Indonesians face serious health issues that arise from malnutrition, particularly in children who are under unfavorable dietary environments. The present study established a school meal program consisting of dietary and educational interventions and evaluated its impact on promoting continuous improvement in dietary behavior among junior and senior high school students in Indonesia. A total of 319 students belonging to an Islamic Boarding School participated in the pre-post intervention study for 9 months. All participants were assessed based on their Knowledge, Attitude, and Practice (KAP). A subgroup of 115 participants who were anemic and underweight was examined for dietary intake, nutrition status, and hemoglobin level. The KAP test scores for both nutrition and hygiene showed a significant increase for all students and the undernutrition group post-intervention. Protein, iron, and vitamin C intake significantly improved. Although there were no significant improvements in nutrition status, there was a significant increase in the hemoglobin level and a reduction in the prevalence of anemia from 42.6% to 21.7%. Thus, school meal program that combines dietary and educational interventions may effectively improve anemia in undernourished students as well as enhance the knowledge, attitudes, and practices related to health, nutrition, and hygiene in junior and senior high school students.

Okra (Abelmoschus esculentus L.), a tropical vegetable has been reported to have many important biological properties and has been used extensively as a traditional medicine especially for diabetic.In general, the objective of this study was to analyze the potentialof okra extract to body weight and pancreas histopathology in streptozotocin (STZ)-induced diabetic rats and the result will be compared with that of control DM. The experimental design in this study was pre and post test controlled group design. The first step of this study was analyzing the bioactive compound of okra extract. The next step was administiring okra extract to control group and diabetic rats induced by STZ 50 mg/kgBW for 14 days group. Sprague dawley rats were divided into six groups: normal control (N), diabetic control (DM), diabetic treated with green okra extract (GOE) with the dosage of 5 mg/kgBW quercetin and 10 mg/kgBW quercetin, diabetes treated with purple okra extract (POE) with the dosage of 5 mg/kgBW quercetin and 10 mg/kgBW quercetin. Body weight was weighed every three days and pancreas histopathology was measured by immunohistochemistry indirect method. The following results showed that IC50, antioxidant capacity, fenolic, and quercetin contents ofpurple okra extract were higher (316.86 ppm; 417.54 mg/100g; 3.60%; 0.45 mg/g) than green okra extract (326.48 ppm; 341.43 mg/100g; 3.58%; 0.27 mg/g). Administration of GOE I, GOE II, POE I and POE II in diabetic did not give a significant effect to changes in body weight of rats, but effectively could improve repairmen of β cell pancreas destruction due to STZ induction. These results suggest that intervention of green okra extract and purple okra extract based on quercetin compound showed an antidiabetic potency.

The diet of Indonesian women of childbearing age is relatively poor, posing increased risk for suboptimal pregnancy outcome. In a cross-sectional study including 403 women in three economic quintiles (Q), we investigated differences in dietary intake and nutrition sufficiency according to economic status and whether regular dietary intakes of pregnant women (PW, n 203) differ from that of pre-pregnant women (PPW, n 200). Dietary intake data were collected using 2×24 h dietary recall and FFQ. Energy, protein, Fe, Ca, Zn, vitamin A and vitamin C intakes were calculated utilising Food Composition Tables and compared with Indonesian recommendations for adequacy. Energy and protein intakes <70 % and Fe, Ca, Zn, vitamin A and vitamin C intakes <77 % of the local recommendation were considered insufficient. A higher intake of milk/dairy products (Q3, Q4), fruits and vegetables (Q2) and snacks (Q3) in PW was observed compared with PPW, but insufficient to meet nutrient requirements. Nutrient intake calculations showed insufficiency in 26 % of PPW for protein and up to 70 % for Fe. Deficient nutrient intakes in PW were found in 49 % of the subjects for energy and up to 85 % for Fe. Energy and protein intakes decreased with decreasing economic quintiles in PPW and PW. Ca and vitamin A intakes were lower in Q2 compared with Q4. The proportion of animal protein in Q2-PW was low (31 %). Biochemical status parameters in a subset showed that anaemia and Fe and Zn deficiencies were prevalent among PPW and PW. Habitual diets in the study area did not meet the nutrient requirements for both PPW and PW across the investigated economic groups.

The way in which women accommodate for their increased nutritional needs during the lactation period is poorly investigated. In a cross-sectional study involving 220 lactating women (LW), equally distributed in economic quintiles (Q2, Q3, Q4), we investigated whether habitual dietary intake of LW differed from that of 200 pre-pregnant women (PPW) studied using the same methodology. Differences in dietary intake and nutrition sufficiency according to economic status were also investigated. Dietary intake data were collected using 2×24-h dietary recalls and FFQ. Energy, protein, Fe, Ca, Zn and vitamins A and C intakes were calculated utilising local food composition tables and were compared against Indonesian recommendations for adequacy. Energy and protein intakes <70 % of the recommendation and Fe, Ca, Zn and vitamins A and C intakes 25 % of LW. For Q2-LW, this proportion was >50 %, except for protein. LW across all studied economic quintiles approximately doubled their vegetable intake, and 71 % of LW indicated a belief that this enhances lactation performance. Biochemical status parameters were analysed in a subset of forty-five women. Anaemia as well as Fe, Zn and Se deficiencies were prevalent among LW, supporting the nutrient intake deficiency data. Despite increasing intakes in LW compared with PPW, habitual diets in the study area do not provide for daily nutrient requirements in substantial proportions for both LW and PPW across all investigated economic groups.

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Adolescent girls are vulnerable group to anemia. Students who live in dormitories tend to have less intake that can cause iron defi ciency. This study aimed to determine the risk factors of anemia among female students in the Darusalam Islamic Boarding School Bogor. This was an observational study with a cross sectional design. Subjects were 84 female students who selected purposively by inclusion and exclusion criteria. Anemic status was determined by measuring hemoglobin levels with HemoCue 301. Data on subjects characteristics, health status, menstrual status, skipping meal behavior collected by questionnaire. Level knowledge, attitudes and nutrition practices related to anemia assessed by of fi ve questions for each indicators. Nutritional status is assessed based on BMI/A indicator. The intake data was obtained by the 2×24 hour food record method collected by questionnaires. Statistical analysis using chi-square test and logistic regression. Students with mild anemia were 38.1%, while 20.2% had moderate anemia. Intake of energy, protein, iron, vitamin C were inadequate. The results of bivariate analysis showed that skipping meals were signifi cantly associated with anemia status (p=0.007; OR 4.0; 95% CI 1.4-11.4). Nutritional attitudes also had a signifi cant relationship with anemia status (p=0.048; OR 2.6; 95% CI 1.0-6.6). The results of the logistic regression test showed that the variables associated with anemia were skipping meals (p=0.024; OR 3.5; 95% CI 1.0-11.8). Islamic boarding schools are expected to provide balanced healthy and nutritious food and provide nutrition education so it can support the improvement of student’s health status.