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"Program jangka panjang, dengan "pendekatan berbasis pangan" untuk penanggangan kekurangan vitamin A (KVA) semakin penting peranannya. Telah dilakukan penelitian dalam rangka sistim pemantauan Vitamin A di Jawa Tengah yanig menghubungkan asupan vitamin A dengan kadar serum retinal pada ibu-ibu laktasi dengan Batita (anak bawah tiga tahun) selama krisis. Median asupan vitamin A 319 RE/d buta senja : 0,34%. Kadar serum retinal (rerata 1,23 jMnol/L} berhubungan dengan asupan vitamin A model multiple logistic regresi untuk memprediksikan peluang terjadinya pengaruh berbagai faktor determinant menunjukkan : Asupan vitamin A dari pangan nabati (OR/95% Cl] per quartile, 1 : LOO, 2': 1,63 fO.99-2.80/, 3rd: 1.99 11,58-2,991, dan 4'1': 2.62 [1,68-4,04], dari pangan hewani (V dan T1: 1,00. 3 : 137 [0,89-2,09] dan 4'h: 2,86 [1,59-3,98 j). Kebun gizi (tidak 1.00, ya 1.88 f1,08-2,68J ) dan pendidikan ibu ( sekolah lanjutan: 1,46 /1,00-2.16J ). Kontribusi asupanan vitamin A sumber nabati 16 kali lebih besar dibanding sumber hewani, sama pentingnya dalam mempengaruhi status vitamin A. Kebun gizi dan tingkat pendidikan ibu merefleksikan konsumsi pangan sumber nabati dan hewani dalam jangka panjang. (MedJ Inidones 2006; 15:259-66)

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For the Longer term food-based approaches for controlling vitamin A deficiency and its consequences, become increasingly important. A nutrition survailance system in Central-Java, Indonesia assessed vitamin A intake and serum retinal concentration of lactating women with a child <36 mo old during crisis. Median vitamin A intake was 319 RE/d and night blindness 0,34%. Serum retina! concentration (mean : 1,23 jMnol/L] was related to vitamin A intake in a dose-concentration manner. The multiple logistic regression model for predicting the chance far a scrum retinal concentration > observed median of the population (27,27 funol/L) intended determinant factors, vitamin A intake from plant foods (OR/95% Cl) per quarttie, 1" : 1.00, 2"d: 1.63 [0.99-2,80], 3nl: 1.99 [1.58-2,99], and /'': 2,62 [1,68-4,04], from, animal foods (T and 2'"': 1,00. 3"': 1,37 [0,89-2,09] and 4th: 2,86 [1,59-3,98]). Home gardening (no 1,00, yes 1.88 f 1,08-2.68}) and woman's education level (< primary school : 1,00 >secondary school: 1,46 [1,00-2,16]). Tints, although contributing 16 times more to total vitamin A intake plant foods were as important for vitamin A status as animal foods. Home gardening and woman's education level seem to reflect longer-term consumption of plant and animal foods respectively. (Med J Indones 2006; J 5:259-66)"

"Program jangka panjang dengan "Pendekatan berbasis pangan" untuk penanggulangan kekurangan vitamin A (KVA) semakin penting peranannya."

"ABSTRAKTujuan : Mengetahui perubahan kadar vitamin A plasma dan hubungannya dengan keadaan klinis penderita stroke iskemikMetodologi : Penelitian dengan desain potong lintang dilakukan pada 26 pasien stroke iskemik dengan onset kurang dari 48 jam. Pengambilan subyek penelitian dilakukan dengan cara consecutive sampling. Pemeriksaan kadar vitamin A dengan metode high performance liquid chromatography (HPLC), dilakukan pada saat pasien masuk, hari kedua, ketiga dan kelima perawatan. Data yang dikumpulkan meliputi : karakteristik demografi, faktor-faktor risiko, asupan nutrisi dengan metode recall 1 x 24 jam, food frequency questionnaire (FFQ) semik antitatif dan selama dirawat dg food record, indeks massa tubuh (IMT) serta penilaian klinis dengan National Institutes of Health Stroke Scale (NIHSS).Hasil : Jumlah subyek penelitian 26 orang (20 laki-laki dan 6 perempuan) dengan rerata usia 60.58 + 9.36 tahun. Faktor risiko terbanyak adalah hipertensi yaitu 80.1%. Berdasarkan WIT, 53.9% subyek masuk dalam kategori berat badan lebih. Tidak didapatkan hubungan yang bermakna antara asupan vitamin A, lemak dan vitamin E dengan kadar vitamin A plasma Rerata kadar vitamin A plasma masuk dalam kategori nominal dan menunjukkan peningkatan yang bermakna pada hari kelima perawatan (p: 0,035). Perjalanan klinis penyakit berdasarkan NIHSS menunjukkan perbaikan yang bermakna (p: 0,045 - 0,005). Terdapat korelasi negatif dan bermakna antara peningkatan kadar vitamin A plasma dengan penilaian NIHSS pada hari kelima perawatan (r:0,391, p: 0,049).Kesimpulan : Terdapat perbedaan yang bermakna antara kadar vitamin A plasma pada hari pertama dengan hari kelima perawatan. Terdapat perbedaan yang bermakna pada penilaian NIHSS selama lima hari perawatan. Terdapat korelasi negatif bermakna antara kadar vitamin A plasma dengan penilaian NIHSS pada hari kelima perawatan.Kata kunci : Vitamin A, stroke iskemik

