Introduction: Hypertension in the elderly can be influenced by several factors, including a lack of physical activity. Older adults with low physical activity levels tend to engage in monotonous daily routines, which may negatively affect their mental health by increasing stress levels. Prolonged stress can increase the risk of depression among older adults. Aim: To examine the relationship between depression levels, physical activity, and hypertension in older adults. Methods: This analytical observational study had a cross-sectional design and involved 63 proportionally selected participants through random sampling. Data collection included questionnaires to assess depression levels and physical activity, as well as blood pressure measurements. The study was conducted from May to June 2024 at a public institutional care facility in Surabaya. Results: A significant correlation was found between physical activity levels and hypertension (p = 0.000; OR = 62.000), whereas depression levels showed no significant relationship with hypertension (p = 0.515). Conclusion: Based on these findings, it can be concluded that hypertension in older respondents is significantly associated with daily physical activity levels, although depression levels do not appear to be related to hypertension in this population.
Background: Adolescents in Indonesia face a triple burden of malnutrition which is aggravated by poor dietary behaviors. In West Java, adolescents commonly exhibit low dietary diversity, a habit of skipping meals, and frequent consumption of unhealthy snacks. The school setting offers strategic opportunities for health promotion through peer education. Objective: This study aims to explore the roles and challenges experienced by peer educators in promoting healthy dietary behavior in schools implementing the Nutrition Goes to School (NGTS) program in West Java. Methods: A qualitative study with an interpretive descriptive approach was applied. Data were collected through in-depth interviews with teachers and program stakeholders as well as focus group discussions involving peer educators and peer learners from each school. The data were analyzed thematically using NVivo 12. Results: The findings indicate that peer educators perform diverse and adaptive roles, including acting as healthy school advocates, health educators, influencers, role models, and school-based health facilitators. However, they encountered both internal and external challenges. Internally, they experienced low motivation, difficulty in maintaining healthy behavior, and lack of confidence. Externally, barriers included peer ignorance, limited availability of healthy food option at school, limited continuous training, and poor coordination with related stakeholders. Conclusion: These findings highlight the essential role of peer educators in promoting healthy dietary behavior, while underscoring the need for stronger institutional frameworks, continuous training, and improved collaboration between schools, stakeholders and families to ensure the sustainability of school-based nutrition programs.
Spiced fish floss is a nutritious and practical food product combining animal protein with local spices. However, information regarding its quality changes and shelf life remains limited. This study aimed to evaluate the effect of ozone treatment on the quality and shelf life of spiced fish floss during accelerated storage. An experimental study with two replications was conducted using two treatments: ozone treatment and no ozone treatment. The products were packed in aluminium foil and stored at 30°C, 40°C, and 50°C for 28 days. Quality evaluations were conducted on days 0, 7, 14, 21, and 28 by measuring moisture content, free fatty acid content, total plate count, and sensory attributes. Shelf life was estimated using Arrhenius-based Accelerated Shelf-Life Testing, with calculations performed in Microsoft Excel 2021. The results showed that spiced fish floss without ozone treatment had the longest estimated shelf life, reaching 206.31 days at 30°C. In contrast, ozone-treated products showed a shorter estimated shelf life of 205.33 days at the same temperature. Ozone treatment was associated with increased lipid oxidation and faster quality deterioration, particularly in this high-fat product. Therefore, spiced fish floss without ozone treatment demonstrated better quality stability and a longer estimated shelf life than ozone-treated products.
Rice is a staple food for most Indonesians. Freezing rice for 24 hours and then reheating it will lower glucose levels and increase resistant starch (RS), thus affecting the glycemic index (GI) and glycemic load (GL). This quantitative study used a crossover design, with subjects acting as both the control and intervention groups. The GL and GL analysis involved 10 healthy respondents, aged 19-29 years with normal nutritional status and fasting blood glucose levels. The data were normally distributed, so an independent sample T-test was used to examine the differences in GL and GL between rice and frozen rice. The results of the analysis of carbohydrate, glucose, and RS content in rice were rice (34.01%, 43.57%, 20.06%), frozen rice (25.94%, 39.62%, 23.59%), and rice (25.94%, 39.62%, and 23.59%), respectively. There was a significant difference in GI between regular rice (82.61) and frozen rice (76.41) p-value 0.005 (>0.05), as well as a significant difference (p-value 0.001 (<0.05)) between BG of regular rice (28.1) and frozen rice (19.82). It was concluded that rice and frozen rice differed in the rate of increase in blood glucose per gram of carbohydrate and in the total impact on blood glucose levels.
