JTUS, Vol. 01, No. 11 December 2023 961
JTUS, Vol. 01, No. 11 December 2023
E-ISSN: 2984-7435, P-ISSN: 2984-7427
Nutrigenomic Engineering in Children Under Five With Infectious
Diseases After the Covid-19 Pandemic
Ignatius Hapsoro Wirandoko, Catur Setiya Sulistiyana
Universitas Swadaya Gunung Jati, Indonesia
Email: ignatiushapsorowirandok[email protected], Catursetiya71@gmail.com
Abstract
It is estimated that about 3 million children worldwide each year exhibit xerophthalmia, i.e. they
are clinically deficient in vitamin A and are at risk of blindness. In addition, about 250 million
more children under five are estimated to have sub-clinical vitamin A deficiency and are at risk
of severe morbidity and premature death. Zinc is a vital element for the synthesis of DNA and
RNA. This mineral is needed in the formation of eye tissue so that it can remain seeing in the
dark, the formation of white blood cells in the immune system, gastric function, skin health,
growth and function of the reproductive system, fetal growth and the central nervous system.
Zinc also helps in the activity of immune function. The purpose of this study is to determine
nutrigenomic intake (Vit A, Zinc, Fe iron) in toddlers with infectious diseases during the
pandemic. Research Method using Pre n post test Research Design. One month before the
intervention, blood sampling levels of Vitamin A, Zinc, and Iron (Fe) were asked about infectious
diseases. (How many times in the last 1 month). One month after the intervention, blood
samples were taken again, levels of Vitamin A, Zinc, and Iron (Fe) were asked again infectious
diseases. The results of the analysis showed that vitamin A intake was low compared to the
RDA of 4.39 (CI 1.62-4.89) times in children whose parents had low socioeconomic status, while
according to age 1.01 (CI 0.98-1.18) times. While iron intake is lower than the RDA of 2.52 (CI_),
according to age 1.07 (CI 1.01-1.14). Zinc intake was lower than the RDA of 91.6 (CI 0.11-756.3).
Food intake of zinc, iron and vitamin A for children 24-60 months in Indonesia is still unable to
meet the needs and is far below the Daily Value (RDA).
keywords: nutigenomik, vitamin A, Zink, Fe, Infeksi.
INTRODUCTION
The era of genetic nutrition was marked by the start of human genome mapping research (
Human Genome Project ) in 1998 (Wardani et al., 2017). Nutrigenomics in humans began to be
widely carried out so it gave birth to a new area of study, namely Nutrigenomics and Nutrigenetics
(Essers, 2013). Rapid advances in gene mapping will change scientists' systems of thinking and
approaches to nutritional status and public health as well as disease prevention and therapy
(Saidin et al., 1998) (National Academies of Sciences and Medicine, 2018).
In this era there is also a rapid progress in the application of genetic engineering in the field
of food production (Genetically Modified Food) and nutritional genetic selection (Vitamin A, Iron
Ignatius Hapsoro Wirandoko, Catur Setiya Sulistiyana
962 JTUS, Vol. 01, No. 11 December 2023
(Fe), Zinc and other minerals) to develop food through food biofortification and the surge in
progress of digital and cellular communication science and technology (Frewer et al., 2004).
Nutrigenomics studies the relationship or effect of dietary variations, micronutrients, or
bioactive components of food with gene expression (Fanardy, 2020). Nutrigenetics studies the
relationship or effect of gene expression with dietary response, micronutrients, bioactive
components of food, and body health conditions.
Unlike the relatively stable human genome, nutrigenomic aspects in humans are not
permanent or reversible plasticity and interactions between nutrition and DNA to modify gene
expression. An interesting example in the world of bees, is that bee larvae are genetically similar,
but only larvae fed royal jelly will develop into Queen Bees, while other bees become worker bees
(Kucharski et al., 2008). Knowledge of nutrigenomics allows us to explain why certain nutrient
responses are not the same in every child.
