Journal of Indonesian Specialized Nutrition

MAPPING STUNTING REDUCTION EFFORTS IN INDONESIA: A SCOPING REVIEW OF EVIDENCE PUBLISHED FROM 2020 TO 2025

Refani Alycia Kusuma — 2026-09-30

Background: Indonesia reduced its national stunting prevalence from 21.5% in 2023 to 19.5% in 2024 through accelerated multisectoral interventions. However, evidence regarding the characteristics, implementation approaches, and outcomes of these interventions remains fragmented. Objective: This scoping review mapped the evidence on stunting reduction efforts implemented in Indonesia between 2020 and 2025, focusing on intervention characteristics, target populations, implementation approaches, reported outcomes, and research gaps. Methods: A scoping review was conducted following the Joanna Briggs Institute methodology and reported according to the PRISMA-ScR guidelines. Scopus and PubMed/MEDLINE were systematically searched for studies published between January 2020 and December 2025. Eligible studies were selected using the Population–Concept–Context framework, and findings were synthesized through narrative evidence mapping. Results: Thirty-one studies were included. Nutrition supplementation and complementary feeding were the most frequently reported interventions, followed by nutrition education, community empowerment, health cadre strengthening, governance, and multisectoral collaboration. Most interventions improved maternal knowledge, child feeding practices, health worker capacity, community participation, and child growth indicators. Successful implementation consistently depended on implementation capacity, interprofessional collaboration, community engagement, and supportive local governance. Limited evidence was identified regarding implementation fidelity, cost-effectiveness, scalability, and long-term sustainability. Conclusion: Indonesia's stunting reduction efforts have evolved toward integrated, multisectoral strategies addressing both immediate and underlying determinants of child growth. Strengthening implementation research and context-specific, evidence-informed approaches will be essential to sustain equitable reductions in childhood stunting

BEYOND HEMOGLOBIN: RISK-BASED AND NONINVASIVE SCREENING TO ENHANCE EARLY DETECTION OF IRON DEFICIENCY AMONG CHILDREN IN INDONESIA

Mardatillah — 2026-09-30

Background: Iron deficiency anemia (IDA) remains the most common micronutrient deficiency globally and continues to represent a major public health concern among children younger than five years, particularly in low- and middle-income countries. Early identification of children at risk is essential to prevent adverse effects on growth, neurodevelopment, and long-term health outcomes. Methods: A narrative review was undertaken to synthesize evidence from observational studies indexed in Scopus and published between 2019 and 2026. The review focused on studies evaluating screening approaches beyond conventional hemoglobin measurement, with particular emphasis on risk-based and non-invasive strategies for improving the early detection of IDA among Indonesian children. Results: The available evidence indicates that, in settings where access to invasive laboratory investigations is constrained, validated risk-based screening instruments and non-invasive assessment methods may improve the identification of children at risk for IDA. These approaches contribute not only to more accurate estimation of disease burden but also to a broader understanding of the cognitive implications and nutritional determinants of iron deficiency, extending beyond reliance on biomarker-defined diagnostic thresholds. Conclusion: Incorporating a practical risk-based IDA screening tool into routine child growth monitoring has the potential to enhance the early identification of vulnerable children, facilitate appropriate referral for confirmatory testing and timely intervention, and support the integration of anemia prevention within Indonesia's existing child nutrition and growth promotion programs.

