Journal of SAGO Gizi dan Kesehatan (Nutrition and Health) is a peer-reviewed journal of a scientific nature contained in the Polytechnic of Health Ministry of Health of Aceh, who publish high quality of nutrition and health-related individuals, populations, groups and communities who are vulnerable to malnutrition and health and risk issues. The scope of the journal study associated issues of nutrition, food technology, nutrition and maternal and child health, environmental health, hygiene and sanitation, oral health, treatment of individuals/families and communities, and safety of medical drugs.
Every article or scientific paper published in the SAGO Gizi dan Kesehatan Journal remains the copyright of the respective authors. The publisher retains the right to edit certain parts of the text, provided that such edits do not alter the substantive content of the article. After the publication process is completed by the SAGO Gizi dan Kesehatan Journal, the authors retain full copyright ownership of their work without restriction. This policy affirms and supports the authors’ rights to maintain complete and unrestricted control over their intellectual property. The statement also supports the authors to maintain the right of limitation without limitation. This copyright notice is under the license agreement: Creation is distributed under License Creative Commons Attribution-ShareAlike 4.0 International
Tinjauan literatur sistematis: Dampak inisiasi menyusui dini (IMD) terhadap pola menyusui dan kesehatan bayi
Background: Breast milk is the main source of nutrition for infants, and early initiation of breastfeeding within the first hour after birth plays an important role in supporting the success of exclusive breastfeeding. Despite being recommended by the World Health Organization, early initiation of breastfeeding (EIB) coverage in Indonesia remains low. The 2023 Indonesian Health Survey noted that only 45.1% of infants received EIB, which is influenced by a lack of education, medical interventions during delivery, and unsupportive health facility policies. This highlights the importance of further examining the impact of IMD on breastfeeding success and overall infant health. Objectives: This article aims to to explore the impact of EIBF on breastfeeding patterns and infant health. Methods: This study is a literature review that uses a systematic approach with searches on Google Scholar and the PubMed database using the keywords ‘early initiation of breastfeeding’, ‘exclusive breastfeeding’, and ‘breastfeeding patterns’ (2020–2025). Article selection followed the PRISMA guidelines, starting with identification of 550 initial articles, followed by screening based on tittles and abstracts, resulting in 258 articles. The eligibility evaluation stage excluded 66 articles that could not be included in the criteria, resulting in six final articles for review. Results: Early initiation of breastfeeding is important for the success of exclusive breastfeeding and infant health. EIB increases maternal confidence, reduces early interventions, such as the use of formula, and stimulates the suckling reflex during the sensitive first 2 hours after birth. In addition, EIB supports milk production through the stimulation of the hormones prolactin and oxytocin. Skin contact during EIB helps maintain the baby's body temperature and prevents hypothermia. In addition to these physiological benefits, EIB strengthens the emotional bond between mothers and babies, which contributes to the long-term success of breastfeeding. Conclusion: EIBF provides significant benefits for infant health and development while supporting successful breastfeeding.
Copyright (c) 2026 Audry Maharani Agustine Putri, Anita Rahmiwati, Haerawati Idris http://creativecommons.org/licenses/by-sa/4.0
Hubungan pengetahuan ibu dan pola asuh terhadap stunting pada balita di Kota Samarinda
Background: Stunting, characterized by failure to grow and develop in toddlers because of malnutrition, is indicated by a body that is shorter than that of children of the same age. Mother's knowledge has less impact on childcare and causes an increase in the incidence of stunting in toddlers. Objective: This study aims to determine the relationship between maternal knowledge and parenting style and the incidence of stunting in toddlers in Samarinda City. Methods: The method in this study uses a quantitative and cross-sectional study design and then uses a stratified random sampling technique with a sample of 77 stunted mothers under five. It will be conducted in February 2024 in the city of Samarinda. Data collection used observation and questionnaires. The data analysis technique used the chi square test. Results: Lack of maternal knowledge in short (79.5%) and very short toddlers (20.5%) and poor parenting in very short (51.2%) and short toddlers (48.8%). The results of the statistical test presented that there was a significant relationship between maternal knowledge and parenting style and the incidence of stunting (P-value = 0.003 and P-value = 0.002). Conclusion: There was a significant relationship between maternal knowledge and parenting style and the incidence of stunting in toddlers in Samarinda City.
Copyright (c) 2026 Nurdhayanti Anggaini, Aminah Toaha, Kurniati Dwi Utami, Joko Sapto Parnomo http://creativecommons.org/licenses/by-sa/4.0
Hubungan antara faktor sosiodemografi dan kesadaran pola makan seimbang pada orang dewasa di Kota Kediri, Jawa Timur
Background: Awareness refers to a person ’scomprehension of a certain topic and realization that the topic is important for them. Lack of awareness of a balanced diet can lead to nutrient-related diseases, such as obesity, heart disease, diabetes, or iron deficiency, resulting in excess or deficient diet intake. Data from 2022 states that more than 1 billion people worldwide suffer from obesity, including 650 million adults, 340 million adolescents, and 39 million children. Objectives: This study aimed to identify demographic factors (sex, age, education level, and income level) associated with nutritional awareness. Research. Methods: A cross-sectional online survey using accidental sampling of 581 respondents aged 15–70 years was conducted in Kediri between March 4 and 14, 2025. The survey collected respondents’ sociodemographic attributes and nutritional awareness. Spearman and Chi Square test were performed to asses correlation between variables using SPSS version 26 for MacOS. Results: Some sociodemographic attributes were significantly correlated with dietary awareness (age, p < 0.000, r = 0.207; income, p = 0.000, r = 0.162; and sex, p = 0.000, r = 0.252) but not with nutritional awareness (p values = 0.000, p-values = 0.000, p-values = 0.000); in contrast, the level of education was not correlated with nutritional awareness (p = 0.512). Conclusion: Some sociodemographic attributes (age, income, gender) correlate with nutritional awareness while education level has no relationship.
Copyright (c) 2026 Riza Yuliawati, Ridha Rachmathiany, Ardi Bastian, Ema Mayasari http://creativecommons.org/licenses/by-sa/4.0
Uji organoleptik dan kandungan gizi cookies moricorn (moringa oleifera, jagung, dan kacang tanah) sebagai alternatif camilan remaja
Background: Inadequate nutritional intake during adolescence can lead to various health problems, such as anemia and obesity. The urgency of this research is due to unhealthy snacking habits in adolescents and the lack of vegetable and fruit consumption, which results in anemia at a prevalence of up to 15.5%, and the high prevalence of central obesity and being overweight in adolescents, at 14.8%. The use of local foods such as moringa, which is high in iron, peanuts as an alternative source of protein, and corn as a source of carbohydrates can be an alternative complex snack for adolescents with optimal nutritional content. Objectives: This study aimed to create a formula for “moringa oleifera, corn, and peanut” cookies made from a mixture of moringa flour, corn flour, and peanuts as a healthy snack alternative for teenagers. Methods: This experimental study was conducted in the Food Processing and Dietetics Laboratory of the Bachelor of Nutrition Study Program in 2025. This study used a Completely Randomized Design (CRD) with 3 combined formulations, namely substitution of moringa flour: corn flour: peanuts with formula 1 (F1 = 5%: 65%: 30%), formula 2 (F2 = 10%: 60%: 30%) formula 3 (F3 = 15%: 55%: 30%). Furthermore, a hedonic test was carried out based on color, aroma, taste, texture and overal with a total of 30 panelists. Nutritional content was determined using the Indonesian Food Composition Table of the Ministry of Health of the Republic of Indonesia in 2020. The hedonic test was the Kruskal Wallis test and the Mann Whitney advanced testusing the SPSS application. Results: Organoleptic test results revealed the highest average value for color parameters in F1 (3.20 ± 0.664), aroma in F2 (2.87 ± 0.629), taste in F1 (3.47 ± 0.629), aroma in F1 (2.8 ± 0.59), texture in F2 (3.03 ± 0.718), and overall in F1 (3.30 ± 0.596). The Kruskal–Wallis test revealed differences in the treatment of F1, F2, and F3 in terms of color, taste, and overall parameters. Further Mann-Whitney tests showed that there were significant differences in colour parameters (p <0.05) in F1 and F2, F1 and F3, taste parameters (p <0.05) in F1 and F3, F2 and F3 and overall (p <0.05) in F1 and F3, F2 and F3. The nutritional value of every 6 grams of cookies (1 piece) in F1 is 53.61 kcal of energy, 1.65 g of protein, 3.02 g of fat, 7.86 g of carbohydrates, and 0.39 mg of iron. Conclusion: The formulation of "moricorn" cookies (M. oleifera, corn, and peanut) showed significant differences in color, flavor, and overall performance. The cookie with the best formulation, F1, can be used as a nutritious snack alternative for teenagers, especially as a source of additional energy and iron.
