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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

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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.
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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
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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
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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
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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
n
%
5
25
15
75
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
insufficientif 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
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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.
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Venables, P. H., & Raine, A. (2016). The impact of
malnutrition on intelligence at 3 and 11 years of
age: The mediating role of temperament.
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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
... 2 This disorder is characterized by a deficiency or imbalance in energy and nutrient consumption, leading to symptoms such as wasting, stunting, or being underweight. 3,4 The prevalence of malnutrition among school-aged children in South Asia is alarmingly high, with nearly 60% of both boys and girls classified as underweight. Furthermore, Southeast Asia has the highest rate of stunting among adolescents aged 5 to 19, at 12%. 5 DOI: https://dx.doi.org/10.18203/2320-6012.ijrms20243687 ...
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Background: Malnutrition poses a significant threat to the health and development of children in developing countries. The purpose of the study was to compare plasma calcium, albumin, and total cholesterol levels between severely malnourished and healthy children in Bangladesh. The aim of the study was to compare plasma calcium, albumin, and total cholesterol levels between severely malnourished and healthy children in Bangladesh. Methods: This cross-sectional study included 120 subjects, consisting of 60 severely malnourished children aged 18 months to 5 years in Group I (Case) and 60 healthy children in Group II (Control), conducted at Mymensingh Medical College & Community Based Medical College Bangladesh from July 2008 to June 2009. Serum calcium, albumin, and total cholesterol levels were measured and analyzed using SPSS version 22.0, applying descriptive statistics and Student’s unpaired t-test for group comparisons. Results: In this study, Group I (severely malnourished children) had a significantly lower mean weight (10.70±2.20 kg) compared to Group II (healthy children) at 14.30±2.30 kg (p<0.001). Group I also exhibited significantly lower serum calcium (7.3±1.5 mg/dl vs. 8.6±0.55 mg/dl; p<0.001), albumin (3.1±0.32 g/dl vs. 4.5±0.22 g/dl; p<0.001), and cholesterol levels (117.0±17.0 mg/dl vs. 127.0±17.6 mg/dl; p = 0.004). Conclusions: The study found significantly lower levels of plasma calcium, albumin, and total cholesterol in severely malnourished children compared to healthy controls, indicating critical nutritional deficiencies that require targeted interventions.
... The higher the quality of the aroma, the wider its range for mixing with the surrounding air. The human sense of smell varies in terms of shape and sensitivity to scent recognition [15]. ...
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The problem of stunting in Indonesia is still quite high, namely 21,6% based on data from the 2022 Indonesian Nutrition Status Survey (SSGI). One of the effective measures to control stunting is through providing additional food (PMT) such as biscuits to children. Carrots and pumpkin are local foods that are rich in beta carotene. Carotenoids as a source of provitamin A are able to overcome the problem of vitamin A deficiency (VAD), which is the cause of growth disorders in children. This research aims to determine the effect of substitution of yellow pumpkin (Cucurbita moschata) and carrot (Daucus carota L.) composite flour on organoleptic characteristics including color, aroma, taste, texture and nutritional content (beta carotene, carbohydrates, protein and fat). This research used a Randomized Block Design (RAK) with 3 treatments, namely formula 1 (150 grams of wheat flour, 50 grams of pumpkin flour and 50 grams of carrot flour), formula 2 (50 grams of wheat flour, 60 grams of pumpkin flour and 50 grams of flour carrots) and formula 3 (50 grams of wheat flour, 50 grams of pumpkin flour and 150 grams of carrot flour) with 3 repetitions. The research results showed that formula 3 biscuits were the best formulation in terms of organoleptic characteristics with the highest beta carotene content compared to F1 and F2. F3 biscuits contain 30,97 mg beta carotene, 7,45 grams of carbohydrates, 3,22 grams of protein and 8,89 grams of fat. The conclusion of this research is that the substitution of wheat flour with composite flour (Cucurbita moschata and Daucus carota L.) has an effect on the nutritional content (beta carotene, carbohydrates, protein and fat) of biscuits. Consuming pumpkin biscuits per 100 grams can qualify as a good source of the antioxidant beta carotene.
