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Endang Dewi Lestari
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Relation of complementary foods and anemia in urban underprivileged children in Surakarta Endang Dewi Lestari; Annang Giri Moelya; Elief Rohana; Budiyanti Wiboworini
Paediatrica Indonesiana Vol 47 No 5 (2007): September 2007
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (230.429 KB) | DOI: 10.14238/pi47.5.2007.196-201

Abstract

Background Iron deficiency anemia (IDA) is still prevalent inIndonesian children. Attempt to treat patients with IDA withiron supplementation has been difficult because of lowcompliance.Objective To determine the complementary foods that contributesin the prevalence of anemia in children.Methods A cross sectional study was conducted in three urbanunderprivileged villages. Healthy children aged 6-23 months atthe time of interview were selected. The questionnaire wasspecially developed for determining the risks of IDA. We tookblood sampling to measure the hemoglobin concentration.Results A total of 86 children participated in the study; but only dataof 78 children were available for analysis. The prevalence of anemiaamong those children was 35%. Most children (90%) consumedanimal protein inadequately. Rice-based diet was the main meal ofmost children (97%). Analysis of possible factors associated with theanemia showed that inadequate plant or animal protein consumption,wasted children, less than 2 orange consumption, not consumingiron fortified formula/cereal had OR 1.2 (95%CI 0.40; 3.61), 4.13(95%CI 0.48;35.45), 4.67 (95%CI 1.04;20.04), 6.25 (95% CI1.32;29.55) and 3.15 (95%CI 1.18;8.41), respectively. Logistic analysisrevealed that the factors associated with anemia were wasted children(OR 9.10, 95%CI 1.38;60.18), low or no orange consumption (OR7.86, 95%CI 1.36;45.40) and not consuming iron fortified formula/cereal (OR 3.01, 95%CI 1.02;8.90).Conclusion In children with rice-based diet as main meal,consuming orange as an enhancing factor should also be addressedin order to prevent anemia.
Association between C-reactive protein levels and physical fitness in 7 to 9 year old children at poor elementary schools in Surakarta, Indonesia Lilisianawati Lilisianawati; Endang Dewi Lestari; Diana Mayasari Hadianto; Maria Galuh Kamenyangan Sari; Leilani Lestarina; Harsono Salimo
Paediatrica Indonesiana Vol 49 No 2 (2009): March 2009
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (126.27 KB) | DOI: 10.14238/pi49.2.2009.75-81

Abstract

Background  Data  regarding inflammatory factors  in  children arenot  so  well developed  as  in adults. Higher levels  of  physical fitnessmay be helpful in modifying the low-grade inflammatory state  thatis  indexed  by  C-reactive protein (CRP) levels.Objective  To  evaluate the association  of  physical fitness with  CRPlevels in children  and  to identify the possible related factors.Methods  This  cross-sectional study was  conducted  at  poorelementary schools in Surakarta, Indonesia using a group  of  217underweight children aged from 7 to 9 years old. Physical fitnesswas assessed using a modified Harvard Step Test.  CRP  levels weremeasured using a high-sensitivity  assay.  The  association betweenphysical fitness and  CRP  level was assessed using linear regressionanalysis. Multivariate analyses were used to adjust covariates,and statistical analyses were performed using SPSS for Windowssoftware version 15.0.Results  Subjects were 48% female  and  52% male, and elevenchildren (5%) had a  CRP  level  >  5 mg/L. Mean fitness level  andCRP  level did not differ  by  age and gender. Fitness level was notinversely correlated with  CRP  (r=0.10,  P=0.14).  Physical fitnesswas significantly correlated with BMI  (r=0.14;  P=0.04),  physicalactivity  [0R=3.3  (95% CI  1.7  to 6.4)], and fat intake  [0R=0.5(95%  CI  0.2 to 0.9) ].Conclusion  These findings indicate  that  physical fitness  is  notinversely correlated to  CRP  levels in children. However, ourstudy reveased  an  association between high fat intake and lowphysical fitness as well  as  a significant association  betweenhigh physical activiry and physical fitness.
Effect of iron ... zinc fortified milk on iron status and functional outcomes in underweight children Endang Dewi Lestari; Saptawati Bardosono; Leilani Lestarina; Harsono Salimo
Paediatrica Indonesiana Vol 49 No 3 (2009): May 2009
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (132.517 KB) | DOI: 10.14238/pi49.3.2009.139-148

