Human Milk Oligosaccharide Profiles and the Secretor and Lewis Gene Status of Indonesian Lactating Mothers.

Purpose: Human milk oligosaccharides (HMOs) may be genetically determined based on the secretor and Lewis status of the mother. This study aims to determine the HMO profile and the secretor and Lewis gene status of Indonesian lactating mothers. Methods: Baseline data of 120 mother-infant pairs between 0-4 months post-partum obtained from a prospective longitudinal study was used. The concentrations of 2'-fucosyllactose (2'FL), lacto-N-fucopentaose I (LNFP I), lacto-N-tetraose (LNT), lacto-N-neotetraose (LNnT), 3'-sialyllactose (3'SL), and 6'-sialyllactose (6'SL) were measured. Genetic analysis was performed for mothers using targeted next-generation sequencing and Sanger sequencing. Wild-type AA with the rs1047781 (A385T) polymorphism was categorized as secretor positive, while heterozygous mutant AT was classified as a weak secretor. The presence of rs28362459 (T59G) heterozygous mutant AC and rs3745635 (G508A) heterozygous mutant CT genes indicated a Lewis negative status, and the absence of these genes indicated a positive status. Subsequently, breast milk was classified into various groups, namely Group 1: Secretor+Lewis+ (Se+Le+), Group 2: Secretor-Lewis+ (Se-Le+), Group 3: Secretor+Lewis- (Se+Le-), and Group 4: Secretor-Lewis- (Se-Le-). Data were analyzed using the Mann-Whitney and Kruskal-Wallis rank tests, and a p-value of 0.05 indicated statistical significance. Results: A total of 58.3% and 41.7% of the samples had positive and weak secretor statuses, respectively. The proportion of those in Group 1 was 85%, while 15% were Group 3. The results showed that only 2'FL significantly differed according to the secretor status (p-value=0.018). Conclusion: All Indonesian lactating mothers in this study were secretor positive, and most of them had a Lewis-positive status.

Corrigendum: Micronutrient intake inadequacies in different types of milk consumers in Indonesian children 1-5 years: dietary modeling with young child milk improved nutrient intakes.

[This corrects the article DOI: 10.3389/fnut.2023.1169904.].

Micronutrient intake inadequacies in different types of milk consumers in Indonesian children 1­5 years: dietary modeling with young child milk improved nutrient intakes

Background: Indonesian children under-five have a high prevalence of micronutrient deficiencies. Improving young child feeding practices may be the solution. Increasing the consumption of appropriate milk products could help to reduce nutrient inadequacy. Methods: The objective of this study was to assess nutrient inadequacy in Indonesian children to evaluate the potential improvement using dietary modeling analysis. Data from children aged 1-5 years from the Indonesian Individual Dietary Consumption Survey in 2014 were used in this analysis (n = 11,020). Diet modeling was conducted in two scenarios, substitution volume to volume and calories to calories. Results: The proportion of children consuming young child milk (YCM) was the highest compared to other milk types across all age groups, followed by condensed milk and cow's milk. YCM, also called "Growing-Up Milk" (GUM), are marketed as a product specifically formulated for the nutritional needs of young children. YCM consumers had lower prevalence of inadequate intakes in iron, zinc, vitamins A, C and D across age groups when compared to condensed milk consumers. The prevalence of inadequate intakes of nutrients in condensed milk consumers was Vitamin A (67, 64%), folate (92, 91%), Vitamin D (87, 84%), iron (84, 76%), and zinc (76, 76%) in 1-2y and 3-4y, respectively. The substitution of condensed milk with a YCM reduced the prevalence of inadequate intakes of micronutrients, such as Vitamin A, vitamin D, folate, iron and zinc, which are important for immune function. YCM reduced the prevalence of inadequate intakes of micronutrients by 20-40% (Vit A and folate) and 40-50% (Vit D and zinc). The reduction of prevalence of inadequate iron intake was 31% in 1-2y and 63% in 3-4y. Conclusion: The prevalence of inadequate micronutrient intakes was high among children aged 1-5 years old in Indonesia. YCM consumers had better nutrient intake. The substitution of condensed milk with a YCM reduced the prevalence of inadequate of micronutrient intake. Thus, nutrient intakes could be improved by YCM consumption in 1-5 years old children in Indonesia, along with nutrition education on feeding practices.