FACTORS INHIBITING OPTIMAL PROTEIN UTILIZATION AMONG CHILDREN: A NARRATIVE REVIEW

Nurul Hasanah — 2026-09-30

Background: Adequate protein intake is essential for child growth, yet optimal growth depends not only on protein quantity but also on the efficiency of protein utilization. Multiple biological and environmental factors may impair the conversion of dietary protein into functional body proteins, contributing to growth faltering despite sufficient protein intake. Methods: This narrative review synthesized recent evidence published between 2020 and 2026 from PubMed, Scopus, ScienceDirect, and Google Scholar. Relevant peer-reviewed studies, systematic reviews, meta-analyses, and clinical guidelines were critically reviewed to identify determinants affecting protein digestion, absorption, metabolism, and tissue protein synthesis in children. Results: Protein utilization is influenced by dietary protein quality, digestive function, intestinal absorption, environmental enteric dysfunction, gut microbiota, infection, inflammation, micronutrient status, energy adequacy, and socioeconomic and environmental conditions. These factors interact to reduce amino acid bioavailability, suppress anabolic pathways, increase protein catabolism, and impair tissue protein synthesis, thereby limiting linear growth. Conclusions: Optimizing child growth requires integrated nutrition strategies that combine high-quality protein intake with interventions supporting intestinal health, adequate energy and micronutrient intake, infection prevention, and improved environmental conditions to maximize protein utilization.

NUTRITION EDUCATION AS BENEFICIAL COMPLIMENT ON CHILDREN’S NUTRITION INTERVENTION: A NARRATIVE REVIEW

Saskia Piscesa — 2026-09-30

Introduction: Malnutrition remains a significant public health concern, particularly in low- and middle-income countries where children are disproportionately affected. In Indonesia, although various nutrition-specific and nutrition-sensitive interventions have been implemented, stunting, wasting, and growth faltering continue to pose major challenges. Most nutrition programs emphasize food or nutrient provision, yet the behavioural factors influencing feeding practices and intervention adherence often receive less attention. Nutritional education has increasingly been recognized as an important strategy to complement these interventions. This narrative review aims to examine the current evidence on the role of nutritional education in improving the effectiveness of nutrition interventions. Methods: A narrative literature review was conducted by searching PubMed, Scopus, Google Scholar, and ScienceDirect for English-language publications from 2014 to 2026. The review included studies that integrated nutritional education with nutrition interventions, such as food supplementation, complementary feeding, and community-based nutrition programs. Relevant reports from international organizations were also included to provide broader context. Results: The available evidence suggests that nutritional education strengthens the impact of nutrition interventions by improving caregivers' knowledge, infant and young child feeding practices, dietary diversity, adherence to intervention programs, and health-seeking behaviors. Overall, interventions that combined nutritional education with nutrition support showed more favorable improvements in child growth and nutritional outcomes than those focusing solely on nutrient provision. In addition, educational components contributed to more sustainable changes in health and nutrition behaviors. Conclusion: Nutritional education is a valuable complement to nutrition interventions because it addresses the behavioral and knowledge-related factors that influence nutritional outcomes. Integrating evidence-based educational approaches into nutrition programs has the potential to improve program effectiveness and contribute to more sustainable reductions in childhood malnutrition.

BEYOND BREASTFEEDING: A NARRATIVE REVIEW OF EVIDENCE-BASED NUTRITION APPROACHES TO SUPPORT HEALTHY GUT MICROBIOTA IN NON-BREASTFED INFANTS

Bianda Aulia — 2026-09-30

Background: During pregnancy, maternal microbiota transfer, and modifiable factors such as diet may contribute to fetal development. This review aims to clarify how maternal gut microbiota and diet interact to influence fetal nutrition and long-term health outcomes. Methods: A This narrative review synthesizes current evidence on interventions that support healthy gut microbiota development in non-breastfed infants. The Keywords included “infant gut microbiota”, “prebiotic”, “probiotic”, “synbiotic”, “human milk oligosaccharides”, “partially hydrolyzed protein formulas”, and “complementary feeding”. Results: Among the reviewed interventions, formulas supplemented with HMO analogs (2′-fucosyllactose and lacto-N-neotetraose) and galacto-/fructo-oligosaccharide blends consistently promoted a more breastfed-like gut microbiota characterized by increased Bifidobacterium abundance. Probiotic- and synbiotic-containing formulas also demonstrated beneficial microbiota modulation, although effects varied according to strain and formulation. Conclusion: HMO- and prebiotic-supplemented formulas show the strongest evidence for promoting healthy gut microbiota development in non-breastfed infants. Further studies are needed to evaluate long-term outcomes and effectiveness across diverse populations.