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ABSTRACT

Levels Of Vitamin A In Ischemic Stroke Patients

Objective : The purpose of this study was to investigate the time course of plasma vitamin A changes and its relation with clinical state in ischemic stroke patients.

Metodology : A cross sectional study was carried out among 26 patients with ischemic stroke of recent onset (< 48 hours). Consecutive sampling method was used to obtain the subject. Plasma vitamin A level was measured using high performance liquid chromatography (HPLC) on admission, and days 2, 3, and 5. Data collected were demographic characteristics, risk factors of stroke, nutrient intake using 24 hours recall, semi quantitative food frequency questionnaire (FFQ) and food record method when hospitalized, body mass index (BMI), and clinical condition using National Institutes Health Stroke Scale (NIHSS).

Result, : The subjects consist of 26 patients (20 males and 6 females) with a mean of age 60.58 + 9.36 years. Hypertension was the most modifiable risk factors (80.1%) that found. Based on SMI, 53.9% subjects had overweight. There were no relationship between nutrient intake (vitamin A, fat and vitamin E) and plasma vitamin A level. Plasma vitamin A level was still in the normal range and gradually increased in the following days, it showed a significant increase on day 5 since admission (p: 0.035). The score of NIHSS was significantly decreased along hospitalized (p: 0.045 - 0.005)_ A significant negative correlation between plasma vitamin A levels and NIHSS score on day 5 was found (r: -0.391, p: 0.049).

Conclusion : There was significant difference in plasma vitamin A level between day 5 and at admission. Scores of NIHSS were significantly different in the following days. A significant negative correlation between plasma vitamin A levels and scores of NIHSS on day 5 was found."

"ABSTRACTThe relationship between serum vitamin A level and protein-energy status of 61 children in Jakarta was studied. The children 1 - 6 years old either received vitamin A supplements at various times, or never received any vitamin A supplements at all. There was a high prevalence of PEM among the sample and their energy and vitamin A consumption were low, though protein intake was adequate. The serum vitamin A levels of PEM children who received vitamin A supplements tended to decline more rapidly with time after supplementation compared to their non-PEM counterparts. A positive correlation, though weak, was also observed between serum vitamin A level and Wt/Age of the children. It was thus concluded that the fast decline in serum vitamin A level of PEM children could predispose them to vitamin A deficiency despite vitamin A supplementation. It was also suggested that further investigation is needed on the relationship between Wt/age and serum vitamin A level, because if such a relationship is established, Wt/age could be a very useful index for identifying children who are "at risk" of developing vitamin A deficiency."

"Makalah ini merupakan penulisan ilmiah yang membahas mengenai bagaimana mekanisme Kerja Vitamin E sebagai Suatu Antioksidan. Vitamin E diketahui merupakan vitamin yang mempunyai banyak peranan, namun bagaimana mekanisme kerjanya di jaringan masih banyak dibicarakan dan didalami oleh peneliti-peneliti. Mudah-mudahan penulisan ilmiah ini memberikan keluasan wawasan pengetahuan bagi penulis khususnya dan pembaca umumnya."