... In Indonesia, moringa leaves have been widely used for many purposes, such as traditional rituals and medicine, beauty, environmental management, and food fortification/supplementation, that is, for malnourished toddlers, anemic pregnant women, and diabetic treatment (Ahmad et al., 2019;Indriani et al., 2019;Isnan & Nurhaedah, 2017;Mayangsari & Rasmiati, 2020). The prevalence of exclusive breastfeeding and continued breastfeeding at 1 and 2 years is low among breastfeeding mothers in Indonesia (Nurokhmah et al., 2022). ...
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Moringa leaves (Moringa oleifera) have many health benefits and have been used by the wider community to support health. The purpose of this review is to provide an overview of the acceptability of food products substituted with moringa leaves, based on studies conducted in Indonesia. Indosesia’s reference database, Garuda (Garba Rujukan Digital), was used for the eligible studies. The search terms used to obtain relevant studies were "Moringa leaf," "organoleptic," and "acceptability" published between 2016 and 2021. The inclusion criteria were full-text articles written in Indonesian or English and published in Sinta 1-4 indexed journals. This study used a completely randomized design and sensory testing in humans. Results: Nine studies qualified for this review, with a variation substitution of moringa leaf in instant noodles, jelly candy, cookies, biscuits, and pancakes. The addition of moringa leaves to the products was carried out in the form of powder, protein concentrate, flour, and puree–1,5-5% to improve the content of certain nutrients, such as protein, beta-carotene, iron, calcium, vitamin C, or overall nutrients. Untrained panelists of 15-33 were used to select consumer preferences for the products, followed by nutrient analysis to determine the increase in the content of certain nutrients by adding moringa leaves. In conclusion, the more moringa leaves were added to the food products, the lower the panelists' preference for aroma, color, texture, and taste.
... Daun kelor yang digunakan adalah daun kelor yang masih muda yang terletak dipucuk pohon selanjutnya daun kelor tersebut dicuci dengan air bersih lalu di petik dari tangkai daunnya, kemudian disebar di atas jaring kawat di panas matahri selama 6 jam(sudah cukup kering). Pembuatan tepung dari daun kelor kering sering digunakan blender kering dan diayak dengan ayakan 100 mash untuk memisahkan batang-batang kecil yang tidak hancur dengan blender, selanjutnya disimpan dalam wadah plastik kedap udara (Mayangsari & Rasmiati, 2020) Berdasarkan tabel 2 didapatkan rata-rata kadar Hb remaja putri sebelum dan sesudah diberikan es krim kelor mengalami peningkatan yaitu 0,976 dengan standar deviasi 0,362 dan standar error 0,544. Hasil uji statistik didapatkan nilai p-Value 0,002 (<0,005). ...
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Adolescents are the group most vulnerable to anemia. Adolescents are categorized as anemic if their Hb level is <12 gr/dl. The prevalence of anemia in adolescents was 32% in 2018. Anemia can be caused by insufficient iron intake, menstruation, impaired absorption of iron, and the presence of infectious diseases. Increasing iron intake can be done by increasing local food intake. Moringa contains nutrients such as iron (fe), calcium (ca), vitamins A, β-carotene, protein, vitamins A, C, D, E, K, and B, and antioxidant compounds. Moringa can be processed into one of adolescents favorite snacks, namely ice cream. This study aims to determine the effect of giving ice cream with the addition of moringa leaf flour on the hemoglobin levels of female adolescents. This research was conducted with a one group pre post-test design. The sample in this study was 30 female adolescents. There is an effect of giving ice cream with the addition of Moringa flour on hemoglobin levels in young girls with a p-value of 0.002 (α<0.005). Giving ice cream with the addition of Moringa flour effects on increasing hemoglobin levels in female adolescents
... Freshly picked Moringa leaves have a nutritional content of 100 grams which is equivalent to 8 grams of dried Moringa leaves which are effective in increasing the weight of children under five years who experience Caloric Energy Deficiency and malnutrition (21). This research is in line with the results of research conducted by Riska Mayangsari et al, in 2020 which found that there was a significant effect of giving 6 biscuits equivalent to 100 grams per day to improve nutritional status in toddlers who were experiencing malnutrition (22). The results of Yulia Fitri et al, 2020's research are also in line with this study which says that providing biscuits (dry snacks) with the addition of 100 mg of Moringa leaf powder per day for 3 weeks significantly increases toddler's weight (p-value = 0.000) (20). ...
