Unraveling diabetes complexity through natural products, miRNAs modulation, and future paradigms in precision medicine and global health.

BACKGROUND AND AIMS: The challenge posed by diabetes necessitates a paradigm shift from conventional diagnostic approaches focusing on glucose and lipid levels to the transformative realm of precision medicine. This approach, leveraging advancements in genomics and proteomics, acknowledges the individualistic genetic variations, dietary preferences, and environmental exposures in diabetes management. The study comprehensively analyzes the evolving diabetes landscape, emphasizing the pivotal role of genomics, proteomics, microRNAs (miRNAs), metabolomics, and bioinformatics. RESULTS: Precision medicine revolutionizes diabetes research and treatment by diverging from traditional diagnostic methods, recognizing the heterogeneous nature of the condition. MiRNAs, crucial post-transcriptional gene regulators, emerge as promising therapeutic targets, influencing key facets such as insulin signaling and glucose homeostasis. Metabolomics, an integral component of omics sciences, contributes significantly to diabetes research, elucidating metabolic disruptions, and offering potential biomarkers for early diagnosis and personalized therapies. Bioinformatics unveils dynamic connections between natural substances, miRNAs, and cellular pathways, aiding in the exploration of the intricate molecular terrain in diabetes. The study underscores the imperative for experimental validation in natural product-based diabetes therapy, emphasizing the need for in vitro and in vivo studies leading to clinical trials for assessing effectiveness, safety, and tolerability in real-world applications. Global cooperation and ethical considerations play a pivotal role in addressing diabetes challenges worldwide, necessitating a multifaceted approach that integrates traditional knowledge, cultural competence, and environmental awareness. CONCLUSIONS: The key components of diabetes treatment, including precision medicine, metabolomics, bioinformatics, and experimental validation, converge in future strategies, embodying a holistic paradigm for diabetes care anchored in cutting-edge research and global healthcare accessibility.

Revealing the mechanism and efficacy of natural products on treating the asthma: Current insights from traditional medicine to modern drug discovery.

Asthma remains a significant global health challenge, demanding innovative approaches to treatment. Traditional medicine has a rich history of using natural products to alleviate asthmatic symptoms. However, transitioning from these traditional remedies to modern drug discovery approaches has provided fresh insights into the mechanisms and effectiveness of these natural products. This study provides our comprehensive review, which examines the current state of knowledge in the treatment of asthma. It delves into the mechanisms through which natural products ameliorate asthma symptoms, and it discusses their potential in the development of novel therapeutic interventions. Our analysis reveals that natural products, traditionally employed for asthma relief, exhibit diverse mechanisms of action. These include anti-inflammatory, bronchodilatory, immunomodulatory effects, and reducing gene expression. In the context of modern drug discovery, these natural compounds serve as valuable candidates for the development of novel asthma therapies. The transition from traditional remedies to modern drug discovery represents a promising avenue for asthma treatment. Our review highlights the substantial efficacy of natural products in managing asthma symptoms, underpinned by well-defined mechanisms of action. By bridging the gap between traditional and contemporary approaches, we contribute to the growing body of knowledge in the field, emphasizing the potential of natural products in shaping the future of asthma therapy.

Mechanism of Action of Isoflavone Derived from Soy-Based Tempeh as an Antioxidant and Breast Cancer Inhibitor via Potential Upregulation of miR-7-5p: A Multimodal Analysis Integrating Pharmacoinformatics and Cellular Studies.