"Kurangnya gizi pada anak dan remaja masih menjadi masalah yang mendunia, khususnya vitamin A yang memiliki peran yang sangat penting dalam pertumbuhan dan perkembangan. Indonesia masih termasuk dalam negara dengan penduduk yang memiliki angka kecukupan gizi vitamin A yang kurang. Ini bisa disebabkan selain kondisi ekonomi mereka, tapi juga karena kurangnya pengetahuan mengenai manfaat vitamin A. Penelitian ini dilakukan untuk mengetahui pengaruh pemberian edukasi mengenai nutrisi terhadap pengetahuan vitamin A pada sekelompok remaja. Sasaran penelitian ini adalah siswa - siswi di pesantren Tapak Sunan, Condet, Jakarta Timur dengan usia 14-19 tahun. Sebanyak 68 siswa berpartisipasi dalam penelitian ini. Data diperoleh melalui kuesioner yang diisi sebelum dan setelah diberikan edukasi nutrisi. Informasi yang didapat kemudian diuji dengan menggunakan metode Wilcoxon dan McNemar. Hasil penelitian menunjukan bahwa edukasi nutrisi yang diberikan berpengaruh cukup signifikan dengan nilai post-test. Uji statistik Wilcoxon menunjukan bahwa pemberian edukasi memiliki peran yang signifikan dengan perubahan nilai post-test. Uji statistik McNemar juga menunjukan adanya perubahan nilai yang signifikan sebelum dan setelah pemberian edukasi (p = 0.006). Kesimpulannya: Edukasi nutrisi yang diberikan cukup efektif dalam meningkatkan pengetahuan remaja tentang vitamin A.

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The lack of nutrition amongst children and adolescence is still a worldwide problem, especially vitamin A that plays an important role in process of growth and development. Indonesia is listed as one of the country with low recommended dietary allowance of vitamin A. This can be cause not only by their economic status, but also the lack of knowledge about the benefit of vitamin A.

This research is conducted to learn the effect of nutritional education towards the knowledge of vitamin A in a group of adolescent. The research is done to a group of students in pesantren Tapak Sunan, Condet, East Jakarta with age range of 14-19 years. A number of 68 students participated in this research. Data is collected by questionnaire that is given before and after the nutritional education. The information that is obtained was then tested using the Wilcoxon and McNemar method.

The result of the research shows that the nutritional education that was given has a significant effect towards the post-test score. Data analysis using Wilcoxon shows that the nutritional education has a significant role in the changes of post-test level of knowledge (p = < 0.001). McNemar data analysis also revealed significant changes before and after the provision of education (p = 0.006).

Conclusion: The nutritional education that was given is effective in increasing the knowledge of adolescent about vitamin A."

"Berdasarkan indikator klinis, kekurangan vitamin A di Indonesia sudah bukan masalah kesehatan masyarakat lagi karena prevalensi xeroftalmia telah berhasil diturunkan hingga 0,34%. Namun penurunan prevalensi xeroftalmia tersebut tidak dibarengi dengan penurunan angka KVA marginal pada kelompok rawan, termasuk pada kelompok bayi. Hal ini perlu mendapat perhatian mengingat dampak yang diakibatkan menyangkut kelulushidupan anak. Banyak faktor yang berpengaruh terhadap status vitamin A. Pada kelompok bayi menyusu, status gizi anak dipengaruhi oleh status gizi ibunya.Penelitian ini merupakan studi dasar dari penelitian intervensi, yang bersifat cross-sectional yang dilakukan di dua desa Kecamatan Cibungbulang, Kabupaten Bogor tahun 1997. Penulisan yang menggunakan data sekunder ini bertujuan mendapatkan informasi mengenai gambaran status vitamin A ibu dan status vitamin A bayi serta informasi mengenai hubungan antara status vitamin A ibu menyusui maupun faktor lain terhadap status vitamin A bayi. Sampel penelitian adalah bayi menyusu usia 2-10 bulan tanpa disertai penyakit kronis dan tidak mengalami kelainan bawaan maupun KEP berat serta bukan bayi kembar. Besar sampel 183 anak. Untuk mengetahui hubungan antara variabel independen dengan variabel dependen digunakan uji Chi-kuadrat dan prevalence odds ratio (POR) dengan selang kepercayaan 95%. Sedangkan regresi logistik ganda digunakan untuk melihat hubungan variabel independen utama terhadap variabel dependen setelah variabel independen lain yang berpengaruh dikontrol. Hasil penelitian menunjukkan bahwa 18,7% ibu menyusui menderita KVA dan pada bayi sebesar 54,1%. Secara bivariat, terdapat dua variabel independen yang menunjukkan hubungan yang signifikan dengan variabel dependen yaitu variabel status vitamin A ibu (POR=2,85; 95% CI:1,25-6,53) dan status infeksi bayi (POR=3,90; 95% CI:I,25-12,1S). Besarnya prevalence odds ratio dari empat variabel independen lainnya adalah POR=0,56; 95% CI: 031-1,01 untuk variabel pemberian ASI dan POR=1,29; 95%Cl: 0,63-2,64 untuk variabel pemberian MP-ASI, sedangkan untuk variabel umur bayi dan status gizi bayi (BBIU) besarnya POR masing-masing POR=2,07; 95% CI: 0,96-4,46 dan POR=2,37; 95% CI: 0,61-9,25. Stratifikasi menurut umur menunjukkan adanya interaksi antara pemberian MP-ASI dengan umur, sedangkan pemberian ASI tidak menunjukkan interaksi dengan umur. Analisis regresi logistik ganda menunjukkan besarnya POR yang menggambarkan hubungan status vitamin A ibu dengan status vitamin A bayi setelah pengontrolan variabel lain yang signifikan, adalah POR=3,18; 95% CI: 1,36-7,44.Dari penelitian ini dapat diambil simpulan bahwa KVA marginal pada bayi menyusu usia 2-10 bulan di daerah penelitian, merupakan masalah kesehatan masyarakat tingkat berat. Status vitamin A ibu mempunyai hubungan yang kuat dengan status vitamin A bayi setelah variabel independen lain yang berpengaruh yakni status infeksi bayi dan frekuensi pemberian ASI, dikontrol.Disarankan, pelaksanaan program pemberian kapsul vitamin A bagi bayi hendaknya mempertimbangkan kapan puncak kejadian penyakit infeksi yang berhubungan dengan KVA terjadi. Disarankan pula, sebagai upaya pencegahan KVA pada bayi dan ibunya, perlu peningkatan konsumsi bahan makanan setempat yang kaya vitamin A bagi ibu, yang lebih mudah dilakukan dibandingkan pada bayi.

