Diana Aly, Rahmannia Sofa, Suhadi Yenni Zuhairini, Luftimas Dimas Erlangga, Rizqi Haidar, Purnamasari Afini Dwi, Jihadillah Ayunda, Ansari Mohammad Brachim, Haq Dearly Ayu Zahrotun, Pratiwi Aisyah Nur, Scott Samuel, Hampel Daniela, Allen Lindsay H, Haszard Jillian J, Houghton Lisa A, Gibson Rosalind S, Fahmida Umi
Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, 40161, Indonesia.
Nutrition Working Group, Faculty of Medicine, Universitas Padjadjaran, Bandung, 40161, Indonesia.
Wellcome Open Res. 2022 Jun 9;7:167. doi: 10.12688/wellcomeopenres.17879.1. eCollection 2022.
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. 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 the 8-14 weeks of pregnancy to 5 months post-partum on attained linear growth and linear growth velocity of breast-fed infants. A total of 324 pregnant women from 28 clusters (villages) located in 3 sub-districts in Sumedang district, West Java, Indonesia, will be randomly assigned to either intervention (n=14 villages) or control (n=14 villages). This will be the first study in Indonesia to use crackers based on powdered eggshells and chicken liver, in a form which is acceptable, safe, and has a long shelf life. If daily consumption of MEC for 6 months during pregnancy can enhance birth length, or their continued daily consumption for 5 months postpartum improves both attained and incremental linear growth at 5 months of age, then scaling-up in Indonesia may be considered. : https://clinicaltrials.gov/ct2/show/NCT04564222 ; 25 September 2020.
印度尼西亚发育迟缓儿童数量位居世界第五，且过去十年中发育迟缓患病率几乎没有变化。在2014 - 2015年进行的早期观察性研究中，我们确定了印度尼西亚西爪哇省苏梅当区存在几个可能影响发育迟缓的关键潜在问题。研究发现生长限制性微量营养素摄入不足，最明显的是钙、铁、锌和维生素A，这凸显了需要采取基于食物的干预措施来克服母亲及其婴儿饮食中的这些微量营养素缺乏问题。一项双盲安慰剂对照整群随机试验，比较母亲在两个时间段每日食用75克当地生产的富含微量营养素饼干（MEC）（干预组）与安慰剂饼干（对照组）的效果：（i）从怀孕8 - 14周到分娩（即食用MEC 28 - 34周）对出生身长的影响，以及（ii）从怀孕8 - 14周到产后5个月对母乳喂养婴儿的线性生长和线性生长速度的影响。来自印度尼西亚西爪哇省苏梅当区3个分区28个整群（村庄）的324名孕妇将被随机分配到干预组（n = 14个村庄）或对照组（n = 14个村庄）。这将是印度尼西亚第一项使用基于蛋壳粉和鸡肝的饼干的研究，这种形式可接受、安全且保质期长。如果孕期每日食用MEC 6个月能增加出生身长，或者产后继续每日食用5个月能改善5月龄时的线性生长和线性生长速度，那么可能会考虑在印度尼西亚扩大推广。: https://clinicaltrials.gov/ct2/show/NCT04564222 ; 2020年9月25日
