Probability Method for Analyzing the Prevalence of Calcium, Iron, Zinc, and Vitamin D Deficiencies among Indonesian Adolescents
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Issue
Vol. 13 No. 2 (2018)
Accepted
9 April 2018
Published
16 July 2018
Keywords:
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food source, micronutrient deficiency, nutrient density, probability method
Abstract
The objective of this study was to analyse the prevalence of Ca, Fe, Zn, and vitamin D deficiency (micronutrient deficiency-MD) in adolescents using probability method (PBM) and cut-off point method (CPM). This study utilized secondary data from nation-wide Basic Health survey (Riskesdas) 2010 from the Ministry of Health, in which data on nutrient intakes were collected using 24-hour recall. The total subjects were 24,833 Indonesian males and females aged 13-18 years. The nutrient requirement of each micronutrient was derived from the Institute of Medicine (IOM). The prevalence of MD using PBM was analysed by calculating the proportion of subjects with intake of below their requirement in the population. The prevalence of MD using CPM analysed by applying three cut-off point i.e. less than 100% (CP-100), less than 85% (CP-85), and less than 70% (CP-70) of the micronutrient requirement. Results showed that the prevalence of MD was high both calculated by PBM and CPM. In both methods, the prevalence of MD deficiencies were slightly higher in females than in males, and in older age group than younger age group. The prevalence of MD calculated using PBM was higher compared to the CPM-85 and CPM-70, but not always higher compared to CPM-100. Overall, the nutrient density of Ca, Fe, Zn and vitamin D for both male and female adolescents were below recommendations, however the nutrient density of Ca, Zn, and vitamin D in females were higher than in males (p<0,05). This study concludes that the intakes of micronutrient (Ca, Fe, Zn, and , D) among Indonesian adolescent were far below the requirement based on PBM and CPM calculations. In addition, the nutrient density of each micronutrient was classified as inadequate. This implies the importance of improvement in the quantity and quality of micronutrient intakes among Indonesian adolescents through increasing the consumption of fish, meat, eggs, legumes, milk, and green vegetables.
References
Abbaspour N, Hurrell R, Kelishadi R. 2014. Review on iron and its importance for human health, J Res Med Sci 19(2):164-174.
Aounallah-Skhiri H, Traissac P, El Ati J, Eymard-Duvernay S, Landais E, Achour N, Maire B. 2011. Nutrition transition among adolescents of a South-Mediterranean Country: dietary patterns, association with socio-economic factors, overweight and blood pressure. A cross-sectional study in Tunisia. Nutrition Journal 10:38. http://doi.org/10.1186/1475-2891-10-38.
Beaton GH. 1972. The use of nutritional requirements and allowances, In: Proceedings of Western Hemisphere Nutrition Congress II, Futura Publishing Co. Mt. Kisco. NY. pp. 356-363.
Berg T, Magala-Nyago C, Iversen PO. 2017. Nutritional status among adolescent girls in children’s homes: Anthropometry and dietary patterns. Clin Nutr 37(3): 926-933.
Black RE et al. 2013. Maternal and child undernutrition and overweight in low-income and middle-income countries. The lancet 382(9890):427-451.
Bloem MW et al. 2013. Key strategies to further reduce stunting in Southeast Asia: Lessons from the ASEAN countries workshop, Food Nutr Bull 34(2):8-16 (supplement).
Briawan D, Arumsari E, Pusporini. 2011. Faktor risiko anemia pada siswi peserta program suplementasi. J Gizi Pangan 6(1):74-83.
Briawan D, Adrianto Y, Ernawati D. 2012. Konsumsi pangan, bioavailabilitas zat besi, status anemia siswi di Kota Bogor. Prosiding Seminar hasil-hasil penelitian IPB: 219-230.
Bueno AL, Czepielewski MA. 2008. The importance for growth of dietary intake of calcium and vitamin D. J Pediatr 84(5):386-394.