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Relationships between Maternal Vitamin A Status and Other Factors with Infant Vitamin A Status in Bogor 1997Based on clinical indicators, vitamin A deficiency in Indonesia is no longer considered a public health problem because the prevalence of xerophthalmia has been decreased to 0,34%. But this decrease has not been followed by a decrease of marginal deviancy of vitamin A in vulnerable groups, especially infants. This is important considering the impact on child survival. There are many factors related to vitamin A status. Also, the nutritional status of the breastfed infant has a strong relationship with the maternal nutrition status.This is the cross-sectional baseline study of an intervention study that was conducted at two villages of Cibungbulang District of Bogor Regency in 1997. The aim of this secondary data study was to get information about maternal vitamin A status and the vitamin A status of the breastfed infant, and to look at the relationships between maternal vitamin A status and other factors, with infant vitamin A status. The study sample included 183 breastfed infants 2-10 months without chronic disease, congenital disease, severe PEM nor twins. The Chi-square and the Prevalence Odds Ratio (POR) at the 95% confidence interval were used to measure the association between independent variables with dependent variable. Multiple logistic regressions were used to measure the association between the independent variable and the dependent variable by controlling for other significant independent variables.Results of this study showed that 18,7% of mothers and 54,1% of their breastfed infants were at risk of vitamin A deficiency. By bivariate analysis, there are two significant independent variables related to the dependent variable, namely maternal vitamin A status (POR 2,85; 95% CI:1,25-6,53) and infant infection status (POR- 3,90; 95%CI:1,25-12,18). The prevalence odds ratio of the other independent variables are POR 0,55; 95% CI: 0,30-1,02 for breastfeeding and POR=1,29; 95% CI; 0,63-2,64 for supplementary feeding, POR=2,07; 95% CI 0,96-4,46 and POR=2,37; 95% Cl: 0,61-9,25 for infant age and nutrition status (weight for age) respectively. Stratification by age showed an interaction between supplementary feeding with age, but no interaction between age and breastfeeding. Multiple logistic regression analysis showed that the POR adjusted for maternal vitamin A status was 3,18 with 95% CI: 1,36-7,44.Conclusions of this study are: i. Marginal vitamin A deficiency in infants 2-10 months is still a public health problem in the research area; ii. Maternal vitamin A status is strongly related with infant vitamin A status after controlling for other significant variables e.g. infant infection status and breast feeding frequency.It is suggested to consider the peak season of infection in infants, as there is a relationship with vitamin A deficiency when implementing programs of the vitamin A capsule distribution for infants. It is also suggested, in order to prevent vitamin A deficiency in infants and their mothers, it is easier to increase consumption of vitamin A rich local food by mothers than by the infants."

