Available via license: CC BY-NC
Content may be subject to copyright.
Public Health of Indonesia, Volume 6, Issue 1, January – March 2020
Public Health of Indonesia
Mayangsari, R., Rasmiati, K. (2020). Public Health of Indonesia: 6(1), 28-34
http://stikbar.org/ycabpublisher/index.php/PHI/index
ISSN: 2477-1570
Original Research
EFFECT OF SUPPLEMENTATION OF F100 BISCUITS MODIFIED
WITH MORINGA OLEIFERA FLOUR SUBSTITUTION ON
NUTRITIONAL STATUS OF UNDER-FIVE CHILDREN WITH
MALNUTRITION IN KENDARI CITY INDONESIA
Riska Mayangsari1*, Ketut Rasmiati2
1S1 Gizi Study Program, STIKes Karya Kesehatan, Indonesia
2S1 Keperawatan Study Program, STIKes Karya Kesehatan, Indonesia
Received: 13 December 2019 | Accepted: 7 March 2020
DOI: http://dx.doi.org/10.36685/phi.v6i1.318
Correspondence:
Riska Mayangsari
STIKes Karya Kesehatan, Indonesia
Jl. Jend AH Nasution No 89 Anduonohu, Kendari City, 93232, Indonesia
Email: riska.mayangsari28@gmail.com
Copyright: © 2020 the author(s). This is an open-access article distributed under the terms of the Creative Commons
Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any
medium, provided the original work is properly cited.
ABSTRACT
Background: Malnutrition is a condition of severe nutritional deficiency caused by an insufficient intake of energy and protein
from daily food consumption. The most lethal impacts are declined IQ score, decreased cognitive development, and diminished
sensory integration, which could harm the life of the children and resulted in the loss of the national youth generation. One
effort to overcome this problem is to develop a diet alternative using F100 materials substituted from kelor (Moringa Oleifera)
flour as the main ingredient and reform it into edible biscuits. Kelor leaves contain multiple micronutrient elements that are
essential for children and have been proven to increase the nutritional status of children with malnutrition.
Objective: This research aims to identify the effect of the supplementation of F100 biscuits modified with kelor flour
substitution on the nutritional status of under-five children with malnutrition.
Methods: This was a pre-experimental study conducted in Kendari city Indonesia from May-June 2019. Twenty children were
included and given modified biscuits on a scale of 100 gm per day for six consecutive weeks. Data were analyzed using
dependent and independent sample t-test.
Results: There was a significant effect of the supplementation of F100 modified biscuits on the nutritional status of under-five
children with malnutrition (p = 0.002).
Conclusion: The F100 supplementation modified with kelor flour substitution biscuits has been proven to be effective in
increasing the nutritional status of under-five children with malnutrition.
Keywords: biscuit, F100, kelor, malnutrition, children, moringa oleifera
BACKGROUND
Nutritional status is one of the factors determining
the quality of human resources. Toddlers are one
of the groups that are more susceptible to health
problems, especially if their nutritional
consumption are unbalanced with the standard
their body needed. This situation potentially leads
to nutritional complications (Mardalena, 2017;
Sahu et al., 2015; Yisak, Gobena, & Mesfin,
2015).
Malnutrition is a condition of severe nutritional
deficiency caused by insufficient energy and
protein intake from daily food consumption that
happened in long terms. The short-term effect of
28
Public Health of Indonesia, Volume 6, Issue 1, January – March 2020
malnutrition includes apathy, speech disorder, and
growth disorder in children. Furthermore, the long
terms effects are including the decline in IQ score,
a decrease of cognitive development, and
diminish sensory integration which could harm
the life of the children and resulted in the loss of
the National young generation (Almatsier, 2009;
Venables & Raine, 2016).