Breast cancer presents a significant global health challenge with rising incidence rates worldwide. Despite current efforts, it remains inadequately controlled. Functional foods, notably tempeh, have emerged as promising candidates for breast cancer prevention and treatment due to bioactive peptides and isoflavones exhibiting potential anticancer properties by serving as antioxidants, inducing apoptosis, and inhibiting cancer cell proliferation. This study integrates pharmacoinformatics and cellular investigations (i.e., a multifaceted approach) to elucidate the antioxidative and anti-breast cancer properties of tempeh-derived isoflavones. Methodologies encompass metabolomic profiling, in silico analysis, antioxidant assays, and in vitro experiments. Daidzein and genistein exhibited potential therapeutic options for breast cancer treatment and as antioxidant agents. In vitro studies also supported their efficacy against breast cancer and their ability to scavenge radicals, particularly in soy-based tempeh powder (SBT-P) and its isoflavone derivatives. Results have demonstrated a significant downregulation of breast cancer signaling proteins and increased expression of miR-7-5p, a microRNA with tumor-suppressive properties. Notably, the LD50 values of SBT-P and its derivatives on normal breast cell lines indicate their potential safety, with minimal cytotoxic effects on MCF-10A cells compared to control groups. The study underscores the favorable potential of SBT-P as a safe therapeutic option for breast cancer treatment, warranting further clinical exploration.

The Importance of Philanthropy Foundation for the Future Sustainability of Agriculture and Nutrition: An Opinion Study on Practical Applications, Policies, and Strategies.

Food security, food sustainability, and malnutrition represent critical global challenges. Th urgency of comprehensive action is evident in the need for research collaboration between the food industry, agriculture, public health, and nutrition. This article highlights the role of philanthropy, of a non-profit organization, in supporting research and development and filling financial gaps. The article also explores the interplay of nutrition, agriculture, and government and policy, positioning philanthropy as a catalyst for transformative change and advocating for collaborative efforts to comprehensively address global food challenges. In addition, the discussion also underscores the ethical complexities surrounding charitable food aid, especially in terms of the dignity and autonomy of its recipients. The paper concludes by proposing future directions and implications, advocating for diversified intervention portfolios and collaborative efforts involving governments, businesses, and local communities. Apart from that, the importance of answering and alleviating ethical dilemmas related to food charity assistance needs to be a concern for future studies related to philanthropy because of the significant challenges faced by the contemporary food system, which include food security, health, and nutritional sustainability.

Gene-Diet Interactions on Metabolic Disease-Related Outcomes in Southeast Asian Populations: A Systematic Review.

Diabetes and obesity are chronic diseases that are a burden to low- and middle-income countries. We conducted this systematic review to understand gene-diet interactions affecting the Southeast Asian population's risk of obesity and diabetes. The literature search was performed on Google Scholar and MEDLINE (PubMed) search engines independently by four reviewers who evaluated the eligibility of articles based on inclusion criteria. Out of 19,031 articles, 20 articles examining gene-diet interactions on obesity and/or diabetes-related traits met the inclusion criteria. Three (Malaysia, Indonesia, and Singapore) out of eleven Association of Southeast Asian Nations (ASEAN) countries have conducted studies on gene-diet interactions on obesity and diabetes. From the 20 selected articles, the most common interactions were observed between macronutrients and genetic risk score (GRS) on metabolic disease-related traits in the Malay, Chinese, and Indian ethnicities. Overall, we identified 29 significant gene-diet interactions in the Southeast Asian population. The results of this systematic review demonstrate ethnic-specific gene-nutrient interactions on metabolic-disease-related traits in the Southeast Asian population. This is the first systematic review to explore gene-diet interactions on obesity and diabetes in the Southeast Asian population and further research using larger sample sizes is required for better understanding and framing nutrigenetic approaches for personalized nutrition.

The importance of lutein-plant based nanoencapsulation studies - An effort to improve clinical studies on the stability and bioaccessibility of lutein for health vision.