Article
Introduction: Weight is an indicator of the nutritional status of toddlers; it shows if they have poor nutrition, undernutrition, good nutrition, or overnutrition. One of the interventions carried out to solve the malnutrition problem is the provision of supplementary foods with various innovations, such as fortified biscuits with the extract of Moringa leaves (Moringa oleifera). This study aims to determine the effect of supplemental moringa biscuits on improving the nutritional status of toddler’s nutritional as seen from the increase in toddler weight. Methods: This quasi-experimental study uses a pre- and post- test design approach. The number of respondents in this study was 113 toddlers. The research was carried out in the work area of the Hinai Kiri Health Centre Integrated Service Unit, Langkat Regency, North Sumatra Province. Results: This shows that there is a significant difference in the weight of the toddler between the first measurement (before the intervention) and the second measurement (a month after the intervention). In the third measurement (2 months after the intervention) there was an increase in the average toddler’s weight, namely 1.18 kg with a p-value = 0.005 which indicated a significant difference between the toddler’s weight with the first measurement and the third measurement (2 months after the biscuit intervention). Conclusion: Moringa oleifera contains multivitamins that are effective in improving the nutritional status of malnourished toddlers. It is suggested that Moringa leaf extract can be used as a supplement to toddlers diets which can be processed according to toddlers’ tastes.
... Malnutrition is defined as a deficiency or imbalance of a person's energy and nutrient intake; it can be formed as wasting, stunting, and being underweight (Mayangsari & Rasmiati, 2020;World Health Organization, 2020). School-aged children are vulnerable to malnutrition (Effendy, Wirjatmadi, Adriani, & Tosepu, 2015;Murhima Alika et al., 2022). ...
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Background: School-aged children between 6-12 years are a vulnerable group that could be affected by malnutrition, which may cause growth failure and affect their school achievement. East Nusa Tenggara, Indonesia, is known as the province with the highest cases of malnutrition. Objective: This study aimed to determine serum total protein and albumin levels among malnourished elementary-aged children. Serum total protein and albumin are biochemical parameters that give valuable data due to malnutrition. Methods: This study employed a case-control design. Purposive sampling was used to select the samples with a total of 90 children aged 6 – 12 years, of which 45 were assigned to a case group and a control group. The children’s blood was collected and analyzed using Riele Photometer 5010. The Biuret method was applied for total protein and bromocresol green for albumin serum. Independent sample t-test with a significant value <0.05 was used to determine the difference between mean total protein and albumin levels. Results: The percentage of low total protein levels in malnourished children was 36%, and the percentage of low albumin levels was 27%. The mean level of total protein and albumin was found to be lower in malnourished than in well-nourished children, 6.324±1.1748 g/dL vs. 7.047±0.6330 g/dL (p = <0.001), and 3.927 g/dL±0.7779 g/dL vs. 4.242 g/dL±0.5272 (p = 0.016), respectively. Conclusion: There were significant differences in total protein and albumin serum among malnourished and well-nourished children. The results may serve as basic information for further studies or to create an intervention to reduce malnutrition.
... Moringa leaves are rich in macronutrients and micronutrients as well as antioxidants 11,12 . Moringa leaves contain higher iron than other vegetables, namely 17 15 . According to the results of previous research, the nutritional content of Moringa leaf flour is beta-carotene content 10 times carrots, 25 times banana potassium, 25 times iron spinach, ½ times vitamin C oranges, 17 times calcium milk, and 9 times yogurt protein. ...