The result of nutritional status assessment in 2016
using the weight/height index of children 0-59
months in Indonesia revealed the percentage of
3.4% for malnutrition in Indonesia (Kementerian
Kesehatan Republik Indonesia, 2017). There is
not a single area in Sulawesi Tenggara that is free
from malnutrition. Most of the areas presented 20
incidents/area on average, including Kendari city
(Dinas Kesehatan Sultra, 2017). To accelerate the
malnutrition elimination program in Indonesia,
apart from the food diversification program, it is
also important to develop a formula for food
supplementation contains standardized nutrients
to increase child immunity, and also to generate a
food processing technology that sustains the
excellence of local food resources (Osendarp et
al., 2015; Zakaria, Lestari, & Hartono, 2013).
F100 is a food formula contains energy, fat, and
high proteins recommended by WHO to treat
children with malnutrition (Bhandari, 2016;
Fekadu, Mesfin, Haile, & Stoecker, 2015;
Lanyero et al., 2017). However, F100
supplementation to children with malnutrition still
facing some obstacles, e.g. sanitation during food
processing and hygiene of the tools that are being
used (Ambarwati, Setiadi, Tursilowati, &
Rahmawati, 2018). F100 supplementation in
unhygienic conditions could give rise to bacterial
pathogens to grow. Therefore, there needs to be a
development of food materials that contain good
nutrients, highly bioavailable, relatively
procurable, and economically convenient. The
potential alternative is the production of biscuits
as a form of extra food using F100 substituted
with Kelor flour as the main ingredient (Kholidah,
Prawirohartono, & Nisa, 2013).
Biscuit is one type of food widely consumed in
different forms by all ages, from babies to adults
(Sari, 2013). Moreover, kelor is a type of plant
commonly found in Kendari City. It is already
integrated into the culinary culture of Sulawesi
Tenggara Province, and people often consume it
as vegetables. Kelor leaves contain multiple
micronutrients that are essential for babies and
pregnant woman, such as beta carotene, thiamin
(B1), riboflavin (B2), niacin (B3), calcium, iron,
phosphor magnesium, zinc, dan vitamin C (Daba,
2016; Rudianto & Alharini, 2013; ShM, Kassim,
AbouRayya, & Abdalla, 2017). Kelor is
recommended to be transformed into flour
because this form is more durable and easy to
store (Jerri, Adolfsen, McCullough, Velegol, &
Velegol, 2012; Kusharto & Damayanthi, 2017).
The nutritional content of kelor will be increased
in quantity if it is consumed after being dried and
made into flour (Adwiyah, 2016; Bolarinwa,
Aruna, & Raji, 2019; Singh & Prasad, 2013).
Another benefit of kelor is to increase the nutrient
status of children with malnutrition (Dhakar,
Maurya, Pooniya, Bairwa, & Gupta, 2011;
Gopalakrishnan, Doriya, & Kumar, 2016;
Rahmawati & Adi, 2016).
There has been a lot of precedent research that
studies the effect of adding kelor leaves
supplement formula into food products to increase
the food nutritional value, for example in biscuits,
soy meatballs, and yogurt (Diantoro, Rohman,
Budiarti, & Palupi, 2015; Evivie,
Ebabhamiegbebho, Imaren, & Igene, 2015;
Kholis & Hadi, 2010). Transforming the kelor
leaves into biscuits will increase its likeability
among people, which in turn is expected to
increase the consumption of kelor leaves in
society. Therefore, all the benefits contain by the
kelor leaves will be absorbed by the body
(Rahmawati & Adi, 2016). This study aimed to
examine the effect of supplementation of F100
biscuits modified with kelor flour substitution on
nutritional status of children with malnutrition in
Kendari city Indonesia.
METHODS
Study Design and Participants
This was a pre-experimental study conducted in
Kendari city Indonesia from May-June 2019. The
participants in this study were 20 under-five
children with malnutrition in Kendari city. The
29
Public Health of Indonesia, Volume 6, Issue 1, January – March 2020
exclusion criterion was children with malnutrition
but experiencing medical complications.
Instrument
The instruments in this study included digital
scales, microtoise, and biscuit intake recording
form. WHO Anthro 2005 application was used to
measure children’s nutritional status, and
Nutrisurvey 2007 was used to measure food and
biscuits consumption.