Bueno AL, Czepielewski MA, Raimundo FV. 2010. Calcium and vitamin D intake and biochemical tests in short-stature children and adolescents. EJCN 64(10):1296-1301.
Carriquiry AL. 1998. Assessing the prevalency of nutrient inadequacy, Public Health Nutrition 2(1):23-33,
Cusick SE, Kuch AE. 2012. Determinants of undernutrition and overnutrition among sdolescents in developing countries. Adolesc Med State Art Rev 23(3):440-456.
de Lauzon B, Volatier JL, Martin A. 2004. A Monte Carlo simulation to validate the EAR cut point method for assessing the prevalence of nutrient inadequacy at the population level. Pub Health Nutr 7(7):893-900.
de Onis M, Branca F. 2016. Childhood stunting: a global perspective, Maternal & Child Nutrition 12(1):12-26.
Drewnowski A. 2005. Concept of a nutritious food: Toward a nutrient density score, American J Clin Nutr 82(4):721-732.
Elliot V, Lutter C, Lamstein S, Koniz-Booher P, Caulfield L. 2015. Systematic review of the dietary intakes of adolescent girls in low and middle-income countries. The FASEB Journal 29(1): Suppl: 898.4.
Fang A, Li K, Li H, Guo M, He J, Shen X, Song J. 2017. Low habitual dietary calcium and linear growth from adolescence to young adulthood: results from the china health and nutrition survey. Scientific Reports 7(1):9111.
Gibson RS. 2005. Principles of Nutritional Assessment Second Edition. USA: Oxford University Press.
Hardiansyah A, Rimbawan, Ekayanti I. 2013. Efek suplementasi multivitamin mineral terhadap kadar hemoglobin dan hematokrit mahasiswi TPB IPB. J Gizi Pangan 8(1):47-54.
Hardinsyah, Briawan D. 1994. Penilaian dan perencanaan konsumsi pangan, [diktat]. Bogor: Fakultas pertanian, Institut Pertanian Bogor.
Hardinsyah. 2007. Review faktor determinan keragaman konsumsi pangan. J Gizi Pangan 2(2):55-74.Hardinsyah, Damayanthi E, Zulianti W. 2008. Hubungan konsumsi susu dan kalsium dengan densitas tulang dan tinggi badan remaja. J Gizi Pangan 3(1):43-48.
[IOM] Institute of Medicine. 2005. Dietary Reference Intake for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids. Washington DC: National Academy Press.
[IOM] Institute of Medicine. 2011. Dietary Reference Intake Calcium, Vitamin D, Washington DC: National Academy Press.
Imdad A, Bhutta ZA. 2011. Effect of preventive zinc supplementation on linear growth in children under 5 years of age in developing countries: a meta-analysis of studies for input to the lives saved tool. BMC Public Health 11(Suppl 3): S22.
Jensen HH, Nusser SM, Riddick H, Sands L. 1992. A critique of two methods for assessing the nutrient adequacy of diets, J Nutr Edu Behav 24(3):123-129.
Kamal S, Erfan M, Kholoussi SM, Bahgat KAE. 2010. Growth Pattern in Anemic Children and Adolescents, Aged 12-14 Years. J Am Sci 6(12):1636-1646.
Kumssa DB, Joy EJM, Ander EL, Watts MJ, Young SD, Walker S, Broadley MR. 2015. Dietary Calcium and Zinc Deficiency risks are decreasing but remain prevalent. Sci Rep 5:10974.
Lee JA, Hwang JS, Hwang IT, Kim DH, Seo J, Lim JS. 2015. Low Vitamin D Levels Are Associated with Both Iron Deficiency and Anemia in Children and Adolescents. J Pediat Hematol Oncol 32:99-108.
Majid HA, Ramli L, Ying SP, Su TT, Jalaludin MY, Mohsein NAA. 2016. Dietary Intake among Adolescents in a Middle-Income Country: An Outcome from the Malaysian Health and Adolescents Longitudinal Research Team Study (the MyHeARTs Study). PLoS ONE 11(5): e0155447.
