The Ministry of Health has issued dietary guidelines, namely ”Isi Piringku” [My Plate]. However, ... more The Ministry of Health has issued dietary guidelines, namely ”Isi Piringku” [My Plate]. However, few studies have evaluated the implementation and its relationship to nutritional status in the university student population, especially during the COVID-19 pandemic. The objectives of this study include (1) evaluating student eating patterns during the pandemic based on the ”Isi Piringku” guidelines; (2) analyze the correlation of diet to changes in body weight during the pandemic. This research was conducted using an online survey of 110 students spread throughout Indonesia in the first to eighth semesters. The analysis was carried out by descriptively comparing the median portion of the type of food to the ”Isi Piringku” recommendations and analyzing the correlation using Spearman's analysis. In 4 types of food (staple food, side dish, vegetables, and fruit), there is a gap between the median proportions eaten by respondents and recommendations including staple foods (29% and 33%...
Covid-19 pandemic caused large-scale mobility restrictions, including for students. This conditio... more Covid-19 pandemic caused large-scale mobility restrictions, including for students. This condition might induce lifestyle changes which could impact metabolic conditions. This study aims to (1) investigate lifestyles pre and mid pandemic; (2) investigate the relative differences of the students' BMI early pandemic until recent; (3) estimate the relationship between lifestyle alterations and increased BMI during the pandemic. The research conduct using an online survey of 110 students spread across Indonesia in the first to ninth semesters. Analysis was performed using the Wilcoxon signed-rank test and Spearman's analysis. The results showed that there were lifestyle alterations; namely, 15% of respondents reduced their walking habits, duration, and the number of steps. 9% reduced exercise frequency, with more than 50% of respondents reducing their exercise duration. Nearly 20% increased sedentary frequency. 11% experience stress and take it out on food. As many as 93% of res...
Background: Indonesia ranks fifth in terms of the number of stunted children and there has been l... more Background: Indonesia ranks fifth in terms of the number of stunted children and there has been little change in the stunting prevalence in the last decade. In earlier observational studies conducted in 2014-2015, we identified several key underlying problems with the potential to impact stunting in Sumedang district, West Java, Indonesia. Deficits in intakes of growth-limiting micronutrients were observed, most notably calcium, iron, zinc, and vitamin A, emphasizing the need for a food-based intervention to overcome these micronutrient deficits in the diets of mothers and their infants. Methods: A double-blind placebo-controlled cluster randomised trial comparing the effect of daily consumption of 75 grams of locally produced micronutrient-enriched crackers (MEC) (intervention group) compared to placebo crackers (control group) by mothers at two-time intervals: (i) from the 8-14 weeks of pregnancy to delivery (i.e., 28-34 weeks of consumption of MEC) on birth length, and (ii) from ...
To reduce the burden of early-life linear growth faltering in low- and middle-income countries, i... more To reduce the burden of early-life linear growth faltering in low- and middle-income countries, interventions have focused on nutrition strategies, sometimes combined with water quality, sanitation, and hygiene (WASH). However, even when combined, their effects on linear growth have been inconsistent. Here, we investigate potential predictors of length-for-age z-scores (LAZ) in a cohort of resource-poor rural Indonesian infants to inform the optimal strategies to reduce linear growth faltering. Apparently healthy rural breastfed Indonesian infants were randomly selected from birth registries at age 6 months (n = 230) and followed up at 9 (n = 202) and 12 (n = 190) months. Using maximum likelihood estimation, we examined longitudinal relationships among socio-demographic status, maternal height, infant sex, age, water source, sanitation facility, energy, protein, micronutrient intakes and biomarkers (serum ferritin, zinc, retinol binding protein (RBP), selenium–adjusted for inflammat...
