Journal of Indonesian Specialized Nutrition

A NARRATIVE REVIEW ON THE PROTECTIVE MECHANISM OF PROBIOTICS TO COMMUNICABLE DISEASES AMONG CHILDREN IN ASIA

Saskia Piscesa — 2025-12-31

Background: Communicable diseases remain a major cause of morbidity among children in Southeast Asia, where malnutrition, environmental enteric dysfunction, and limited sanitation increase susceptibility to infection. Probiotics have gained attention as a nutrition-based strategy capable of improving gut health, enhancing immunity, and reducing pathogen burden. This narrative review summarizes the protective mechanisms of probiotics and their relevance for child health in Indonesia and neighboring countries. Methods: A comprehensive literature search was conducted in PubMed, Scopus, and Google Scholar for studies published from January 2004 to February 2025. Search terms included “probiotics,” “children,” “communicable diseases,” “gut microbiota,” “malnutrition,” and “synbiotics.” Inclusion criteria were: pediatric populations (0–18 years), probiotic interventions, and outcomes related to infection, intestinal integrity, immune function, or nutritional status. Fourteen core studies (RCTs, systematic reviews, meta-analyses, and narrative reviews) met criteria, and five additional sources were used for epidemiological and conceptual background. Results: Evidence across Indonesia, Vietnam, Malaysia, China, India, and Thailand shows that probiotics improve gut microbiota diversity, reduce pathogenic colonization, strengthen tight-junction expression, and enhance mucosal immunity. Clinical benefits include reduced incidence and duration of diarrhea and respiratory infections, improved recovery reflected in increased appetite and weight gain, reduced antibiotic prescriptions, and decreased school absenteeism. Probiotics were feasibly delivered through fortified milk, yogurt, supplements, and school-based nutrition platforms, aligning well with existing child-health programs. Conclusion: Probiotics offer a safe, nutrition-focused intervention that helps mitigate the infection–malnutrition cycle in children. By supporting gut integrity and immune maturation, probiotics complement established nutrition strategies. Integrating probiotics into routine child nutrition and infectious-disease prevention programs may provide meaningful public health benefits, though long-term and multi-strain studies are needed to guide scalable implementation.

THE GUT-BRAIN-MICROBIOME AXIS IN CHILDHOOD OBESITY: MECHANISMS AND CLINICAL IMPLICATIONS

Bianda Aulia — 2025-12-31

Background: Childhood obesity has become a global health crisis affecting 188 million children aged 5–19 years worldwide, with serious metabolic complications. The gut–brain–microbiome axis has emerged as a key mechanistic link and therapeutic target for obesity in children.

Methods: A narrative literature review was conducted using PubMed, Scopus, and Google Scholar and included studies published up to December 2025. Search terms, used in various combinations, included “childhood obesity,” “gut microbiota,” “gut–brain axis,” “targeted interventions,” “probiotic,” and “prebiotic”.

Results: Childhood obesity is associated with early-life gut dysbiosis characterized by reduced diversity, higher Firmicutes/Bacteroidetes ratios, and shifts in key taxa, driven by prenatal, postnatal, and lifestyle factors. This dysbiotic microbiota enhances energy harvest, promotes low-grade inflammation and barrier dysfunction, and disrupts gut–brain axis signaling via altered short-chain fatty acids, neurotransmitter, and gut hormone profiles, thereby impairing appetite regulation and favoring positive energy balance. Emerging evidence indicates that targeting the gut microbiota–brain axis with probiotics, prebiotics, synbiotics, and fecal microbiota transplantation may improve metabolic outcomes and body composition in children with obesity.

Conclusion: Gut microbiota dysbiosis contributes to childhood obesity via altered metabolism, inflammation, and gut–brain axis–mediated appetite regulation.