Copyright (c) 2026 Nur Fauzia Asmi, Dandi Sanjaya, Deni Alamsah, Widya Lestari Nurpratama, Utami Putri Kinayungan http://creativecommons.org/licenses/by-sa/4.0
Pengaruh edukasi gizi dengan video animasi terhadap pengetahuan dan sikap gizi seimbang siswa tunarungu di SMPLB-B Surabaya
Background: Adolescence is a phase of significant physical change, making it important to meet nutritional needs. Malnutrition and overnutrition are problems encountered in deaf adolescents. The poor nutritional status of deaf children is caused by a lack of nutritional knowledge. Efforts that can be made include providing nutritional education with the aim of improving knowledge and attitudes related to balanced nutrition. Objectives: To determine the effect of nutrition education using animated videos on the knowledge and attitudes regarding balanced nutrition of deaf students at SMPLB-B Karya Mulia Surabaya. Methods: This study used a pre-experimental design with a one-group pre-test post-test design without a control group. The population consisted of 23 students from SMPLB-B Karya Mulia Surabaya. The sample was selected using total sampling. Data were collected using knowledge questionnaires and attitude questionnaires. Data processing consists of editing, coding, scoring, and cleaning. Data analysis was performed using the Wilcoxon statistical test. Results: There was a significant effect on improving students knowledge and attitudes after providing nutrition education using animated videos (p=0.001). There is an increase in the average knowledge score of 25.65 and thereis an increase in the average attitude score of 6.52. Conclusion: There is an effect of animated video media as a nutrition education media related to balanced nutrition on the knowledge and attitudes of deaf students of SMPLB-B Karya Mulia Surabaya.
Copyright (c) 2026 Nisa Naila Nirmalasari, Choirul Anna Nur Afifah http://creativecommons.org/licenses/by-sa/4.0
Pengetahuan ibu dan praktik pemberian MPASI pada anak stunting usia 6-24 bulan di Kabupaten Natuna: Studi Kualitatif
Background: Stunting, a chronic condition resulting from prolonged malnutrition, is influenced by maternal education, knowledge, and attitudes. The lack of knowledge regarding complementary feeding can influence maternal attitudes. Natuna Regency is a 3 area (frontier, outermost, disadvantaged) region; therefore, there has been limited study on complementary feeding in this region. Stunting in children can adversely affect brain development, motor skills, and overall physical growth. Objective: To explore maternal knowledge and practices related to complementary feeding (CF) among mothers of stunted and non-stunted children aged 6–24 months in the Natuna Regency. Methods: This qualitative study used a descriptive-analytic design in Serasan and Serasan Timur Health Centers. from September to October 2024. Informants included 18 mothers (FGDs) and four key informants, two heads of health centers, and two nutritionists (in-depth interviews). Thematic analysis focused on timing, early initiation, feeding frequency, and CF schedules using NVivo 12.0. Results: Mothers of non-stunted children were more knowledgeable and adaptive in complementary feeding (CF) practices, whereas mothers of stunted children tended to rely on food availability and non-nutritional strategies. Both groups preferred homemade CF foods because of economic, health, and variety considerations. These qualitative findings are consistent with the quantitative results, which demonstrated a significant association between CF practices and stunting incidence (p < 0.001). Conclusion: Mothers of non-stunted children demonstrated more effective and responsive feeding practices. These findings highlight the importance of maternal knowledge and creativity in supporting optimal child nutrition and reducing stunting prevalence.
Copyright (c) 2026 Effatul Afifah, Misna Hidayati, Arif Sabta Aji, Hastrin Hositanisita, AD Nabiela, Hammada Hanifia Mumtaz, Safira Nurlita http://creativecommons.org/licenses/by-sa/4.0
Validitas dan reliabilitas kuesioner kepatuhan konsumsi tablet tambah darah pada remaja putri: Pendekatan Health Belief Model (HBM) sebagai alat ukur efektivitas
Background: Questionnaires are data collection tools that are used relevantly in a study. Questionnaire items can be used if they have been proven valid and reliable. An instrument if r count ≥ r table then the statement item can be said to be valid, reliable if the Cronbach's alpha result is > 0.70. . The prevalence of anemia in women in Indonesia is 23.9%, while the prevalence of anemia in women aged 5-14 years is 26.4% and 15-24 years is 18.4%. . Compliance is generally influenced by individual perceptions regarding drug use and health status. Objective: To assess whether the iron supplement consumption compliance questionnaire for adolescent girls based on the HBM theory is valid and reliable, so that it can be used as a basis for health programs and policies to prevent anemia in adolescents. Methods: A cross-sectional analytical observational technique was used with 40 respondents from SMPN 4 Bengkulu City. This study used 40 respondents because this number was sufficient for the questionnaire trial and was appropriate for the time and conditions. However, this number is still limited; therefore, the results cannot be representative of all junior high school girls in general. The six HBM domain statements of the questionnaire include vulnerability (8 items), severity (3), benefits (7), barriers (6), self-confidence (6), and cues to action (7). The survey was completed directly by respondents using a Likert scale. Results: The study found that all 37 questionnaire items were valid and reliable. This valid and reliable questionnaire can form the basis for more targeted adolescent health interventions to improve adherence to iron supplement consumption in the field. Conclusion: All questionnaire items refer to the HBM theoretical approach and can be used as a valid and reliable measuring tool to assess compliance with iron supplement consumption among adolescent groups, which can be used to educate adolescents with low compliance in iron supplement consumption.
Copyright (c) 2026 Rini Dwi Amalya, Betty Yosephin Simanjuntak, Anang Wahyudi http://creativecommons.org/licenses/by-sa/4.0
Penentuan kalsium susu kambing segar dengan Spektrofotometri Serapan Atom (SSA)
Background: Calcium (Ca) is an essential mineral abundantly present in goat milk and plays a crucial role in bone and dental development. Data on Ca levels in local goat milk from Banda Aceh remain limited, although such information is important for nutritional purposes and the development of livestock products. Atomic absorption spectrophotometry (AAS) is employed for mineral analysis owing to its high sensitivity and selectivity. Objective: This study aimed to determine the calcium content in fresh goat milk from three locations in Banda Aceh and Aceh Besar and to evaluate any differences between them. Methods: This was a descriptive quantitative research with an experimental laboratory approach conducted in Banda Aceh in 2025. Fresh goat milk samples were collected from Gampong Tibang (GT), Gampong Kopelma Darussalam (KD), and Gampong Lamblang Manyang (LM) in April 2025. The samples were digested with concentrated HNO₃ and analyzed using AAS at 422.7 nm. Data were statistically analyzed using one-way ANOVA. Results: The highest calcium content was found in KD (0.892 mg/L), followed by GT (0.856 mg/L), and the lowest in LM (0.582 mg/L). The overall mean calcium level was 0.777 mg/L. One-way ANOVA confirmed significant differences among locations (F = 61.62; p = 0.0001). Conclusion: Calcium levels in fresh goat milk varied significantly among locations and were potentially influenced by environmental factors, feeding practices, and goat physiology. These findings are expected to serve as a basis for developing high-quality local goat milk products and supporting the utilization of functional foods.
Copyright (c) 2026 Safrina, Azmalina adriani, Eva Novita http://creativecommons.org/licenses/by-sa/4.0
Hubungan aktivitas fisik dan kebiasaan jajan dengan prevalensi gizi lebih pada anak usia sekolah di Kota Bekasi
Background: Overnutrition in school-aged children (6–12 years) in Indonesia continues to increase and has become a serious health issue. This condition is characterized by fat accumulation due to energy imbalance, with a BMI/A of >+1 SD to +2 SD at risk of over-nutrition. The increasing prevalence in Bekasi City emphasizes the urgency of interventions to prevent long-term impacts on children's health. Objectives: This study aimed to explain the relationship between physical activity, snack consumption patterns, and the risk of overnutrition in school children in Bekasi. Methods: This quantitative, cross-sectional study involved 215 children in grades V–VI of elementary school selected through consecutive sampling. Physical activity was measured using the Physical Activity Questionnaire for Children (PAQ-C) categories: light physical activity (≥ 1 to < 2), moderate (≥ 2 to< 5), heavy (value 5), and frequency of snack consumption using the Food Frequency Questionnaire (FFQ), and nutritional status using body mass index/A index. The study locations included five public elementary schools in Bekasi City: SDN Aren Jaya XVIII, SDN Bekasi Jaya IV, SDN Margahayu XII, SDN Duren Jaya XIV, and SDN Duren Jaya V. Results:The chi-square test showed no significant relationship between physical activity and overnutrition (OR = 1.44; 95% CI: 0.63–3.33; p = 0.389) or between snacking habits and overnutrition (OR = 0.73; 95% CI: 0.41–1.32; p = 0.301). Conclusion: Overnutrition among schoolchildren remains a problem, with pocket money being a significant factor, whereas physical activity and snacking habits are unrelated to obesity. Pocket money management and promotion of healthy eating patterns in schools should be considered in comprehensive intervention policies.
