Vitamin D Supplementation and Sun Exposure Maintain Blood Pressures of Pregnant Women and Increase Birth Weight in a Randomized Controlled Trial.

Background: Vitamin D supplementation or sun exposure increase pregnant women's Calcidiol levels, lower the blood pressures and increase birth weight. We aimed to compare the effects between sun exposure and vitamin D supplementation on pregnant women's Calcidiol levels, blood pressures and newborns' anthropometric indices. Methods: This randomized clinical trial was conducted on 108 pregnant women at 20 wk of gestation on 2021's dry season in Semarang City, Indonesia. The subjects were randomly and evenly divided into 3 groups of 36 subjects (sunlight exposure, vitamin D supplement, and control). Vitamin D group received 1000 IU daily and sun exposure group was recommended to have 15-30 min for 3 times/week for 17 wk. Compliance was monitored every 2 d through home visits. Calcidiol levels, blood pressures, in all groups were compared before and after intervention. The increments and the newborn anthropometric indices were compared between the groups and controlled for confounding factors. Results: At baseline, all groups had vitamin D deficiency, different mean Calcidiol levels, systolic, and diastolic blood pressures. The mean Calcidiol levels increased in the sun exposure and vitamin D group after the intervention. Systolic blood pressure decreased in the vitamin D group only (P=0.019). The mean birth weight was the highest in the vitamin D group (3,172±181.8 g) compared to the sun exposure (3,091±362.5g) and control groups (2,861 ± 208.0 g). Conclusion: Vitamin D supplementation and sun exposure increased Calcidiol levels and birth weights. Vitamin D supplementation maintained systolic blood pressure.

Association of malnutrition and main-meal- and snack-predominant intake among female adolescent students in boarding schools in Tasikmalaya, Indonesia.

Background: Balanced dietary intake is needed to prevent malnutrition which is one of the nutritional problems faced by adolescents. Aim: To study the association between predominant dietary intake and nutritional status of female adolescent students in boarding schools in Tasikmalaya, Indonesia. Method: This cross-sectional study was conducted on 323 female adolescent students residing full-time in eight boarding schools in Tasikmalaya, West Java. Students' dietary intake was measured using the 3-non-consecutive-day 24-h recall method. The association between the predominant dietary intake and nutritional status was evaluated using binary logistic regression. Results: Of the 323 students, 59 (18.3%) were overweight/obese (OW/OB) and 102 (31.6%) had stunted growth. The predominant dietary intake in the OW/OB group was snacks, whereas, in the stunted group, it was main meals. Snack-predominant dietary intake was a risk factor for overweight and obesity (p = 0.008; adjusted odds ratio [AOR]: 2.276; 95% confidence interval [CI]: 1.244-4.164), but it was a protective factor against stunting (p = 0.008; AOR: 0.521; 95% CI: 0.322-0.842). Conclusion: The predominance of main meals and snacks as components of total dietary intake affected the nutritional status of female adolescent students living in boarding schools. Therefore, the dietary intake interventions should tailor and design the nutritional contents of main meals and snacks according to the nutritional status of the targeted individuals.

Plant-based Diet and Iron Deficiency Anemia in Sundanese Adolescent Girls at Islamic Boarding Schools in Indonesia.

BACKGROUND: Adolescent girls are at risk for iron deficiency anemia (IDA) due to the higher demand of iron for growth and the loss of blood during menstruation. Consumption of foods containing iron that have higher bioavailability can reduce the risk of IDA although diets that are largely plant-based, like those consumed by many Sundanese people, may not contain sufficient bioavailable iron. Here, we investigated the correlation between plant-based diets and IDA in adolescent Sundanese girls who were students at Islamic boarding schools in Indonesia. METHODS: A total of 176 girls from seven Islamic boarding schools in Tasikmalaya were recruited. Nutritional intake data were obtained using 24-hr dietary recall. Blood samples were analyzed with a Sysmex-XNL instrument to measure several parameters including hemoglobin, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC). RESULTS: The prevalence of IDA in the study population was 22.2%. Iron intake was 6.59 mg/day, which was lower than the recommended amount. The molar ratio of phytic acid to iron and vitamin C to iron was 8.72 and 0.03, respectively. There was a correlation between heme iron and both hemoglobin (p=0.009) and hematocrit (p=0.018). Iron from meat, fish, and poultry was correlated with hemoglobin (p=0.009) and hematocrit (p=0.011). CONCLUSION: The Sundanese plant-based diet did not affect the IDA status. Instead, IDA was associated with consumption of less animal-based foods that have iron with higher bioavailability. Increased access to an animal-based menu at the school cafeteria could be an approach to prevent IDA in students at Islamic boarding schools in Indonesia.

Effect of zinc and vitamin A supplementation on immune responses in Indonesian pre-schoolers.

BACKGROUND AND OBJECTIVES: Vitamin A and zinc are interrelated, but the effects of zinc on vitamin A supplementation on morbidity are inconsistent and not well understood. We investigated the effects of zinc and vitamin A supplementation on immune responses in Indonesian pre-schoolers. METHODS AND STUDY DESIGN: In a twostage study design, 826 children (2-5year old) were randomly assigned to receive daily zinc supplement (10 mg) or placebo for 4 months. At 2 months, both groups received a 200,000 IU vitamin A capsules through national vitamin A program. Data were collected at baseline, two and four months, resulting in 4 groups for comparisons: - no zinc no vitamin A (Placebo), zinc only, vitamin A only, and zinc plus vitamin A. Hair, blood and saliva samples were collected to measure hair zinc and serum retinol (vitamin A) concentration, ex-vivo IFN-γ, serum IgG and salivary IgA from 81 children selected randomly from each group. RESULTS: At baseline, there were no differences between treatment groups. Zinc supplementation increased ex-vivo IFN-γ production, greatest amongst boys, younger (<3.5 years), normal weight and children with low baseline retinol concentration. Vitamin A supplementation increased IFN-γ only in those with low baseline retinol, with no effect on serum IgG and salivary IgA. After vitamin A supplementation, zinc had an effect on salivary IgA among younger and underweight children. CONCLUSIONS: Zinc supplementation increased IFN-γ (cellular immune responses) and modified the effect of vitamin A supplementation on salivary IgA (mucosal innate immune response) in younger and underweight children.