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"Bayi dengan berat badan lahir rendah dan retardasi perkembangan intrauterin masih merupakan masalah khususnya di Indonesia, karena menunjukkan angka kejadian yang tinggi dan perlu diturunkan. Malnutrisi pada anak kurang dari 1 tahun terbanyak pada bayi dengan berat badan lahir rendah. Pada penelitian menggunakan hewan coba, didapatkan nutkosa usus halus hipotmfi dan normoplasi pada tikus maltmtrisi. Keadaan ini memperlihatkan bahwa mukosa usus halus dapat mempertahankan jumlah selnya dalam menghadapi pembatasan nutrien, dan memberi petunjuk akan dapat berkembang bila mendapatkan masukan nutrien yang cukup. Apakah realimentasi dapat memulihkan mukosa yang hipotrofi normoplasi menjadi normofrofi nonnoplasi ? Penelitian ini bertujuan untuk menjawab peitanyaan itu. Penelitian experimental dengan desain post text-control group dilakukan dengan menggunakan 40 ckor anak tikus jantan jcnis Sprague-Dawiey, yang diberikan makanan baku yang latim digunakan untuk penelitian. Penelitian dibagi dalam lahap induksi malnutrisi pranatal dilanjutkan dengan tahap realimentasi. Didapatkan berat badan, tebal mukosa, tinggi vilus, kedalaman kripta, nisbahi vilus/kripta, jumlah vilus, kandungan protein, dan nisbali protein/DNA mukosa usus tikus malnutrisi pranatal yang direalimentasi lebih linggi dari tikus malnultrisi pranatal yang tidak dircalimtmuisi, tetapi lebilt rendah dari tikus kontrol. Aktivitas disakaridttse nmkosa usus halus tikus malntttmi pranatal yang direalimentasi lebih tinggi dari tikus malnutrisi pranatal yang tidak direalimentasi, tetapi lebih rendah dari tikus kontrol. Disimpulkan bahwa manultrisi pranatal tidak menguranigi populasi enterosit usus halus tikus. Realiinentasi pada tikus malnutrisi pranatal dapat memperbaiki hipotrofi mukosa usus halus dan meningkatkan aktivitas diaakaridase namun lidak mencapai nilai normal. Realimentasi pada tikus inalnutrisi pranatal dapat memperbaiki inatnritas mukosa usus halus tetapi tidak mencapai nilai normal. Informasi ini dapat bermanfaal dalam menetapkan kebijakan pengelolaan malnutrisi maternal. (Med J Indones 2006; 15:208-16)

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Low birth-weight infant and intrauterine growth retardation are still a health problem, especially in Indonesia due to high prevalence ami need to be reduced. Malnutrition in infants are most common occur in low birth-weight infants. Malnutrition in nits resulted in hypotrophic and nonnoplastic mucosa of the small intestine. The finding was not only showed that small intestine was able to maintain its cell number in condition with restriction nutrient, however also suggested the posibility of epithelial regeneration if given adequate nutrient intake. Did realimentation recover the hypotrophic nonnoplastic mucosa to norniotrophic. nonnoplastic'.' The study aim to answer that question. Experimental animal study with post test-control group design was performed using 40 male litter of Sprague-Dawley rats, was fed standard chow. The study was divided into phases prenatally-inducccl malnutrition and continued with phase realimentation. The result of this study is the body weight, mucosal thickness, villas height, crypt us depth, ratio of vilus/crypt, number of rilli. protein content, and disaccharidases of rats realimentation group was higher than non-realimentation group, but lower than control group. Prenatally-induced malnutrition did not reduced the population of small intestinal enlem cytes. Realimentalion in rats in prenaially-induced malnutrition was able to improve the hypotrophy of small intestinal mucosa and to increase the distifcharidases activities but did no! reach the normal values. Realimentation in rats in prenatally-induced malnutrition was able to improve the maturity of small intestine mucosa but did not reach the normal values. The information will be helpfull to decide the policy of maternal malnutrition. (Med J Indones 2006; 15:208-16)."