Introduction: Indonesia introduced the Free Nutritious Meals (Makan Bergizi Gratis, MBG) program in January 2025 to address stunting, undernutrition, and the double burden of malnutrition among children and vulnerable groups. Aims: This review evaluates early nutritional outcomes, food safety, hygiene management, and operational challenges of MBG. Methods: A narrative review of peer-reviewed studies, policy documents, government reports, and international agency materials published up to September 2025 was conducted. Sources were synthesized by three domains: nutritional improvement, food safety and hygiene management, and operational and governance challenges. Results: Early evidence suggests improvements in dietary diversity and protein and iron intake, with potential benefits for growth, attendance, and learning concentration. However, reported foodborne illness incidents indicate weaknesses in kitchen capacity, cold-chain logistics, food handling, and local monitoring. Low budget absorption and regional disparities further challenge rapid nationwide scale-up. Conclusions: Strengthening standardized menus, kitchen certification, food-safety protocols, real-time monitoring, and inter-ministerial coordination is essential to improve MBG implementation and sustainability
Background: Breastfeeding provides babies with the best nutrients possible and is essential for promoting their development. Objectives: The purpose of this study was to investigate the connection between the expression of the fatty acid desaturase (FAD) and FUT genes in breast milk cells and the nutritional status, dietary consumption, and growth of the newborn. Methods: In Jombang, East Java, Indonesia, 52 pairs of nursing women and their babies participated in a cross-sectional study. Breast milk samples were collected for mRNA expression analysis using RT-qPCR, while dietary, sociodemographic, anthropometric, and child growth data were assessed using standardized protocols. Results: The majority of mothers had inadequate energy (78.8%) and protein (42.3%) intake, while 76.9% met adequate iron intake. Higher maternal energy (69.5% vs. 59.5%, p<0.001), protein (95.5% vs. 80.3%, p=0.033), and iron intake (136% vs. 105%, p=0.023) were significantly associated with increased FUT1 gene expression. Additionally, higher FAD2 gene expression was linked to increased maternal energy intake (p=0.045) and older maternal age (p=0.004). Interestingly, FUT3 gene expression was elevated in mothers of lower-birth-weight infants (3003 ± 551 g vs. 3302 ± 411 g, p=0.031). Conclusions: These findings emphasize the influence of maternal nutrition on functional gene expression in breastmilk, with potential implications for infant health and development.
Background: Household food waste may occur even in resource-constrained households, creating a paradox in which food waste coexists with inadequate energy consumption. Understanding the structural, psychosocial, and behavioral determinants of food waste is essential for developing effective interventions. Objective: This study aimed to examine the role of structural, psychosocial, and food management behavioral factors associated with household food waste and energy consumption among low-income households. Methods: A cross-sectional study was conducted among 100 low-income households. Structural characteristics, psychosocial factors based on the Theory of Planned Behavior (TPB), and food management behaviors were assessed using structured questionnaires. Household food waste was recorded for eight consecutive days, while energy consumption was evaluated using energy adequacy levels. Data were analyzed using chi-square tests and logistic regression. Results: Food waste was identified in all households, while 63.4% experienced energy deficits. Educational attainment was the only structural factor significantly associated with lower household food waste. Psychosocial factors were not significantly associated with either food waste or energy consumption. Food storage practices were associated with energy consumption in the bivariate analysis but were not retained as significant predictors in the multivariate model. Conclusion: Household food waste in resource-constrained households is influenced primarily by structural factors, particularly educational attainment. Strengthening food literacy through practical educational interventions may contribute to reducing household food waste and improving food security.