Objectives This study aimed to characterize the impact of feeding practices on the infant fecal m... more Objectives This study aimed to characterize the impact of feeding practices on the infant fecal metabolome and microbiome at 2 months and 5 months of age in exclusive breastfeeding (EBF) and partial breastfeeding (PBF) infants. Methods Fecal samples were collected from infants at 2 months and 5 months of age from Bandung, Indonesia. Exclusive breastfeeding was determined using the stable isotope deuterium dose-to-mother (DTM) technique. Fecal metabolites were extracted using Dulbecco's phosphate-buffered saline, and analyzed using NMR spectroscopy. Fecal microbial DNA was extracted at the same time using the MoBio PowerLyzer PowerSoil DNA isolation kit (MoBio, Carlsbad, CA). The V4 region of 16SrRNA was targeted. The DNA library sample was analyzed via 300-bp paired-end sequencing on the Illumina MiSeq platform. Results Fecal samples from EBF infants at 2 months of age revealed significantly higher human milk oligosaccharides (HMOs), short-chain fatty acids and related metabolit...
Background Breast milk is the sole source of nutrition for exclusively breastfed infants in the f... more Background Breast milk is the sole source of nutrition for exclusively breastfed infants in the first 6 mo of life, yet few studies have measured micronutrient concentrations in breast milk in light of maternal diet and subsequent infant micronutrient intakes. Objectives We evaluated the adequacy of micronutrient intakes of exclusively breastfed Indonesian infants by measuring milk volume and micronutrient concentrations and assessed maternal micronutrient intakes and their relationship with milk concentrations. Methods Mother–infant (2–5.3 mo) dyads (n = 113) were recruited for this cross-sectional study. Volume of breast-milk intake via the deuterium dose-to-mother technique over 14 d and analyzed micronutrient concentrations were used to calculate micronutrient intakes of exclusively breastfed infants. Maternal 3-d weighed food records were collected to assess median (IQR) micronutrient intakes. Multivariate regression analyses examined the association of usual maternal micronutr...
Background When maternal micronutrient intakes and statuses are compromised, reductions in micron... more Background When maternal micronutrient intakes and statuses are compromised, reductions in micronutrient concentrations in neonatal stores and human milk may result in suboptimal micronutrient intakes, statuses, and functional outcomes of breastfed infants during the critical first 6-month period. Objectives We compared the adequacy of micronutrient intakes and statuses at 2 and/or 5 months and morbidity and growth faltering at 2, 5, and 12 months in a cohort of exclusively breastfed (EBF) and partially breastfed (PBF) infants from low-resource Indonesian households. Methods At 2 and 5 months, the breastfeeding status and human milk intake of 212 infants were determined using the deuterium oxide dose-to-mother technique, and intakes were calculated from milk micronutrient concentrations and 3-d weighed food intakes. At 5 months, five infant micronutrient biomarkers, hemoglobin, C-reactive protein, and α-1-acid-glycoprotein were measured. Infant morbidity, weight, and length were mea...
Background Maternal micronutrient deficits during preconception and pregnancy may persist during ... more Background Maternal micronutrient deficits during preconception and pregnancy may persist during lactation and compromise human milk composition. Objective We measured micronutrient concentrations in human milk and investigated their association with maternal micronutrient intakes, status, and milk volume. Methods Infant milk intake (measured via a deuterium dose-to-mother technique), milk micronutrient and fat concentrations, and maternal micronutrient intakes were assessed at 2 and 5 mo postpartum in 212 Indonesian lactating mother–infant pairs. Maternal hemoglobin, ferritin, transferrin receptors, retinol binding protein (RBP), zinc, selenium, and vitamin B-12 were measured at 5 mo (n = 163). Multivariate or mixed effects regression examined associations of milk micronutrient concentrations with maternal micronutrient intakes, status, and milk volume. Results Prevalence of anemia (15%), and iron (15% based on body iron), selenium (2.5%), and vitamin B-12 deficiency (0%) were low ...
