METHODS AND ANALYSIS: The target participants are infants born from January to June 2015 in the South East Asia Community Observatory (SEACO) platform. The SEACO is a Health and Demographic Surveillance System (HDSS) that is established in the District of Segamat in the state of Johor, Malaysia. For the quantitative strand, the sociodemographic data, feeding practices, anthropometry measurement and total nutrient intake will be assessed. The assessment will occur around the time complementary feeding is expected to start (7 Months) and again at 12 months. A 24-hour diet recall and a 2-day food diary will be used to assess the food intake. For the qualitative strand, selected mothers will be interviewed to explore their infant feeding practices and factors that influence their practices and food choices in detail.
ETHICS AND DISSEMINATION: Ethical clearance for this study was sought through the Monash University Human Research and Ethics Committee (application number CF14/3850-2014002010). Subsequently, the findings of this study will be disseminated through peer-reviewed journals, national and international conferences.
METHODS AND STUDY DESIGN: The data used for this analysis were from 1143 children, 6-12 years old, that participated in the South East Asian Nutrition Survey (SEANUTS). Physical activity (PA) was measured using pedometers for 2 consecutive days and was categorized low, moderate and high. Child nutritional status was categorized based on body mass index for age z-scores (BAZ) into normal weight (-2 SD ≤BAZ≤1 SD) or overweight (BAZ >1 SD). Energy intake was calculated from a one day 24 hour recall and compared to the Indonesian recommended dietary allowance (RDA) for energy.
RESULTS: Children with low PA had higher risk (ODDs 3.4, 95% CI: 2.0, 6.0) of being overweight compared to children who had high PA. Children with moderate PA and energy take >100% RDA had higher risk (ODDs 4.2, 95% CI 1.9, 9.3) of being overweight than children with high PA and energy intakes ≤100% RDA.
CONCLUSIONS: Low physical activity independently or moderate physical activity and high energy intake are risk factors for Indonesian children to get overweight. Program intervention such as increasing physical activity at school and home is needed to reduce overweight among children.
AIMS: To analyze the factors associated with complementary feeding practices among children aged 6-23 months in Indonesia.
METHODS: A cross-sectional design was employed using data from the 2017 Indonesia Demographic and Health Survey. A total of 502,800 mothers with children aged 6-23 months were recruited through multistage cluster sampling. Data were analyzed using a logistic regression test to determine the correlation between predisposing, enabling, and reinforcing factors and complementary feeding practices.
RESULTS: A prevalence values of analysis showed that approximately 71.14%, 53.95%, and 28.13% of the children met MMF, MMD, and MAD, respectively. The probability of achieving minimum dietary diversity (MDD) was high in the following: children aged 18-23 months (odds ratio [OR] = 9.58; 95% confidence interval [CI] = 7.29-12.58), children of mothers with higher education (OR = 5.95; 95% CI = 2.17-16.34), children from households with upper wealth index (OR = 2.53; 95% CI = 1.85-3.48), children of mothers who received childbirth assistance by professionals (OR = 1.63; 95% CI = 1.20-2.20), and children of mothers who had access to the Internet (OR = 1.26; 95% CI = 1.06-1.50). Moreover, children from households with the upper wealth index (OR = 1.40; 95% CI = 1.03-1.91), children whose mothers were employed (OR = 1.19; 95% CI = 1.02-1.39) living in urban areas (OR = 1.28; 95% CI = 1.06-1.54) and children of mothers who received childbirth assistance by professionals (OR = 1.33; 95% CI = 0.98-1.82) were more likely to meet Minimum Meal Frequency (MMF). Finally, children aged 18-23 months (OR = 2.40; 95% CI = 1.81-3.17), of mothers with higher education (OR = 3.15; 95% CI = 0.94-10.60), from households with upper wealth index (OR = 1.41; 95% CI = 1.05-2.90) and born with professional childbirth assistance (OR = 1.82; 95% CI = 1.21-2.75) were significantly associated with minimum acceptable diet (MAD).
CONCLUSIONS: The findings revealed that the prevalence of MDD and MAD in Indonesia was low. Strategies such as improving health services, economic conditions, and education level of mothers are needed to improve infant and young child feeding in Indonesia.
METHODS: MICOS is a prospective cohort study conducted at selected government health clinics in two states, namely Selangor and Wilayah Persekutuan Kuala Lumpur, Malaysia. Women in their third trimester of pregnancy are recruited into the study and their infants will be followed-up at 3, 6, and 12 months of age. Information on prenatal factors including socio-demographic characteristics, obstetric history, pre-pregnancy body mass index, gestational weight gain, smoking, family history of allergic diseases, maternal dietary intake and sunlight exposure during pregnancy are obtained through face-to-face interviews. Postnatal factors including dietary intake, sun exposure, and anthropometric measurements of the mothers, as well as feeding practices, dietary intake, anthropometric measurements, and development of allergic diseases of the infants are assessed at each follow-up. Blood samples are collected from the mothers in the third trimester to determine 25-hydroxyvitamin D levels as well as from the infants at age 12 months to determine atopic sensitisation.
DISCUSSION: The concept of developmental origins of health and disease (DOHaD) which emphasises on the role of early life environments in shaping future health and disease susceptibility in adulthood has gained a huge interest in recent years. The DOHaD paradigm has influenced many fields of research including malnutrition and allergic diseases. While findings from the developed countries remain controversial, such studies are scarce in developing countries including Malaysia. The present study will determine the cause and effect relationship between early nutrition and the development of malnutrition and allergic diseases in infants' first year of life.
METHODS: European, Thai and Malaysian universities collaborated with SEA national nutrition associations in the Early Nutrition eAcademy Southeast Asia (ENeA SEA) project. We assessed HCPs' needs using questionnaires and mapped CME/CPD programmes and regulations through stakeholder questionnaires. Using a co-creation approach, we established an e-learning platform. Evaluation in users was undertaken using questionnaires.
RESULTS: HCPs in SEA reported major training gaps relating to the first 1000 days of nutrition and limited impact of existing face-to-face training. Existing pre/postgraduate, residency and CME/CPD programmes did not adequately address the topic. To address these gaps, we produced a targeted e-learning platform with six modules and CME-tests. National ministries, Thai and Malaysian universities, and professional associations endorsed the training platform. To date, over 2600 HCPs have registered. Evaluation shows high acceptance and a very positive assessment.
CONCLUSIONS: Dedicated e-learning can reduce major gaps in HCP training in SEA regarding nutrition during the first 1000 days of life at scale and is highly valued by both users and key stakeholders.