Copyright (c) 2026 Ezri Yohanna Gultom, Arindah Nur Sartika http://creativecommons.org/licenses/by-sa/4.0
Hubungan status gizi, konsumsi fast food, tingkat stres dengan kejadian hipertensi di Kota Bengkulu
Background: This study was motivated by the high incidence of hypertension in the Pasar Ikan Health Center area of Bengkulu City. Lifestyle changes, such as increased fast-food consumption and high stress levels, are suspected to be the main risk factors contributing to the incidence of hypertension in the local community. Objectives: This study aimed to determine the relationship between nutritional status, fast-food consumption, stress levels, and the incidence of hypertension at the Pasar Ikan Community Health Center in Bengkulu City in 2025. Methods: An observational study with a cross-sectional design was conducted at the Fish Market Health Center in Bengkulu City from April to May 2025. The sample calculation results were obtained using accidental sampling of visitors aged 20–45 years, and 84 respondents who met the criteria were selected. Data were collected through nutritional status measurements, completion of questionnaires using the Food Frequency Questionnaire (FFQ) and Perceived Stress Scale-10 (PSS-10), and statistical analysis using the chi-square test. Results: Most respondents were aged 36–45 years (83.3% female and 16.7% male). Based on the results of statistical testing, nutritional status and fast-food consumption were not significantly associated with the incidence of hypertension, as indicated by p-values of 0.262 (nutritional status), 0.498 (fast food), and 0.001 (stress level), respectively. A relationship between stress levels and the incidence of hypertension in the working population of the Pasar Ikan Community Health Center, Bengkulu City was identified (p = 0.001). Conclusion: Nutritional status and fast food consumption were not associated with hypertension. However, stress levels were associated with hypertension in the Pasar Ikan Community Health Center in Bengkulu City.
Copyright (c) 2026 Sela Maria, Emy Yuliantini, Kamsiah http://creativecommons.org/licenses/by-sa/4.0
Kurang konsumsi buah dan sayur sebagai faktor dominan hipertensi pada dewasa muda usia 25-34 tahun di Jawa Barat: Analisis data sekunder SKI 2023
Background: Hypertension is characterized by persistently elevated blood pressure above the normal limit. Current data reveal an increasing prevalence of hypertension among young adults in Indonesia; however, many remain unaware of the condition, resulting in uncontrolled hypertension. Hypertension in young adults is associated with the development of cardiovascular diseases and cognitive impairment in middle age. Objectives: To determine the prevalence of hypertension and identify the dominant factors associated with hypertension among young adults aged 25–34 years in West Java Province in 2023. Methods: This study was conducted cross-sectionally using secondary data from SKI 2023 with a sample of 6,105 young adults aged 25-34 years in West Java. As secondary data were used, this study was limited to the variables available in the SKI dataset. Data were analyzed using univariate, bivariate analysis with the chi-square test, and multivariate analysis with logistic regression. Results: Approximately 18.9% of young adults in West Java have hypertension. Multivariate analysis showed that low fruit and vegetable consumption was the dominant factor of hypertension among young adults aged 25–34 years in West Java Province in 2023, with an OR of 2.741 (95% CI: 1.449 – 5,182). However, the wide confidence interval indicates a limitation in the precision of the estimate. In addition, 98.3% of young adults aged 25–34 years in West Java were found to have insufficient fruit and vegetable intake. Conclusion: Adequate daily consumption of fruits and vegetables is important in preventing hypertension among young adults. Health campaigns in the workplace or collaborations with digital platforms for nutrition education are needed to create an environment that supports fruit and vegetable consumption behaviors.
Copyright (c) 2026 Layra Azkadzkiya Arradhin, Sandra Fikawati, Khoirul Anwar, Wahyu Kurnia Yusrin Putra http://creativecommons.org/licenses/by-sa/4.0
Karakteristik sensoris dan nilai gizi snack bar berbahan tepung ubi ungu, kacang hijau, dan jagung sebagai kandidat pangan darurat lokal
Background: Limited access to food during disasters can lead to energy and protein deficiencies (EPD). Therefore, nutrient-dense, shelf-stable, and easy-to-consume emergency foods, such as snack bars made from local ingredients, are needed. The use of local foods as alternative sources of energy and protein, such as a combination of purple sweet potato flour, mung beans, and corn should be tested. Methods: This experimental study used a completely randomized design with four raw material formulations with different ratios of purple sweet potato flour, mung beans, and corn: F1 (70%:10%:20%), F2 (60%:20%:20%), F3 (50%:30%:20%), and F4 (40%:40%:20%), with three replicates for each. The study was conducted at the UAD from June to August 2024. A hedonic test was employed to evaluate preferences on a five-point scale with 30 semi-trained panelists aged 18–25 years. Proximate analysis was conducted to determine the moisture, ash, carbohydrate, protein, and fat contents. Results: Significant differences were observed in the color and texture characteristics, with the highest color hedonic score in F3 (3.43±1.006) (p<0.05). Regarding texture, the highest hedonic score was observed for F3 (3.53 ± 1.074). The nutritional content of the formulas differed; the highest energy content was observed in F1 (380.08 kcal/100 g), the highest protein content was observed in F4 (9.94 g/100 g), and the lowest water content was observed in F2 (13.46 g/100 g). Conclusion: The level for preference between snack bars and F3 snack bars, indicating a strong preference for the former. The nutritional content also differed, with F4 having the highest energy and protein contents. This study shows that all three snack bar ingredients have the potential to be developed as emergency foods; however, further development is required to meet these standards.
Copyright (c) 2026 Nurul Putrie Utami, Herlin Septiana Kusniadi, Kartika Hariani http://creativecommons.org/licenses/by-sa/4.0
Pengaruh konseling sebaya terhadap pengetahuan dan asupan zat gizi pada remaja putri anemia: studi kuasi-eksperimen
Background: Anemia is a condition in which hemoglobin (Hb) levels are below the normal level. In Sukoharjo Regency, 36.9% of the population suffers from anemia. The main cause of anemia is iron deficiency. A lack of dietary variety is also associated with poor eating habits, which contribute to anemia. Lack of knowledge leads to inappropriate food choices. One way to reduce anemia is through peer counseling. Peer counseling was chosen as an intervention because the peer-led approach has been shown to be more effective in increasing knowledge and changing nutritional behavior in adolescents than conventional educational methods. Objectives: To examine the effect of peer counseling on nutritional intake and knowledge level of adolescent girls with anemia Methods: This study was conducted at SMAN 1 Mojolaban and SMAN 1 Kartasura from June to August 2025. A sample of 136 adolescent girls with anemia was selected using purposive sampling. Data on knowledge levels were collected through questionnaires, and nutrient intake was assessed using SQ-FFQ interviews. The study employed a quantitative (quasi-experimental) design with a pre-post-test control group. Data were analyzed using the paired-sample t-test, Wilcoxon test, and Mann–Whitney U test. Results: The intervention group showed significant increases in knowledge (57.87±5.94→90.44±6.95) and all nutrient intakes (p<0.05). The control group showed limited improvement, significant only in protein intake (p<0.05). Significant differences were found between groups in knowledge and nutrient intake (p<0.05). Conclusion: Peer counseling has an impact on the knowledge levels and nutrient intake of anemia adolescent girls
Copyright (c) 2026 Fitria Fahma Nur Cahyani, Aditya Nanda Priyatama, Ika Sumiyarsi Sukamto http://creativecommons.org/licenses/by-sa/4.0
Potensi inhibisi enzim alfa-Amilase oleh cuka buah belimbing wuluh (Averrhoa Bilimbi L.) sebagai aktivitas antidiabetik in vitro
Background: Diabetes mellitus (DM) is a noncommunicable disease with a high prevalence worldwide. One management strategy for DM involves the control of postprandial glucose levels. Starfruit vinegar (Averrhoa bilimbi L.) is a fermented product containing acetic acid and secondary metabolites, particularly flavonoids, which have the potential to inhibit α-amylase activity, thereby helping to regulate postprandial glucose levels. Objectives: This study aimed to identify the antidiabetic activity of starfruit vinegar by inhibiting α-amylase enzyme activity. Methods: This study utilized an in vitro experimental design and was conducted at the Testing Laboratory of Poltekkes Kemenkes Pontianak from February to June 2025. The treatment groups comprised starfruit (Averrhoa bilimbi) vinegar at concentrations of 3000, 3500, 4000, 4500, and 5000 ppm, each with five replicates (25 samples). The positive control group was treated with acarbose (five samples). α-Amylase inhibitory activity was assessed using the Fuwa method and measured using a UV-Vis spectrophotometer at the maximum absorption wavelength. The IC50 values and statistical analysis were determined using a linear regression test. Results: Both starfruit vinegar and acarbose significantly inhibited α-amylase, with a p-value of 0,008 (p< 0,05). The IC₅₀ value of starfruit vinegar was 2822 mg/ml, indicating very weak inhibitory activity. However, similar to the positive control, acarbose (2548.463 mg/ml) showed weak inhibitory activity. Conclusion: The significant p-value indicates that star fruit vinegar effectively inhibited α-amylase activity. The IC50 value, comparable to that of acarbose, suggests that star fruit vinegar has potential inhibitory activity similar to that of the positive control and may serve as a natural antidiabetic agent.