Intervention
The supplementation of F100 biscuits modified
with kelor flour substitution were explained in the
following:
a. Tools and material. The main ingredient used
in this study was moringa flour of Southeast
Sulawesi, while other supplementary
ingredients included wheat flour, egg yolks,
refined sugar, margarine, skimmed milk
powder, vanilla, and salt. Tools included
blenders, 80 mesh sieves, mixers, biscuit
molds, ovens, wood rollers, basins, spoons,
brushes, and food scales.
b. Making moringa flour. The production of
moringa leaf flour used a dry blender and was
sieved using 80 mesh sieves to separate small
stems that cannot be destroyed with a blender,
then stored in an airtight plastic container
(Rudianto & Alharini, 2013; Zakaria et al.,
2013).
c. Making biscuits. Biscuits were made with
mixing ingredients including flour (500 gr),
sugar (250 gr), margarine (400 gr), egg yolks
(3 grains), followed by mixing until they were
fused, then added moringa flour to the ratio
according to the treatment that was 5 g, 10 g,
15 g, and 20 g and powdered skim milk (70 gr),
salt (2 gr) and vanilla (4 gr), then gradually
stirred with a mixer for about 30 minutes until
the mixture was mixed equally. The obtained
dough was then molded into 4 shapes
according to the number of treatments and
baked in an oven at 160 ◦C for 20 minutes.
d. Organoleptic test included texture, aroma,
color, and taste of the modified F100 biscuit
product in each treatment to determine the
F100 modified biscuit product most preferred
by the panelists. Assessment scores were given
based on hedonic test criteria from selected 23
trained panelists. The results of this study
indicated that according to the level of
preference of the F100 biscuit modification
product panelists with the addition of moringa
flour which was preferred by the panelists, was
the formula R2 with the addition of 10 grams
of moringa flour.
e. Nutrition content analysis included protein
content analyzed by the Kjeldahl method, fat
by the Soxhlet method, carbohydrates by the
difference method, water content by the oven
method, ash content by the drying ash method.
The results of the analysis of the nutritional
content of biscuits based on panelist choices
were biscuits with the addition of 10 grams of
moringa flour showed that the calorie value
was 429.6 kcal, protein 25.63 gr, fat 33, 71 gr,
carbohydrate 101.56 gr, water content 3, 45%,
and ash content 1.51%.
f. Giving biscuits to malnourished children. The
amount of modified F100 biscuits consumed
daily for 6 weeks including how much was
given, the amount consumed, and the
remaining amount. Data on the amount of
intake were recorded on the receipt form.
Determination of the frequency of giving F100
modified biscuits to all samples was calculated
based on body weight per individual, condition
of the toddler at the time of examination and
according to energy requirements, protein per
individual for 6 weeks. Given after
breastfeeding for infants who were still
breastfed, or given before family feeding for
children who received the main food.
Data Analysis
Data were analyzed using dependent and
independent sample t-test using the SPSS
program.
Ethical Consideration
This study was approved by the Research Ethics
Committee of IAKMI Pengda Sultra with number:
003/ KEPK-IAKMI/ V/ 2019. An informed
consent was signed by each participant in this
study.
RESULTS
The majority of children were boys (n = 11, 55%)
than girls (n = 9, 45%), with the average age of
30
Public Health of Indonesia, Volume 6, Issue 1, January – March 2020
46.50 months (SD = 7.008) with malnutrition
status. Nutritional intake of children was obtained
from daily food consumption in the sum of
breakfast, lunch, dinner and snack. Table 1 shows
that the average of energy intake of the
participants before given biscuits was 854.21
calories, and after given biscuits was 1006.15
calories. The average protein intake before given
biscuits was 9.72 grams, and after given biscuits
was 15.09 gr. Statistical test results showed there
were significant differences in the increase in
energy and protein intake after consuming F100
biscuits modified with kelor flour substitution.