"Gizi ganda (dual form of malnutrition/DFM) merupakan fenomena kesehatan yang tidak hanya terjadi di tingkat nasional tetapi sudah sampai pada tingkat keluarga. Kondisi ini cukup unik, mengingat anggota keluarga tinggal dalam kondisi yang sama. DFM menjadi tantangan dan masalah kesehatan baru, kedua masalah gizi salah sama penting dan memberikan beban lebih besar pada rumahtangga. Tujuan penelitian adalah mengetahui prevalensi dan determinan DFM di Indonesia dengan menggunakan data Riskesdas 2010. Analisis multilevel modelling digunakan untuk mengidentifikasi determinan DFM di level rumahtangga, wilayah desa/kota dan propinsi. Definisi Dual form of Malnutrition yang digunakan adalah anggota rumahtangga mempunyai status gizi yang berbeda; dipilih pasangan balita kurang gizi (<-2 z-score) dan ibu gizi lebih (IMT>25 kg/m2). Kriteria inklusi adalah rumahtangga dengan pasangan ibu kandung dan balita, usia ibu >18-40 tahun, dan usia balita >=2-5 tahun, sedangkan kriteria eksklusi adalah ibu hamil dan anak masih menyusu. Determinan variabel yang digunakan adalah jumlah anggota rumahtangga, komposisi rumahtangga, sosial ekonomi, Intra Household Food Distribution/IHFD, usia dan jenis kelamin anak, pekerjaan, usia dan pendidikan ibu, wilayah desa-kota, dan kondisi fiskal, akses ke pelayanan kesehatan, kondisi kesehatan propinsi, tingkat kemiskinan, petugas gizi, angka melek huruf yang merupakan proksi indikator kondisi nutrition and epidemiologic transition. Hasil penapisan diperoleh 1899 rumahtangga yang memenuhi syarat. Hasil penelitian menunjukkan prevalensi DFM adalah 29.8% (95%CI 26.5-31.2). ibu berusia diatas 30 tahun OR=1.68;95%CI (0.31-0.72), ibu berpendidikan kurang dari SMA OR=1.63;95%CI(1.23- 1.71), balita mendapatkan alokasi karbohidrat lebih sedikit OR=1.28;95%CI(1.02-1.60), rendahnya distribusi lemak pada anak di level rumahtangga OR=1.24;95%CI(1.02-1.51), dan kondisi kesehatan di masyarakat (IPKM) di level propinsi OR=1.43;95%CI(1.06-1.93). Wilayah desa/kota tidak berhubungan dengan kejadian DFM. Resiko kejadian DFM antara rumahtangga berisiko dengan rumahtangga kurang berisiko adalah 1.33. Level kontekstual propinsi tidak terlalu berpengaruh terhadap perbedaan kejadian DFM di rumahtangga MOR 1.28 (perubahan MOR 3.75%), IOR 0.89-2.29). Penelitian ini menunjukkan bahwa rumahtangga khususnya ibu mempunyai peran yang sangat penting dalam upaya preventif kejadian DFM.

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Dual form of malnutrition/DFM is a health phenomenon that is not only happening at the national level but has reached the lowest level of the family. This condition is quite unique, given the family members living and share the same conditions. DFM is a health challenge and new health problem, of which problem has equal/same important and provide a greater burden to households.

The research objective was to determine the prevalence and determinants of DFM in Indonesia using data Riskesdas 2010. Multilevel modeling analysis used to identify the determinants of DFM in household, urban/rural area and province level. Dual form of malnutrition defined as member of household has an opposite nutritional status; the study used pair of malnourished child (<-2 z-score) and overweight mother (BMI> 25 kg/m2). Inclusion criteria were households with pair child and mother, maternal age> 18-40 years, and child’s age >=2-5years, whereas exclusion criteria were pregnant women and breastfed children. Determinants variable used were the number of household members, household composition, household socio-economic, Intra Household Food Distribution/IHFD, age and gender of children, occupation, age and maternal education, rural and urban areas, and fiscal conditions, access to health care, provincial health condition, poverty level, nutrition workers, literacy rate which are considered as a proxy indicator of nutrition and epidemiologic transition.