Copyright (c) 2026 Imma Fatayati, Febiola Panjaitan, Hendra Budi Sungkawa, Ratih Indrawati, Wahdaniah http://creativecommons.org/licenses/by-sa/4.0
Efektivitas video animasi edukasi gizi berbasis instagram reels terhadap emotional eating dan konsumsi makanan cepat saji pada remaja obesitas sentral
Background: Central obesity is a growing health problem among adolescents due to unhealthy eating patterns and fast food consumption habits. One of the triggering factors is emotional eating, which is overeating in response to emotions rather than physiological hunger. Nutrition education is an important strategy for obesity prevention; however, it needs to be tailored to the characteristics of adolescents, who are attracted to visual and digital media content. The use of social media, such as Instagram, is considered effective for conveying nutrition messages in an engaging and easily accessible way. Objective: This study aimed to analyze the effectiveness of animated nutrition education videos on Instagram Reels on emotional eating behavior and fast food consumption in adolescents with central obesity in Palu City. Methods: This study used a quasi-experimental design with a pretest-posttest control group. The study was conducted from July to September 2025 at SMA Model Terpadu Madani and SMA Al-Azhar Palu, and 34 students with central obesity were selected by purposive sampling. Data were collected using the Emotional Eating Questionnaire (EEQ) with a Cronbach's alpha reliability value (α = 0.829) and the Food Frequency Questionnaire (FFQ) with a reliability value (α = 0.802) to assess fast food consumption. Data analysis was performed using the Mann–Whitney U test for comparisons between groups and the Wilcoxon signed-rank test for comparisons within the groups. Results: The results of the animated video research showed a decrease in emotional eating behavior scores and fast food consumption in the intervention group (p<0,05). Conclusion: An Instagram Reels-based nutrition education animation video has the potential to reduce emotional eating levels and fast food frequency in centrally obese adolescents.
Copyright (c) 2026 Arifa Aulia Fatihaturrahma, Tri Rejeki Andayani, Anik Lestari http://creativecommons.org/licenses/by-sa/4.0
Pengaruh pendampingan terhadap kemampuan guru PAUD dalam deteksi dini pertumbuhan dan perkembangan anak
Background: Child growth and development are influenced by various factors, including nutritional intake, health, and education. Success in these developmental stages serves as the foundation for a child's future quality of life. Early childhood education (PAUD) plays a strategic role in monitoring child development through the Early Stimulation, Detection, and Intervention of Growth and Development (SDIDTK) program. However, the reality in the field indicates that PAUD teachers’ ability to implement SDIDTK remains relatively low due to several factors. Objectives: This study aimed to determine the impact of mentoring on early childhood educators’ (PAUD teachers) ability to conduct early detection of child growth and development. Methods: This quasi-experimental study used a one-group pretest–posttest design. The population consisted of all 23 PAUD teachers at PAUD Al Marhamah in Langsa City, and the study was conducted in July 2024. The research instruments comprised a questionnaire to assess knowledge and a checklist to evaluate the practical skills. Data were collected before and after the intervention. The collected data were analyzed using paired t-tests and Wilcoxon signed-rank tests. Results: The average knowledge score increased from 3.43 in the pretest to 7.91 in the posttest, with a mean difference of 4.48. The average skill score of the respondents was 40.17 at pretest and 81.57 at posttest, with a mean difference of 41.39, indicating improvement in both knowledge and skill scores after the intervention. Statistical analysis revealed that mentoring significantly influenced the knowledge and skills of PAUD teachers in the early detection of child growth and development (p = 0.000). Conclusion: Mentoring significantly influences PAUD teachers’ knowledge and skills in the early detection of children’s growth and development. It is expected that PAUD teachers will provide developmental stimulation appropriate for the child's age.
Copyright (c) 2026 Isnaini Putri, Cut Mutiah, Rayana Iswani, Emilda http://creativecommons.org/licenses/by-sa/4.0
Analisis kandungan gizi, kadar magnesium, & kalium bolu kukus berbasis tepung biji kecipir dan tepung pati garut sebagai inovasi produk sport food
Background: Exercise-associated muscle cramps (EAMC) in athletes are associated with fluid and electrolyte loss during intense physical activity. Therefore, sports nutrition that supports adequate intake of macronutrients and essential minerals is necessary. Winged beans have potential as a source of protein and minerals, and arrowroot flour can serve as an alternative source of carbohydrates for developing sports foods. Objectives: To develop steamed cake products based on winged bean flour and arrowroot starch as local sports food innovations and analyze their nutritional composition, magnesium and potassium levels, and organoleptic properties. Methods: This experimental study used a completely randomized design with variations in the proportions of winged bean flour and arrowroot flour in three formulations: F1 (25%:75%), F2 (50%:50%), and F3 (75%:25%). The proximate composition and mineral content were analyzed at the Saraswanti Indo Genetech Laboratory, Bogor, while the organoleptic evaluation was conducted using a nine-point hedonic scale by 30 semi-trained panelists. The data were analyzed using ANOVA, Duncan's Multiple Range Test, and DeGarmo’s Method. Results: Significant differences (p<0.05) were observed among the formulations with respect to energy, protein, carbohydrate, fat, ash, magnesium, and potassium content. Formulation F3 was selected as the best owing to its superior nutritional quality, with higher protein and electrolyte mineral levels; however, organoleptic testing showed that F1 had the highest sensory acceptance level. Conclusion: The steamed cake made from winged bean flour and arrowroot starch (F3) has potential as a local sports food rich in protein and essential minerals to support energy, muscle function, and electrolyte balance in athletes.
Copyright (c) 2026 Sahirah Aliyah Firdaus, Nanang Nasrulloh http://creativecommons.org/licenses/by-sa/4.0
Pengaruh jus alpukat dan jus jambu biji terhadap kadar kolesterol total pada pengguna depo-medroxyprogesterone acetate
Background: Depo-medroxyprogesterone acetate (DMPA) contraceptives are a cause of hypercholesterolemia. Natural treatments using fruits, specifically avocado and red guava, can be administered as preventive and curative measures to address this issue. Objectives: To determine the effects of red guava juice and avocado juice on reducing cholesterol levels among DMPA contraceptive users at the Banda Sakti Health Center. Methods: This study used a quasi-experimental method with a pretest-posttest two-group design. The research subjects were selected using accidental sampling; they comprised 60 mothers using DMPA contraceptives who experienced hypercholesterolemia at the Banda Sakti Health Center. The study was conducted from June to August 2024. The research process involved three stages: pretest measurement of cholesterol levels, a 14-day intervention with 250 mL/day of avocado juice and red guava juice, and posttest cholesterol measurement. The instrument used was an observation sheet, and data analysis was performed using the paired t-test Results: The mean cholesterol level before the avocado juice intervention was 228.07, which decreased to 204.73 after the intervention, with a mean difference of 23.33. The p-value was 0.000, indicating that avocado juice significantly affected the reduction of cholesterol levels in DMPA acceptors. In the guava juice group, the mean level before intervention was 227.53, decreasing to 211.13 afterward, with a mean difference of 16.40. With a p-value of 0.000, it was concluded that red guava juice also significantly impacted the reduction of cholesterol levels among DMPA acceptors at the Banda Sakti Health Center. Conclusion: Health workers should provide information, education, and counseling regarding effective non-pharmacological therapies for managing cholesterol levels among women using contraceptives.
Copyright (c) 2026 Rayana Iswani, Ernita, Erlina, Cut Mutiah, Agus Hendra Al Rahmad http://creativecommons.org/licenses/by-sa/4.0
Hubungan lingkar leher dan skor gaya hidup dengan tekanan darah sistolik pada guru SMP Negeri di Kabupaten Bojonegoro
Background: In Indonesia, civil servants have the highest prevalence of hypertension (36.9%), with teachers included as a high-risk population. High blood pressure is influenced by anthropometric factors, including neck circumference as an indicator of upper body adiposity, as well as lifestyle factors affecting systolic blood pressure. However, studies examining these factors among teachers are scarce. Objective: This study aimed to investigate the relationship between neck circumference, lifestyle score, and systolic blood pressure in junior high school teachers in Bojonegoro Regency. Methods: An analytical observational study with a cross-sectional design was conducted. Eight public junior high schools were selected using cluster random sampling, followed by convenience sampling of 320 teachers from these schools. Neck circumference was measured using a tape with 0.1 cm accuracy, lifestyle score was assessed via a questionnaire, and systolic blood pressure was measured using a digital sphygmomanometer. Data were analyzed using multiple linear regression without adjusting for confounding variables. Results: Neck circumference was positively and significantly associated with systolic blood pressure (p < 0.001), whereas lifestyle showed no significant association (p = 0.402). The model explained 22.8% of the variability in the systolic blood pressure (R² = 0.228). The mean systolic blood pressure was 131.80 ± 18.71 mmHg. Conclusion: Neck circumference was significantly associated with systolic blood pressure, whereas lifestyle factors did not have a direct effect.