Table 1 The Average Energy and Protein Intake Before and
After the Intervention
Nutrient
Pretest
Posttest
P-value
Energy (Kal)
854.21
1006.15
0.000
Protein (g)
9.72
15.09
0.000
Table 2 The Level of Biscuits Consumption
Consumption level
n
%
Insufficient (<50%)
5
25
Sufficient (>50%)
15
75
Total
20
100
The children’s consumption level was observed
from the number of biscuits that had been
consumed for 6 weeks, which was divided into the
number of biscuits supposed to be consumed (252
pieces). The level of consumption of children is
categorized “sufficient” when spending biscuits
as many as ≥126 pieces, while the level of
consumption of children is categorized as
“insufficient” if children consumes biscuits as
<126 pieces. Table 2 shows that 15 children
(75%) had sufficient consumption level of
biscuits, and 5 children (25%) had insufficient
level of biscuit consumption.
Table 3 Effect of supplementation of F100 modified with kelor flour substitution biscuit on nutritional status of children
Consumption level
Final nutritional status
p-value
Malnutrition
Undernutrition
n
%
n
%
Insufficient
2
10
3
15
0.002
Sufficient
1
5
14
70
Total
3
15
17
85
Table 3 shows that there was a change in
nutritional status in children. Before the
intervention, all children were in malnutrition
status, but after given the intervention, the status
was changed from malnutrition to undernutrition
specifically for the children who had sufficient
consumption level of biscuits (70%). However,
for those who had insufficient level of biscuit
consumption, only 15% of children were changed
from malnutrition to undernutrition. The
statistical test showed that there was a significant
effect of giving the supplementation of F100
biscuits modified with kelor flour substitution on
the nutritional status of children under five with p-
value of 0.002.
DISCUSSIONS
Nutrient contribution of F100 substituted with
kelor biscuits to the nutrient sufficiency range
of the children
The number of biscuits consumed by children was
6 pieces or equivalent to 100 g per day. On
average, the contribution of energy from biscuits
was above 10% of nutrient range, which was
10.9% from the total. Meanwhile, the average
proportion of protein contribution from biscuit
consumption was 21.48% of nutrient range.
According to BPOM, food is categorized as a
good source of protein if it contains at least 20%
of nutrient range recommended per serving
(Badan Pengawas Obat dan Makanan, 2014).
Additional food supplementation (AFS, or PMT
in Bahasa Indonesia) for recovery purposes is one
of the efforts to handle malnutrition problems.
PMT is a diet capable of providing an extra
beneficial effect for health besides the nutritional
elements that naturally contained in food (Chaix,
Zarrinpar, Miu, & Panda, 2014). PMT given to
children with malnutrition intend to gradually
provide a good and enough protein, vitamin, and
mineral intake to achieve optimal nutritional
status with sufficient nutritional composition.
Biscuit intake level
The children’s consumption level could be
observed from the number of biscuits taken in 6
weeks divided into the number of biscuits
supposed to be consumed (252 pieces). In this
31
Public Health of Indonesia, Volume 6, Issue 1, January – March 2020
study, 75% of the children had enough level of
consumption, and only 25% of the children had an
insufficient level of consumption. Based on the
interview with the mothers, the children enjoyed
the biscuits for the good flavor. On the other hand,
the children in category middle level of
consumption became disinterested with the
biscuits in weeks 4 and 5. This disinterest feeling
resulted from the preference of the children who
had to consume 6 pieces of biscuits with the same
form and flavors for 6 weeks consecutively. As a
result, the children who were initially able to
finish 6 biscuits per day in the first weeks,
eventually could only take 1-2 pieces of biscuits
per day in week 4 to week 5.