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Adolescents are a high-risk group for anemia. The prevalence of anemia in adolescents was 32% in 2018. One of the risk factors for anemia is the low intake of iron (Fe). Local food diversification is an effort to increase iron intake, one of which is by making ice cream using Moringa and soybean flour. Moringa leaves contain higher iron than other vegetables, namely 17.2 mg / 100 g. Ice cream is a snack that is loved by all levels of society. This study aims to determine the melting time and fe content of ice cream by utilizing Moringa leaf flour. This study used a one-factor completely randomized design (CRD). The research data were analyzed descriptively. The results of this study indicate that the ice cream with the addition of 5 gram of Moringa leaf flour has an average melting time of 49,18 minutes, and the laboratory results show the ice cream content is 0.114 mg / L and the addition 10 grams of Moringa leaf flour has an average melting speed of 58.26 minutes, and the laboratory results show the ice cream content is 0.135 mg / L. The results of this study indicate that the ice cream with the addition of 10 grams of Moringa leaf flour has an average melting speed of 58.26 minutes, and the laboratory results show the ice cream content is 0.135 mg / L. Soybean ice cream with the use of Moringa leaf flour can be used as an alternative healthy snack for adolescents.
... Addition of Moringa leaf powder ( MOLP ) in snacks can contribute to coping problem nutrition in children who are vulnerable to malnutrition (Zungu et al., 2020). Fortified biscuits powder leaf moringa increase heavy body child not enough nutrition (Has & Ariestiningsih, 2020;Mayangsari & Rasmiati, 2020). While research in Northern Benin observed impact gift fortified food with 15 gr of powder moringa for 2 weeks no raise heavy body child in a manner significant (Naga & Jo, 2020). ...
Article
Malnutrition could resulted disturbance physique and mental illness and risk death . Moringa oleifera is rich in phytonutrients so that Becomes source promising nutrition _ however use in fortification food still limited . The research objective was to determine the effect of giving cake snacks dry moringa against enhancement heavy body toddler underweight . Design used _ is Quasi Experimental with nonrandomized pretest-posttest design. The research sample is 30 toddlers (15 case groups and 15 control groups). Measurement heavy body conducted with digital scales and be measured 2 times ie before intervention and after intervention . Moringa snacks given for 3 weeks Data analysis using the T test. The results of the study showed the provision of cake snacks dry with additions powder Moringa leaves 100 mg per day for 3 week significantly improve heavy body toddler (P=0.00). Moringa can increase the weight of underweight toddlers. Further research is needed regarding the effectiveness of Moringa in overcoming health problems in children in more coverage large including stunting.
... So, they can used to fortify food products other than biscuits e.g. yogurt, soy meatballs, etc. to the nutrition content of these food products which in turn will improve the nutritional well-being of children and other individuals [11]. ...
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Results of the monitoring and evaluation of programs comprehensive examination malnutrition children in the city of Semarang, 2014 shows a toddler can not spend PMT, one reason is the toddler suffering from boredom, so that changes in nutritional status and the expected weight gain cannot be achieved is not expected to be achieved so as to consider alternative forms of formulas for children malnutrition. The alternative to the manufacture of food in the form of crackers by using basic ingredients WHO F100 formula with flour substitute pumpkin. Ria and Yuwono study (2016) that cRackers with basic materials modification F100 with pumpkin flour substitution of 10% can be accepted by a toddler. Provide training on making crackers modified F100 with pumpkin flour substitution on energy malnutrition nutrition assistant at Home Nutrition Semarang. The training methods include lectures, practice and assessment discussion participants include taste, aroma, colour and texture Most participants (80%) were able to make modifications crackers F100 pumpkin flour substitution. Acceptance test conducted by the participants of the colour of 3.56, 3.14 aroma, flavour and texture 3,12 3.44. Crackers modified F100 with pumpkin flour substitution can be used as an alternative food supplement for children with malnutrition.