Background The stable isotope deuterium dose-to-mother (DTM) technique to estimate nonbreast milk... more Background The stable isotope deuterium dose-to-mother (DTM) technique to estimate nonbreast milk water intake demonstrates that maternal self-report methods of infant feeding overestimate the true prevalence of exclusively breastfeeding practices. Objective We aimed to determine potential monosaccharide and oligosaccharide markers that distinguish between exclusively breastfed (EBF) versus nonexclusively breastfed (non-EBF) infants utilizing LC-MS-based methods. Methods Data for the analysis were collected as part of a larger, longitudinal study of 192 breastfed Indonesian infants aged 2 mo and followed up at 5 mo. Feces samples were collected from infants aged 2 mo (n = 188) and 5 mo (n = 184). EBF and non-EBF strata at each time point were determined via the DTM technique. Feces samples were analyzed to determine monosaccharide content using ultra-high-performance LC-triple quadrupole MS (UHPLC-QqQ MS). Relative abundances of fecal oligosaccharides were determined using nano-LC-C...
The addition of desiccated beef liver to infant and young child complementary foods can be used t... more The addition of desiccated beef liver to infant and young child complementary foods can be used to overcome nutrient deficits, however its acceptability is unknown. We conducted a series of studies to test the acceptability of complementary foods fortified with either powdered beef liver, beef meat, beef liver + meat or placebo among 96 Indonesian children aged 12 to 23 mo. This was achieved by determining liking of a single test food with added study powder, followed by a 2-wk home trial and focus group discussions to assess liking during repeated consumption of the study powders added to daily meals. The test food with added beef powders were well liked by mothers, with liking scores never falling below neutral on a 7-point scale. After home use, mothers reported that their children moderately liked their meals with added powder, with scores ranging between 3.3 and 3.5 on a 5-point scale. With the exception of lower liking for the combination beef liver + meat powder, there were n...
The addition of desiccated beef liver to infant and young child complementary foods can be used t... more The addition of desiccated beef liver to infant and young child complementary foods can be used to overcome nutrient deficits, however its acceptability is unknown. We conducted a series of studies to test the acceptability of complementary foods fortified with either powdered beef liver, beef meat, beef liver + meat or placebo among 96 Indonesian children aged 12 to 23 mo. This was achieved by determining liking of a single test food with added study powder, followed by a 2-wk home trial and focus group discussions to assess liking during repeated consumption of the study powders added to daily meals. The test food with added beef powders were well liked by mothers, with liking scores never falling below neutral on a 7-point scale. After home use, mothers reported that their children moderately liked their meals with added powder, with scores ranging between 3.3 and 3.5 on a 5-point scale. With the exception of lower liking for the combination beef liver + meat powder, there were n...
The addition of desiccated beef liver to infant and young child complementary foods can be used t... more The addition of desiccated beef liver to infant and young child complementary foods can be used to overcome nutrient deficits, however its acceptability is unknown. We conducted a series of studies to test the acceptability of complementary foods fortified with either powdered beef liver, beef meat, beef liver + meat or placebo among 96 Indonesian children aged 12 to 23 mo. This was achieved by determining liking of a single test food with added study powder, followed by a 2-wk home trial and focus group discussions to assess liking during repeated consumption of the study powders added to daily meals. The test food with added beef powders were well liked by mothers, with liking scores never falling below neutral on a 7-point scale. After home use, mothers reported that their children moderately liked their meals with added powder, with scores ranging between 3.3 and 3.5 on a 5-point scale. With the exception of lower liking for the combination beef liver + meat powder, there were n...
The addition of desiccated beef liver to infant and young child complementary foods can be used t... more The addition of desiccated beef liver to infant and young child complementary foods can be used to overcome nutrient deficits, however its acceptability is unknown. We conducted a series of studies to test the acceptability of complementary foods fortified with either powdered beef liver, beef meat, beef liver + meat or placebo among 96 Indonesian children aged 12 to 23 mo. This was achieved by determining liking of a single test food with added study powder, followed by a 2-wk home trial and focus group discussions to assess liking during repeated consumption of the study powders added to daily meals. The test food with added beef powders were well liked by mothers, with liking scores never falling below neutral on a 7-point scale. After home use, mothers reported that their children moderately liked their meals with added powder, with scores ranging between 3.3 and 3.5 on a 5-point scale. With the exception of lower liking for the combination beef liver + meat powder, there were n...