Potential studies and evidence regarding nutrient nanoencapsulation combined with emulsion-based delivery systems are relatively limited. Therefore, for the importance issue of health vision, with this critical opinion to the editor is scientifically important to invite worldwide researchers to raise their concern for clinical research and the development of plant-based lutein nanoencapsulation in staple foods in alleviating nutritional problems for the eyes, which has not been reported before. This is in line with the WHO World Report which aimed to overcome the challenge regarding vision and galvanizing action, one of which is through innovation and research. With the hypothesis that, through this opinion will increase the awareness of scientists to improve clinical studies on the stability and bioaccessibility of lutein for health vision concern. As our hypothesis and objectives, we hope that this critical short opinion to the editor will assist efforts to reduce the burden of eye conditions and vision loss to achieve the Sustainable Development Goals (SDGs), particularly SDG 3.8 on universal health coverage through lutein-plant based nanoencapsulation clinical studies by worldwide researchers. Finally, it is very important and needed an effort to improve clinical studies focus on the stability and bioaccessibility of lutein for health vision via lutein-plant based nanoencapsulation approaches. Moreover, the benefit of lutein supplementation for the health vision might be limited by its bioaccessibility and bioavailability. Future studies and approaches should employ strategies that could overcome the foregoing limitations, of which is through nanoencapsulation approach. Something new has been synthesized in this work, "Because, every human eye, is the eye of the world".

Anti-Inflammatory, Antioxidant, Metabolic and Gut Microbiota Modulation Activities of Probiotic in Cardiac Remodeling Condition: Evidence from Systematic Study and Meta-Analysis of Randomized Controlled Trials.

Heart failure (HF) is a global pandemic with increasing prevalence and mortality rates annually. Its main cause is myocardial infarction (MI), followed by rapid cardiac remodeling. Several clinical studies have shown that probiotics can improve the quality of life and reduce cardiovascular risk factors. This systematic review and meta-analysis aimed to investigate the effectiveness of probiotics in preventing HF caused by a MI according to a prospectively registered protocol (PROSPERO: CRD42023388870). Four independent evaluators independently extracted the data using predefined extraction forms and evaluated the eligibility and accuracy of the studies. A total of six studies consisting of 366 participants were included in the systematic review. Probiotics are not significant in intervening left ventricular ejection fraction (LVEF) and high-sensitivity C-reactive protein (hs-CRP) when compared between the intervention group and the control group due to inadequate studies supporting its efficacy. Among sarcopenia indexes, hand grip strength (HGS) showed robust correlations with the Wnt biomarkers (p < 0.05), improved short physical performance battery (SPPB) scores were also strongly correlated with Dickkopf-related protein (Dkk)-3, followed by Dkk-1, and sterol regulatory element-binding protein 1 (SREBP-1) (p < 0.05). The probiotic group showed improvement in total cholesterol (p = 0.01) and uric acid (p = 0.014) compared to the baseline. Finally, probiotic supplements may be an anti-inflammatory, antioxidant, metabolic, and intestinal microbiota modulator in cardiac remodeling conditions. Probiotics have great potential to attenuate cardiac remodeling in HF or post-MI patients while also enhancing the Wnt signaling pathway which can improve sarcopenia under such conditions.

Antiobesity potential of major metabolites from Clitoria ternatea kombucha: Untargeted metabolomic profiling and molecular docking simulations.

The prevalence of obesity is rapidly increasing and poses serious health risks accompanied by a decrease in life expectancy and quality of life. Therefore, the therapeutic potential of natural-derived nutraceuticals against obesity and its comorbidities needs to be explored. Molecular inhibition of lipase enzymes and fat mass and obesity-associated (FTO) protein has attracted some recent interest in efforts to find antiobesity agents. This study aims to innovate a fermented drink from Clitoria ternatea kombucha (CTK), find out their metabolites profile, and determine the antiobesity potential through a molecular docking study. The CTK formulation refers to previous research while the metabolites profile was determined using HPLC-ESI-HRMS/MS. Major compounds were selected based on best match value > 99.0% of the M/Z cloud database. A total of 79 compounds were identified in CTK, and 13 ideal compounds were selected to be simulated in the molecular docking study against human pancreatic lipase, α-amylase, α-glucosidase, porcine pancreatic lipase, and FTO proteins. The study found that Kaempferol, Quercetin-3ß-D-glucoside, Quercetin, Dibenzylamine, and α-Pyrrolidinopropiophenone showed the best potential as functional antiobesity compounds since their affinity value ranked high in each respective receptor. In conclusion, the major compounds of CTK metabolites have the potential to be promising functional foods against obesity. However, further in vitro and in vivo studies should validate these health benefits.

