Agustina Rina, Mufida Rachmi, Lasepa Wanda, Mustika Ajeng, Debilauralita Ardini, Limbong Sepriani T, Siregar Deviana As, Prafiantini Erfi, Manikam Nurul Rm, Soewondo Pradana
Department of Nutrition, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.
Human Nutrition Research Center, Indonesian Medical Education and Research Institute, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
Curr Dev Nutr. 2025 Mar 24;9(5):106010. doi: 10.1016/j.cdnut.2025.106010. eCollection 2025 May.
Under- or overconsumption of nutrients significantly increases the likelihood of future health impairments. However, comprehensive studies that systematically analyzed nutrient intake, especially among adults, are limited. This systematic review and meta-analysis explored studies reporting macro- and micronutrient intake among adults aged ≥18 y in Indonesia and Malaysia (PROSPERO: CRD42023464054). In total, 4501 studies were retrieved from 4 databases (PubMed, Scopus, ProQuest, and Cochrane) and searched manually from January 1980 to December 2023. Nutrient adequacy was determined by calculating the percentage of Recommended Daily Allowance (RDA)/Recommended Nutrient Intake (RNI), Estimated Average Recommendation (EAR), and Standardized Mean Differences (SMDs) for several nutrients. The systematic review of 82 studies revealed variations in energy and macronutrient intake among Indonesian and Malaysian adults. The meta-analysis showed that protein intake among Malaysians exceeded the recommendation [SMD: 0.56; 95% CI: 0.29, 0.684] but was insufficient among Indonesians (SMD: -0.86 (95% CI: -2.11, 0.39). Twenty-six studies reported insufficient fiber intake (10.7%-72.7% RDA/RNI) in both countries. Fat-soluble vitamin intake, except for vitamin A, was lower than 100% EAR. Meanwhile, a wide range of water-soluble vitamin intake was observed (13%-838% EAR). Calcium intake was reported as insufficient in 18 studies ( = 5394) (Overall SMD: -3.69; 95% CI: -4.18, -3.19; Indonesia SMD: -5.55; Malaysia SMD: -3.35). Magnesium intake was inadequate, although phosphorus and sodium intake were excessive in Malaysian adults. Moreover, there was inadequate intake (<100% EAR) of potassium, manganese, and copper among adults in both countries, and also iron and zinc in Indonesia. Selenium intake exceeded the recommendation (33-103 μg/158%-450% EAR) for Indonesians but not for Malaysian adults. In conclusion, Indonesian and Malaysian adults had a wide range of adequacy in energy and nutrient intake particularly for macronutrients and water-soluble vitamins. Some deficiencies in nutrients include fiber, fat-soluble vitamins, calcium, potassium, manganese, and copper persisted in both countries, Indonesians lacked iron and zinc intake, while Malaysians had low magnesium intake. In contrast, excessive sodium and phosphorus intake were observed in Malaysians, while Indonesians showed excessive selenium intake. Multistakeholder collaboration is essential to promote a healthy diet while maintaining regulations for individual dietary intake.
营养素摄入不足或过量会显著增加未来健康受损的可能性。然而，系统分析营养素摄入量的全面研究，尤其是在成年人中，是有限的。本系统评价和荟萃分析探索了报告印度尼西亚和马来西亚≥18岁成年人宏量营养素和微量营养素摄入量的研究（国际前瞻性系统评价注册库：CRD42023464054）。总共从4个数据库（PubMed、Scopus、ProQuest和Cochrane）中检索到4501项研究，并于1980年1月至2023年12月进行了手动检索。通过计算几种营养素的推荐每日摄入量（RDA）/推荐营养素摄入量（RNI）、估计平均推荐量（EAR）和标准化均值差（SMD）的百分比来确定营养素充足性。对82项研究的系统评价揭示了印度尼西亚和马来西亚成年人在能量和宏量营养素摄入量方面的差异。荟萃分析表明，马来西亚人的蛋白质摄入量超过了推荐量[SMD：0.56；95%置信区间：0.29，0.684]，但印度尼西亚人不足（SMD：-0.86（95%置信区间：-2.11，0.39）。26项研究报告称，两国的膳食纤维摄入量均不足（RDA/RNI的10.7%-72.7%）。除维生素A外，脂溶性维生素摄入量低于100%EAR。同时，观察到水溶性维生素摄入量范围广泛（13%-838%EAR）。18项研究报告钙摄入量不足（n = 5394）（总体SMD：-3.69；95%置信区间：-4.18，-3.19；印度尼西亚SMD：-5.55；马来西亚SMD：-3.35）。马来西亚成年人的镁摄入量不足，尽管磷和钠摄入量过高。此外，两国成年人的钾、锰和铜摄入量不足（<100%EAR），印度尼西亚成年人的铁和锌摄入量也不足。印度尼西亚人的硒摄入量超过了推荐量（33-103μg/158%-450%EAR），但马来西亚成年人未达到。总之，印度尼西亚和马来西亚成年人在能量和营养素摄入量方面，特别是宏量营养素和水溶性维生素方面，充足程度差异很大。两国在某些营养素方面仍存在不足，包括膳食纤维、脂溶性维生素、钙、钾、锰和铜，印度尼西亚人缺乏铁和锌摄入量，而马来西亚人的镁摄入量较低。相比之下，马来西亚人钠和磷摄入量过高，而印度尼西亚人硒摄入量过高。多方利益相关者合作对于促进健康饮食同时维持个人饮食摄入规定至关重要。