[MOH] Ministry of Health of Indonesia. 2010. Laporan Nasional Riset Kesehatan Dasar (Riskesdas) 2010. Jakarta: Balitbangkes, Depkes RI.
[MOH] Ministry of Health of Indonesia. 2011. Keputusan Menteri Kesehatan Republik Indonesia, Nomor: 1995/MENKES/SK/XII/2010 Tentang Standar Antropometri Penilaian Status Gizi Anak. Jakarta: Dirjen Bina Gizi dan Kesehatan Ibu dan Anak, Kemenkes RI.
[MOH] Ministry of Health of Indonesia. 2013. Laporan Riset Kesehatan Dasar 2013, Jakarta: Balitbangkes, Kemenkes RI.
[MOH] Ministry of Health of Indonesia. 2014. Angka Kecukupan Gizi yang Dianjurkan bagi Bangsa Indonesia, Jakarta: Kemenkes RI.
Murphy SP, Poos MI. 2002. Dietary reference intakes: summary of applications in dietary assessment. Pub Health Nutr 5(6):843-849.
Naeeni MM, Jafari S, Fouladgar M, Heidari K, Farajzadegan Z, Fakhri M, Omidi R. 2014. Nutritional Knowledge, Practice, and Dietary Habits among school Children and Adolescents. Int J Prev Med 5(Suppl 2):S171-S178.
Nimitphong H, Holick MF. 2013. Vitamin D status and sun exposure in southeast Asia. Dermatoendocrinol 5(1):34-37.
Osredkar J, Sustar N. 2011. Copper and zinc, biological role and significance of copper/zinc imbalance. J Clinic Toxicol S3:001.
Pittas AG, Lau J, Hu FB, Dawson-Hughes B. 2007. The role of vitamin D and calcium in type 2 diabetes. A systematic review and meta-analysis. J Clin Endocrinol Metab 92(6):2017-2029.
Riyadi H. 2007. Zinc (Zn) untuk pertumbuhan dan perkembangan anak. [Proceeding] Penanggulangan masalah defisiensi seng :33-67.
Rogol AD, Roemmich JN, Clark PA. 2002. Growth at Puberty. J Adolesc Health 31(2):192-200.
Salamoun MM, Kizirian AS, Tannous RI, Nabulsi MM, Choucair MK, Deeb ME, El-Hajj Fuleihan GA. 2005. Low calcium and vitamin D intake in healthy children and adolescents and their correlates. EJCN 59(2):177-184.
Serra-Majem L, Ribas-Barba L, Pe ́rez-Rodrigo C, Bartrina JA. 2006. Nutrient adequacy in Spanish children and adolescents. BJN 96(Suppl 1): S49-S57.
Soliman AT, de Sanctis V, Kalra S. 2014. Anemia and growth. Indian J Endocrinol Metab 18(1):S1-S5.
Stang J, Story M (eds). 2005. Guidelines for Adolescent Nutrition Services. Center for Leadership, Education, and Training in Maternal and Child Nutrition Division of Epidemiology and Community Health School of Public Health. Minneapolis: Division of Epidemiology and Community Health, University of Minnesota.
Stewart CP, Iannotti L, Dewey KG, Michaelsen KF, Onyango AW. 2013. Contextualising complementary feeding in a broader framework for stunting prevention. Matern Child Nut 9(2):27-45.
Tai V, Leung W, Grey A, Reid IR, Bolland MJ. 2015. Calcium intake and bone mineral density: systematic review and meta-analysis. BMJ 351: h4183.
Taylor CL, Carriquiry AL, Bailey RL, Sempos CT, Yetley EA. 2013. Appropriateness of the probability approach with a nutrient status biomarker to assess population inadequacy: a study using vitamin D. Am J Clin Nutr 97(1):80-86.