Foodomics Approaches to Facilitate the Verification of the Authenticity of Foods: A Possible Strategy to Screen,Validate, and Standardize Food Matrices / Enfoques de Foodomics para facilitar la verificación de la autenticidad de los alimentos: una posible estrategia para evaluar, validar y estandarizar matrices alimentarias

The complexity of globalization, including the global food trade market, has the side effect that various raw foodstuffs are vulnerable to intentional and unintentional adulteration. However, food validation and standardization approaches are still unclear and challenging and need to be explored. Through this opinion article, the author would like to introduce a foodomics approach (Food, -Omics) to facilitate integrated food authenticity verification through biosensors. This approach is potentially suitable and offers more valuable accuracy as it combines biological analysis methods spanning genomics, transcriptomics, proteomics, and metabolomics. Meanwhile, several subdisciplines of Foodomics, such as metallomics, volatomics, and lipidomics, which are considered feasible to facilitate the verification of food authenticity, are also explored in this critical opinion. Foodomics consists of four main omics technologies, namely genomics, transcriptomics, proteomics, and metabolomics. This is an integration of promising approaches to provide standardized food matrices, thus becoming the most likely strategy to verify the authenticity of food. However, after trying to uncover this food authentication problem and provide a Foodomics approach, we felt the need for synergies in building a database capable of storing food matrices in the form of unique genes, bioactive peptides, and secondary metabolites. We hope that through this opinion article, the target database can be formed, although databases such as MEDLINE and PubChem have provided this data facility. In particular, we suggest the development of nanobiosensors that should undoubtedly be environmentally friendly and portable (making use of smartphones) and creating a cloud database capable of storing food matrices in the form of unique genes, bioactive peptides, and secondary metabolites, integrated with smartphone biosensors.(AU)

Dietary Supplementation of Caulerpa racemosa Ameliorates Cardiometabolic Syndrome via Regulation of PRMT-1/DDAH/ADMA Pathway and Gut Microbiome in Mice.

This study evaluated the effects of an aqueous extract of Caulerpa racemosa (AEC) on cardiometabolic syndrome markers, and the modulation of the gut microbiome in mice administered a cholesterol- and fat-enriched diet (CFED). Four groups of mice received different treatments: normal diet, CFED, and CFED added with AEC extract at 65 and 130 mg/kg body weight (BW). The effective concentration (EC50) values of AEC for 2,2-diphenyl-1-picrylhydrazyl (DPPH), 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS), and lipase inhibition were lower than those of the controls in vitro. In the mice model, the administration of high-dose AEC showed improved lipid and blood glucose profiles and a reduction in endothelial dysfunction markers (PRMT-1 and ADMA). Furthermore, a correlation between specific gut microbiomes and biomarkers associated with cardiometabolic diseases was also observed. In vitro studies highlighted the antioxidant properties of AEC, while in vivo data demonstrated that AEC plays a role in the management of cardiometabolic syndrome via regulation of oxidative stress, inflammation, endothelial function (PRMT-1/DDAH/ADMA pathway), and gut microbiota.

The interlink between chrono-nutrition and stunting: current insights and future perspectives.

