Irritable bowel syndrome in Indonesian adolescents

Abstract Objective: Irritable bowel syndrome is a frequent functional gastrointestinal disorder. The aims of this study were to investigate its epidemiology, focusing on the role of intestinal mucosal integrity and to evaluate the impact on the quality of life. Methods: A community-based survey applying a comparative cross sectional approach was conducted in six high schools in Palembang. Subjects were recruited using multistage random sampling divided in two groups. Rome III criteria were used to establish a diagnosis of IBS in combination with a questionnaire to determine risk factors. Determination of fecal alpha-1-antitrypsin and calprotectin levels was performed to determine impaired intestinal mucosal integrity. A questionnaire was used to evaluate how quality of life was affected by irritable bowel syndrome. Results: The survey was performed in 454 14−18 years old adolescents, of whom 30.2% fulfilled the Rome III criteria for IBS, with the following subtypes: 36.5% diarrhea, 18.9% constipation, 21.9% mixed, and 22.6% unclassified. Major risk factors were female gender, bullying, age 14-16 years, history of constipation and diarrhea, eating nuts, and drinking coffee, tea, and soft drinks. There was a significant association with intestinal inflammation (p = 0.013). A significantly impaired quality of life was found (p = 0.001). Conclusions: The prevalence of irritable bowel syndrome in adolescents was high, with bullying, female gender, age 14-16 years, constipation and diarrhea, and dietary consumption of soft drinks, coffee, and tea as risk factors. A significant association with intestinal inflammation was found.

Serum folate levels among healthy infants aged 6–8 months: relation to infants’ nutritional status indicators and maternal knowledge-attitude-practice.

Background: Vitamin B12 and folate deficiency can cause anemia which may lead growth and development impairments. This study was aimed to determine serum folate levels among infants aged 6–8 months and the relation to infants’ nutritional indicators and maternal knowledge-attitude-practice about infant feeding. Methods: A cross–sectional design was implemented in infants aged 6–8 months and their mothers as respondents who met the study criteria. Data collected among the infants included sex, age, length, weight, intake of energy, protein and folate (based on a one–month semi–quantitative FFQ and a 24–hour food recall), serum folate and hemoglobin levels. Data collected among the mothers included age, education level, income based on average minimum monthly wage, knowledge, attitude and behavior concerning infant’s feeding, i.e. breast milk and complementary feeding practices. Results: This study found that the median of serum folate levels was 43.05 nmol/L with values ranging from 19.92 nmol/L to 104.24 nmol/L. Serum folate level had a strong positive correlation with its related factors, protein and folate intake. Conclusions: Protein-folate–rich complementay food should be provided to infants aged 6 months and over to maintain serum folate level.

Dietary iron intake, serum ferritin and haemoglobin levels, and cognitive development scores of infants aged 6–8 months.

Background: Iron deficiency during infancy may lead to negative effect on cognitive function and psychomotor development. This study aimed to investigate serum ferritin, haemoglobin level and its relation to cognitive development score in infants aged 6–8 months. Methods: This cross-sectional study was done on 76 infants recruited from several selected community health center in Kampung Melayu Village, Jatinegara Jakarta who had fulfilled the study criteria. Data collected consist of age, weight, height, head circumference, energy, protein and iron intake, serum feritin levels, haemoglobin levels and cognitive development score using Capute Scales method (Cognitive Adaptive Test/ Clinical Linguistic Auditory Milestone Scales/ CAT-CLAMS). Results: Among 74 infants aged 6-8 months, 73% had less dietary iron intake as compared to its RDA (7 mg/d), 18.9% were with serum ferritin less than normal value (20 μg/L), and 56.7% with haemoglobin levels less than normal value (11 mg/dL). In relation to cognitive development score, this study revealed that the CAT score was significantly lower among subjects with hemoglobin value less than 11 mg/dL (p = 0.026). Conclusion: Early prevention of impaired cognitive development is urgently needed by providing iron-rich complementary foods to infants since 6 months (mo) old to maintain the normal level of hemoglobin.