Abstract

Background Iron and zinc are essential micronutrients duringschool-age period. Milk could be an alternative medium formineral fortification because it is consumed frequently bychildren.Objective To evaluate the effect of iron-zinc fortified milksupplementation on iron status and functional outcomes inunderweight children.Methods 44 2 underweight subjects aged 7-10 years attending 10primary schools in Jakarta and Solo were recruited in the study.Subjects who had chronic illnesses, severe anemia, thalassemiaor cow's milk allergy were excluded. Blood samples were analyzedto determine hemoglobin, serum ferritin and serum zinc. SerumCRP was measured in sub sampled subjects (n= 60). Subjectswere randomizedly allocated to receive iron-zinc fortified milk(n = 225) and standard milk (n = 217) for six months. The fortifiedmilk will provide additional6.3 mg iron and 1.5 mg zinc per day (2feeds). The main outcomes measured were iron status, cognitivefunction, growth, physical fitness and morbidity.Results Study groups were comparable at baseline. The fortifiedmilk group had better physical fitness score and exercise durationat baseline. Both milk supplementations reduced the prevalenceof anemia and iron deficiency. Fortified milk improved the speedprocessing score (P< 0.0001), height (P<0.0001) and sittingheight (P=O.Ol) significantly.Conclusion Supplementation of milk reduces the prevalence ofanemia and iron deficiency. Zinc-iron fortified milk gives positiveimpact on cognitive performance, growth, and physical fitness.
The role of indoor air pollution and other factors in the incidence of pneumonia in under-five children Sunyataningkamto Sunyataningkamto; Iskandar Z; Alan R T; Budiman I; Ahmad Surjono; Tunjung Wibowo; Endang Dewi Lestari; Dwi Wastoro
Paediatrica Indonesiana Vol 44 No 1 (2004): January 2004
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (343.443 KB) | DOI: 10.14238/pi44.1.2004.25-9

Abstract

Background The World Health Organization has asked for a spe-cial attention to the relation between pneumonia and indoor airpollution, i.e., household biomass fuel smoke, cigarette smoke,and mosquito coil smoke, especially in developing countries.Objective To analyze the role of indoor air pollution and otherfactors as risk factors for pneumonia in under-five-year children.Methods This case-control study was carried out from August un-til December 2000 at Public Health Centers in Banjarnegara,Kebumen, Jepara, and Pekalongan districts. All children qualify-ing pneumonia classification as recommended by WHO in IMCI(Integrated Management of Childhood Illness) were defined ascases and without pneumonia as controls. Severe pneumonia andno pneumonia (as classified in IMCI) were excluded. Statisticalanalysis was done using bivariate and logistic regression.Results There were three hundreds and five children with pneu-monia and 289 children without pneumonia. By bivariate analysis,biomass fuel smoke (OR=3.25; 95%CI 1.50;7.07) and cigarettesmoke exposure from other family members (OR=1.63; 95%CI1.11;2.38) were risk factors for pneumonia, while mosquito coilsmoke (OR=1.13; 95%CI 0.79;1.69) was not. History of wheezing(OR=2.60; 95%CI 2.7;8.55), malnutrition (OR=2.60; 95%CI1.33;5.07), and male sex (OR=1.47; 95%CI 1.06;2.04) were otherrisk factors.Conclusions Household biomass fuel smoke and cigarette smokewere risk factors for pneumonia. Other variables as risk factorswere history of wheezing, male sex, and malnutrition
Nutritional status and nutrient intake from complementary foods among breastfed children in Purworejo District, Central Java, Indonesia Endang Dewi Lestari; T Ninuk S Hartini; M Hakimi; A Surjono
Paediatrica Indonesiana Vol 45 No 1 (2005): January 2005
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (607.906 KB) | DOI: 10.14238/pi45.1.2005.31-9