Stunting is the one factor that is responsible for the irretrievable damage to children's mental and physical health. Stunting imitates chronic undernutrition throughout the most extreme critical stages of growth and development of a child in their early life, and due to that stunted child does not completely develop and are too short for their age. Stunting is mainly linked with brain underdevelopment, along with lifelong damaging consequences, comprising weakened mental and learning capacity, deprived performance in school during childhood, and enhanced risks of nutrition linked to chronic long-lasting ailments, such as diabetes, hypertension, diabesity, and obesity in the future. In this review, the authors mainly summarize the latest studies related to chronic nutrition and how it is related to stunting. Optimal nutrition, particularly during pregnancy and the first 24 months of a child's life, is crucial in preventing stunting. Circadian rhythms play a significant role in maternal and fetal health, affecting outcomes such as premature birth and stunting. Maintaining a balanced diet, avoiding late-night carbohydrate-heavy meals during pregnancy, and promoting breastfeeding align with the body's biological clock, which can benefit newborns in various ways. Providing dedicated spaces for breastfeeding in public places is important to support infant health.

Bioactive peptides identification and nutritional status ameliorating properties on malnourished rats of combined eel and soy-based tempe flour.

Background and aims: A combined eel and soy-based tempe (CEST) flour is rich in nutrients, especially its high amino acid content in which bioactive peptides (BPs) are expected to be found. Hence, this research aimed to identify the BPs of CEST flour and CEST supplementation's effect on improving nutritional status biomarkers by ameliorating serum protein, hemoglobin, and IGF-1 of malnourished rats. Methods: CEST flour with a ratio of eel and soy-based tempe of 1:3.5 was produced by applying the oven drying method. Amino acid sequences from six BPs were analyzed using a protein sequencer and spectrometer-electrospray ionization (MS-ESI). A total of thirty malnourished male Rattus norvegicus aged 3-4 weeks were given low-protein (LP; 4% w/w protein) diet treatment for 4 weeks. Afterward, rats were divided into 3 groups of 10 rats. Group A and B remained on a low-protein diet for 4 weeks, receiving an LP diet and getting doses of CEST of 100 and 200 mg/kg BW, respectively, via oral. Group C or control was given a Normal-protein (NP) diet (23% w/w of protein) and was allowed to feed ad libitum during the trial period without a dose of CEST. Results: Six bioactive peptides were found, with WMGPY being the most abundant, along with a DPPH radical scavenging activity of 5.0 mg/mL. The results showed that serum protein, hemoglobin, and IGF-1 of group B were significantly higher compared to groups A and C (p = 0.0021). CEST dose of 200 mg/kg BW was more effective to increase serum levels of protein (p = 0.0052), hemoglobin, and IGF-1 (p < 0.0001) compared to a 100 mg/kg BW dose. Conclusion: This indicates that the CEST flour has six bioactive peptides, which may contribute to the improvement of nutritional status biomarkers. To establish its potential impact, a human clinical study is urgently needed.

Modulation of gut microbiota and markers of metabolic syndrome in mice on cholesterol and fat enriched diet by butterfly pea flower kombucha.

Clitoria ternatea, with an alternative name, Butterfly pea, is increasingly being explored for medical purposes and the development of a wide range of processed products. This study aimed to incorporate Butterfly pea into an innovative probiotic drink through a symbiotic culture of bacteria and yeast (SCOBY) fermentation and to evaluate the biological activity. The benefits of the drink, referred to as butterfly pea flower kombucha (KBPF) was determined in vitro and in metabolically disorder mice that receive a diet rich in cholesterol and fat (CFED). Forty white male were categorized into four groups, i.e., A = Control/Normal Diet; B = CFED alone; C = CFED + KBPF 65 mg/kg BW (Body Weight); D = CFED + KBPF 130 mg/kg BW, and then sacrificed after 6 weeks of intervention. Seventy-nine secondary metabolite compounds were successfully identified in KBPF using LC-HRMS. In vitro studies showed the potential activity of KBPF in inhibiting not only ABTS, but also lipid (lipase) and carbohydrate (α-amylase, α-glucosidase) hydrolyzing enzymes to levels similar to acarbose control at 50-250 µg/mL. In the in vivo study, the administration of KBPF (130 mg/kg BW) significantly alleviated metabolic disorders caused by high-fat diet. Specifically, lipid profile (HDL, LDL, TC, TG), blood glucose, markers of oxidative stress (SOD liver), metabolic enzymes (lipase, amylase), and markers of inflammation (PGC-1α, TNF-α, and IL-10) were in most cases restored to normal values. Additionally, the gut microbiota community analysis showed that KBPF has a positive effect (p = 0.01) on both the Bacteroidetes phylum and the Firmicutes phylum. The new KBPF drink is a promising therapeutic functional food for preventing metabolic diseases.