The screening result obtained 1899 households are eligible. Results showed the prevalence of DFM was 29.8% (95% CI 26.5-31.2). Mothers aged over 30 years OR =1.68; 95% CI (0.31- 0.72), lower mother’s education (less than senior high school) OR = 1.63, 95% CI (1.23- 1.71), child received lower carbohydrate allocation over the family OR = 1.28, 95% CI (1.02- 1.60), child received lower fat distribution over the family OR = 1.24;95% CI (1.02-1.51), and health conditions in the community (IPKM score) at the provincial level OR = 1.43;95% CI (1.06-1.93. Urban/rural was not associated with DFM. The risk of DFM between households at risk with less risk households is 1.33. Contextual level of provinces do not much affect to the incidence of DFM among households MOR 1.28 (small change of MOR 3.75%) and IOR 0.89-2.29). This study showed that household and particularly mother has a very important role in to prevent DFM events."

"protein-energy malnutrition is common in patients with liver cirrhosis , especially in advanced and severe stage. Liver cirrchosis patients with malnutrition have increasing risk to get post-operative complication and mortality...."

"ABSTRAKMeningkatnya prevalensi kekurangan gizi dan kelebihan berat badan di Indonesia timur menimbulkan dugaan bahwa keterbatasan akses pangan, baik dari sisi akses ke pasar maupun akses secara ekonomi berpengaruh terhadap beban ganda malnutrisi. Studi ini bertujuan untuk menganalisis pengaruh akses pangan terhadap kekurangan gizi pada balita dan kelebihan berat badan individu dewasa serta kemungkinan terjadinya beban ganda malnutrisi dalam satu rumah tangga di Indonesia timur. Dengan menggunakan data IFLS East tahun 2012 dan metode estimasi OLS serta probit with sample selection, hasil studi menunjukkan bahwa keterbatasan akses pangan secara geografis dapat menyebabkan ketidakterjangkauan pangan yang berakibat pada meningkatnya kekurangan gizi, baik pada anak balita maupun individu dewasa.Sedangkan dari sisi akses pangan secara ekonomi, hasil studi menemukan bahwa keterbatasan akses pangan dari sisi pendapatan maupun harga pangan pokok tidak hanya meningkatkan kemungkinan kekurangan gizi pada anak balita, tetapi juga dapat beban ganda malnutrisi dalam satu rumah tangga. Hasil studi ini mengimplikasikan bahwa diperlukan kebijakan stabilisasi harga pangan, terutama pangan pokok untuk mengatasi malnutrisi, termasuk menurunkan kemungkinan beban ganda malnutrisi dalam satu rumah tangga di Indonesia timur. Namun, untuk daerah yang cenderung mengalami kekurangan gizi, diperlukan pula perbaikan akses pasar untuk dapat meningkatkan status gizi masyarakat di daerah tersebut.

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ABSTRACT

The increasing of overweight and underweight prevalence in Indonesia represent that Indonesia face double burden of malnutrition. In the Eastern of Indonesia, as high as the prevalence of underweight, the prevalence of overweight are also higher than national prevalence. From these fact, we have an opinion that lack of food access, either geographically or economically, lead adult gain overweight, but in other side, child tend to being underweight. Using IFLS East data 2012, this study aim to analyze the impact of food access to child undernutrition, adult overweight, and household double burden of malnutrition in Eastern Indonesia.

Estimate with ordinary least square and probit with sample selection, this study find out that lack of food accessibility lead children and adult being underweight. In other side, food affordability, higher food price lead to double burden malnutrition. These result imply that stabilizing food price would be one of key to attacking double burden of malnutrition in the Eastern of Indonesia. These study also imply that the policies are needed to tackling malnutrition in the Eastern of Indonesia should be different between province, for province with high prevalence of underweight also need to provide better access to market."