The effectiveness of self-empowerment-based patient-centered care for obese students in primary services: A randomized controlled trial.

BACKGROUND: Self-empowerment-based patient-centered services with a coaching approach are imperative in the management of students with obesity. This study evaluated the applicability and effectiveness of self-empowerment-based patient-centered coaching for the weight loss program model for obese students. MATERIALS AND METHODS: This randomized control trial recruited 60 obese students aged 17-22 years in Universitas Indonesia from August to December 2021. Intervention group subjects were coached by a health coach. Each health coach assisted four subjects with SMART model coaching in six meetings every 2 weeks through a zoom platform. Both groups had instructions on obesity, nutrition, and physical activity from specialist doctors online. Paired t-test or Mann-Whitney test, as appropriate, to compare the measurements of anthropometry, body composition (bioelectrical impedance analysis), food intake (food record form), physical activity (physical activity form), subjective well-being (subjective well-being questionnaire), and healthy behavior habits (satisfaction scale) between the two groups before and after the intervention. RESULTS: A total of 41 obese students completed the study, 23 from intervention group and 18 from the control group. The change in total body fat (-0.9 [-12.9, 0.70] vs. 0.0 [-6.9, 3.50], P = 0.02) and healthy behavior habit (13.5 ± 11.85 vs. 7.5 ± 8.08, P = 0.04) in the intervention group was significantly greater than in the control group. The change in satisfaction scale of hobby/passion (2 [-4.6] vs. 1 [-2.2], P = 0.02), movement exercise (2.3 ± 2.11 vs. 1.2 ± 1.93, P = 0.03), sleep rest (2 [-6.5] vs. 1 [-3.2], P = 0.01), and spiritual (1 [0.6] vs. 0 [-1.3], P = 0.00) was significantly higher in the coached group. CONCLUSION: A weight loss program for obese students was tested through self-empowerment-based patient-centered care with a coaching approach and has proven to effect changes in anthropometric indicators, body composition, self-empowerment, food intake, and physical activity.

Health effects of alkaline, oxygenated, and demineralized water compared to mineral water among healthy population: a systematic review.

OBJECTIVES: There are many water types available on the market. They are widely known in public with health claims. The questions are, are those claims are scientifically proven or those are just testimonies from the consumers or overclaimed by the producers. This study aims to systematically review evidences on the health effects of alkaline, oxygenated, and demineralized water in comparison with mineral water among healthy population. CONTENTS: Data were obtained from databases PubMed, Cochrane, Scopus, EBSCO, dan Science Direct since January 2000 until July 2022. There were 10 eligible articles, consisted of two articles on alkaline, four articles on oxygenated, and four articles on demineralized water, that furtherly being analyzed. SUMMARY: Compared to consumption of mineral water, consumption of alkaline and oxygenated water did not show any significant difference on gut microbiota, urine pH, blood parameter, or fitness parameter. While, consumption of demineralized water in the long term resulted in lower quality of certain nutrient intake. OUTLOOK: Recent evidences do not prove any additional health effects of alkaline, oxygenated, or demineralized water compared to mineral water. In contrast, demineralized water consumption in the long run was proven to lead to adverse effect.

Assessment of water consumption during Ramadan intermittent fasting: Result from Indonesian cross-sectional study.

