Development and validation of a social impact questionnaire for household food waste.

This exploratory study was conducted to develop and validate an instrument for measuring the social impact of food waste at the household level. A mixed methodology was employed, commencing with a qualitative approach through in-depth interviews and focus group discussions, to identify the social impact of food waste at the household level. This was followed by a quantitative assessment of the questionnaire's validity and reliability. The process involved seven experts for content validity testing, 150 households for face validity testing, and 202 households for reliability testing. The content validity revealed an I-CVI 0.86-1 and a kappa statistic 0.85-1. The face validity demonstrated I-FVI ≥ 0.90 and S-FVI ≥ 0.95. Additionally, the Cronbach's alpha for the reliability test was 0.743. The questionnaire proved to be a simple, valid, and reliable instrument for measuring the social impact of household food waste. •Mixed method used in developing and validating the questionnaire.•Content validity, face validity, and reliability testing to evaluate a newly developed instrument.

Formulation and Effect of Iron Fortified Instant Bose Corn on Addressing Anemia among Adolescent Girls in Kupang, Indonesia.

This study aimed to develop Fe-fortified instant Bose corn (IBC), a traditional Timorese food, as a strategy to address anemia among adolescent girls in Kupang, Indonesia. Instant corn and cowpea grits were made to shorten the preparation time with various times of soaking (IBC1=10 min; IBC2=15 min; IBC3=20 min) to select the best formula. The selected IBC was then fortified with NaFeEDTA·3H2O and nutrient content was evaluated. In the intervention study, a pre-post controlled trial was applied to 40 anemic adolescent girls aged 16∼19 years. Subjects with severe anemia (Hb=8.5∼10.4 g/dL) received the fortified selected IBC, whereas those with moderate anemia (Hb=10.5∼11.5 g/dL) received the unfortified selected IBC. A total of 100 g IBC were provided three times/week for 2 months. The hemoglobin and soluble transferrin receptor (sTfR) levels were measured at baseline and endline, respectively. IBC3 produced the highest acceptance level as compared to other formulas. The fortified IBC3 met 127.4% recommended dietary allowances for iron. Moreover, both fortified and unfortified IBC3 significantly increased the hemoglobin levels of adolescent girls with the higher improvement found in the group of fortified IBC3 (1.73±1.21 g/dL; P<0.05). However, the beneficial effects of the fortified IBC3 could not be observed on sTfR levels. Since the effect on Hb levels was significant with less effect, the intervention of IBC3 for only 2 months did not adequate to improve sTfR levels. Nevertheless, this study suggests that Fe-fortified IBC may be effective in preventing anemia among adolescent girls in Kupang, Indonesia.

Increased vegetable intake improves glycaemic control in adults with type 2 diabetes mellitus: a clustered randomised clinical trial among Indonesian white-collar workers.

Dietary patterns high in fibre and green leafy vegetables have shown an inverse association with lower risks of type 2 diabetes mellitus and improved glycaemic control. The study aimed to investigate the effects of increased vegetable intake and conventional diabetes diet on glycaemic control among type 2 diabetic patients. White-collar workers from one telecommunication company with type 2 diabetes were assigned to two treatment groups by cluster randomisation. Individuals with known type 2 diabetes and poor glycaemic control (HbA1c ≥8 g%) were eligible and a total of 84 subjects were recruited. Subjects in the intervention group (n 41) were offered to attend seminars and intensive coaching weekly to encourage them to increase raw vegetable intake. The control group (n 40) followed the conventional diet according to the guidelines of the Indonesian Society of Endocrinology. Glycated haemoglobin (HbA1c), plasma lipids, blood pressure, vegetable intake and anthropometric measurements were assessed at baseline and end line of 12 weeks intervention. A regression analysis was conducted using differences in HbA1C between baseline and 12 weeks as the dependent variable. Student's t test was conducted for the changes of biochemical indicators from baseline to end line during the period of 12 weeks intervention. Glycaemic control improved in the intervention group and mean HbA1C, fasting blood glucose and post-prandial blood glucose in the intervention group decreased significantly along with body weight, waist circumference and total cholesterol. The finding suggested that the intervention which emphasised raw vegetable intake contributed to improved glycaemic control among Indonesian adults with type 2 diabetes mellitus.

Cross-Sectional Study of Plant Sterols Intake as a Basis for Designing Appropriate Plant Sterol-Enriched Food in Indonesia.

Coronary heart disease (CHD) is one of the leading causes of mortality in many low-income and middle-income countries, including Indonesia, with elevated blood cholesterol level being one of significant risk factors for this condition. The problem should be addressed by combining healthy lifestyle and diet, where functional foods having a cholesterol-lowering activity could play a significant role. A group of compounds that had been proven to show cholesterol-lowering ability are plant sterols. To develop more suitable functional foods that could substantially contribute to hypercholesterolemia prevention in Indonesian population, up-to-date data about plant sterols dietary intake are required, and were not available until this research was done. This study aimed to estimate daily plant sterols intake and to determine the consumption pattern of foods containing plant sterols in rural and urban area of Bogor, West Java, Indonesia. The research was conducted with a cross-sectional design, with 200 respondents. The study revealed that the level of plant sterols intake in Bogor reached on average 229.76 mg/day and was not significantly different between urban and rural area. Cereals, vegetables, and fruit products were the main food sources of plant sterols in both areas. In addition, a list of several surveyed food items possible to be enriched with plant sterols was developed within the study. These results provide baseline data to develop functional foods fortified with plant sterols suitable for the Indonesian needs and taste. However, further studies are needed to confirm efficacy and safety of introducing such phytosterol-enriched products into a habitual diet, especially considering possible long-term side effects of plant sterol treatment.