Toselli S, Argnani L, Canducci E, Ricci E, Gualdi-Russo E. 2010. Food habits and nutritional status of adolescents in Emilia-Romagna, Italy. Nutr Hosp 25(4):613-621.
Valentina V, Palupi NS, Andarwulan N. 2014. Asupan kalsium dan vitamin D pada anak indonesia usia 2-12 tahun. J Teknologi dan Industri Pangan 25(1):83-89.
Wessells KR, Brown KH. 2012. Estimating the global prevalence of zinc deficiency: results based on zinc availability in national food supplies and the prevalence of stunting. PLoS ONE 7(11): e50568.
[WHO] World Health Organization. 2006. Adolescent Nutrition: A Review of the Situation in Selected South-East Asian Countries. New Delhi: WHO Regional office for South East Asia.
[WHO] World Health Organization. 2009. WHO AnthroPlus for personal computers Manual: Software for assessing growth of the world’s children and adolescents. Geneva: WHO, (http://www.who.int/growthref/tools/en/).
Aounallah-Skhiri H, Traissac P, El Ati J, Eymard-Duvernay S, Landais E, Achour N, Maire B. 2011. Nutrition transition among adolescents of a South-Mediterranean Country: dietary patterns, association with socio-economic factors, overweight and blood pressure. A cross-sectional study in Tunisia. Nutrition Journal 10:38. http://doi.org/10.1186/1475-2891-10-38.
Beaton GH. 1972. The use of nutritional requirements and allowances, In: Proceedings of Western Hemisphere Nutrition Congress II, Futura Publishing Co. Mt. Kisco. NY. pp. 356-363.
Berg T, Magala-Nyago C, Iversen PO. 2017. Nutritional status among adolescent girls in children’s homes: Anthropometry and dietary patterns. Clin Nutr 37(3): 926-933.
Black RE et al. 2013. Maternal and child undernutrition and overweight in low-income and middle-income countries. The lancet 382(9890):427-451.
Bloem MW et al. 2013. Key strategies to further reduce stunting in Southeast Asia: Lessons from the ASEAN countries workshop, Food Nutr Bull 34(2):8-16 (supplement).
Briawan D, Arumsari E, Pusporini. 2011. Faktor risiko anemia pada siswi peserta program suplementasi. J Gizi Pangan 6(1):74-83.
Briawan D, Adrianto Y, Ernawati D. 2012. Konsumsi pangan, bioavailabilitas zat besi, status anemia siswi di Kota Bogor. Prosiding Seminar hasil-hasil penelitian IPB: 219-230.
Bueno AL, Czepielewski MA. 2008. The importance for growth of dietary intake of calcium and vitamin D. J Pediatr 84(5):386-394.
Bueno AL, Czepielewski MA, Raimundo FV. 2010. Calcium and vitamin D intake and biochemical tests in short-stature children and adolescents. EJCN 64(10):1296-1301.
Carriquiry AL. 1998. Assessing the prevalency of nutrient inadequacy, Public Health Nutrition 2(1):23-33,
Cusick SE, Kuch AE. 2012. Determinants of undernutrition and overnutrition among sdolescents in developing countries. Adolesc Med State Art Rev 23(3):440-456.
de Lauzon B, Volatier JL, Martin A. 2004. A Monte Carlo simulation to validate the EAR cut point method for assessing the prevalence of nutrient inadequacy at the population level. Pub Health Nutr 7(7):893-900.
de Onis M, Branca F. 2016. Childhood stunting: a global perspective, Maternal & Child Nutrition 12(1):12-26.
Drewnowski A. 2005. Concept of a nutritious food: Toward a nutrient density score, American J Clin Nutr 82(4):721-732.
Elliot V, Lutter C, Lamstein S, Koniz-Booher P, Caulfield L. 2015. Systematic review of the dietary intakes of adolescent girls in low and middle-income countries. The FASEB Journal 29(1): Suppl: 898.4.
Fang A, Li K, Li H, Guo M, He J, Shen X, Song J. 2017. Low habitual dietary calcium and linear growth from adolescence to young adulthood: results from the china health and nutrition survey. Scientific Reports 7(1):9111.