During Ramadan fasting, people are likely to consume water and beverages lower than recommended intake due to the limited time. However, it is necessary to achieve the recommended daily water intake to maintain the hydration status, as well as productivity during fasting. Unfortunately, there is a lack of data on drinking patterns during Ramadan. This study aims to investigate water and beverage intake and drinking patterns to help achieve water requirements during Ramadan among Indonesian adults. This is a cross-sectional study conducted during the Ramadan period from April to May 2021 (Ramadan 1442 Hijri). We used a self-administered questionnaire on drinking habits during Ramadan and utilized a 7-day fluid record (Liq.In 7) to assess water and beverage intake among participants who were managed through online procedure. There were 380 participants from five universities across Indonesia who completed the questionnaire accordingly and then analyzed it. The result shows that total water and beverage intake during Ramadan among participants was below the recommendation [1,670 (1,326-2,034) ml/day]. Among the type of beverages, water is the highest level of consumption [1,262 (983-1,666) ml/day] then followed by sugar-sweetened beverages [200 (91-350) ml/day]. We found a significant difference in water and beverages consumption between time of iftar [474 (375-590) ml/day], nighttime [574 (414-810) ml/day], and suhoor [560 (423-711) ml/day]. From this study, we found that during Ramadan the most common drinking pattern is 2-4-2, but a drinking pattern of 4-2-2 glasses (sequence of four glasses at iftar, two glasses at nighttime, two glasses at suhoor) had a significantly higher chance to adhere with the recommendation of fluid intake compared to other patterns. Therefore, based on this research on water and beverage intake, it is necessary and important to make improvements among Indonesian adults during Ramadan, and the drinking pattern of 4-2-2 glasses may help to achieve the recommended daily water consumption.

Ultrasonographic measurement of abdominal and gluteal-femoral fat thickness as a predictor for android/gynoid ratio.

OBJECTIVE: To evaluate the use of ultrasonography (US) as an alternative to dual-energy x-ray absorptiometry (DXA) to predict the percentage ratio of android/gynoid (A/G) fat mass. METHODS: This was a cross-sectional study. Twenty-eight participants included in the study underwent whole-body DXA examinations and the A/G ratio was calculated. Soft-tissue US was performed in several standardised anthropometric areas of the body. Correlation analysis between abdominal and gluteal-femoral fat thickness based on US and A/G ratio was conducted using the Pearson or Spearman test depending on the data normality. Multiple regression analysis using the backward stepwise method was performed to establish an equation for estimating the A/G ratio. RESULTS: There was a strong and significant correlation between fat thickness in the six anthropometric areas and the A/G ratio in female participants. The analysis revealed three anthropometric areas: upper abdomen (S4), lower abdomen (S5), and mid-xiphoid-umbilical region (S7), that can accurately predict the A/G ratio by 82.3%. (P < 0.05). However, no such correlation was found in male participants. CONCLUSIONS: US measurement of fat thickness can predict A/G ratio in the female population. However, this method is not recommended for men.

Water and Beverages Intake Among Workers Amid the COVID-19 Pandemic in Indonesia.

As the COVID-19 pandemic hit worldwide in the early 2020, people were urged to alter their behavior to prevent disease spread, thus, led to change water intake. This study aimed to analyze water and beverage intake among health workers and general workers during COVID-19 pandemic in Indonesia. This study was a comparative descriptive study where the participants were 20-45-year-old health workers and general workers in Indonesia. Data collected included demographic, water and beverage intake, physical activity, nutrient intake, and body weight and height. All data collection was obtained online using self-reported questionnaire. Water intake data was collected for 7 days consecutively using a 7-day fluid record. There were 246 participants comprised of 102 (41.5%) general workers and 144 (58.5%) health workers who were analyzed in this study. All participants showed barely adequate intake of daily total fluid 1,882 (1,473-2,433) ml/day. Total fluid intake among general workers was 1,759 (1,447-2,396) ml/day, whereas in health workers it was slightly higher 1,939 (1,516-2,446) ml/day (p-value = 0.378). Among health workers who were highly exposed to patients with COVID-19 showed the highest percentage in drinking water adequately (20 participants, 60.6%) compared to health workers who worked under moderate (29 participants, 48.3%) and low (24 participants, 47.2%) level of exposure to patients with COVID-19. In conclusion, workers need to improve their daily fluid intake. This study also showed better behavior of water consumption among health workers compared to general workers despite of their strict personal protection equipment during working hour.

Dietary Determinants of Anemia in Children Aged 6-36 Months: A Cross-Sectional Study in Indonesia.