Copyright (c) 2026 Adhiestya Mayangsarie, Selfi Handayani, Anik Lestari http://creativecommons.org/licenses/by-sa/4.0
Efektivitas kombinasi pembatasan kalori dan kapsul kacang kedelai (Glycine max) terhadap kadar trigliserida pada individu obesitas usia 25-45 tahun
Background: Obesity is significantly associated with lipid metabolism disorders, one of which is characterized by elevated triglyceride levels that may lead to cardiovascular complications. Caloric restriction is a commonly applied non-pharmacological approach for managing obesity; however, its effectiveness may be enhanced when combined with functional foods, such as soybeans, which are rich in bioactive compounds. Objectives: This study aimed to evaluate the effects of caloric restriction combined with soybean capsule consumption on triglyceride levels in individuals with obesity. Methods: This study was conducted in Kuningan, West Java, using a single-blind randomized controlled trial with a pre-post design over 14-day period. Thirty individuals with obesity were randomly assigned to two groups. The control group underwent caloric restriction of 1800 kcal/day, whereas the intervention group received the same caloric restriction along with 3000 mg/day soybean capsules. Triglyceride levels were measured before and after the intervention. Data were analyzed using parametric and non-parametric tests according to the data distribution, with a 95% confidence interval (CI), complemented by effect size analysis using Cohen’s d. Results: The intervention group demonstrated a significantly greater reduction in triglyceride levels than that in the control group (p = 0.004). The mean decrease in triglyceride levels was 5.9±3.9 mg/dL in the intervention group, whereas the control group showed a reduction of 3.13±1.64 mg/dL. Cohen’s d value of 0.93 indicated a large effect size. Conclusion: The combination of caloric restriction and soybean capsules for 14 days resulted in a more significant reduction in triglyceride levels than caloric restriction alone. These findings suggest a potential short-term metabolic benefit in individuals with obesity.
Copyright (c) 2026 Hanifah Mardhotillah, Al Rivan Marsyah Dzikri, Fitriani Ekawati http://creativecommons.org/licenses/by-sa/4.0
Faktor gaya hidup yang berhubungan dengan indeks massa tubuh mahasiswa Universitas Muhammadiyah Aceh
Background: Obesity has become an increasing public health problem, including among Indonesian university students. Lifestyle changes, particularly low physical activity and high fast-food consumption, are suspected to contribute to an increased body mass index (BMI) among students. Objective: This study aimed to analyze the factors associated with body mass index (BMI) among Universitas Muhammadiyah Aceh students. Methods: This study employed an analytical observational design with a cross-sectional approach and was conducted in August 2019. A total of 94 students were selected using proportional sampling methods. Data were collected through structured interviews and anthropometric measurements of the participants. Bivariate analysis was performed using the chi-squared test, followed by multivariate analysis using logistic regression to identify the determinant factors associated with BMI. Results: Most respondents had a normal nutritional status (62.77%), followed by overweight (17.02%) and obese (20.21%) statuses. Fast food consumption, snacking habits, screen-viewing duration, physical activity, nutritional knowledge, food promotion exposure, and use of food delivery services were significantly associated with body mass index (p<0.05). Low physical activity was the strongest determinant, increasing the risk of obesity by 12.84 times, followed by frequent fast food consumption, which increased the risk by 7.62 times. Conclusion: Low physical activity and high fast-food consumption were the main factors associated with increased BMI in university students. Campus-based interventions focusing on physical activity promotion, practical nutrition education, and improvement of the campus food environment are recommended to prevent obesity in students.
Copyright (c) 2026 Edi Ardiansyah, Asnawi Abdullah, Fauzi Ali Amin http://creativecommons.org/licenses/by-sa/4.0
Formulasi kombucha teh hijau tayu berbasis variasi jenis gula sebagai pangan fungsional: Analisis sensoris, kadar gula, dan aktivitas antioksidan
Background: Green tea and sugar are the main ingredients of kombucha. The antioxidant compounds in kombucha may play a role in the management of glucose metabolism. Using local Tayu green tea and a variety of sugars may potentially achieve the best kombucha characteristics for individuals with diabetes. Objectives: This study aimed to identify the sensory characteristics, total sugar content, and antioxidant activity of tayu green tea kombucha fermented with different sugar types. Methods: A Completely Randomized Design was used in this study. Three treatments based on the type of sugar in Tayu green tea kombucha were used: coconut sugar kombucha (GK), palm sugar kombucha (GA), and cane sugar kombucha (GT). Three kombucha samples were developed in the Pangkalpinang Laboratory and analyzed in the Bogor Laboratory from July to August 2025. The sensory characteristics were described based on product acceptability obtained from a hedonic test involving 30 panelists. The total sugar content was determined using the Luff Schoorl method, and the antioxidant activity was determined using the spectrophotometric method as IC50. Differences in acceptability data were analyzed using the Kruskal–Wallis test (p<0.05). Sugar content and antioxidant activity were analyzed univariately. Results: Significant differences (p<0.05) in color and taste acceptability were observed, with the highest average observed for GK kombucha. The highest aroma and overall acceptability scores were observed for GT (4.3) and GK (4.6) samples. GK kombucha had the lowest IC50 value (6682.9mg/L), indicating the highest antioxidant activity because a lower concentration was required to neutralize 50% of free radicals. GA kombucha had the lowest sugar content at 12.1%, and GK had a slightly higher sugar content at 13.3%. Conclusion: GTK with coconut sugar is the best formula for DM, with the highest acceptability value, moderate sugar content, and highest antioxidant activity.
Copyright (c) 2026 Sutyawan, Endah Mayang Sari, Emmy Kardinasari, Karina Dwi Handini http://creativecommons.org/licenses/by-sa/4.0
The effect of carbohydrate loading on physical performance and adaptations in amateur sports enthusiasts: A systematic review
Background: Carbohydrate loading (CL) increases muscle glycogen reserves before intense physical activity. While CL has been shown to be beneficial for elite athletes, the metabolic capacity and activity duration of amateur and recreational athletes are variable. As sports nutrition guidelines for amateur athletes vary, especially regarding CL indications, duration, and dose, this variance has practical and therapeutic ramifications. Objectives: This study aimed to systematically review the effects of carbohydrate loading on the physical performance and adaptation of amateur sports enthusiasts. Methods: This systematic review was conducted following the PRISMA 2020 guidelines. We searched PubMed, ScienceDirect, ProQuest, and Google Scholar for publications from 2005 to 2025. Experimental or randomized controlled trials of high-carbohydrate diets in non-elite athletes were included in this review. Two reviewers independently selected the articles, and a third reviewer resolved any disagreements. VO2max, time to exhaustion, race results, and metabolic responses were all recorded. The risk of bias and study quality were assessed using the Cochrane Risk of Bias 2.0 and the NIH Quality Assessment Tools. Results: Seven studies were included in the analysis. Five trials found that carbohydrate loading improved endurance and glucose stability and reduced fatigue. Events lasting > 90 min showed the greatest performance gains. Short-term and moderate-intensity activities had no meaningful impact on the two studies. These differences may have been caused by differences in training, glycogen storage, and diet. Conclusion: Carbohydrate loading improves endurance performance and metabolic efficiency, particularly during long-duration exercise. However, inter-individual heterogeneity emphasizes the need for tailored carbohydrate regimens to maximize athletic performance in endurance sports.
Copyright (c) 2026 Putu Ayu Savitri Dewvi, Putu Ayu Wulandari, Natasha Pradnya Devi, Ni Ketut Sumartini http://creativecommons.org/licenses/by-sa/4.0
Efektifitas edukasi dan konseling faktor risiko hipertensi terhadap peningkatan pengetahuan, sikap dan frekuensi konsumsi natrium pada remaja dengan tekanan darah di atas normal
Background: Hypertension is no longer limited to older adults and increasingly affects adolescents. Behavioral risk factors, such as high sodium intake, high fat consumption, and insufficient physical activity, contribute to an increased risk of hypertension. Limited knowledge and unfavorable attitudes toward hypertension prevention among adolescents may perpetuate unhealthy behaviors, highlighting the need for educational interventions as an early strategy to prevent non-communicable diseases. Objective: This study aimed to determine the effectiveness of education and counselling in improving adolescents’ knowledge, attitudes, and dietary patterns related to hypertension risk factors. Methods: An experimental study using a pretest–posttest control group design was conducted at SMAN 10, Semarang City, from June 19 to July 23, 2025. A total of 29 tenth-grade students with blood pressure >120/80 mmHg were randomly assigned to the intervention (n = 15) and control (n = 14) groups. The intervention consisted of nutrition education and counselling using a booklet entitled “Healthy Living to Prevent Hypertension.” The collected data included knowledge, attitudes, and frequency of sodium-rich food consumption. Data were analyzed using independent t-tests. Results: The mean increase in knowledge (6.6 points) and attitude (2.1 points) scores was higher in the intervention group (p=0.109; p=0.333), and the mean frequency score of sodium-rich food consumption decreased by 3 points (p=0.115) compared to that in the control group. However, these differences were not statistically significant. Based on effect size, the intervention showed a greater tendency to reduce the frequency of sodium-rich food consumption (12.9%) than to improve knowledge (10.5%) and attitudes (3.7%). Conclusion: Nutrition education and counselling have the potential to improve knowledge, attitudes, and sodium-related dietary patterns among adolescents, although the results were not statistically significant in this study. This intervention shows promise as a preventive strategy for hypertension in adolescents.