Unintentional weight loss is an important clinical indicator of malnutrition in patients with chronic kidney disease and frequently reflects the development of protein-energy wasting. This narrative review summarizes current evidence on its prognostic value, underlying mechanisms, and management strategies. A total of 17 studies published between January 2021 and March 2025 were identified through PubMed, Scopus, and Web of Science. Eligible studies included adults with chronic kidney disease in whom unintentional weight loss was examined in relation to nutritional status, protein-energy wasting, muscle mass, or mortality. The evidence consistently demonstrated that weight loss identified using the Subjective Global Assessment, Malnutrition-Inflammation Score, or Global Leadership Initiative on Malnutrition criteria was associated with increased mortality, functional decline, and poorer clinical outcomes. Contributing mechanisms include chronic inflammation, metabolic and hormonal alterations, nutrient losses during dialysis, and inadequate dietary intake resulting from gastrointestinal or sensory symptoms. Early recognition depends on regular weight monitoring supported by body composition and functional assessments. Management focuses on individualized nutritional therapy, rehabilitation, correction of metabolic acidosis, and symptom control. Overall, unintentional weight loss represents a practical, inexpensive, and reliable prognostic marker in chronic kidney disease. Routine screening and prompt intervention may improve clinical outcomes and quality of life.
Background: Natural galactagogues are widely used to support lactation, but evidence for their effectiveness remains limited. This study evaluated the effects of a breast milk booster supplement (BBS) containing Moringa oleifera, Channa striata, and Sauropus androgynus on breast milk volume and nutrient composition. Methods: In this single-blind randomized controlled trial, 77 lactating mothers were assigned to receive either BBS or a placebo. Expressed breast milk volume and nutrient composition were assessed at baseline, day 7, and day 28. Nutrient analyses included energy, protein, carbohydrate, calcium, and omega-3 fatty acids, including docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). Data were analyzed using the Mann-Whitney and Greenhouse-Geisser repeated-measures tests. Results: The intervention group showed a greater increase in expressed breast milk volume than the control group (348.6 vs. 281.8 mL; p=0.016). EPA concentration was significantly higher at day 28 (3.2 mg/100 g; p=0.027). Although DHA and calcium increased to a greater extent in the intervention group, the differences were not statistically significant. Infants in the intervention group also had significantly greater increases in mid-upper arm circumference (MUAC). Conclusion: Twenty-eight days of BBS supplementation increased expressed breast milk volume and EPA content, supporting its potential as a lactation supplement.
Among fishing families with stunted children in coastal areas, exclusive breastfeeding occurs within intergenerational feeding norms, economic vulnerability, and limited paternal involvement. This study explored relational resilience strategies developed by fishing couples to sustain breastfeeding practices amid child stunting. A qualitative dyadic phenomenological design guided by Walsh's Family Resilience Framework was employed. Data were collected from 35 participants: 10 husband-wife dyads, five community leaders, and 10 extended family members, through individual and joint in-depth interviews and focus group discussions. Data were analyzed iteratively through within-participant, within-dyad, and cross-dyad comparisons to identify relational patterns and develop an empirically derived typology of relational resilience. Findings showed that couples experienced overlapping emotional, cultural, and structural shocks, including pressure to provide prelacteal feeding and reduced paternal involvement due to fishing-related work. Most dyads demonstrated moderate resilience, characterized by emotional solidarity, silent empathy, and adaptive compromise, often prioritizing family harmony over resistance to intergenerational norms, resulting in early supplementation and incomplete exclusive breastfeeding. Relational resilience functioned as a dyadic process maintaining emotional cohesion and caregiving continuity rather than strict adherence to breastfeeding recommendations. Strengthening breastfeeding sustainability in coastal settings requires culturally responsive, family-centered interventions engaging fathers and extended kin.