The Ministry of Health has issued dietary guidelines, namely ”Isi Piringku” [My Plate]. However, ... more The Ministry of Health has issued dietary guidelines, namely ”Isi Piringku” [My Plate]. However, few studies have evaluated the implementation and its relationship to nutritional status in the university student population, especially during the COVID-19 pandemic. The objectives of this study include (1) evaluating student eating patterns during the pandemic based on the ”Isi Piringku” guidelines; (2) analyze the correlation of diet to changes in body weight during the pandemic. This research was conducted using an online survey of 110 students spread throughout Indonesia in the first to eighth semesters. The analysis was carried out by descriptively comparing the median portion of the type of food to the ”Isi Piringku” recommendations and analyzing the correlation using Spearman's analysis. In 4 types of food (staple food, side dish, vegetables, and fruit), there is a gap between the median proportions eaten by respondents and recommendations including staple foods (29% and 33%...
Covid-19 pandemic caused large-scale mobility restrictions, including for students. This conditio... more Covid-19 pandemic caused large-scale mobility restrictions, including for students. This condition might induce lifestyle changes which could impact metabolic conditions. This study aims to (1) investigate lifestyles pre and mid pandemic; (2) investigate the relative differences of the students' BMI early pandemic until recent; (3) estimate the relationship between lifestyle alterations and increased BMI during the pandemic. The research conduct using an online survey of 110 students spread across Indonesia in the first to ninth semesters. Analysis was performed using the Wilcoxon signed-rank test and Spearman's analysis. The results showed that there were lifestyle alterations; namely, 15% of respondents reduced their walking habits, duration, and the number of steps. 9% reduced exercise frequency, with more than 50% of respondents reducing their exercise duration. Nearly 20% increased sedentary frequency. 11% experience stress and take it out on food. As many as 93% of res...
Background: Indonesia ranks fifth in terms of the number of stunted children and there has been l... more Background: Indonesia ranks fifth in terms of the number of stunted children and there has been little change in the stunting prevalence in the last decade. In earlier observational studies conducted in 2014-2015, we identified several key underlying problems with the potential to impact stunting in Sumedang district, West Java, Indonesia. Deficits in intakes of growth-limiting micronutrients were observed, most notably calcium, iron, zinc, and vitamin A, emphasizing the need for a food-based intervention to overcome these micronutrient deficits in the diets of mothers and their infants. Methods: A double-blind placebo-controlled cluster randomised trial comparing the effect of daily consumption of 75 grams of locally produced micronutrient-enriched crackers (MEC) (intervention group) compared to placebo crackers (control group) by mothers at two-time intervals: (i) from the 8-14 weeks of pregnancy to delivery (i.e., 28-34 weeks of consumption of MEC) on birth length, and (ii) from ...
To reduce the burden of early-life linear growth faltering in low- and middle-income countries, i... more To reduce the burden of early-life linear growth faltering in low- and middle-income countries, interventions have focused on nutrition strategies, sometimes combined with water quality, sanitation, and hygiene (WASH). However, even when combined, their effects on linear growth have been inconsistent. Here, we investigate potential predictors of length-for-age z-scores (LAZ) in a cohort of resource-poor rural Indonesian infants to inform the optimal strategies to reduce linear growth faltering. Apparently healthy rural breastfed Indonesian infants were randomly selected from birth registries at age 6 months (n = 230) and followed up at 9 (n = 202) and 12 (n = 190) months. Using maximum likelihood estimation, we examined longitudinal relationships among socio-demographic status, maternal height, infant sex, age, water source, sanitation facility, energy, protein, micronutrient intakes and biomarkers (serum ferritin, zinc, retinol binding protein (RBP), selenium–adjusted for inflammat...