Another potential explanation was that the
condition of the children that were sick at the
moment they were being assessed. During the
study, 6 children experienced sickness with
common types of symptoms like fever, cough, and
flu. This condition could affect the appetite of the
children which in turn affects the intake level of
the biscuits
The effect of supplementation of F100 modified
with kelor flour substitution biscuit on the
nutritional status of children
F100 modified with kelor flour substitution
biscuit is a type of snack made from several
ingredients, including the main element of kelor
flour with certain nutrient levels to achieve a high
level of nutrition. kelor flour consumption is one
of the alternatives to increase the weight of
children with malnutrition. This study shows that
there was an increase of nutritional status from
malnutrition to undernutrition to those who had
sufficient level of biscuit consumption. This result
is in line with a study conducted an experiment of
PMT-P supplementation in form of Tempe
biscuits for 1 month to 17 children with
tuberculosis aged 12-59 months (Muslimah,
Judiono, Suparman, Ichwannudin, & Diandini,
2019).
The result of statistical analysis displayed the
significant effect of supplementation of F100
modified with kelor flour substitution biscuit to
the nutritional status of children. This means that
the larger portion of children with enough intake
of F100 modified biscuits had better nutritional
status (70%). On the other hand, the children with
low intake of F100 modified biscuits had lower
nutritional status (15%), This could indicate that
biscuit consumption according to the
recommendation could increase the nutritional
status of the children. This result is due to the high
level of energy contribution and protein from the
biscuit intake resulted from the addition of kelor
flour in the biscuits.
This is in line with the theory stated that the more
kelor flour added, the higher the level of protein,
iron, calcium, fiber content, and ß-carotene in the
food. This indicates the potential of kelor flour is
used to increase the nutrient level in foods
(Dachana, Rajiv, Indrani, & Prakash, 2010). The
digestibility of amino acid and protein is up to
60%, increasing the ability of nutritional
absorption contained in kelor flour (Baptista et al.,
2017). This result is in line with previous study
that that the weight of the children administered
with kelor flour intake was higher than the
unadministered children (8.9±4.30 g/kg/days
compared to 5.7±2.72 g/kg/days), and faster
recovery rate with the average of 36±16.54 days
for administered children compared to 57±19.20
days in unadministered children (Zongo,
Zoungrana, Savadogo, & Traoré, 2013)
CONCLUSION
The supplementation of F100 modified with kelor
flour substitution biscuits increases the nutritional
status of children with malnutrition. This study
can be an input as an alternative treatment to
increase the nutritional status of under-five
children with malnutrition. Future studies with
control groups were needed to see the
effectiveness of this intervention on nutritional
status of the children.
Declaration of Conflicting Interest
There is no conflict of interest in this study.
Acknowledgment
The authors delivered the deepest gratitude to all parties that
helped this research.
REFERENCES
Adwiyah, A., Melani, V., & Fadhila, R. (2016). Uji Daya
Terima, Nilai Gizi dan Analisis Jumlah Bakteri
Pada Produk Mi Kering Dengan Penambahan
32
Public Health of Indonesia, Volume 6, Issue 1, January – March 2020
Tepung Daun Kelor. Theses. Universitas Esa
Unggul, Jakarta.
Almatsier, S. (2009). Prinsip Dasar Ilmu Gizi, Jakarta: PT.
Gramedia Pustaka Utama.
Ambarwati, R., Setiadi, Y., Tursilowati, S., & Rahmawati, A.
Y. (2018). Pelatihan pembuatan crackers
modifikasi f100 dengan substitusi tepung labu
kuning bagi tenaga gizi pendamping gizi buruk.
LINK, 14(1), 22-25.
Badan Pengawas Obat dan Makanan. (2014). Peraturan
kepala Badan Pengawas Obat dan Makanan
Republik Indonesia nomor 12 tahun 2014 tentang
persyaratan mutu obat tradisional: Badan
Pengawas Obat dan Makanan Republik Indonesia.
Baptista, A. T. A., Silva, M. O., Gomes, R. G., Bergamasco,
R., Vieira, M. F., & Vieira, A. M. S. (2017). Protein
fractionation of seeds of Moringa oleifera lam and
its application in superficial water treatment.
Separation and Purification Technology, 180, 114-
124.
Bhandari, N. (2016). Infant and Young Child Feeding.
Proceedings of the Indian National Science
Academy, 82(5), 1507-1517.