"Gizi buruk merupakan kekurangan gizi tingkat berat terutama pada anak-anak dibawah umur lima tahun (balita) dan merupakan salah satu masalah gizi utama di Indonesia yang perlu ditanggulangi karena berdampak terhadap kesehatan dan Human Devolopment Index manusia Indonesia 15-20 tahun yang akan datang. Masalah gizi memiliki dimensi yang luas, tidak hanya merupakan masalah kesehatan tetapi juga meliputi masalah sosia}, ekonomi, budaya, pola asuh, pendidikan dan lingkungan. Faktor pencetus munculnya masalah gizi dapat berbeda antara wilayah ataupun antara kelompok masyarakat, bahkan akar masalah ini dapat berbeda antara kelompok usia balita. Kondisi krisis ekonomi sejak tahun 1997 dan terus berkelanjutan sampai saat ini, menyebabkan daya beli pada masyarakat secara umum menjadi menurun, karena disatu pihak relatif banyak yang kehilangan sumber mata pencaharian sementara dipihak lain adanya peningkatan harga barang dan jasa. Hal ini dapat mengakibatkan dampak buruk terhadap kesehatan dan gizi masyarakat, terutama balita. Masalah gizi pada anak balita di provinsi Riau dari tahun ke tahun cenderung meningkat. Penelitian ini bertujuan untuk mengetahui hubungan antara faktor status ekonomi keluarga dengan terjadinya kasus gizi buruk pada anak balita umur 6 bulan sampai < 5 tahun di Kabupaten Kampar Riau tahun 2002, dengan variabel kovariatnya yaitu riwayat diare, pendidikan ayah, pendidikan ibu, umur balita, jenis kelamin, jumlah anggota keluarga, pekerjaan ayah, pekerjaan ibu, pengetahuan ibu, dan pemberian ASI ekslusif. Penelitian ini merupakan penelitian bservasional dengan metoda kasus kontrol. Responden dalam penelitian ini adalah ibu-ibu yang mempunyai anak balita umur 6-59 bulan dengan status gizi buruk saat penelitian, dan sebagai kontrolnya adalah ibu dengan balita gizi baik (148 kasus dan 148 kontrolnya). Penelitian dilakukan di Kabupaten Kampar Riau. Analisis data dilakukan dengan uji kai kuadrat dan analisis multivariat menggunakan regresi logistik. Hasil uji analisis logistik diketahui ada hubungan yang signifikan antara status ekonomi keluarga dengan terjadinya kasus gizi buruk pada anak balita di Kabupaten Kampar Riau (p=0,0001) dengan OR 2,8599 (95% CI: 1,7176 - 4,7619 ). Dari hasil perhitungan dampak potensial diketahui bahwa status eknomi keluarga (keluarga miskin) mempunyai kontribusi sebesar 47% sebagai faktor risiko terjadinya gizi buruk balita, artinya jika faktor ini dihilangkan maka akan dapat dicegah terjadinya gizi buruk pada balita sebesar 47%. Disimpulkan bahwa status ekonomi keluarga mempunyai hubungan yang signifikan dengan terjadinya gizi buruk pada anak balita, untuk itu dalam upaya penanggulangan dan pencegahan masalah gizi agar memberikan perhatian dan penekanan kepada variabel status ekonomi keluarga (kemiskinan), dengan melakukan upaya terpadu. Dalam pemilihan dan perencanaan upaya yang berkaitan dengan masalah gizi buruk ini agar mempertimbangkan ukuran dampak potensial yang berkontribusi terhadap terjadinya kasus gizi buruk pada anak balita.

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The Relationship Between Family Economical Status and The Incidence of Severe Malnutrition Cases Among Children of Under five Years in Kabupaten Kampar Riau Province 2002Severe Malnutrition is the chronic nutrient deficiency, which usually occurs at under five years old children. It also the main nutrient problems in Indonesia that should have to decline and reducing its effects to health and Indonesians Human Development Index for the next 15 - 20 years.

The nutrition problem has a very wide dimension, not just public health problems but also social, economic, culture, care, education, and environment. The ignitions of nutrition problems in one region or society to another could be different, in fact the occurrence among under five years old children could be different.

Indonesia's economic crisis conditions in 1997 and still continuing today caused public's purchasing power decreasing generally, as effect of un-employments and the raise of goods and services prices. Those conditions could make worst for public's health and nutrients, especially toddlers. Nutrient problems in Riau Province inclination increase years after years.

The goals of this research is to determines the connection between economical status factors and severe malnutrition incidences, age between 6 months - 5 years old, at Kabupaten Kampar Riau in 2002; with diarrheic, parents educational, toddlers age, gender, numbers of family members, parents works, mother's maternity knowledge, and breast feeding, as the covariate variables.

This research is an observational research with case control method. The respondents of this research are the mothers that have children of under five years, which have severe malnutrition, and as the controls are the mothers that have good nutrition (148 cases and 148 controls). The research took place at Kabupaten Kampar Riau (p = 0,0001) with OR 2, 8599 (95% CI: 1,7176 - 4,7619).