Objectives This study aimed to characterize the impact of feeding practices on the infant fecal m... more Objectives This study aimed to characterize the impact of feeding practices on the infant fecal metabolome and microbiome at 2 months and 5 months of age in exclusive breastfeeding (EBF) and partial breastfeeding (PBF) infants. Methods Fecal samples were collected from infants at 2 months and 5 months of age from Bandung, Indonesia. Exclusive breastfeeding was determined using the stable isotope deuterium dose-to-mother (DTM) technique. Fecal metabolites were extracted using Dulbecco's phosphate-buffered saline, and analyzed using NMR spectroscopy. Fecal microbial DNA was extracted at the same time using the MoBio PowerLyzer PowerSoil DNA isolation kit (MoBio, Carlsbad, CA). The V4 region of 16SrRNA was targeted. The DNA library sample was analyzed via 300-bp paired-end sequencing on the Illumina MiSeq platform. Results Fecal samples from EBF infants at 2 months of age revealed significantly higher human milk oligosaccharides (HMOs), short-chain fatty acids and related metabolit...
Background Breast milk is the sole source of nutrition for exclusively breastfed infants in the f... more Background Breast milk is the sole source of nutrition for exclusively breastfed infants in the first 6 mo of life, yet few studies have measured micronutrient concentrations in breast milk in light of maternal diet and subsequent infant micronutrient intakes. Objectives We evaluated the adequacy of micronutrient intakes of exclusively breastfed Indonesian infants by measuring milk volume and micronutrient concentrations and assessed maternal micronutrient intakes and their relationship with milk concentrations. Methods Mother–infant (2–5.3 mo) dyads (n = 113) were recruited for this cross-sectional study. Volume of breast-milk intake via the deuterium dose-to-mother technique over 14 d and analyzed micronutrient concentrations were used to calculate micronutrient intakes of exclusively breastfed infants. Maternal 3-d weighed food records were collected to assess median (IQR) micronutrient intakes. Multivariate regression analyses examined the association of usual maternal micronutr...
Background When maternal micronutrient intakes and statuses are compromised, reductions in micron... more Background When maternal micronutrient intakes and statuses are compromised, reductions in micronutrient concentrations in neonatal stores and human milk may result in suboptimal micronutrient intakes, statuses, and functional outcomes of breastfed infants during the critical first 6-month period. Objectives We compared the adequacy of micronutrient intakes and statuses at 2 and/or 5 months and morbidity and growth faltering at 2, 5, and 12 months in a cohort of exclusively breastfed (EBF) and partially breastfed (PBF) infants from low-resource Indonesian households. Methods At 2 and 5 months, the breastfeeding status and human milk intake of 212 infants were determined using the deuterium oxide dose-to-mother technique, and intakes were calculated from milk micronutrient concentrations and 3-d weighed food intakes. At 5 months, five infant micronutrient biomarkers, hemoglobin, C-reactive protein, and α-1-acid-glycoprotein were measured. Infant morbidity, weight, and length were mea...
Background Maternal micronutrient deficits during preconception and pregnancy may persist during ... more Background Maternal micronutrient deficits during preconception and pregnancy may persist during lactation and compromise human milk composition. Objective We measured micronutrient concentrations in human milk and investigated their association with maternal micronutrient intakes, status, and milk volume. Methods Infant milk intake (measured via a deuterium dose-to-mother technique), milk micronutrient and fat concentrations, and maternal micronutrient intakes were assessed at 2 and 5 mo postpartum in 212 Indonesian lactating mother–infant pairs. Maternal hemoglobin, ferritin, transferrin receptors, retinol binding protein (RBP), zinc, selenium, and vitamin B-12 were measured at 5 mo (n = 163). Multivariate or mixed effects regression examined associations of milk micronutrient concentrations with maternal micronutrient intakes, status, and milk volume. Results Prevalence of anemia (15%), and iron (15% based on body iron), selenium (2.5%), and vitamin B-12 deficiency (0%) were low ...