Bolarinwa, I. F., Aruna, T. E., & Raji, A. O. (2019). Nutritive
value and acceptability of bread fortified with
moringa seed powder. Journal of the Saudi Society
of Agricultural Sciences, 18(2), 195-200.
Chaix, A., Zarrinpar, A., Miu, P., & Panda, S. (2014). Time-
restricted feeding is a preventative and therapeutic
intervention against diverse nutritional challenges.
Cell metabolism, 20(6), 991-1005.
Daba, M. (2016). Miracle tree: A review on multi-purposes
of Moringa oleifera and its implication for climate
change mitigation. Journal of Earth Science and
Climate Change, 7(4).
Dachana, K., Rajiv, J., Indrani, D., & Prakash, J. (2010).
Effect of dried moringa (Moringa oleifera lam)
leaves on rheological, microstructural, nutritional,
textural and organoleptic characteristics of
cookies. Journal of Food Quality, 33(5), 660-677.
Dhakar, R. C., Maurya, S. D., Pooniya, B. K., Bairwa, N., &
Gupta, M. (2011). Moringa: The herbal gold to
combat malnutrition. Chronicles of Young
Scientists, 2(3), 119.
Diantoro, A., Rohman, M., Budiarti, R., & Palupi, H. T.
(2015). Pengaruh penambahan ekstrak daun kelor
(Moringa Oleifera L.) terhadap kualitas yoghurt.
TEKNOLOGI PANGAN: Media Informasi dan
Komunikasi Ilmiah Teknologi Pertanian, 6(2).
Dinas Kesehatan Sultra. (2017). Profil Kesehatan Sulawesi
Tenggara.
Evivie, S., Ebabhamiegbebho, P., Imaren, J., & Igene, J.
(2015). Evaluating the organoleptic properties of
soy meatballs (BEEF) with varying levels of
Moringa oleifera leaves powder. Journal of
Applied Sciences and Environmental Management,
19(4), 649-656.
Fekadu, Y., Mesfin, A., Haile, D., & Stoecker, B. J. (2015).
Factors associated with nutritional status of infants
and young children in Somali Region, Ethiopia: a
cross-sectional study. BMC Public health, 15(1),
846.
Gopalakrishnan, L., Doriya, K., & Kumar, D. S. (2016).
Moringa oleifera: A review on nutritive importance
and its medicinal application. Food Science and
Human Wellness, 5(2), 49-56.
Jerri, H. A., Adolfsen, K. J., McCullough, L. R., Velegol, D.,
& Velegol, S. B. (2012). Antimicrobial sand via
adsorption of cationic Moringa oleifera protein.
Langmuir, 28(4), 2262-2268.
Kementerian Kesehatan Republik Indonesia. (2017). Profil
Kesehatan. Kementerian Kesehatan Republik
Indonesia
Kholidah, D., Prawirohartono, E. P., & Nisa, F. Z. (2013).
Pemberian makanan F100 dengan bahan substitusi
tepung tempe terhadap status protein pasien anak
dengan gizi kurang. Jurnal Gizi Klinik Indonesia,
10(2), 92-100.
Kholis, N., & Hadi, F. (2010). Pengujian bioassay biskuit
balita yang disuplementasi konsentrat protein daun
kelor (Moringa oleifera) pada model tikus
malnutrisi. Jurnal Teknologi Pertanian, 11(3),
144-151.
Kusharto, C. M., & Damayanthi, E. (2017). Pengembangan
crackers sumber protein dan mineral dengan
penambahan tepung daun kelor (Moringa oleifera)
dan tepung badan-kepala ikan lele dumbo (Clarias
gariepinus). Nutri-Sains: Jurnal Gizi, Pangan dan
Aplikasinya, 1(1), 22-38.
Lanyero, B., Namusoke, H., Nabukeera-Barungi, N., Grenov,
B., Mupere, E., Michaelsen, K. F., . . . Briend, A.
(2017). Transition from F-75 to ready-to-use
therapeutic food in children with severe acute
malnutrition, an observational study in Uganda.