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Moringa oleifera is local plant rich in nutrients, unfortunately its utilization as a foodstuff is limited. In order to maximize the absorbtion of nutrients inside moringa, it should be made as favor food enjoyed by the people such as jelly candy. This research was conducted to evaluate organoleptic properties and nutritional value (energy and â-caroten) of jelly candy formulated with Moringa leaves powder. Using Comlpetely Randomized Design with 6 times repetition in 4 formulas which are 1 controlled formula and 3 modifi ed formulas (F1, F2, and F3), jelly candy then tested to 32 untrained panels. Treatment given in this study was by adding 2%, 4%, and 6% moringa leaves powder into jelly candy formula. Data was analyzed descriptively and statistically using Kruskal Wallis and Mann Whitney test to fi nd out the difference pair. Recommended formula was chosen by counting the highest mean score of the sensory evaluation test. The result of sensory evaluation showed that Moringa Jelly Candy was generally accepted with category “like”. However, jelly candy with lowest level of Moringa leaves powder (F1) was most acceptable in terms of color, odor, texture, and fl avor. Statistical analysis showed that the scores of color, odor, and texture were not signifi cantly different (p > 0.05) and fl avor was (p < 0.005) which means that by adding moringa leaves powder into jelly candy formula only infl uence the fl avor of jelly candy. Recommended jelly candy formula is F1 with nutritional analysis showed that per 100 g of jelly candy contains 205,8 kcal and 0.178 mcg of B -caroten. Keywords: moringa leaves powder, sensory evaluation, Moringa oleifera, jelly candy
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p class="Default"> Kelor is one of the vegetables with high nutrients contents but haven’t been widely utilized. Adding kelor leaves flour to the crackers made with catfish flour to increase protein and minerals is one way to maximize the potential of its nutrient content. This research purposed to develop the formulation of crackers by adding kelor leaves flour and catfish dumbo flour as a food source of protein and minerals. Kelor leaves flour obtained from this research contains protein, calcium, iron, and zinc respectively for 23.25%, 640.5 mg/100g, 30.6 mg/100g, and 6.65 mg/100g. The best formula chosen from organoleptic was is crackers with the addition 10% catfish dumbo flour and 2.5 g kelor leaves flour. The crackers contain 11.50% protein, 30.73 mg/100g calcium, 8.56 mg/100g iron, and 609.70 mg/100g zinc respectively. Selected crackers contain more than 20% protein and more than 15% of iron and zinc standart for 2-5 years old children group based on nutrition label reference (ALG, for Indonesian), so it can be claimed as a food source of protein, iron and zinc. Key words: crackers, kelor, catfish dumbo, protein, mineral. </p
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Background World Health Organization now recommends the transition from F-75 to ready-to-use therapeutic foods (RUTF) in the management of severe acute malnutrition (SAM). We described the transition from F-75 to RUTF and identified correlates of failed transition. Methods We conducted an observational study among children aged 6–59 months treated for SAM at Mulago hospital, Kampala, Uganda. Therapeutic feeding during transition phase was provided by first offering half of the energy requirements from RUTF and the other half from F-75 and then increasing gradually to RUTF as only energy source. The child was considered to have successfully transitioned to RUTF if child was able to gradually consume up to 135 kcal/kg/day of RUTF in the transition phase on first attempt. Failed transition to RUTF included children who failed the acceptance test or those who had progressively reduced RUTF intake during the subsequent days. Failure also included those who developed profuse diarrhoea or vomiting when RUTF was ingested. ResultsAmong 341 of 400 children that reached the transition period, 65% successfully transitioned from F-75 to RUTF on first attempt while 35% failed. The median (IQR) duration of the transition period was 4 (3–8) days. The age of the child, mid-upper arm circumference, weight-for-height z-score and weight at transition negatively predicted failure. Each month increase in age reflected a 4% lower likelihood of failure (OR 0.96 (95% CI 0.93; 0.99). Children with HIV (OR 2.73, 95% CI 1.27; 5.85) and those rated as severely ill by caregiver (OR 1.16, 95% CI: 1.02; 1.32) were more likely to fail. At the beginning of the rehabilitation phase, the majority (95%) of the children eventually accepted RUTF while only 5% completed rehabilitation in hospital on F-100. Conclusion Transition from F-75 to RUTF for hospitalized children with SAM by gradual increase of RUTF was possible on first attempt in 65% of cases. Younger children, severely wasted, HIV infected and those with severe illness as rated by the caregiver were more likely to fail to transit from F-75 to RUTF on first attempt.