Copyright (c) 2026 Sri Noor Mintarsih, Zuhria Ismawanti, Kun Aristiati Susiloretni, Izzati Hayu Andari, Mardiana Mardiana, Etika Ratna Noer http://creativecommons.org/licenses/by-sa/4.0
Validitas konten penapisan mandiri malagizi pada aplikasi “IDAMAN GIZI”
Background: Malnutrition is a complex condition involving interactions between underlying diseases, metabolic alterations, and inadequate nutritional intake, thereby requiring early management to prevent health deterioration. The self-screening tool in the “IDAMAN GIZI” application improves the early detection of malnutrition risk, reduces the burden on healthcare workers, and empowers patients.”. Objectives: This study assessed the validity of a self-screening instrument for malnutrition implemented within the “IDAMAN GIZI” mobile application for outpatients at RSD Idaman Banjarbaru City, Indonesia. Methods: This study used the CVI assessed by four media and four subject matter experts, along with the face validity index (FVI) by ten respondents. The study was conducted at RSD Idaman Banjarbaru from August to December 2025. Quantitative data from the assessment questionnaires were analyzed using the item content validity index (I-CVI), scale content validity index (S-CVI), and Cohen’s kappa reliability test. Qualitative data in the form of comments and suggestions were thematically analyzed to improve the instrument. Results: Based on the assessment by experts, the I-CVI, S-CVI, and overall content validity index (CVI) scores were all 1. Furthermore, the FVI scores provided by the respondents were I-FVI before (P0) = 1 and I-FVI after (P1) = 1, with S-FVI/Ave = 0.99 and S-FVI/UA = 0.86. Conclusion: The validity assessment of the “IDAMAN GIZI” self-screening instrument indicates that it is valid for wide-scale implementation. Further research is warranted to develop secure data storage features, a monitoring dashboard for nutrition professionals, and integration with national health programs to enhance the detection of regional malnutrition.
Copyright (c) 2026 Nadia Susiyana, Meilla Dwi Andrestian, Ermina Syainah, Zulfiana Dewi http://creativecommons.org/licenses/by-sa/4.0
Pengaruh penambahan jantung pisang kepok (Musa paradisiaca Linn) terhadap karakteristik organoleptik dan proksimat abon berbagai jenis ikan air tawar
Background: Although freshwater fish are highly nutritious, fish products are processed using traditional and limited methods. Shredded fish (abon) is a diversified product with high economic value and a long shelf life, but it has low fiber content. Saba banana blossom is a local ingredient that is rich in nutrients and fiber and can increase the fiber content of shredded fish products. Objective: This study aimed to analyze and conduct organoleptic tests on the addition of 25% saba banana blossoms to various types of shredded fish samples. Methods: An experimental design was employed using a non-factorial completely randomized design with three treatments and three replicates. Organoleptic tests were conducted in August 2025 at the Organoleptic Laboratory with 30 panelists, whereas chemical tests were performed at the Food and Agricultural Product Analysis Laboratory. Data analysis was performed using analysis of variance, followed by Duncan’s multiple range test if significant differences were observed. Results: Organoleptic tests on shredded tilapia, catfish, and carp with 25% saba banana blossom showed no significant effects on color (mean score 3.62; p>0.05), taste (mean score 3.63; p>0.05), aroma (mean score 3.68; p>0.05), and texture (mean score 3.51; p>0.05). Proximate analysis indicated that the highest moisture, ash, fat, protein, carbohydrate, and fiber contents were 4.34 %, 6.31%, 25.08%, 50.99%, 22.69%, and 1.41%, respectively Conclusion: The addition of 25% saba banana blossom did not significantly affect the color, taste, aroma, or texture of the shredded carp, tilapia, and catfish. The highest average proximate values were observed for shredded catfish. Future studies should use other fish species and involve expert panels and consumers for organoleptic testing to obtain more accurate results.
Copyright (c) 2026 Sastri Sastri, Andriani Andriani, Yulia Fitri http://creativecommons.org/licenses/by-sa/4.0
Analisis faktor determinan terhadap kejadian anemia pada wanita usia subur: Studi analitik
Background: Anemia remains a global public health problem, commonly affecting women of reproductive age, with a prevalence of approximately 30% worldwide and 32% in Indonesia. This condition is influenced by multifactorial determinants, including nutritional status, iron levels, reproductive factors, and education and knowledge levels. Objectives: This study aimed to identify the main determinants of anemia in women of reproductive age. Methods: This quantitative study used an analytical observational design with a cross-sectional approach. Data were gathered through interviews and anthropometric measurements of 44 women of reproductive age (15–49 years) from Cikeas Udik Village, Bogor Regency. Bivariate analysis was conducted using the chi-square test, and multivariate analysis was conducted using logistic regression analysis. Results: Nutritional status was significantly associated with anemia (p = 0.033). Respondents with abnormal nutritional status had a nine-fold higher risk of developing anemia than those with normal nutritional status (OR = 9.391; 95% CI: 1.205–73.178). Although iron supplementation in the past year did not show a statistically significant association with anemia (p = 0.108), it tended to reduce the risk of anemia. Conclusion: Nutritional status is a significant determinant of anemia in women of reproductive age. These findings highlight the importance of improving nutritional status through balanced nutrition education, adequate micronutrient intake, and adherence to iron supplementation.
Copyright (c) 2026 Duta Liana, Erry Yudhya, Jerry Maratis, Fifi Dwijayanti, Nuraini Fauziah http://creativecommons.org/licenses/by-sa/4.0
Comparative immunohistochemical expression of α-smooth muscle actin in pediatric indirect inguinal hernia and hydrocele
Background: Indirect inguinal hernia and hydrocele, with reported incidences of up to 4% and 0.0034%, respectively, are consequences of incomplete obliteration of the processus vaginalis. Although both conditions share a similar embryological origin, the molecular mechanisms driving their distinct clinical presentations remain unclear. Alpha-smooth muscle actin (α-SMA) is a widely used marker of myofibroblast activity and tissue remodeling. This study aimed to compare the expression of α-SMA in the processus vaginalis tissue of pediatric patients with indirect inguinal hernia and hydrocele. Methods: An observational analytical study with a cross-sectional approach was conducted at the H. Adam Malik General Hospital between January and June 2025. Processus vaginalis tissues were collected from 50 male pediatric patients (25 hernia and 25 hydrocele cases). The expression of α-SMA was evaluated through semi-quantitative immunohistochemical analysis, assessing both staining intensity and distribution. Data were analyzed using the chi-square test, and p < 0.05 was considered statistically significant. Results: A total of 50 patients were enrolled in the study, with a mean age of 3.98 ± 3.78 y. Statistical analysis revealed a highly significant difference in α-SMA expression between the two groups (p < 0.001). Strong α-SMA expression was observed in 96% of the indirect inguinal hernia group, whereas 96% of the hydrocele group exhibited weak expression (OR 576; 95% CI 34.0–9751.0; p < 0.001). The magnitude of this association indicates a strong relationship between clinical diagnosis and α-SMA expression. Conclusion: α-SMA expression differed significantly between indirect inguinal hernias and hydroceles, with a strong expression predominating in hernia specimens. These findings support an association between indirect inguinal hernias and increased α-SMA–positive stromal elements in the processus vaginalis.
Copyright (c) 2026 Anshari Dwi Nugraha, Erjan Fikri, Delyuzar http://creativecommons.org/licenses/by-sa/4.0
Model prediktif kejadian stunting berdasarkan status gizi pra-kehamilan, kenaikan berat badan selama kehamilan, dan berat bayi lahir di Kabupaten Hulu Sungai Utara
Background: Stunting is a nutritional problem that must be addressed in Indonesia. According to the World Health Organization, the prevalence of stunting will reach 150.2 million children under 5 years of age by 2024, who are too short for their age. Data from the South Amuntai Community Health Center show that 10.3% of children aged 0-2 years are suspected to be stunted. Most of the mothers of these children were found to have poor pre-pregnancy nutritional status and low weight gain during pregnancy, and some children were born with low birth weight. Objectives: To develop a stunting prediction model based on nutritional status before pregnancy, weight gain during pregnancy, and birth weight. Methods: This was a quantitative, analytical, observational research design with, retrospective cohort study. This study was conducted in the working area of the Amuntai Selatan Community Health Center, Hulu Sungai Utara Regency, South Kalimantan Province from September to December 2025. The study population comprised 601 toddlers, and samples were taken using Proportionate Stratified Random Sampling (PRS), resulting in 95 respondents. Data collection was performed using questionnaires, KIA books, and the EPPGBM application to determine the z-score. Data analysis was performed using Pearson’s test and multiple linear regression. Results: Maternal nutritional status before pregnancy (p=0.037, r=0.214), weight gain during pregnancy (p=0.010, r=0.264), and birth weight (p=0.000, r=0.450) were associated with stunting. The prediction model for the incidence of stunting was as follows: y = -5.205 + 0.017x₁ + 0.064x₂ + 0.001x₃. Nutritional status before pregnancy, weight gain during pregnancy, and birth weight influenced the incidence of stunting (R2 = 23.2%). Conclusion: The prediction model for stunting incidence is that each additional weight gain during pregnancy will reduce the incidence of stunting by 6.4%, and each additional weight gain at birth will reduce the incidence of stunting by 0.1%.