Abstract

Background The growth rate of Indonesian infants beyond sixmonths of age declines compared with that of the internationalreference population.Objective This study aimed to describe the pattern of nutritionalstatus among breastfed children and their intake of energy, pro-tein, and zinc from complementary foods in Purworejo District, Cen-tral Java, Indonesia.Methods The study was a cross sectional survey drawing breastfedchildren under 24 months old from a well-defined population. Chil-dren with a history of prematurity or low birth weight were excluded.Anthropometrical measurements were collected. Intake of comple-mentary food was assessed using 24-hour recall. Analysis of nu-tritional intake was only performed in 11-23 month-old children.Results Of 577 children enrolled, the prevalence of underweight,stunting, and wasting were 8.1%, 8.8%, and 4.6%, respectively.The prevalence of undernutrition increased with age. There wasno association between frequency of breastfeeding during 24 hoursin the second year of life and the nutritional status. The averageintake of energy, protein, and zinc from complementary foods wasvery low i.e., 30%, 45%, and 5% of the Indonesian recommendeddietary allowance (RDA), respectively.Conclusion The prevalence of undernutrition in breastfed chil-dren increases with age. The breastfed children beyond 11 monthsof age in Purworejo District need sufficient density of nutrients fromcomplementary foods.
Social maturity among obese children in Surakarta, Indonesia Endang Dewi Lestari; Dwi Hidayah; Suci Murti Karini
Paediatrica Indonesiana Vol 46 No 4 (2006): July 2006
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi46.4.2006.174-8

Abstract

Background Although it is clear that childhood obesity has asso-ciation with many aspects included social aspect, the social matu-rity aspect on childhood obesity is scarcely found.Objective To examine the prevalence of social maturity and thepossible associated factors among obese children.Methods A cross sectional study was conducted from January toFebruary 2005. Twenty percent of elementary schools in every sub-district were randomly selected. All obese children from selectedschools were recruited to the study after obtaining the informedconsent. Criteria of obesity in children was based on BMI e”95 thpercentile according to age and sex. Social maturity was measuredusing Vineland Social Maturity Scale, which consisted of 8 catego-ries, i.e., self-help general, self-help eating, self-help dressing, self-direction, occupation, communication, locomotion, and socializa-tion. Social maturity score was determined using age group. Thetotal score was divided into two categories i.e. immature and ma-ture. Possible associated factors with the social maturity such asgender, maternal education less than 9 years, being held back aclass, and parental guidance by step mother were analyzed usingSPSS 10.0 for Windows.Results There were 158 obese children recruited in the study. Theprevalence of social immaturity was 32.5%. The odds ratio (OR)for parental guidance by single parent or others was 2.32 (95%CI1.01;5.31); OR for intelligence was 3.93 (95%CI 1.42;10.89); ORfor male was 2.41 (95%CI 1.08;5.38) and OR for maternal educa-tion less than 9 years was 1.22 (95%CI 0.61;2.41). Multivariateregression, analysis showed significant association between gen-der (for male OR=2.44; 95%CI 1.06;5.58) and intelligence(OR=3.31; 95%CI 1.12;9.84) with social maturity.Conclusion The prevalence of social maturity in obese children ishigh. The factors associated with social maturity among obese chil-dren are the history of had ever been held back a class and male.Further investigation is needed to find out the understanding ofspecific influence of social maturity in the prevalence of obesity.
Co-Authors A Surjono Ahmad Surjono Alan R T Annang Giri Moelya Budiman I Budiyanti Wiboworini Diana Mayasari Hadianto Dwi Hidayah Dwi Wastoro Elief Rohana Harsono Salimo Iskandar Z Leilani Lestarina Lilisianawati Lilisianawati M Hakimi Maria Galuh Kamenyangan Sari Saptawati Bardosono Suci Murti Karini Sunyataningkamto Sunyataningkamto T Ninuk S Hartini Tunjung Wibowo