There is little literature on fathers’ roles in complementary feeding and monitoring children’s growth in rural areas aged 6-23 months. This study aimed to understand the role of fathers in complementary feeding behaviors and growth-monitoring behaviors, such as household nutrition decision-making and attendance at primary health services in rural Brebes, Central Java, Indonesia. We conducted a qualitative study using direct observation, focus group discussions, and document review with fathers of children at risk of stunting and key stakeholders (community leaders, heads of community health centers, nutrition workers, and district health officials). Thematic analysis of the data was conducted to identify patterns in caregiving and decision-making. Fathers determined household food distribution and health-seeking behavior, helped with access to social support systems, and influenced parenting behavior in terms of stimulation and caregiving. Active involvement of fathers increased family communication and compliance with recommended nutrition and health practices, whereas community-based programs that aligned with community sociocultural standards increased participation and acceptability. In summary, primary health care and community-based strategies to combat stunting, aimed at enhancing complementary feeding and growth monitoring practices, must prioritize father-targeted strategies.
This study assessed the correlation between saturated fat intake and the double burden of malnutrition (DBM) among Indonesian adolescents, specifically focusing on obesity and anemia. The research examined the prevalence of DBM and its association with saturated fat consumption in this population. Anemia was collected using a finger-pick, a Semi-quantitative Food Frequency Questionnaire (SFFQ) was employed to analyze the dietary intake. Data analysis univariately and regression for bivariate analysis. Six hundred and twenty-one adolescents were collected for anemia screening, and only 107 completed dietary assessments. Adolescent girls who live alone and have lower food expenses are more risk to DBM. The results found that overall fat intake was significantly linked to the occurrence of DBM in Indonesian adolescents, with those consuming higher levels of fat being more likely to experience both obesity and anemia simultaneously. This finding highlights the complex nutritional challenges faced by developing countries, where both overnutrition and undernutrition coexist. The study emphasizes the importance of limiting fat intake, and reducing the prevalence of DBM among adolescents in Indonesia.
There is a need for instruments with good validity and reliability to assess three domains of responsive feeding practices in early childhood in Indonesia. This study aims to analyze the validity and reliability of the responsive feeding knowledge, attitude, and practice instrument, which was developed for children under three years old. A cross-sectional design examined the validity among diverse toddler parents. The variables studied include knowledge, attitude, and practice of responsive feeding. The questionnaire is structured as doing or not doing practice, attitudes in true or false statements, and knowledge in multiple-choice questions. The construct validity of the Responsive Feeding Knowledge, Attitude, and Practice questionnaire (RF-KAP Q) was evaluated by determining the Pearson correlation coefficient values for each item with the overall score. Additionally, a reliability test was performed to assess the internal consistency of the questionnaire. Cronbach's alpha coefficient measured internal consistency. The 20 items of responsive feeding knowledge questions were categorized as valid; two items were categorized as constant (K6 and K7), and one other was classified as invalid (K14). A total of 25 attitude statement items were considered valid. All practice indicators consisting of 12 statement items were categorized as valid (p-value<0.05). The Cronbach's alpha of the responsive feeding knowledge, attitude, and practices questionnaire was 0.677, 0.699, and 0.778, indicating reliability. The RF-KAP Q has been tested as valid and reliable in measuring three domains of responsive feeding based on evidence-based recommendations in Indonesia. However, development is still needed to improve its validity.
The surge of tuberculosis (TB) in Indonesia, reaching over 385 cases per 100,000 population in 2024, presents an evident public health challenge. Primary drug-based (OAT/anti-TB drugs) therapy has adverse effects, affecting patient compliance and health outcomes. Nutritional therapy derived from animal-plant protein enriched with vitamin D has been offered as an adjunct therapy. This study investigated the effectiveness of catfish-derived biscuit substitutes, isolated soy protein, and moringa flour enriched with vitamin D in improving physical and immunological outcomes. Using a completely randomized design, the research process encompassed product development and pre-clinical testing in 35 adult white male Rattus norvegicus aged 8 weeks weighing 130-140 grams which were randomly divided into five groups, namely negative control (K0), Mycobacterium tuberculosis (Mtb)-injected (K1), Mtb-injected + OAT (anti-tuberculosis drugs), Mtb-injected + OAT + 1,000 IU vitamin D biscuit (D1), and Mtb-injected + OAT + 2,000 IU vitamin D biscuit (D2), and were observed for a total of 46 days. H37Rv Mycobacterium tuberculosis (Mtb) was injected into as much as 106 colonies/ml of 100 µL. Complete blood count was measured using the HEMAVET method, albumin and total protein were determined using spectrophotometry, and C-reactive protein (CRP) was analyzed using enzyme-linked immunosorbent assay (ELISA). Although product administration did not show a significant impact towards erythrocytes (p>0.05), it was still able to improve BMI within normal limits, increase albumin and total serum protein values, maintain leukocyte, hemoglobin, and hematocrit within standard values, lower CRP levels.
