Search

Background and Objectives: Fast-food companies have been reproached for rising obesity levels due to aggressive marketing tactics targeted at children. They have countered that parents should be held responsible considering their critical role as nutritional gatekeepers. This study examined the comparative effects of media exposure and parental mediation on Indonesian children's fast food consumption and how the effects compare in the metropolitan versus suburban areas.Methods and Study Design: The sample consisted of 394 child-mother pairs comprising grade three and four children and their mothers from two schools each in Jakarta and Bogor representing 40.9% metropolitan sample and 59.1% suburban sample, respectively. The children completed a guided inclass survey, while the mothers completed a paper-and-pen survey at home. Measures comprised children's weekly media exposure to broadcast media, computer and mobile games, print media, and online and social media, active and restrictive parental mediation strategies, children's fast food consumption and nutrition knowledge. The relationship of media exposure and parental mediation with children's fast food consumption was analyzed using Structural Equation Modelling.Results: Fast food consumption was positively influenced by exposure to broadcast media among metropolitan children, and by exposure to online and social media among suburban children. Active parental mediation was related to lower fast food consumption, but only for suburban children.Conclusions: Active parental mediation is critical in preventing fast food consumption. The media play a key role in influencing fast food consumption, and hence, literacy education is important to alleviate the adverse effects of exposure to junk food marketing. [ABSTRACT FROM AUTHOR]

Indonesia, as a major population in the Asia Pacific region, threatened with food and health insecurity through climate change and rapid economic development, faces the challenge to build capacity among its science-based food and health professionals and institutions. The nutrition research agenda is now being more actively set within the region, rather than by external imposition. A series of papers emanating from a new generation of public health and clinical nutrition scientists is reported in this issue of APJCN. It draws attention to the importance of food patterns and background culture as contributors to the failure of the nutrient rather than a food, food system and socio-ecological approach to solve the region's intransigent nutritionally-related health problems. New understandings of human eco-social biology are providing opportunities to accelerate the resolution of these problems. The challenge is to transform the food-health construct from one which is not sufficiently concerned about the precarious state of ecologically dysfunctional health and its nutrient market drivers to one which strives for more sustainable and affordable solutions. The present reports address a range of options to these ends. [ABSTRACT FROM AUTHOR]

Background and Objectives: Current practices and available resources for nutrition therapy in paediatric intensive care units (PICUs) in the Asia Pacific-Middle East region are expected to differ from western countries. Existing guidelines for nutrition management in critically ill children may not be directly applicable in this region. This paper outlines consensus statements developed by the Asia Pacific-Middle East Consensus Working Group on Nutrition Therapy in the Paediatric Critical Care Environment. Challenges and recommendations unique to the region are described.Methods and Study Design: Following a systematic literature search from 2004-2014, consensus statements were developed for key areas of nutrient delivery in the PICU. This review focused on evidence applicable to the Asia Pacific-Middle East region. Quality of evidence and strength of recommendations were rated according to the Grading of Recommendation Assessment, Development and Evaluation approach.Results: Enteral nutrition (EN) is the preferred mode of nutritional support. Feeding algorithms that optimize EN should be encouraged and must include: assessment and monitoring of nutritional status, selection of feeding route, time to initiate and advance EN, management strategies for EN intolerance and indications for using parenteral nutrition (PN). Despite heterogeneity in nutritional status of patients, availability of resources and diversity of cultures, PICUs in the region should consider involvement of dieticians and/or nutritional support teams.Conclusions: Robust evidence for several aspects of optimal nutrition therapy in PICUs is lacking. Nutritional assessment must be implemented to document prevalence and impact of malnutrition. Nutritional support must be given greater priority in PICUs, with particular emphasis in optimizing EN delivery. [ABSTRACT FROM AUTHOR]