According to potential effect formula, had known that the family's economical status (poor family) have 47% contributions as risk factor of severe malnutrition cases , that mean if we can eliminate this factor, we can reduce the toddlers bad nutrient cases to 47%.

The conclusion of the research, that family's economical status has a significant connection to incidence severe malnutrition cases, therefore any dealing and prevention acts with public's nutrients and health problems should pay attention to family's economical status variable by doing full planning works. In determining and planning acts to prevent the nutrient problems, we have to considering the potential effect values that make contributions to severe malnutrition cases."

"ABSTRAKNama : Herlina PurbaNPM : 1306489205Falkultas : Ilmu Keperawatan Program Profesi NersJudul : Analisis Praktik Klinik Keperawatn Anak Kesehatan Masyarakat Perkotaan dengan Masalah Gangguan Kebutuhan Nutrisi pada Klien Gizi Kurang di RSPAD Gatot Subroto Perkotaan dengan penduduk yang memiliki pendapatan tinggi, menengah dan rendah tetap menunjukkan adanya masalah malnutrisi. Malnutrisi ini berakar pada kemiskinan dan ketidakmampuan. WHO 2010 menunjukkan 18 103 juta anak balita di Negara berkembang mengalami kurang gizi. WHO juga memperkirakan 54 kematian bayi dan anak dilatarbelakangi oleh keadaan gizi buruk, sedangkan di Indonesia masalah gizi mengakibatkan 80 kematian anak WHO, 2011 . Anak dengan gizi buruk akan mempengaruhi tumbuh kembangnya. Upaya penanganan balita dengan gizi kurang sudah dilakukan di puskesmas atau rumah sakit. Asuhan perawatan gizi anak memerlukan monitoring yang berkelanjutan mulai dari rumah sakit sampai klien pulang ke rumah. Hal inilah yang mengakibatkan perlunya edukasi pada keluarga klien agar tujuan pencapaian gizi anak dapat optimal. Edukasi adalah salah satu tugas perawat yang penting untuk meningkatkan kesehatan klien. Perawat memberikan informasi kepada klien yang membutuhkan perawatan untuk kelanjutan pelayanan kesehatan dari rumah sakit ke rumah Falvo, 2004 dalam Potter Perry, 2009 .Kata kunci : malnutrisi, anak, perkotaan

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ABSTRACTAbstractName Herlina PurbaStudy Program Ners ProgrammeTitle Analysis of clinical practice children with problem of urban community health disorder nutritional needs of the clients of malnutrition in the RSPAD Gatot SubrotoCities with a population whose income is high, medium and low fixed indicate a problem of malnutrition. Malnutrition is rooted in poverty and disability. WHO 2010 showed 18 103 million of children under five in developing countries are malnourished. WHO also estimates that 54 of deaths of infants and children is motivated by the poor nutritional status, while in Indonesia, nutritional problems resulted in 80 of childhood deaths WHO, 2011 . Children with poor nutrition will affect growth and development. The handling infants with malnutrition has been done in the clinic or hospital. Child nutrition care requires continuous monitoring ranging from hospitals to the clients home. This has resulted in the need to educate the client 39 s family for the purpose of achieving the optimal child nutrition. Education is one of the duties of nurses are critical to improve the health of the client. Nurses provide information to clients who require treatment for the continuation of health care from hospital to home Falvo, 2004 in Perry, 2009 Keywords malnutrition, child,city "

"Penelitian ini bertujuan mengetahui efektifitas PERGIZI dilihat dari komponen input, proses, output dan outcome. Penelitian kualitatif dengan rancangan RAP (Rapid Assesment Procedure), dilakukan minggu keempat bulan Mei 2013 dengan informan kepala seksi gizi, petugas gizi, kader, bidan di desa, ibu balita dan tokoh masyarakat. Hasil penelitian menunjukkan PERGIZI efektif untuk menanggulangi gizi buruk di Puskesmas Sepatan. dengan indikator meningkatnya status gizi sebesar 69,1%, hanya komponen input yakni dana yang disebagian besar pos gizi masih kurang, sedangkan dari komponen proses dan output telah dapat mencapai tujuan yang ditetapkan. Agar mengoptimalkan penanggulangan gizi buruk di wilayah Puskesmas Kabupaten Tangerang dengan PERGIZI.