Copyright (c) 2026 Nurul Ain, Meilla Dwi Andrestian, Rahmani, Siti Mas'Odah http://creativecommons.org/licenses/by-sa/4.0
Hubungan antara pengetahuan ibu, praktik pemberian makan balita, dan pendapatan orang tua dengan stunting pada anak usia 12–59 bulan: Studi kasus-kontrol di Kalimantan Tengah, Indonesia
Background: Stunting (tengkes) remains a major nutritional problem in Indonesia and is closely related to child care, feeding practices, and household socioeconomic conditions. Objectives: To assess the effects of maternal knowledge, toddler feeding patterns, and parental income on stunting among toddlers in the service area of UPT Puskesmas Palingkau. Methods: This quantitative comparative study used a case–control design conducted at UPT Puskesmas Palingkau, Kapuas Murung Subdistrict, Kapuas Regency, Central Kalimantan, from November 3 to 9, 2025. The population comprised mothers with toddlers aged 12–59 months; July population data recorded 146 stunted and 477 non-stunted toddlers. A proportional random sampling technique was applied with a 1:3 case-to-control ratio, yielding 204 respondents (51 cases and 153 controls). Maternal knowledge was measured using a questionnaire, feeding patterns were assessed based on toddler meal pattern categorization, and parental income was grouped into high/low categories. Data were analyzed using the chi-square test and Odds Ratio (OR) estimation. Results: Low maternal knowledge was more common in cases than in controls (58.8% vs. 16.9%, p=0.001, OR=1.930). Low parental income was higher in cases than in controls (74.5% vs. 37.9%, p=0.001, OR=1.558). Poor feeding patterns predominated in cases (72.5% vs. 22.9%) with p=0.001 and OR=2.174. Conclusion: Maternal knowledge, parental income, and toddler feeding patterns were significantly associated with stunting. Strengthening nutrition education and improving dietary diversity, along with socioeconomic support for vulnerable households, are recommended to reduce stunting in the study area.
Copyright (c) 2026 Nur Hikmah, Meilla Dwi Andrestian, Siti Mas’Odah, Niken Widyastuti Hariati http://creativecommons.org/licenses/by-sa/4.0
Pengaruh edukasi gizi berbasis tiktok terhadap pengetahuan gizi dan status gizi pada remaja di SMP Batik Surakarta
Background: Interactive nutrition education using social media platforms, such as TikTok, has the potential to improve adolescents’ nutritional knowledge. However, evidence regarding its effectiveness on both knowledge and nutritional status is limited to date. Objectives: This study aimed to analyze the effect of TikTok-based nutrition education on nutritional knowledge and nutritional status among adolescents at SMP Batik Surakarta in Indonesia. Methods: This study employed a quasi-experimental design with a two-group pretest–posttest control group. The sample consisted of students aged 12–15 years, divided into a treatment group (n = 48) and a control group (n = 48). The treatment group received balanced nutrition education through three TikTok-based educational videos, whereas the control group received education through a Focus Group Discussion (FGD). Nutritional status was assessed using BMI-for-age (BAZ) and analyzed using the WHO AnthroPlus software. Data normality was tested using the Shapiro–Wilk test, which indicated non-normal distribution; therefore, the Wilcoxon and Mann–Whitney tests were applied with a significance level of p < 0.05. Results: Nutritional knowledge significantly increased in the treatment group compared to that in the control group (p<0.05). The mean increase in knowledge score was higher in the TikTok group (mean=16.06) than in the FGD group (mean=3.73). However, no significant difference was found in nutritional status before and after the intervention between the groups (p>0.05). Conclusion: TikTok-based nutrition education effectively improves adolescents nutritional knowledge but does not significantly affect their nutritional status.
Copyright (c) 2026 Raisya Putri Citranova Nurfadilla, Muwakhidah Muwakhidah, Luluk Ria Rakhma http://creativecommons.org/licenses/by-sa/4.0
Pengaruh formulasi tepung sagu, ikan tembang, dan kelor terhadap kadar proksimat biskuit PMT balita stunting di pesisir Maluku
Background: The coastal areas of Maluku are ecologically rich in marine resources, such as fish, and agricultural resources, such as sago and moringa, which are nutrient-rich. However, many toddlers still experience stunting. The prevalence of stunting in Maluku Province increased by 28,4% in 202,4 higher than the target in the 2019-2024 RPJM of 20%. One way to meet the nutritional needs of stunted toddlers is to provide supplementary food in the form of highly nutritious biscuits formulated from local Maluku foods, namely sago flour, Sardinella fimbriata (Banded Sardinella), and moringa. Objectives: This study aimed to determine the effect of a biscuit formulation of sago flour, Sardinella fimbriata, and moringa on the proximate levels of biscuits as PMT for stunted toddlers in the coastal areas of Maluku. . Methods: This study used an experimental method with a completely randomized design using five treatment levels and repeated three times, resulting in 15 experimental units. The treatments consisted of one control and four formulation treatments of 50% sago flour, 10%, 15%, 20%, and 25% Sardinella fimbriata flour, and 5%, 10%, 15%, 20% Moringa flour. Proximate tests (carbohydrate, protein, fat, fiber, water content, and ash content) of biscuits were performed using the AOAC method and conducted at the UKIM Nutrition Lab and Unpatti Chemistry Lab in August-September 2025. Data were analyzed descriptively and using a one-way analysis of variance (ANOVA) test. Results: The results showed that the carbohydrate, protein, fat, fiber, ash, and water contents of the biscuits ranged from 58.34%-70.78 %, 6.71%-13.78%, 12.24%-13.78%, 1.42%-3.37%, 1.06%-1.65%, and 5.34%-14.27%. The carbohydrate content tended to decrease with the addition of Sardinella fimbriata flour and moringa. Protein, fiber, and ash contents increased, whereas water content fluctuated in each treatment. The average carbohydrate, protein, fat, fiber, ash, and water contents were 63.05%, 10.60%, 13.96%, 2.16%, 1.42%, and 10.85%, respectively. The ANOVA test showed that the formulation of sago flour, Sardinella fimbriata, and moringa had an effect on the proximate content of biscwith (p = 0.000 < α 0.05). Conclusion: The formulation of sago flour, Sardinella fimbriata, and moringa influenced the carbohydrate, protein, fat, fiber, water, and ash content of the biscuits.
Copyright (c) 2026 Zasendy Rehena, Joan Herly Herwawan http://creativecommons.org/licenses/by-sa/4.0
Analisis serat pangan, indeks glikemik, dan beban glikemik pada food bar tepung mocaf, tepung daun kelor, dan tepung ikan kembung
Background: Diabetes Mellitus (DM) is a disease that occurs when the body cannot use insulin effectively, resulting in increased glucose levels in the bloodstream. According to the Indonesian Ministry of Health, the prevalence of diabetes mellitus in Indonesia reached 45.3 million in 2023. One strategy for DM management is the consumption of foods with a low glycemic index (GI). Low-GI foods help control blood glucose levels and are beneficial for the prevention and management of diabetes mellitus. Foods with high dietary fiber content generally have lower GI values. Food bars are considered functional snack alternatives with potential benefits for DM prevention. Objectives: This study aimed to analyze the dietary fiber content, glycemic index, and glycemic load of a food bar. Methods: An experimental laboratory design with a crossover approach was used. The research was conducted at the Nutrition Laboratory of UPN “Veteran” Jakarta and Saraswanti Indo Genetech (SIG) from June to August and involved 10 UPNVJ student subjects who metthe inclusion criteria off being male or female, aged 18-23 years, BMI 18.5-22.9 kg/m2, no history of DM, and normal fasting blood glucose levels ranging from 70-115 mg/dl. The dietary fiber content was analyzed using the gravimetric method, and the glycemic index was determined using the IAUC method. Data were analyzed using the Shapiro-Wilk normality test and Paired Sample T-Test. Results: The average dietary fiber content of the food bars was 11.26% per 100 g. The GI value obtained was 29.54 (low category), and the glycemic load was 10.92 ( upper limit of the low category). The difference test showed that p<0,001 indicating a significant difference between the reference and test foods. Conclusion: Food bars had high dietary fiber content and low GI values.
Copyright (c) 2026 Devia Amanda Putri, Ibnu Malkan Bakhrul Ilmi http://creativecommons.org/licenses/by-sa/4.0
Kandungan flavonoid, α-Tokoferol, aktivitas antioksidan pada food bar tepung mocaf, tepung daun kelor, dan tepung ikan kembung sebagai potensi antihipertensi
Background: Hypertension is a leading global cause of death associated with oxidative stress. Antioxidants help prevent oxidative stress, potentially reducing the risk of hypertension. Food bars from mocaf flour, moringa leaf flour, and mackerel flour have potential to be developed as functional foods due to their flavonoid, α-tocopherol, and antioxidant activity content. Objectives: This study analyzed the total flavonoid content, α-tocopherol, and antioxidant activity in food bars as potential antihypertensive functional foods. Methods: This study used an experimental method with a completely randomized design and three formulas. The study was conducted from June to August at three different locations. Flavonoids were analyzed using AlCl₃ UV-Vis spectrophotometry, α-tocopherol using HPLC, and antioxidant activity using the DPPH method. The results of the measurements were analyzed descriptively, followed by a normality test, with a one-way ANOVA and Duncan's test if normally distributed, and Kruskal-Wallis and Mann-Whitney tests if not normally distributed. Results: The results showed that Among the formulas, the highest total flavonoid content was in F1 (0.71 ± 0.01 mg/g), and the highest α-tocopherol content was in F2 (8.62 ± 0.23 mg/100 g). The strongest antioxidant activity among the three formulas was observed in F1 (1414.105 ± 0.84 mg/L). Based on the Shapiro-Wilk test, the three contents tested were normally distributed (p>0.05), but only the antioxidant activity and α-tocopherol showed a significant difference (p<0.05). Conclusion: Food bars made from mocaf flour, moringa leaf flour, and mackerel flour contain flavonoids and α-tocopherol, which contribute to antioxidant activity, making them potential functional foods with antihypertensive properties.