Gibson RS. 2005. Principles of Nutritional Assessment Second Edition. USA: Oxford University Press.
Hardiansyah A, Rimbawan, Ekayanti I. 2013. Efek suplementasi multivitamin mineral terhadap kadar hemoglobin dan hematokrit mahasiswi TPB IPB. J Gizi Pangan 8(1):47-54.
Hardinsyah, Briawan D. 1994. Penilaian dan perencanaan konsumsi pangan, [diktat]. Bogor: Fakultas pertanian, Institut Pertanian Bogor.
Hardinsyah. 2007. Review faktor determinan keragaman konsumsi pangan. J Gizi Pangan 2(2):55-74.Hardinsyah, Damayanthi E, Zulianti W. 2008. Hubungan konsumsi susu dan kalsium dengan densitas tulang dan tinggi badan remaja. J Gizi Pangan 3(1):43-48.
[IOM] Institute of Medicine. 2005. Dietary Reference Intake for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids. Washington DC: National Academy Press.
[IOM] Institute of Medicine. 2011. Dietary Reference Intake Calcium, Vitamin D, Washington DC: National Academy Press.
Imdad A, Bhutta ZA. 2011. Effect of preventive zinc supplementation on linear growth in children under 5 years of age in developing countries: a meta-analysis of studies for input to the lives saved tool. BMC Public Health 11(Suppl 3): S22.
Jensen HH, Nusser SM, Riddick H, Sands L. 1992. A critique of two methods for assessing the nutrient adequacy of diets, J Nutr Edu Behav 24(3):123-129.
Kamal S, Erfan M, Kholoussi SM, Bahgat KAE. 2010. Growth Pattern in Anemic Children and Adolescents, Aged 12-14 Years. J Am Sci 6(12):1636-1646.
Kumssa DB, Joy EJM, Ander EL, Watts MJ, Young SD, Walker S, Broadley MR. 2015. Dietary Calcium and Zinc Deficiency risks are decreasing but remain prevalent. Sci Rep 5:10974.
Lee JA, Hwang JS, Hwang IT, Kim DH, Seo J, Lim JS. 2015. Low Vitamin D Levels Are Associated with Both Iron Deficiency and Anemia in Children and Adolescents. J Pediat Hematol Oncol 32:99-108.
Majid HA, Ramli L, Ying SP, Su TT, Jalaludin MY, Mohsein NAA. 2016. Dietary Intake among Adolescents in a Middle-Income Country: An Outcome from the Malaysian Health and Adolescents Longitudinal Research Team Study (the MyHeARTs Study). PLoS ONE 11(5): e0155447.
[MOH] Ministry of Health of Indonesia. 2010. Laporan Nasional Riset Kesehatan Dasar (Riskesdas) 2010. Jakarta: Balitbangkes, Depkes RI.
[MOH] Ministry of Health of Indonesia. 2011. Keputusan Menteri Kesehatan Republik Indonesia, Nomor: 1995/MENKES/SK/XII/2010 Tentang Standar Antropometri Penilaian Status Gizi Anak. Jakarta: Dirjen Bina Gizi dan Kesehatan Ibu dan Anak, Kemenkes RI.
[MOH] Ministry of Health of Indonesia. 2013. Laporan Riset Kesehatan Dasar 2013, Jakarta: Balitbangkes, Kemenkes RI.
[MOH] Ministry of Health of Indonesia. 2014. Angka Kecukupan Gizi yang Dianjurkan bagi Bangsa Indonesia, Jakarta: Kemenkes RI.
Murphy SP, Poos MI. 2002. Dietary reference intakes: summary of applications in dietary assessment. Pub Health Nutr 5(6):843-849.
Naeeni MM, Jafari S, Fouladgar M, Heidari K, Farajzadegan Z, Fakhri M, Omidi R. 2014. Nutritional Knowledge, Practice, and Dietary Habits among school Children and Adolescents. Int J Prev Med 5(Suppl 2):S171-S178.