Metabolomic Assay, Computational Screening, and Pharmacological Evaluation of Caulerpa racemosa as an Anti-obesity With Anti-aging by Altering Lipid Profile and Peroxisome Proliferator-Activated Receptor-γ Coactivator 1-α Levels.

Obesity is associated with an accelerated aging process, which prevents healthy aging. Both obesity and aging were manifested in the peroxisome proliferator-activated receptor-γ coactivator α (PGC-1α) level. These studies fulfill the scientific gap in assembled pharmacological activity assay of Caulerpa racemosa done in a previous preclinical trial. Six major compounds from sea grape (C. racemosa) extract were evaluated using an in silico approach against human pancreatic lipase, a-glucosidase, and a-amylase to predict prospective anti-obesity candidates. The lipase inhibitory activity of the extract reached 90.30 ± 0.40%, 1.75% lower than orlistat. The a-amylase inhibitory assay of the extract was 84.07 ± 5.28%, while the inhibitory activity against a-glucosidase was 81.67 ± 1.54%; both were lower than acarbose. We observe the effect of C. racemosa extract as anti-obesity with anti-aging by evaluating the obesity parameters in the human body for a 4-week period. There was a significant decrease in blood glucose, total cholesterol, low-density lipoprotein (LDL), triglycerides (TG), waist circumference, waist-hip ratio, and body weight (p < 0.05); PGC-1α and high-density lipoprotein (HDL) increased significantly (p = 0.000), in Group B when compared with Group A. Our study revealed that sea grape extract is a potent anti-obesity with an anti-aging reagent that does not produce any significant adverse effects.

Sea grapes powder with the addition of tempe rich in collagen: An anti-aging functional food.

Background: This study aimed to determine the potential anti-aging effects of sea grapes and tempe (Fermented soybeans) collagen particle size, by measuring the activities of anti-glycation, antioxidant and tyrosinase inhibitors. Methods: Collagen was isolated from sea grapes and tempe freeze dried powder and treated with different NaOH concentrations (0.10 M; 0.20 M; 0.30 M), and CH 3COOH 1 M solution, separately. The collagen particle size was adjusted by stirring at 1000 rpm for 5 and 10 hours. 2,2-diphenyl-1-picrylhydrazyl (DPPH) was used to measure the antioxidant activity, and L-tyrosine and L-DOPA (l-3,4-dihydroxyphenylalanine) were used as a marker of tyrosine inhibition.  Results:  The collagen treated with 0.10 M NaOH produced the highest collagen yield (11.65%), and largest particle size (2455 nm). Additionally, this collagen, when treated for 5 hours, exhibited 24.70% antioxidant activity, 62.60% anti-glycation, 8.97% L-tyrosine, and 26.77% L-Dopa inhibition activities. Meanwhile, the collagen treated for 10 hours had a 9.98% antioxidant activity, 41.48% anti-glycation, 7.89% L-tyrosine, and 2.67% L-Dopa inhibition activity.   Conclusion: Sea grapes and tempe collagen powder treated with 0.10 M NaOH and stirred for 5 hours, as functional foods have anti-aging properties.

Tempe, Tofu, and Amyloid-ß 1-40 Serum Levels in Ovariectomized Rats.