Vitamin A deficiency is a real public health problem in more than 70 countries (Chakravarty,
2000) including Southeast Asia (Combs Jr & Gray, 1998). In 1995, it was estimated that about 3
million children worldwide each year exhibited xerophthalmia, i.e. they were clinically deficient in
vitamin A and were at risk of blindness. In addition, approximately 250 million more children under
five are estimated to have sub-clinical vitamin A deficiency and are at risk of severe morbidity and
premature death (Howson et el., 1998). Depending on the criteria used, the number of people
with vitamin A deficiency in the world can reach more than 500 million (Kelly & West, 1998)
(Angeles-Agdeppa et al., 2019).
Zinc is a vital element for the synthesis of DNA and RNA. This mineral is needed in the
formation of eye tissue so that it can remain seeing in the dark, the formation of white blood cells
in the immune system, gastric function, skin health, growth and function of the reproductive
system, fetal growth and the central nervous system. Zinc also helps in the activity of immune
function (Gibson et al., 2008; Widiyanto et al., 2022).
There are several causes of anemia, namely infection, vitamin A deficiency, helminthic
infestation, and hemoglobinopathy. It also explains that not all who are iron deficient suffer from
anemia. This mistaken assumption is the main cause of the failure of UNICEF-funded health
projects to reduce anemia. Although iron supplementation and fortification are the most effective
strategies, it is also necessary to take into account the complexity of these issues in order to
succeed an intervention.
METHODS
One month before the intervention, blood sampling levels of Vitamin A, Zinc, and Iron (Fe)
were asked about infectious diseases. (How many times in the last 1 month). One month after
intervention Blood samples were taken again levels of Vitamin A, Zinc, and Iron (Fe) asked again
infectious diseases. Research Variables tied to infectious diseases in toddlers. Free variables of
Nutrigenomic Intake in the form of Vitamin A, mineral Zinc and iron (Fe).
Nutrigenomic Engineering in Children Under Five with Infectious Diseases After the
Covid-19 Pandemic
JTUS, Vol. 01, No. 11 December 2023 963
Measure levels of nutrigenomic intake of vitamin A, minerals Zinc and iron (Fe) in the blood.
Measuring infectious diseases in toddlers. There are 20 children under five children in the
Puskesmas in the city of Cirebon.
RESULTS AND DISCUSSION
Overview of children aged 2-5 years
An overview of children aged 2-5 years can be seen in the Table. A. Gender data with equal
proportions between boys and girls. The socioeconomic situation of families in the village is 10.4
percent classified as very low economic conditions and only 27.4 percent of economic conditions
are very high.
Vitamin A (μg) intakes averaged 303±11 and iron intakes averaged 5.74±0.3 mg, while zinc
intakes averaged 3.8±0. When compared with the Daily Value (RDA), the average intake of vitamin
A, iron and zinc does not meet the RDA of 75.7±2.9 percent, 75.0±4.3 percent and 47.4±1.8
percent.
The Height/Age Indicator (TB/U) of many children with stunting is 15.9 percent, while
children with obese weight/height indicator (BB/TB) is 1 percent.
The description of the health condition of the study sample found that more than half of
the samples suffered from Acute Respiratory Infection (ARI) 60.4 percent and diarrhea 21.3 percent
diarrhea.
Factors associated with lowrisk intake of iron, vitamin A and zinc according to RDA in
children
Many factors are associated with lowrisk intake of iron, vitamin A and zinc including
socioeconomic status, place of residence, age. Table. B is the result of multiple logistic regression
analysis between factors related to the risk of intake of vitamin A, iron and zinc compared to the
RDA of children aged 24-60 months. The results of the analysis showed that vitamin A intake was
low compared to the RDA of 4.39 (CI 1.62-4.89) times in children whose parents had low
socioeconomic status, while according to age 1.01 (CI 0.98-1.18) times. While iron intake is lower
than the RDA of 2.52 (CI_), according to age 1.07 (CI 1.01-1.14). Zinc intake was lower than the
RDA of 91.6 (CI 0.11-756.3).