Nutrition Journal, 16(1), 52.
Mardalena, I. (2017). Dasar-Dasar Ilmu Gizi Dalam
Keperawatan: Konsep dan Penerapan Pada Asuhan
Keperawatan. Yogyakarta: Pustaka Baru Press.
Muslimah, H. Z., Judiono, J., Suparman, S., Ichwannudin, I.,
& Diandini, A. K. (2019). Peranan Pemberian
Cookies Kedelai Mocaf Terhadap Peningkatan
Berat Badan Balita Gizi Kurang. Jurnal Riset
Kesehatan Poltekkes Depkes Bandung, 11(2), 92-
101.
Osendarp, S., Rogers, B., Ryan, K., Manary, M., Akomo, P.,
Bahwere, P., . . . Dibari, F. (2015). Ready-to-use
foods for management of moderate acute
malnutrition: considerations for scaling up
production and use in programs. Food and
Nutrition Bulletin, 36(1_suppl1), S59-S64.
Rahmawati, P. S., & Adi, A. C. (2016). Daya terima dan zat
gizi permen jeli dengan penambahan bubuk daun
kelor (Moringa oleifera). Media Gizi Indonesia,
11(1), 86-93.
Rudianto, S., & Alharini, S. (2013). Studi Pembuatan Dan
Analisis Zat Gizi Pada Produk Biskuit Moringa
Oleifera Dengan Subtitusi Tepung Daun Kelor.
Program Studi Ilmu Gizi Fakultas Kesehatan
Masyarakat Universitas Hasanuddin Makasar.
Sahu, S. K., Kumar, S. G., Bhat, B. V., Premarajan, K.,
Sarkar, S., Roy, G., & Joseph, N. (2015).
Malnutrition among under-five children in India
and strategies for control. Journal of Natural
Science, Biology, and Medicine, 6(1), 18.
33
Public Health of Indonesia, Volume 6, Issue 1, January – March 2020
Sari, O. (2013). Formula Biskuit Kaya Protein Berbasis
Spirulina dan Kerusakan Mikrobiologis Selama
Penyimpanan.[Skripsi]. Program Studi Teknologi
Hasil Perairan.
ShM, T., Kassim, N., AbouRayya, M., & Abdalla, A. (2017).
Influence of foliar application with Moringa
(Moringa oleifera L.) leaf extract on yield and fruit
quality of hollywood plum cultivar. Journal of
Horticulture, 4(193), 2376-0354.1000193.
Singh, Y., & Prasad, K. (2013). Moringa oleifera leaf as
functional food powder: Characterization and uses.
International Journal of Agriculture and Food
Science Technology, 4(4), 317-324.
Venables, P. H., & Raine, A. (2016). The impact of
malnutrition on intelligence at 3 and 11 years of
age: The mediating role of temperament.
Developmental Psychology, 52(2), 205.
Yisak, H., Gobena, T., & Mesfin, F. (2015). Prevalence and
risk factors for under nutrition among children
under five at Haramaya district, Eastern Ethiopia.
BMC Pediatrics, 15(1), 212.
Zakaria, A. T., Lestari, R., & Hartono, R. (2013).
Pemanfaatan Tepung kelor (Moringa Oleifera)
Dalam Formulasi Pembuatan Makanan Tambahan
Untuk Balita Gizi Kurang. Media Gizi Pangan.
Zongo, U., Zoungrana, S. L., Savadogo, A., & Traoré, A. S.
(2013). Nutritional and clinical rehabilitation of
severely malnourished children with Moringa
oleifera Lam. leaf powder in Ouagadougou
(Burkina Faso).
Cite this article as: Mayangsari, R., Rasmiati, K. (2020).
Effect of supplementation of F100 biscuits modified with
moringa oleifera flour substitution on nutritional status of
under-five children with malnutrition in Kendari city
Indonesia. Public Health of Indonesia. 6(1), 28-34.
http://dx.doi.org/10.36685/phi.v6i1.318
34