Effect of Nutrition Education and Multi-Nutrient Biscuit Interventions on Nutritional and Iron Status: A Cluster Randomized Control Trial on Undernourished Children Aged 6–23 Months in Aceh, Indonesia

Abstract

Undernutrition and iron deficiencies on under-five children in Indonesia remain high and very closely related to inadequate complementary feeding. This study investigated the effect of weekly nutrition education by home visite using the food monitoring card (FMC) models and daily provision multi-nutrient biscuits and combination on growth and reduction of iron deficiency and anemia among underweight children aged 6-23 mo in Aceh Indonesia. A 6-mo, cluster randomized, control trial was conducted on 121 children received nutrition education (NE), multi-nutrient biscuit (MNB), combination both nutrition education and biscuits (NE1 MNB), and control group. The outcome weight gain and prevalence of underweight (weight for age z-score ,22SD) were collected by anthropometric and iron deficiency were serum ferritin measuring with ELISA method. After the 6-mo intervention, the rate of weight gain was higher in combination intervention group 1.516 0.68 kg than multi-biscuit group 1.406 0.72 kg, NE group 1.346 0.66 kg and control group 1.216 0.42 kg, and the rate increase of serum ferritin was higher in combination NE1 MNB and biscuit group (2.54 mg/L and 2,17 mg/L). At the end of study there were a significant decrease in prevalence of underweight (p5 0.003), the incidence of underweight in NE1 MNB (45.2%) lower than NE group (63.3%), MNB group (64.5%) and control group (69,0%) and significant decrease of iron deficiency (p5 0.02), the incidence lower in MNB group (6.5%) than NE1 MNB (22.6%), NE group (23.3%) and control group (24.1%). The combination of nutritional education and multi-nutrient biscuits intervention improving nutritional and iron deficiency status on undernourished children. These risearch highlight the need integration of nutrition education and food base intervention to prevent underweight and iron deficiency on children 6-23 mo old.

The Efficacy of Nutrition Education on Anemia and Upper Arm Circumference among Pregnant Women in Aceh Besar District of Indonesia during the Covid-19 Pandemic

“…The results of this study are almost similar to those of Ahmad et al (2020a), researching in Aceh, Indonesia. He discovered that the nutrition education using a structured home visit method coupled with educational media in a pocketbook and an independent evaluation tool in a Food Monitoring Card (FMC) for children aged 6-23 months in undernourished toddlers could improve nutritional status and reduce the prevalence of anemia in undernourished children under five years old (Ahmad et al 2020a).…”

The Influence of Intensive Nutritional Education on the Iron Status in Infants

“…Most of the interventions were undertaken in third world or low-income countries [39][40][41][42]; these are countries with populations that are culturally and nutritionally different from European populations. Moreover, most nutritional education studies involved only children with iron deficiency or anaemia [43][44][45]. There have been no studies that show the effectiveness of interventions on such a young age group; however, the following studies can be relevant to our findings.…”

The effects of nutrition and health education on the nutritional status of internally displaced schoolchildren in Cameroon: a randomised controlled trial

“…These results corroborate earlier studies in Limpopo Province, South Africa where 12 months of nutrition education for mothers/caregivers insignificantly improved the Hb and iron status of their children ( 44 ) . Furthermore, a nutritional intervention that involved nutrition education of the children’s caregivers had no statistically significant effect on the Hb status of undernourished children in Aceh, Indonesia ( 51 ) .…”