Table. 1 Overview of children aged 2-5 years and socioeconomic
Overview of household sosek Village
Socio-Economic RT
Very low
10,4
Low
16,9
Intermediate
23,9
Ignatius Hapsoro Wirandoko, Catur Setiya Sulistiyana
964 JTUS, Vol. 01, No. 11 December 2023
Overview of household sosek Village
Tall
21,4
Highest
27,4
Gender
Man
48,5
Woman
51,5
Child age (month)
24 – 36
37,4
37 – 48
36,5
49 – 60
26,1
X + SE
14.26 + 0.51
Micronutrient Intake
Vitamin A (μg)
303 + 11
Iron (mg)
5.7 + 0.3
Zinc (mg)
3.8 + 0.2
Micronutrient intake
Vitamin A (%DV)
75.7 + 2.9
Iron (%DV)
75.0 + 4.3
Zinc (%DV)
47.4 + 1.8
Nutritional Indicators
BB/Age WAZ (X + SE)
-0.87 + 0.08
BB/TB WHZ (X + SE)
-0.55 + 0.09
TB/U HAZ (X + SE)
-0.93 + 0.11
BMI/U BAZ (X + SE)
-0.44 + 0.09
Nutritional Status (WAZ) (percent)
BB less weight
1,5
BB less
12,4
Good nutrition
84,2
More Nutrition
2,0
Nutritional Status (HAZ) (percent)
Severe stunting
6,2
Stunting
15,9
Normal TB
77,9
Nutritional Status (WHZ) (percent)
Very thin
1,0
Thin
9,7
Usual
85,2
Nutrigenomic Engineering in Children Under Five with Infectious Diseases After the
Covid-19 Pandemic
JTUS, Vol. 01, No. 11 December 2023 965
Overview of household sosek Village
Overweight
3,1
Obese
1,0
Nutritional Status (BAZ) (percent)
Very thin
1,5
Thin
9,2
Usual
84,6
Overweight
3,1
Obese
1,5
Sick a month ago
Acute respiratory tract infections
60,4
Diarrhea
21,3
Table 2 Factors Associated with Low Risk of Vitamin A, Iron and Zinc Intake Compared to
Indonesian RDA in Children 24-60 Months
Variable
Label
95% CI
Iron
95% CI
Zink
95% CI
Odd
ratio
Odd
ratio
Social status
economics
Intermediate >
1,00
1,26 -5,06
1,00
Low <
1,62-4,89
2,52
91,6
0,11-756,3
Residence
Village
-
2,52
1,26-5,06
-
-
Age (months)
24-60
0,98-1,18
1,07
1,01-1,14
-
-
The results of research conducted by SEANUTS illustrate that more than half of the children
who participated as samples had intakes below Indonesia's Daily Value (RDA). Currently, Indonesia
is still experiencing double nutrition problems where the prevalence is high in stunting and
underweight and the high prevalence of iron nutrition anemia in children under 2 years old3.
Stunting according to WHO is the lack of height growth according to age. This indicates a
chronic state of malnutrition, and is the result of prolonged lack of food intake, lack of quality
food, increased pain (frequent illness) or a combination of the two factors (Mann & Truswell,
2017).
Research conducted by Ker et al., (2012) states that diet alone prevalence for the fulfillment
of nutrients is low except for calcium, magnesium, vitamins A and D (Truswell & Leach, 2023).
The results of the SEANUTS study on the diet of children aged 6-23 months provide an
illustration that the consumption of meat, fish and poultry is rarely consumed even most do not
Ignatius Hapsoro Wirandoko, Catur Setiya Sulistiyana
966 JTUS, Vol. 01, No. 11 December 2023
or have never consumed (Mann & Truswell, 2017). This diet results in unfulfilled intake of iron,
vitamin A and zinc so that the percent RDA is low.
CONCLUSION
Food intakes of zinc, iron and vitamin A for children 24-60 months in Indonesia still cannot
meet the needs and are far below the Daily Value (RDA). Factors that consistently affect the
fulfillment of micronutrient needs (iron, zinc, vitamin A) and low socioeconomic status.
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