Anemia has been acknowledged as worldwide problem, including in Indonesia. This cross-sectional study aims to explore dietary determinants as risk factors for anemia in children aged 6-36 months living in a poor urban area of Jakarta. The study was done in Kampung Melayu sub-district in Jakarta, Indonesia. Data was collected within two weeks in September-October 2020. A structured questionnaire for a 24-h recall and a semi-quantitative Food Frequency Questionnaire (FFQ) were used to collect the dietary intake data, and venous blood was withdrawn to determine the hemoglobin levels. Bivariate chi-square and multiple logistic regression tests were executed to explore the dietary determinant factors for anemia. We recruited 180 subjects. The average hemoglobin concentration was 11.4 ± 1.7 mg/dL; the anemia prevalence was 29.4%. The following variables were significantly associated with higher risk of anemia: no cow's milk formula consumption, inadequate intake of fats, protein, calcium, vitamin D, iron, zinc, vitamin A, vitamin C, vitamin B6, and vitamin B12. Only cow's milk formula consumption and zinc intake were revealed as the determinant factors of anemia. In conclusion, the prevalence of anemia was 29.4% among children aged 6-36 months old. Anemia was significantly associated with two dietary determinants as risk factors that are cow's milk formula consumption and zinc intake.

The importance of balanced nutrition to fortify the immune system during the COVID-19 outbreak

ABSTRACT COVID-19, first reported in December 2019 in Wuhan, China, quickly spread worldwide and was announced as a pandemic in March 2020. As symptoms and outcomes are varied, the elderly and those who have at least one comorbidity (diabetes, cardiovascular disorders or other chronic diseases) are considered to be at high risk and are generally have lower immunity. An optimal immune system is critical for survival, as it protects the body against infectious agents. Nutrition is an essential factor in the immune system, contributing to components in physical barriers, biochemical, innate and adaptive immunity. Research advances show that nutritional deficiencies, namely the inadequacy of energy, macronutrients and micronutrients, affect the immune system and increase infection risk. The following discussion explains the comprehensive role of nutrition in the immune system, nutrition recommendations that can be used as precautions and the need for supplementation during this outbreak.

RESUMEN COVID-19, informado por primera vez en diciembre de 2019 en Wuhan, China, se extendió rápidamente por todo el mundo y se anunció como una pandemia en marzo de 2020. Como los síntomas y los resultados son variados, los ancianos y los que tienen al menos una comorbilidad (diabetes, trastornos cardiovasculares u otras enfermedades crónicas) se consideran de alto riesgo y generalmente se asocian con una inmunidad más baja. Un sistema inmunológico óptimo es fundamental para la supervivencia, ya que protege al cuerpo contra agentes infecciosos. La nutrición es un factor esencial en el sistema inmunológico, contribuyendo a componentes en las barreras físicas, innata y adaptativa. Los avances de la investigación muestran que las deficiencias nutricionales, a saber, la insuficiencia de energía, macronutrientes y micronutrientes, afectan el sistema inmunológico y aumentan el riesgo de infección. La siguiente discusión explica el papel integral de la nutrición en el sistema inmunológico, las recomendaciones nutricionales que se pueden tomar como precauciones y la necesidad de suplementación durante este brote.

Fluid Intake of Pregnant and Breastfeeding Women in Indonesia: A Cross-Sectional Survey with a Seven-Day Fluid Specific Record.

During pregnancy and lactation, the adequate intake (AI) for total water intake is increased. This cross-sectional survey aimed to assess Total Fluid Intake (TFI; sum of drinking water and all other fluids) of 300 pregnant and 300 breastfeeding women in Indonesia. A seven-day fluid specific record was used to assess TFI. Mean TFI of pregnant and breastfeeding women were 2332 ± 746 mL/day and 2525 ± 843 mL/day, respectively. No significant difference in TFI between pregnancy trimesters was observed, while TFI of women breastfeeding for 12-24 months postpartum (2427 ± 955 mL/day) was lower than that of the two other groups (0-5 months: 2607 ± 754 mL/day; 6-11 months: 2538 ± 807 mL/day, respectively). Forty-two and 54% of the pregnant and breastfeeding subjects, respectively, did not reach the AI of water from fluids. These AI were actually known by only 14% and 23% of the pregnant and breastfeeding subjects. However, having the knowledge about the AI did not increase the odds of reaching the AI. Concluding that a high proportion of the pregnant and breastfeeding subjects did not reach the AI of water from fluid, it seems pertinent to further assess the fluid intake, as well as their hydration status, in other countries.