Impact of price and non-price policies on household cigarette consumption and nutrient intake in smoking-tolerant Indonesia.

OBJECTIVE: To examine the impact of cigarette price and smoking environment on allocation of household expenditure and its implication on nutrition consumption. DESIGN: A cross-sectional study was conducted using the 2014 National Socioeconomic Survey (SUSENAS), the 2014 Village Potential Survey (PODES) and the 2013 Basic National Health Survey (RISKESDAS). SUSENAS and PODES data were collected by the Central Bureau of Statistics. RISKESDAS was conducted by National Institute of Health Research and Development (Balitbangkes), Indonesian Ministry of Health (MOH). SETTING AND PARTICIPANTS: The sample covered all districts in Indonesia; with sample size of 285 400 households. These households are grouped into low, medium and high smoking prevalence districts. PRIMARY AND SECONDARY OUTCOME MEASURES: The impact of cigarette price and smoking environment on household consumption of cigarette, share of eight food groups, as well as calorie and protein intake. RESULT: 1% increase in cigarette price will increase the cigarette budget share by 0.0737 points and reduce the budget share for eggs/milk, prepared food, staple food, nuts, fish/meat and fruit, from 0.0200 points (eggs/milk) up to 0.0033 points (fruit). Reallocation of household expenditure brings changes in food composition, resulting in declining calorie and protein intake. A 1% cigarette price increase reduces calorie and protein intake as much as 0.0885% and 0.1052%, respectively. On the other hand, existence of smoke-free areas and low smoking prevalence areas reduces the household budget for cigarettes. CONCLUSION: A pricing policy must be accompanied by non-pricing policies to reduce cigarette budget share.

Quality of vegetable oil prior to fortification is an important criteria to achieve a health impact.

Unbranded palm cooking oil has been fortified for several years and can be found in the market with different oxidation levels. This study aimed to investigate the stability and shelf life of unbranded, bulk, vitamin A-fortified palm oils with the most commonly observed oxidation levels in Indonesia. Three types of cooking oils were tested: (i) cooking oil with a peroxide value (PV) below 2 mEq O2/kg (PO1); (ii) cooking oil with a PV around 4 mEq O2/kg (PO2); and (iii) cooking oil with a PV around 9 mEq O2/kg (PO3). The oil shelf life was determined by using accelerated shelf life testing (ASLT), where the product was stored at 60, 75 and 90 °C, and then PV, free fatty acid and vitamin A concentration in the oil samples were measured. The results showed that PO1 had a shelf life of between 2-3 months, while PO2's shelf life was a few weeks and PO3's only a few days. Even given those varying shelf lives, the vitamin A loss in the oils was still acceptable, at around 10%. However, the short shelf life of highly oxidized cooking oil, such as PO3, might negatively impact health, due to the potential increase of free radicals of the lipid peroxidation in the oil. Based on the results, the Indonesian government should prohibit the sale of highly-oxidized cooking oil. In addition, government authorities should promote and endorse the fortification of only cooking oil with low peroxide levels to ensure that fortification is not associated with any health issues associated with high oxidation levels of the cooking oil.

Fortification of Indonesian unbranded vegetable oil: public-private initiative, from pilot to large scale.

BACKGROUND: Despite improved economic conditions, vitamin A deficiency remains a public health problem in Indonesia. OBJECTIVE: This paper aims to describe the development of the Indonesian unbranded cooking oil fortification program and to discuss lessons learned to date and future steps necessary for implementation of mandatory, large-scale oil fortification with vitamin A. METHODS: An historic overview of the steps involved in developing the Indonesian unbranded cooking oil fortification program is given, followed by a discussion of lessons learned and next steps needed. RESULTS: Indonesia's low-income groups generally consume unbranded vegetable oil, with an average consumption of approximately 25 g/day. Unbranded oil constitutes approximately 70% of the total oil traded in the country. In 2007-10, a pilot project to fortify unbranded vegetable oil was carried out in Makassar, and an effectiveness study found that the project significantly improved the serum retinol concentrations of schoolchildren. In 2010, the pilot was expanded to two provinces (West Java and North Sumatra) involving the biggest two national refineries. In 2011, a draft national standard for fortified oil was developed, which is currently under review by the National Standard Body and is expected to be mandated nationally in 2013 as announced officially by the Government of Indonesia in national and international meetings. CONCLUSIONS: Indonesia is a leading world supplier of cooking oil. With stakeholder support, the groundwork has been laid and efforts are moving forward to implement mandatory fortification. This project could encourage Indonesian industry to fortify more edible oils for export, thus expanding their market potential and potentially reducing vitamin A deficiency in the region.

Expert meeting on Child Growth and Micronutrient Deficiencies--New Initiatives for Developing Countries to Achieve Millennium Development Goals: executive summary report.

Undernutrition in early childhood has long-term physical and intellectual consequences. Improving child growth should start before the age of two years and be an integrated effort between all sectors, covering all aspects such as diet and nutrient intake, disease reduction, optimum child care, and improved environmental sanitation. To discuss these issues, the Indonesian Danone Institute Foundation organized an expert meeting on Child Growth and Micronutrient Deficiencies: New Initiatives for Developing Countries to Achieve Millennium Development Goals. The objective of the meeting was to have a retrospective view on child growth: lessons learned from programs to overcome under-nutrition in the developed countries and to relate the situation to the Indonesian context, as well as to discuss implications for future programs. Recommendations derived from the meeting include focus intervention on the window of opportunity group, re-activation of the Integrated Health Post at the village level, improvement of infant and young child feeding, expand food fortification intervention programs, strengthen supplementation programs with multi-micronutrient, and strengthening public and private partnership on food related programs.