples determined using quantitative polymerase chain reaction analyses. Secondary outcome parameters were faecal %-lactobacilli, pH and stool frequency, and consistency. Growth and tolerance/adverse effects were recorded as safety parameters.ResultsTypical %-bifidobacteria and %-lactobacilli at the end of the adaptation period in the study population were 14% and 2%, respectively. For faecal pH, significant differences between formula groups A vs. C and A vs. B were found at the end of the intervention period. Testing for differences in faecal %-bifidobacteria and %-lactobacilli between groups was hampered by non-normal data set distributions; no statistically significant differences were obtained. Comparisons within groups revealed that only in formula group C, all the three relevant parameters exhibited a significant effect with an increase in faecal %-bifidobacteria and %-lactobacilli and a decrease in pH.ConclusionA consistent prebiotic effect along with a decrease in pH and increase in %-bifidobacteria and %-lactobacilli was found only in the group administered 0.4 g inulin/100 mL.

The World Health Organization (WHO) has projected that the world should prepare for an aging society. As the fourth most populous country in the world, the elderly population in Indonesia is also continuously growing. In 2010, the proportion of the elderly group was merely 5%, and it is expected to increase to 11% in 2035. Understanding the current situation of the adult population in Indonesia would be crucial to prepare for the future aging population. This article analyzed the current socio-demographic status, nutrition status, nutrient intake, and health profile of the current Indonesian adult population through a literature review. The key issues to prepare for healthy aging in Indonesia are summarized. Acknowledging the profile of the adult and senior adult population in Indonesia will provide beneficial information for all stakeholders in preparing Indonesia for a better healthy aging population with improved quality of life.

Indonesia is one of the highest countries for soy-based product consumption, which the usage also started from early age as breastmilk substitute product, although local regulation and guideline stated that soy-based formula recommended for cow’s milk protein allergy. However, evidences showed that soy-based formula supplemented with fiber in non-cow’s milk drinker could also have health effect to gastrointestinal system. This online survey aimed to explore the perspective of health care practitioners (HCPs) in recommending soy-based formula for non-cow’s milk drinker pediatric patients, as well as identify the required additional ingredient or supplementation, specifically on fiber, in soy-based formula. Majority of respondents (97% of paediatricians (P < 0.001)), (96% of nurses  (P = 0.003)), (99% of midwives (P < 0.001)) recommended soy-based formula as nutritional product toward non-cow’s milk drinker patients. On the added ingredients required, 43% of respondents mentioned that AA and DHA and 31% mentioned that fibre is the ingredient that need to be added to complete the benefits of soy formula. This study concluded that the overall perspective of HCPs showed that soy-based formula is a nutritional product recommended for non-cow’s milk pediatric patients. However, fiber is required to be added to achieve the potential benefits of soy-based formula.

Air pollution is an unseen threat to children’s health because it may increase the risk of respiratory infection, atopy, and asthma, and also alter gut microbiota compositions. The impact of air pollution on children’s health has not been firmly established. A literature review followed by a series of discussions among experts were performed to develop a theoretical framework on how air pollution could affect various bodily organs and functions in children. We invited experts from different backgrounds, such as paediatricians, nutritionists, environmental health experts, and occupational health experts, to provide their views on this matter. This report summarizes the discussion of multidisciplinary experts on the impact of air pollution on children’s health. The report begins with a review of air pollution’s impact on allergy and immunology, neurodevelopment, and cardiometabolic risks, and ends with the conceptualization of a theoretical framework. While the allergic and immunological pathway is one of the most significant pathways for air pollution affecting children’s health in which microbiotas also play a role, several pathways have been proposed regarding the ability to affect neurodevelopment and cardiometabolic risk. Further research is required to confirm the link between air pollution and the gut microbiota pathway.

An increasing trend of C-section delivery In Indonesia was found from 2% in 1986 to 16% in 2012. This delivery method was introduced to save women and their newborn baby’s life. On the other side, it can increase short and long-term health risks for children. This study aims to assess and give an overview of the perspective on pediatrician as medical specialist in managing children of the C-section delivery history. A survey was conducted on 89 Indonesian Pediatricians using an online questionnaire. It was found that most pediatrician chose combination partial hydrolyze milk combined with synbiotic (a combination of prebiotic and probiotic) combination as nutrition intervention to decrease the allergy risk on children with C-section delivery mode, and there is a need to emphasize information about short and long-term health effects of C-section, especially in causing gut dysbiosis and its mechanism, information on non-medical causes of gut dysbiosis to increase awareness of recommending right symbiotic to decrease allergy risk in children with C-section history.

Background: The rapid ageing population among older adults from 2020 to 2040 has led to an emerging focus as this group begins to experience ageing and has a higher risk of having chronic illness of non-communicable diseases. Therefore, it is important to provide General Practitioners (GPs) with adequate knowledge and attitude of healthy ageing to ensure the quality of health service among older adults.Objectives: To identify the perspective of general practitioners including the knowledge, attitude and practice towards adult health and nutrition to support healthy ageing in Indonesia.Methods: An online survey was conducted among 100 general practitioners registered at the Indonesian Medical Council (KKI) and domiciled in the Greater Jakarta area and outside the Jabodetabek area. The sample recruitment process was carried out using the Alomedika online application. All data were analyzed using SPSS software.Results: Almost all (92%) of respondents who took this survey had a supportive attitude in providing additional nutrition to adults to support healthy ageing. About 76% of the respondents did so by recommending milk. However, in terms of knowledge, around 67% of the respondents showed inadequate results, especially about physiological changes that occurred in adults. There is no statistically significant difference between respondents’ demographic characteristics and all perspectives measured in this study (i.e., knowledge, attitude and practice)Conclusions: The study indicates that it is important to educate general practitioners about the healthy aging process in order to maintain general practitioners' attitudes and behavior in health services to support the success of achieving healthy aging in Indonesia.