Background: In Indonesia, 37% of children under-five are stunted, 12% wasted and 12% overweight. Adequate feeding practices among children above 6 months of age are critical to tackle malnutrition. National surveys have been conducted to assess feeding practices but these aggregates hide geographic disparities. While several studies have been conducted in specific country locations to address this gap, no attempt has been made to reconcile available information. This paper aims to provide a comprehensive review of the literature on feeding practices among Indonesian children above six months of age. Methods: A literature search was conducted in several databases using combinations of different search terms: feeding, child, Indonesia, MPASI/complementary feeding, gz/nutrition, factor, determinant, praktek/practices. All documents were reviewed using a three-step procedure to assess content appropriateness and research quality. Available information was analyzed using current recommendations on feeding practices. Results: Dietary diversity, consumption of iron-rich foods, active feeding and hygiene practices were among the non-optimal feeding practices. Consequently dietary intakes are not fulfilled for several micronutrients. Some feeding practices are worst in younger children. Differences between data from national and site-specific surveys are noted. Overall quality of the surveys needs to be strengthened. Conclusions: Generally, child feeding practices are not optimal. Indicators used to assess components of child feeding vary and make inter-survey comparisons challenging. The results also stress the need to investigate the underlying factors to optimal child feeding practices. The results may be used for advocacy of additional resource allocation for effective child feeding promotion programs [ABSTRACT FROM AUTHOR]

Background: Feeding practices among young children are not optimal in Indonesia. Improving these practices is crucial to prevent and reduce malnutrition among young children. A better understanding of the underlying factors to appropriate practices is essential to address barriers and identify opportunities to optimal practices. This paper aims to shed light on potential determinants of feeding practices among children above 6 months of age. Methods: A systematic research of several databases using combinations of different search terms: feeding, child, Indonesia, MPASI/complementary food, gz/nutrition, factor, determinant, praktek/practices was conducted. All documents were reviewed using a three-step procedure to assess content appropriateness and research quality. Data were analyzed using the Hector's framework on behaviour change. Results: Available data on individual factors influencing feeding practices related mainly to mother's attributes, namely knowledge, perceptions, attitudes, beliefs and skills. Some of them are positively linked to good practices. Some environmental-related factors such as health services, home and peer environment were conducive to improved practices. Studies on societal factors were mostly restricted to food systems which do not favour optimal feeding practices. Conclusions: The review provides insights on underlying factors conducive to optimal feeding practices. Yet, relevant and quality research is required to get a better understanding on factors related to the environment and society as well as on how they are related with each other and operate in different contexts. Indonesia has already experimented successful programs which can be used as a reference to strengthen young child feeding practices. [ABSTRACT FROM AUTHOR]

Dietary Guidelines are sets of advisory statements that give dietary advice for population to promote nutritional well-being. They contain information on foods or behaviors that are encouraged and cautionary messages derived from scientific evidence-based reviews and specific local conditions. The Indonesian Dietary Guidelines consisting of 13 messages that were publicized by the Ministry of Health in 1995 and have not been reviewed afterward in relation to nutritional status and health outcome of the population. By reviewing studies on different age groups in the past 10 years and comparing the results with the recommended guidelines, this paper aims to identify if messages have been successfully applied and if there are relevant issues not yet covered in the guidelines. The reviews covered 29 out of 33 provinces, representing studies from sub-district or higher levels (district, provincial, national). Results showed that some messages have been better implemented than others; also that information for some messages was not available for which to conclude of its implementation. In addition, some practices were identified which are prevalent in several age groups and have important public health consequence, but not yet included in the 13-guidelines. These include: smoking, increased intakes of fruit and vegetables, limited intakes of salt and sugar, increased intakes of foods rich in zinc and calcium (besides iron), hand-washing before food preparation and eating, and weight-monitoring. For infants and young children, nutrient density, feeding responsiveness and stimulation should be specifically highlighted. Based on the results, several recommendations in revising the guidelines were given. [ABSTRACT FROM AUTHOR]

Dietary Guidelines are sets of advisory statements that give dietary advice for population to promote nutritional well-being. They contain information on foods or behaviors that are encouraged and cautionary messages derived from scientific evidence-based reviews and specific local conditions. The Indonesian Dietary Guidelines consisting of 13 messages that were publicized by the Ministry of Health in 1995 and have not been reviewed afterward in relation to nutritional status and health outcome of the population. By reviewing studies on different age groups in the past 10 years and comparing the results with the recommended guidelines, this paper aims to identify if messages have been successfully applied and if there are relevant issues not yet covered in the guidelines. The reviews covered 29 out of 33 provinces, representing studies from sub-district or higher levels (district, provincial, national). Results showed that some messages have been better implemented than others: also that information for some messages was not available for which to conclude of its implementation. In addition, some practices were identified which are prevalent in several age groups and have important public health consequence, but not yet included in the 13-guidelines. These include: smoking, increased intakes of fruit and vegetables, limited intakes of salt and sugar, increased intakes of foods rich in zinc and calcium (besides iron), hand-washing before food preparation and eating, and weight-monitoring. For infants and young children, nutrient density, feeding responsiveness and stimulation should be specifically highlighted. Based on the results, several recommendations in revising the guidelines were given. [ABSTRACT FROM AUTHOR]