Background The stable isotope deuterium dose-to-mother (DTM) technique to estimate nonbreast milk... more Background The stable isotope deuterium dose-to-mother (DTM) technique to estimate nonbreast milk water intake demonstrates that maternal self-report methods of infant feeding overestimate the true prevalence of exclusively breastfeeding practices. Objective We aimed to determine potential monosaccharide and oligosaccharide markers that distinguish between exclusively breastfed (EBF) versus nonexclusively breastfed (non-EBF) infants utilizing LC-MS-based methods. Methods Data for the analysis were collected as part of a larger, longitudinal study of 192 breastfed Indonesian infants aged 2 mo and followed up at 5 mo. Feces samples were collected from infants aged 2 mo (n = 188) and 5 mo (n = 184). EBF and non-EBF strata at each time point were determined via the DTM technique. Feces samples were analyzed to determine monosaccharide content using ultra-high-performance LC-triple quadrupole MS (UHPLC-QqQ MS). Relative abundances of fecal oligosaccharides were determined using nano-LC-C...
The addition of desiccated beef liver to infant and young child complementary foods can be used t... more The addition of desiccated beef liver to infant and young child complementary foods can be used to overcome nutrient deficits, however its acceptability is unknown. We conducted a series of studies to test the acceptability of complementary foods fortified with either powdered beef liver, beef meat, beef liver + meat or placebo among 96 Indonesian children aged 12 to 23 mo. This was achieved by determining liking of a single test food with added study powder, followed by a 2-wk home trial and focus group discussions to assess liking during repeated consumption of the study powders added to daily meals. The test food with added beef powders were well liked by mothers, with liking scores never falling below neutral on a 7-point scale. After home use, mothers reported that their children moderately liked their meals with added powder, with scores ranging between 3.3 and 3.5 on a 5-point scale. With the exception of lower liking for the combination beef liver + meat powder, there were n...
The addition of desiccated beef liver to infant and young child complementary foods can be used t... more The addition of desiccated beef liver to infant and young child complementary foods can be used to overcome nutrient deficits, however its acceptability is unknown. We conducted a series of studies to test the acceptability of complementary foods fortified with either powdered beef liver, beef meat, beef liver + meat or placebo among 96 Indonesian children aged 12 to 23 mo. This was achieved by determining liking of a single test food with added study powder, followed by a 2-wk home trial and focus group discussions to assess liking during repeated consumption of the study powders added to daily meals. The test food with added beef powders were well liked by mothers, with liking scores never falling below neutral on a 7-point scale. After home use, mothers reported that their children moderately liked their meals with added powder, with scores ranging between 3.3 and 3.5 on a 5-point scale. With the exception of lower liking for the combination beef liver + meat powder, there were n...
The addition of desiccated beef liver to infant and young child complementary foods can be used t... more The addition of desiccated beef liver to infant and young child complementary foods can be used to overcome nutrient deficits, however its acceptability is unknown. We conducted a series of studies to test the acceptability of complementary foods fortified with either powdered beef liver, beef meat, beef liver + meat or placebo among 96 Indonesian children aged 12 to 23 mo. This was achieved by determining liking of a single test food with added study powder, followed by a 2-wk home trial and focus group discussions to assess liking during repeated consumption of the study powders added to daily meals. The test food with added beef powders were well liked by mothers, with liking scores never falling below neutral on a 7-point scale. After home use, mothers reported that their children moderately liked their meals with added powder, with scores ranging between 3.3 and 3.5 on a 5-point scale. With the exception of lower liking for the combination beef liver + meat powder, there were n...
The addition of desiccated beef liver to infant and young child complementary foods can be used t... more The addition of desiccated beef liver to infant and young child complementary foods can be used to overcome nutrient deficits, however its acceptability is unknown. We conducted a series of studies to test the acceptability of complementary foods fortified with either powdered beef liver, beef meat, beef liver + meat or placebo among 96 Indonesian children aged 12 to 23 mo. This was achieved by determining liking of a single test food with added study powder, followed by a 2-wk home trial and focus group discussions to assess liking during repeated consumption of the study powders added to daily meals. The test food with added beef powders were well liked by mothers, with liking scores never falling below neutral on a 7-point scale. After home use, mothers reported that their children moderately liked their meals with added powder, with scores ranging between 3.3 and 3.5 on a 5-point scale. With the exception of lower liking for the combination beef liver + meat powder, there were n...
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