"Tujuan: Mengetahui pengaruh suplementasi vitamin B12 400 µg/hari selama enam minggu terhadap kadar vitamin B12 dan homosistein serum pada adventis vegan dewasa. Tempat: Gereja Masehi Advent Hari Ketujuh, Jakarta Barat. Metadologi: Penelitian pro dan pasca perlakuan pada 27 orang subjek, berusia 20-60 tahun. Setiap subjek mengkonsumsi suplemen vitamin B12 400 µg/hari dosis tunggal selama 42 hari. Data yang dikumpulkan meliputi data demografi, antropometri pra dan pasca perlakuan, asupan nutrisi (energi, karbohidrat, protein, dan lemak) dengan metode recall 1 x 24 jam dua kali seminggu pra, pertengahan dan pasca perlakuan. Data asupan vitamin B6, B12 dan asam folat dengan FFQ semi kuantitatif serta data laboratorium meliputi kadar vitamin B12, asam folat, dan homosistein serum pra dan pasta perlakuan. Hasil: Data demografi menunjukkan sebagian besar (81,5%) subjek berpendidikan tinggi dan semua subjek berpenghasilan di atas garis kemiskinan. Data antropometri pada pra dan pasca perlakuan menunjukkan seluruh subjek mempunyai IMT dalam batas normal. Asupan nutrisi selama perlakuan yang meliputi asupan energi, karbohidrat, lemak dan protein tidak mengalami perubahan. Bila dibandingkan dengan AKG tahun 1988 asupan energi, sebagian besar subjek termasuk cukup, asupan karbohidrat, dan protein termasuk kurang; asupan lemak termasuk lebih, Asupan vitamin B6 pada akhir perlakuan tidak menunjukkan penurunan secara signifikan (p=0,6874), sebaliknya dengan asupan vitamin B12 yang menunjukkan peningkatan signifikan (p = 0,021) dan asam folat yang menunjukkan penurunan signifikan (p = 0,0001). Hasil pemeriksaan laboratoriurn pada akhir perlakuan menunjukkan peningkatan signifikan pada kadar vitamin B12 (p = 0,0000) sebesar 202,6%, dari median 127 (58,0-193,0) pg/mL menjadi 376 (183,0-1168,0) pg/mL dan penurunan kadar homosistein yang signifikan (p = 0,0000) sebesar 39% dari median 14,50 (11,1-34,2) } µmol/L menjadi 9,50 (5,6-24,8) µmol/L. Kadar asam folat tidak mengalami penurunan bermakna (p = 0,2960). Kesimpulan: Suplementasi vitamin B12 sebanyak 400 µg/hari selama 42 hari pada vegan terbukti meningkatkan kadar vitamin B12 dan menununkan kadar homosistein.

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The Effect Of Vitamin B12 Supplementation On Homocysteine Level Of Adult VegansObjective: To investigate the effect of 400 µg /day vitamin B12 supplementation for 42 days on serum vitamin B12, and homocysteine levels of 27 adult vegan subjects.

Location: Seventh Day Adventists Church, West Jakarta.

Method: A pre and post test design study was carried out on 27 subjects, aged 20-60 years, who fulfilled the criteria of the selection. Subjects were given 400 µg/day vitamin B12 single dose supplementation for 42 consecutive days. Data collected were demographic, anthropometric, nutritional, and laboratory. The data of energy, carbohydrate, protein, and fat intake were collected using 1 x 24 recall method twice a week at the beginning, within, and the end of the study; whilst vitamin B6, B12 and folk acid intake were obtained with FF0 semi-quantitative method at the beginning and the end of the study. Laboratory data were collected before and after study including serum vitamin B12, folk acid and homocysteine

Results: Demographic data showed that most of the subjects had high formal education level (81.5%) and all subjects had income above the poverty line. Anthropometric data showed that BMI at the beginning and in the end of the study were in normal range. Dietary intake estimation including energy, carbohydrate, protein, and fat, were not significantly changed. Compared to Indonesian RDA 1998, intake of energy was considered adequate, carbohydrate and protein were low, and fat was high. Vitamin B6 intake did not decrease significantly (p = 0.6874) However vitamin B12 intake increased (p = 0.021) and folic acid intake decreased significantly (p = 0.0001). Median value of serum vitamin B12 after supplementation increased significantly (p = 0,0000) by 202.6% from 127 (58.0-193.0) pg/mL to 376 (183.0-1168.0) pg/mL. There was no significant difference in the serum level of folic acid (p = 0.2960). Median value of homocysteine after supplementation decreased significantly (p = 0.0000) by 39% from 14.50 (3.8-34.2) man, to 9.50 (5.6-24.8) µmol/L.

Conclusion: Supplementation of single dose 400 µg vitamin B12 for 42 consecutive days on adult vegan subjects was proven to elevate the level of serum vitamin B12 and decrease the level of homocysteine."