The prevalence of metabolic syndrome is increasing globally due to various factors that influence the progression of this syndrome. Identifying the factors that influence the development of metabolic syndrome is important, especially among working populations. This study aimed to explore the association between job-related stress and metabolic syndrome in mining workers, with emotional eating and mood disorders as mediating factors. An observational analytic method with a cross-sectional study design was employed. The research subjects were 131 workers from a mining contractor company in East Kalimantan, who were chosen after the research objectives were explained and their informed consent was obtained. The independent variable examined was work stress, and the dependent variable was metabolic syndrome. Emotional eating and mood disturbances were included as mediating variables in the analysis. Data were collected through measurements and questionnaire completion. The data were analyzed using path analysis techniques, and SPSS version 26 was used for statistical processing. The results showed that there was no relationship between work stress and metabolic syndrome mediated by emotional eating and mood disturbances. However, a relationship was found between work stress and the mediator variables of emotional eating and mood disturbances.
The prevalence of hypertension has continued to increase in recent years, highlighting the importance of dietary compliance among patients. This study aimed to analyze the factors influencing the dietary compliance of patients with hypertension. The study procedures were carried out using an observational analytical method with a cross-sectional design from April to October 2023 in the working area of the Kedaton Public Health Center in Bandar Lampung City. The sample population comprised 100 patients diagnosed with hypertension for at least the last 3 months who agreed to participate. The study variables were age, sex, knowledge, education, family income, attitude, motivation, self-efficacy, family support, food availability, psychological factors, health worker support, and diet compliance. Data were collected through interviews and validated questionnaires. Diet compliance was measured based on 2×24-hour food recall and compared with the standards (Recommended Daily Allowance). The data obtained were analyzed using chi-square and logistic regression analyses. The results showed that only 19% of patients with hypertension were compliant with the diet. In addition, knowledge, level of education, family income, attitude, motivation, self-efficacy, family support, food availability, psychological factors, and health worker support influenced diet compliance in patients with hypertension (p<0.05). The most influential factors were education and family support. The results of this study show the importance of educational interventions and increasing the role of the family in supporting the successful diet management of hypertensive patients to maintain normal blood pressure and prevent complications.
Atherosclerosis is predominantly an inflammatory process that is the key pathophysiological cause of ischemic coronary heart disease (CHD). Some studies suggest that sorghum can reduce atherosclerotic parameters through many biological activities, such as antioxidant, anti-inflammation, and anti-thrombotic properties. The primary objective was to evaluate the effect of an enteral sorghum tempeh formula on the levels of Plasminogen Activator Inhibitor-1 (PAI-1) and Interleukin-6 (IL-6) in an atherosclerotic rat model. A total of 24 male rats were utilized, with the experiment structured into an 8-week atherogenic diet induction period, followed by a 4-week intervention phase. The rats were divided into four groups: a healthy control, an atherogenic control, and two treatment groups supplemented with the formula at 0.75g/200 g and 1.50g/200 g body weight (BW), respectively. IL-6 and PAI-1 levels were quantified using Enzyme-Linked Immunosorbent Assay (ELISA). The atherogenic diet successfully induced a significant elevation in both IL-6 and PAI-1 levels compared to the healthy control group (p=0.000), indicating a heightened inflammatory and thrombotic state in the atherosclerotic group. Conversely, the groups receiving the sorghum tempeh-based formula exhibited a significant reduction in both IL-6 and PAI-1 levels compared to the atherogenic control group (p=0.000), suggesting potent anti-inflammatory and antithrombotic properties of the sorghum tempeh.