The food security assessment used by the United State's Food Security/Hunger Survey Module (US- FSSM) was used in five studies: these were in two urban and four rural areas in Indonesia between February 2004 - August 2005. The number of households assessed was 3,704 and consisted of 45% urban and 55% rural. All households had children below five years. This paper aims to assess the applicability of US-FSSM for measuring household food-insecurity in Indonesia. Common coping-strategies discussed are to borrow money from the family, get an additional job, to lessen portion size of food, and to sell small assets. Although households in urban and rural areas were similar in size/number of children and male headed; the urban households were more income-secure, educated, and had better access to electrical appliances. A majority of the households was food-insecure (77% and 84% in urban and rural consecutively). More food-insecure households without and with hunger were found in rural areas. The number of affirmative responses to 17 out of 18 questions in the US-FSSM was more in the rural households, showing less fortunate cases of food-insecurity. For a given coping strategy, as food-security status becomes more severe, the higher the percentage of households employing it. For a given food-security status, percentage of households was higher among lower-degree and less among higher-degree coping. Combining food-security and coping-strategy indicators may help to identify transient-food- secure households. Observing both indicators throughout different time of the year continuously may further identify adaptive mechanism by chronic-food-insecure households. Information on household food diversity could enrich findings on dietary intake modification, hence moving from food-security to nutrition-security. [ABSTRACT FROM AUTHOR]

Indonesia, like many developing countries, is experiencing a rapid urbanisation characterised by double burden of disease in which non communicable diseases become more prevalent while infectious diseases remain undefeated. This report describes the nutrition transition which occurred to Indonesia after economic transformation in 1966, based on information gathered from published reports. The major sources of information used in this paper were: a) a series of Indonesian National Socio-Economic Surveys (SUSENAS) conducted regularly by Central Bureau of Statistics (which provided a coherent picture of the nutrition transition in Indonesia) and b) data collected from two relatively smaller surveys conducted in West Sumatra (which demonstrated the changes in food and nutrient intakes over the period 1983-1999). It was found that while Indonesia had a rapid economic growth since 1970s, major dietary changes included an increase in expenditure for meat, eggs, milk and prepared food, and a fall in expenditure in cereal products. Nutrient proportions had changed from carbohydrate to fat and protein but the proportions remained close to the ideal ratio. There was also a dramatic shift in causes of death from infectious to chronic diseases. It is concluded that the nutrition transition in Indonesia is similar to patterns in other developing countries. Although fat consumption increased slightly, there is movement to maintain the traditional diet. [ABSTRACT FROM AUTHOR]

Indonesia has been afflicted by an economic crisis since July 1997. The economic crisis was preceded by a long drought associated with El Nino. The result has been a decline in food production, especially rice. In the eastern part of the country, especially in Irian Jaya, there was food insecurity during the early stages of the economic crisis. When the crisis escalated to become an economic, social and political crisis in 1998, food insecurity spread to other provinces, especially to urban areas in Java. The crisis led to increasingly high inflation, unemployment, poverty, food insecurity and malnutrition. The official figures indicate that poverty in Indonesia increased from 22.5 million (11.3%) in 1996 to 36.5 million (17.9%) in 1998. Food production decreased by 20–30% in some parts of the country. Compared with prices in January 1998, food prices had escalated 1.5- to threefold by August/November 1998 when acute food shortages occurred, especially in urban Java. Coupled with a drop in purchasing power, the higher food prices worsened health, nutritional status and education of children of urban poor and unemployed families. Despite social and political uncertainties, the Indonesian Government has taken prompt action to prevent a worsening of the situation by massive imports of rice, instituting food price subsidies for the poor and launching social safety net programmes to cope with food shortages and malnutrition. The present paper attempts to highlight the impact of the economic crisis on food insecurity and malnutrition in Indonesia. [ABSTRACT FROM AUTHOR]