THE RELATIONSHIP BETWEEN MATERNAL NUTRITIONAL STATUS AND EXCLUSIVE BREASTFEEDING STATUS WITH INFANT WEIGHT GAIN IN THE SITUBONDO HEALTH CENTER AREA

Nadiro — 2025-12-31

Background: Infant weight gain is a key indicator for monitoring growth and is influenced by various factors, including maternal nutritional status and breastfeeding practices. Based on the data, it is still found that the low percentage of infants with weight gain and exclusive breastfeeding coverage has not reached the target. This study aims to investigate the relationship between maternal nutritional status and breastfeeding status, with the weight gain of infants aged 1-6 months in the Situbondo Health Center area. Method: This study uses a cross-sectional analytical design involving a sample of 70 breastfeeding mothers with infants aged 1-6 months, selected from 18 posyandu. Data were analyzed using the Chi-square test. Result: The findings showed that 55.7% of infants received exclusive breastfeeding, and 62.9% achieved weight gain in accordance with the Weight-for-Age Growth Curve. There is a significant relationship between breastfeeding status (p = 0.013), maternal nutritional status based on BMI (p = 0.018), and maternal nutritional status based on MUAC (p = 0.001) with infant weight gain. Conclusion: Maternal nutritional status (BMI and MUAC) and exclusive breastfeeding play a key role in supporting optimal weight gain in infants aged 1–6 months.

IRON DEFICIENCY IN EARLY LIFE AND LATER BEHAVIORAL OUTCOMES: A SYSTEMATIC REVIEW

Suci Latifah — 2025-12-31

Background: Iron deficiency during early life is the most common micronutrient deficiency worldwide and may have lasting effects on neurodevelopment and behavior. This systematic review aimed to explore the relationship between iron deficiency in infancy (0–24 months) and behavioral outcomes beyond two years of age. Methods: This study was a systematic literature review of twenty-three articles. These articles were sourced from scientific journal articles on ScienceDirect, covering studies published between 2005 and 2025. Inclusion criteria were longitudinal cohort or randomized controlled trials assessing behavioral outcomes such as attention, hyperactivity, and socio-emotional regulation. Results: Early-life iron deficiency was consistently associated with increased internalizing and externalizing behaviors, attention deficits, and symptoms of ADHD and Sluggish Cognitive Tempo persisting into adolescence. Timing and severity of deficiency influenced outcomes, with prenatal deficiency affecting recognition memory and executive function, while infant deficiency predicted behavioral dysregulation and academic difficulties. Targeted iron supplementation reduced behavioral problems, whereas excessive or non-individualized supplementation showed limited benefits. Conclusions: Iron deficiency in early life has long-term behavioral consequences. Early detection and individualized interventions are crucial for preventing neurobehavioral impairments and optimizing child development.

FACTORS ASSOCIATED WITH THE INCIDENCE OF ANEMIA IN PREGNANT WOMEN IN INDONESIA: ANALYSIS OF INDONESIAN HEALTH SURVEY (SKI) 2023 DATA

Jessica Reitanya Putri — 2025-12-31

Anemia is a common nutritional issue among vulnerable populations, including toddlers, adolescents, women of reproductive age, and pregnant women. Anemia in pregnant women impacts both the mother and fetus. For the mother, it reduces quality of life and can lead to mortality. Babies born to anemic mothers are at risk of congenital abnormalities, stillbirth, and stunting. Maternal health issues during pregnancy affect the critical first 1000 days of a child's life, with permanent consequences for survival, necessitating appropriate interventions to minimize these risks. The 2023 SKI Report indicates a 27.7% prevalence of anemia among pregnant women in Indonesia, classified as a moderate public health issue. This study is a quantitative study using a cross-sectional design aimed to identify factors associated with anemia in pregnant women in Indonesia in 2023, utilizing secondary data from the 2023 SKI. The dependent variable was anemia, with independent variables from socio-demographic factors, lifestyle factors, dietary patterns, and pregnancy-related factors. Data analysis used complex samples, including univariate and bivariate analyses with chi-square tests. The study found significant associations between anemia in pregnant women and consumption of meat, poultry, and their processed products (p-value = 0.047), pregnancy interval (p-value = 0.033), and consumption of supplementary feeding (PMT) (p-value = 0.001) in Indonesia in 2023.