Nimitphong H, Holick MF. 2013. Vitamin D status and sun exposure in southeast Asia. Dermatoendocrinol 5(1):34-37.
Osredkar J, Sustar N. 2011. Copper and zinc, biological role and significance of copper/zinc imbalance. J Clinic Toxicol S3:001.
Pittas AG, Lau J, Hu FB, Dawson-Hughes B. 2007. The role of vitamin D and calcium in type 2 diabetes. A systematic review and meta-analysis. J Clin Endocrinol Metab 92(6):2017-2029.
Riyadi H. 2007. Zinc (Zn) untuk pertumbuhan dan perkembangan anak. [Proceeding] Penanggulangan masalah defisiensi seng :33-67.
Rogol AD, Roemmich JN, Clark PA. 2002. Growth at Puberty. J Adolesc Health 31(2):192-200.
Salamoun MM, Kizirian AS, Tannous RI, Nabulsi MM, Choucair MK, Deeb ME, El-Hajj Fuleihan GA. 2005. Low calcium and vitamin D intake in healthy children and adolescents and their correlates. EJCN 59(2):177-184.
Serra-Majem L, Ribas-Barba L, Pe ́rez-Rodrigo C, Bartrina JA. 2006. Nutrient adequacy in Spanish children and adolescents. BJN 96(Suppl 1): S49-S57.
Soliman AT, de Sanctis V, Kalra S. 2014. Anemia and growth. Indian J Endocrinol Metab 18(1):S1-S5.
Stang J, Story M (eds). 2005. Guidelines for Adolescent Nutrition Services. Center for Leadership, Education, and Training in Maternal and Child Nutrition Division of Epidemiology and Community Health School of Public Health. Minneapolis: Division of Epidemiology and Community Health, University of Minnesota.
Stewart CP, Iannotti L, Dewey KG, Michaelsen KF, Onyango AW. 2013. Contextualising complementary feeding in a broader framework for stunting prevention. Matern Child Nut 9(2):27-45.
Tai V, Leung W, Grey A, Reid IR, Bolland MJ. 2015. Calcium intake and bone mineral density: systematic review and meta-analysis. BMJ 351: h4183.
Taylor CL, Carriquiry AL, Bailey RL, Sempos CT, Yetley EA. 2013. Appropriateness of the probability approach with a nutrient status biomarker to assess population inadequacy: a study using vitamin D. Am J Clin Nutr 97(1):80-86.
Toselli S, Argnani L, Canducci E, Ricci E, Gualdi-Russo E. 2010. Food habits and nutritional status of adolescents in Emilia-Romagna, Italy. Nutr Hosp 25(4):613-621.
Valentina V, Palupi NS, Andarwulan N. 2014. Asupan kalsium dan vitamin D pada anak indonesia usia 2-12 tahun. J Teknologi dan Industri Pangan 25(1):83-89.
Wessells KR, Brown KH. 2012. Estimating the global prevalence of zinc deficiency: results based on zinc availability in national food supplies and the prevalence of stunting. PLoS ONE 7(11): e50568.
[WHO] World Health Organization. 2006. Adolescent Nutrition: A Review of the Situation in Selected South-East Asian Countries. New Delhi: WHO Regional office for South East Asia.
[WHO] World Health Organization. 2009. WHO AnthroPlus for personal computers Manual: Software for assessing growth of the world’s children and adolescents. Geneva: WHO, (http://www.who.int/growthref/tools/en/).
Authors
AnwarK., HardinsyahH., DamayanthiE., & SukandarD. (2018). Probability Method for Analyzing the Prevalence of Calcium, Iron, Zinc, and Vitamin D Deficiencies among Indonesian Adolescents. Jurnal Gizi Dan Pangan, 13(2), 93-102. https://doi.org/10.25182/jgp.2018.13.2.93-102
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