BACKGROUND: Estrogens have been found to reduce amyloid-ß (Aß) levels, a risk factor associated with dementia. We hypothesized that phytoestrogenic soybean products such as tempe and tofu might show similar effects. OBJECTIVE: The aim of this study were to analyze the effect of tempe and tofu flour on Aß1-40 serum levels in ovariectomized rats. METHODS: This research was conducted on female Sprague Dawley rats, aged 12 months. Before the intervention rats underwent ovariectomy (OVx) and were grouped into 5 intervention groups which were given tempe flour, tofu flour, estradiol, or casein as an active control. There was also a non-OVx control group which was fed a normal diet. RESULTS: The intake of tempe and tofu flour decreased Aß serum levels in all estrogen and phytoestrogenic treatment groups, offsetting effects of OVx (but not in the casein group, where Aß levels rise). CONCLUSION: The tempe flour group showed the strongest decrease in serum Aß levels compared to the other groups. Future studies should investigate whether tempe can reduce Aß levels in patients with dementia.

Relationship between intra-household food distribution and coexistence of dual forms of malnutrition.

BACKGROUND/OBJECTIVES: The relationship between food intake and nutritional status has been clearly established. Yet, there are only limited studies on food intake among family members and their nutritional status. The study examined the relationship between intra-household food distribution and coexistence of dual forms of malnutrition (DFM) in the same household. SUBJECTS/METHODS: Households with a malnourished child and overweight mother were categorized as DFM. Intra-household food distribution among family members was reported using ratios, which are a measure of individual intakes as compared to all household member intakes adjusted to RDA. RESULTS: A 1,899 families were included in the study. The prevalence of DFM was 29.8% (95%CI 26.5-31.2). Children consumed lower amounts of energy (OR 1.34; 95%CI 1.06-1.69, P = 0.011), carbohydrates (OR 1.2; 95%CI1.03-1.61, P = 0.022), protein (OR 1.3; 95%CI 1.03-1.64, P = 0.026), and fat (OR 1.3; 95%CI 1.05-1.66, P = 0.016) than their mothers and other family members. In contrast, mothers consumed more carbohydrates than children and other family members (OR1.24; 95%CI 1.02-1.51, P = 0.03). CONCLUSIONS: This study is the first to report on the food distribution among family members and its relationship with occurrence of DFM in Indonesia. The results confirm the occurrence of an unequal food distribution between children and mothers, which increases risk of DFM in the household. The results also demonstrate that nutritional education at the household level is important to increase awareness of the impact of DFM.

Relationship between intra-household food distribution and coexistence of dual forms of malnutrition

BACKGROUND/OBJECTIVES: The relationship between food intake and nutritional status has been clearly established. Yet, there are only limited studies on food intake among family members and their nutritional status. The study examined the relationship between intra-household food distribution and coexistence of dual forms of malnutrition (DFM) in the same household. SUBJECTS/METHODS: Households with a malnourished child and overweight mother were categorized as DFM. Intra-household food distribution among family members was reported using ratios, which are a measure of individual intakes as compared to all household member intakes adjusted to RDA. RESULTS: A 1,899 families were included in the study. The prevalence of DFM was 29.8% (95%CI 26.5-31.2). Children consumed lower amounts of energy (OR 1.34; 95%CI 1.06-1.69, P = 0.011), carbohydrates (OR 1.2; 95%CI1.03-1.61, P = 0.022), protein (OR 1.3; 95%CI 1.03-1.64, P = 0.026), and fat (OR 1.3; 95%CI 1.05-1.66, P = 0.016) than their mothers and other family members. In contrast, mothers consumed more carbohydrates than children and other family members (OR1.24; 95%CI 1.02-1.51, P = 0.03). CONCLUSIONS: This study is the first to report on the food distribution among family members and its relationship with occurrence of DFM in Indonesia. The results confirm the occurrence of an unequal food distribution between children and mothers, which increases risk of DFM in the household. The results also demonstrate that nutritional education at the household level is important to increase awareness of the impact of DFM.