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The aims of this study was to determine the effectiveness of the PERGIZI program viewed by its component such as inputs, process, outputs and outcomes. A qualitative research with RAP (Rapid Assessment Procedure) design was conducted at fourth week of May 2013. The data collection methods used an indepth interview and focused group discussion. With the informants 42 persons consisting of section head of nutrition, nutrition workers, cadres, village midwives, mothers of under five children and community leaders. This could be seen from change of nutritional status from the under five children as much as 69,1%. From the input component the mean barrier was funding both component process and output was considered successfull and achieving the predetermined goal. It is recomended to solve existing under five nutritional problem in the district of Tangerang using the PERGIZI approach."

"Kasus gizi buruk balita masih menjadi permasalahan serius di Indonesia. Tujuan penelitian ini menjelaskan pengaruh pemberian diet formula 75 dan 100 terhadap berat badan balita gizi buruk rawat jalan. Desain penelitian menggunakan quasi experimental pre-post test with control group dengan teknik total sampling, terdiri dari 15 responden sebagai kelompok intervensi dan 15 responden sebagai kelompok kontrol. Analisis yang digunakan adalah uji chi squere, paired t-test, independent t-test serta uji ancova. Hasil uji statistik menunjukkan terdapat perbedaan yang bermakna berat badan balita gizi buruk rawat jalan sebelum dan sesudah perlakuan pada kelompok intervensi dan kelompok kontrol (p-value < α). Peningkatan berat badan kelompok intervensi lebih besar daripada kelompok kontrol. Puskesmas diharapkan menindaklanjuti hasil penelitian ini sehingga dapat mencapai target berat badan balita gizi buruk rawat jalan sesuai dengan standar.

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Malnutrition is still a serious problem in Indonesia which often occur in groups of children aged under five years old. The research objective is to describe the influence of diet formulas 75 and 100 to the body weight of under five years old malnutrition outpatient. Research design using quasi experimental pre-post test with control group with total sampling technique, consists of 15 respondents as intervention group and 15 respondents as control group. The analysis using chi square, paired t-test, independent t-test and ancova test.

Statistical test results shows that there were significant differences the body weight of under five years malnutrition outpatients before and after treatment in the intervention group and control group (p-value <α). The improvement of body weight on intervention group is greater than the control group. The public health center are expected to follow up the results of this study as to reach the target of body weight of children under five years malnutrition outpatients according to the standard."

"Banization is one of the causes of dietary changes creating dual form malnutrition. Susilowati (1997) discovered this condition occurred at national level and within households in East Jakarta. Lower energy expenditure and higher energy intake were predicted as potential risk of overweight, opposite to underweight status. This cross sectional survey aimed to explore the dietary intake and physical activity which resulted dual form malnutrition by comparing overweight mothers having underweight children and their normal counterparts. In this study, 81 pairs of mothers and their under fives were recruited for dietary intake, nutritional status and physical activity assessment and divided into two groups: the case group consisting of overweight or obese mothers with their underweight children, and the normal grove comprised of normal mothers with their normal children. Repeated 3 days.24-hour recall food intake of mothers and children, as well as physical activity of mothers but only one day of physical activity data for the children, were collected followed by ale day 24-hour recall plus observation from 08.00 to 16.00 for activities of sub sample children. Mean energy and macronutrients intake of the case mothers was higher than their normal peers, but there was no statistical significant difference between groups, which might be due to under reported energy intake. Estimated BMR and energy expenditure of the case mothers were significantly higher than their normal counterparts, though there was no difference in their PAL. Notorious energy balance was discovered after subtracting energy intake and expenditure, which might be due to under-reported energy intake. After adjustment by age and sex, statistical significant difference was found in energy intake and PAL. BMR and energy expenditure of the underweight children was lower significantly in contrasted to the others. Negative energy balance was discovered among the case children, opposite to positive energy balance of the normal peers. This research was part of a Multi-center study, Dietary Transition and Health in Asia."

"Bayi dengan berat badan lahir rendah dan retardasi perkembangan intrauterin masih merupakan masalah,khususnya di Indonesia karena menunjukkan angka kejadian yang tinggi dan perlu diturunkn"