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Bread is a common staple food in developing countries and many other regions of the world. It is an energy dense food with low micronutrient content. Micronutrient deficiency is increasing among children and pregnant women in Africa and other developing countries. In this study, bread was fortified with moringa seed powder at varying proportions (0 – 20%). The proximate, mineral, vitamin A content and sensory attributes of the moringa fortified bread samples were evaluated. Results of the proximate analysis showed that moringa seed powder addition significantly (p <0.05) increased the protein (8.55 - 13.46%), ash (0.63% - 1.76%), fat (7.31% - 15.75%) and fibre content (0.08% - 0.62%) of the bread samples, while the moisture (22.90% - 20.01%) and carbohydrates content (57.68% - 46.73%) of the bread decreases. The mineral contents (Phosphorus, potassium, calcium and Iron) of the moringa fortified bread also increased significantly. Vitamin A contents of the bread samples increased by 50 – 74%, as the proportion of moringa seed powder increases in the flour blends. Results of the sensory evaluation indicated that the 5% moringa fortified bread was not significantly different from the bread produced from 100% wheat flour in terms of most of the quality atributes evaluated in this study. In conclusion, fortification of bread with moringa seed powder increased both the micro and macronutrient of conventional bread. In addition, the moringa fortified bread was rich in Vitamin A and also acceptable to consumers at 5% fortification level.
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Nutrition during the entire life cycle is a key driver of growth and development. Foetal life and early childhood years are the phases when growth and development are maximum, coinciding with a period of great vulnerability to sub-optimal environment, with early as well as long-term consequences. It is in this context that optimal feeding of infants and young children is critically important. This chapter describes the recommended practices of breast-feeding, and the recommendations for vulnerable subgroups such as low birth weight and HIV infected infants. It also emphasizes on strong lactation support for mothers and describes ways for promoting optimal practices. Feeding of complementary foods after 6 months of age, the guiding principles for complementary feeding of the breast-fed children and the nutritional requirements from complementary feeding are also covered. As non-dietary determinants such as water, sanitation, hygiene, and other factors influence nutritional status of children, integrated interventions are likely to have a greater impact on stunting, rather than individual components alone.
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Moringa oleifera is known as “horseradish tree” or “drumstick tree”, native to India, is one of the best useful tree and an enormous amount of benefits in the world. Numerous Research reports have appeared in different national and international scientific journals by studying its nutritional and medicinal properties of Moringa over the past decades. Different reports show that due to its multipurpose uses Moringa tree has recently grown attention in Ethiopia. Moringa oleifera is a tree that is sometimes called a “Miracle Tree” because of all its parts are used for nutritional, pharmacological properties.Moringa is a very valuable food crop (it is highly nutritive, grows very fast and drought resistant) and even beyond food it serves many benefits in developing countries such as having an ability to be used for some crafts (due to being a tree) and cleaning water. The Moringa tree can also play an important role in soil and water conservation and mitigating climate change.This study provides a brief overview about multipurpose of Moringa oleifera tree and its implication for climate Change mitigation. The purpose of this brief reviews was to: (a) to assess the published scientific journalssuggestion on multipurpose Moringa oleifera, (b) to over view itsmedicinal and nutritional properties(c) suggest future directions for policies, research, market and development strategies and (d) finally to review its implication for climate change mitigation.
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Moringa oleifera Lam. has been reported as a natural coagulant in the treatment of surface waters; however its use presents some disadvantages such as low performance in the coagulation/flocculation of low turbidity waters and organic matter increase in the treated water. In addition, there is little specialized literature about coagulation proteins present in Moringa seeds and their characterization. Thus, this work had as objective the fractionation of Moringa oleifera seeds protein, characterization of the fractions obtained and evaluation of potential coagulant activity in different water turbidity. Based on the results obtained it was found that the globulin and albumin presented the highest values for protein fraction in Moringa seeds with 53% and 44% respectively. Percentage removals of 87.40% of color, 89.71% of turbidity and 79.46% of UV 254nm were reached using 13 mg/L of the globulin coagulant for treatment of low turbidity water (50 NTU) without entailing excessive increase of the dissolved organic carbon in the treated water, even being considered a natural coagulant. Therefore, the use of fractionation as initial purification technique proved to be beneficial by producing a coagulant with high efficiency in the treatment of the low turbidity water.