In Indonesia, stunting remains a public health problem, with a prevalence of > 20%. The objective of this study was to find the determinants of under five children stunting in family characteristics, maternal factors, birth history, and environmental factors. This case-control study was conducted on 1,093 children in ten villages with high stunting rates in Demak District based on stunting loci from the Ministry of Health. A total of 537 stunted children and 556 non-stunted children were found. Data were collected through structured interviews, maternal and child health cards, and anthropometric measurements of children using an infantometer, stadiometer, and digital weighing scales, conducted by trained personnel. The data were analyzed using Chi Square, and multiple logistic regression. Factors associated with stunting were: number of children (OR=1.441; CI 95%= 1.096-1.895), child food expenditure (OR=1.379; CI 95%= 1.087-1.750), Maternal height (OR=2.633; CI 95%=1.994-3.478), MUAC (p=0.04; OR=1.350; CI 95%=1.013–1.798), maternal knowledge (OR=1.630; CI 95%=1.262–2.105), complementary feeding (OR=1.387; OR 95%=1.087–1.771), Birth weight (OR=2.178; CI 95%=1.397–3.396). Birth length (1.638; CI 95%=1.263-2.125). Upper respiratory tract infection (OR=1.302; 95% CI=1.023 – 1.658). The main determinants of stunting were the number of children >2, low birth weight, low expenditure for child' food, upper respiratory tract infection, stunted mother and early complementary feeding.
Stunting remains a major public health problem in Indonesia, particularly in densely populated provinces with a high rates of stunting cases, such as Central Java. The research aimed to investigate determinants of stunting among children under five in Central Java, utilizing the Indonesian Nutritional Status Survey (SSGI) 2022. The analyses included 65,323 children under five, applying a multistage cluster sampling design with complex-sample logistic regression. The strongest predictors of stunting were older child age (AOR=3.27; 95% CI: 2.36–4.53) and low birth weight (AOR=2.39; 95% CI: 2.02–2.84). Stunting occurred more frequently among children whose mothers had less education and from high parity, as well as those living in household with food insecurity. A consistent social gradient was observed, with children from the poorest households being more than twice as vulnerable to stunting as those from the wealthiest households (AOR=2.24; 95% CI: 1.87–2.68). Health care services gaps, including incomplete immunization, lack of Mid-Upper Arm Circumference (MUAC) monitoring, and absence of deworming tablets, significantly increased stunting risks, as did a history of pneumonia. Rural dwelling of children increased the odds for stunting when compared to residing in urban areas (AOR=1.20; 95% CI: 1.09–1.32). These findings underscore the combined influence of biological, maternal, socioeconomic, health service-related, and urban-rural disparities underlying stunting in Central Java. To accelerate stunting reduction, it is important to prioritize the implementation of multisectoral actions for strengthening maternal education, and early childhood optimum nutrition, food security, and reducing rural-urban disparities in access to quality primary health care.
This study used cross-sectional data from the 2022 Indonesian Nutritional Status Survey to examine vitamin A supplementation, dietary diversification, and stunting in North Sumatra, including a group of 7,973 children aged 6–23 months. The results indicated that 62.7% of the youngsters took vitamin A and 39.4% had diversified diets. Multivariate analysis indicated that children lacking vitamin A supplementation were associated with a 1.43-fold increased proportion of stunting (CI: 1.27-1.61), and children with non-diverse diets had a 1.21 times higher risk (CI: 1.10-1.37). Regional stratification analysis revealed that a lack of vitamin A supplementation in rural areas increased the risk of stunting by a higher factor (OR: 1.49; CI: 1.25-1.78) in cities (OR: 1.38; CI: 1.18-1.61). The impact of dietary diversity on stunting was more substantial in rural areas (OR: 1.28; CI: 1.07-1.53) compared than in urban areas (OR: 1.15; CI: 0.98-1.35). The results recommend improving program coverage and nutrition education to account for local differences.