Copyright (c) 2026 Salwa Yasmin, Ibnu Malkan Bakhrul Ilmi http://creativecommons.org/licenses/by-sa/4.0
Kecukupan energi sebagai determinan status gizi anak autism spectrum disorder dan ADHD di Sekolah Luar Bias Negeri Dr. Radjiman Wedyodiningrat Ngawi
Background: Children with ASD and ADHD are prone to malnutrition owing to their sensitivity to certain tastes, textures, or types of food, which can affect their eating patterns. This condition causes an imbalance in energy and macronutrient adequacy levels, which can affect nutritional status. According to data from the Central Statistics Agency, there are 3,2 million children with ASD in Indonesia, while the prevalence of ADHD in Indonesia reaches 26,4%. This study builds upon previous research, which has generally focused only on children with ASD. This study included a group of children with ADHD and was conducted in Ngawi Regency, where similar research is limited. Objectives: To analyze the relationship between eating patterns, energy adequacy, and macronutrients and the nutritional status of children with ASD and ADHD at Dr. Radjiman Wedyodiningrat Public School for Special Needs, Ngawi. Methods: This study used a cross-sectional design and a quantitative analytical approach. A total of 30 students with ASD and ADHD at Dr. Radjiman Wedyodiningrat Public School for Special Needs, Ngawi, were selected using total sampling, with the inclusion criterion being that parents were willing to be interviewed. Data collection will be conducted in July 2025. Children’s dietary patterns were assessed based on parents’ perceptions and feeding practices using the Child Feeding Questionnaire (CFQ). Energy and macronutrient intakes were assessed using a validated Semi-Quantitative Food Frequency Questionnaire with cut-offs of ≤89% (deficit), 90%-119% (normal), and ≥120% (excess), while nutritional status was measured using body mass index-for-age (BMI-for-age). Data were analyzed using the chi-square or Fisher’s exact test if the chi-square assumption was not met. Results: Of the total respondents, 53% were malnourished. The analysis revealed no significant relationship between dietary patterns and nutritional status. There was a significant relationship between energy adequacy and nutritional status (p = 0,02; OR = 21,67; 95% CI=2,234-210,111). The OR value was quite large, which was likely influenced by the relatively small number of respondents in this study. In addition, there was no significant relationship between protein, fat, and carbohydrate adequacy and nutritional status. Conclusion: Energy intake among children with ASD and ADHD plays an important role in their nutritional status. Our study revealed the need for nutritional education interventions to improve energy balance and nutritional status in this population.
Copyright (c) 2026 Wijang Mukti Dharoini, Lini Anisfatus Sholihah http://creativecommons.org/licenses/by-sa/4.0
Formulasi soft cookies ubi jalar ungu (Ipomoea batatas (L.) Lam.) dengan pemanis stevia terhadap uji hedonik, karakteristik warna, dan kandungan gizi
Background: Cookies are among the most widely consumed snack products in Indonesia, with consumption growing at 4,25% every year. However, the high sugar content in conventional cookies has driven the demand for innovations using local ingredients and alternative sweeteners. Purple sweet potato is rich in nutrients and anthocyanins, while stevia provides sweetness 200-300 times sucrose without calories. This study integrated soft cookies using purple sweet potato puree with stevia covering hedonic testing, color characteristics, and nutritional content. Objectives: To analyze the effects of purple sweet potato soft cookies formulated with stevia on hedonic testing, color characteristics, and nutritional content. Methods: An experimental study with a completely randomized design (CRD), three formulations, and three replications (nine experimental units) was conducted. Hedonic testing was performed by 30 untrained panelist using scale 1-6. The color was measured using a chromameter. Proximate analysis was performed according to the AOAC (2005): moisture (gravimetric), ash (dry ashing), protein (Kjeldahl), fat (Soxhlet), carbohydrate (by difference), and energy (Atwater factor). Hedonic data were analyzed using Kruskal-Wallis test, and color and nutritional data using one-way analysis ANOVA (α=0.05). Results: The hedonic parameters of color, taste, texture, and overall acceptability differed significantly (p<0,05), whereas aroma showed no significant difference (p>0,05). All color parameters differed significantly (p<0,05). Moisture, protein, fat, carbohydrate, and energy content differed significantly (P<0,05). The moisture content of all formulations and the ash content of F2 exceeded the SNI 2973:2011 standard, while the protein, fat, carbohydrate, and energy content met the SNI standards. Conclusion: F3 (80%puree) demonstrated the best acceptability in terms of color, taste, texture, and overall acceptance, although it had the highest moisture and lowest protein content.
Copyright (c) 2026 Putri Sulistyawati, Dina Sugiyanti, Angga Hardiansyah http://creativecommons.org/licenses/by-sa/4.0
Formulation and nutritional evaluation of kepilor instant cereal (soybean sprout, plantain banana, and moringa leaves) as functional food for type 2 diabetes mellitus
Background: Type 2 diabetes mellitus (T2DM) is a global health problem with a continuously increasing prevalence and is strongly influenced by dietary patterns, particularly high energy intake, excessive simple sugars, and low fiber intake, which contribute to elevated postprandial glycemic responses. Effective management requires low-glycemic, nutrient-dense dietary interventions; however, commonly consumed processed foods, including instant cereals, often have high glycemic impacts. Therefore, the development of functional foods based on local ingredients such as plantain banana, soybean, and moringa leaves offers a promising strategy to support glycemic control Objectives: This study aimed to formulate and evaluate an instant cereal based on plantain banana flour, soybean sprout flour, and moringa leaf flour (kepilor) that meets the dietary requirements for diabetes mellitus. Methods: This study employed a Completely Randomized Design (CRD) with three levels of plantain flour substitution (20%, 30%, and 40%), each conducted in triplicate. The parameters analyzed included organoleptic properties, yield, energy values, nutrient compositions, and energy densities. Nutrient composition was determined using standard methods (gravimetric, dry ashing, micro-Kjeldahl, Soxhlet, and carbohydrate by difference). Organoleptic evaluation was conducted using a 9-point hedonic scale with 30 semi-trained panelists, and the best treatment was determined using an effectiveness index test with 10 other trained panelists. Data were analyzed using ANOVA or Kruskal-Wallis test with p < 0.05 Results: The results showed that formulation variations did not significantly affect protein, fat, carbohydrate, and fiber contents (p>0.05), with values ranging from 5.57–5.65 g, 2.83–2.90 g, 17.92–18.12 g, and 0.21–0.29 g per serving, respectively. However, significant differences were observed in total energy (119.40–120.63 kcal), energy density (0.597–0.603 kcal/mL), and taste (p<0.05), with taste being the only sensory attribute significantly affected by formulation. The formulation containing 30% plantain banana flour (T2) was identified as the best treatment, providing 120.63 kcal per serving, 5.65 g protein, 2.90 g fat, 17.98 g carbohydrates, 0.29 g fiber, and an energy density of 0.603 kcal/mL Conclusion: In conclusion, kepilor instant cereal has potential as a low-energy-density functional snack suitable for the dietary management of individuals with diabetes mellitus.
Copyright (c) 2026 Fitria Dhenok Palupi, Indri Hapsari, Muhammad Hasan Wattiheluw http://creativecommons.org/licenses/by-sa/4.0
Efektivitas edukasi gizi dengan MediFan StrokeAware dan WhatsApp dalam meningkatkan kepatuhan diet mediterania pada lansia
Background: Stroke remains a leading cause of mortality and disability among older adults in Indonesia, with a prevalence of 8.3 per 1,000 population. The Mediterranean diet is effective in reducing cardiovascular risk; however, its implementation remains limited due to the lack of innovative and age-appropriate nutrition education media, as well as the absence of integrated approaches combining educational media with digital support. Objectives: To analyze changes in knowledge, adherence to the Mediterranean diet, and fat intake following nutrition education using MediFan StrokeAware and WhatsApp among older adults in Mulyorejo Village. Methods: A pre-experimental one-group pretest–posttest study was conducted among 24 participants aged 45–70 years in Mulyorejo, Malang, selected through purposive sampling. Inclusion criteria included the ability to communicate and use WhatsApp, and no severe health conditions. The 2-month intervention utilized MediFan StrokeAware and WhatsApp (three times/week). Dietary adherence was measured using a validated questionnaire. Data were analyzed using Wilcoxon and paired t-tests (α=0.05). Results: Knowledge increased significantly (68.06% vs 80.56%, p=0.044). Most participants (95.8%) achieved adherence to the Mediterranean diet after the intervention. MUFA intake increased (p=0.013), while SAFA intake also increased (p=0.001) as an unintended outcome. PUFA intake did not change significantly (p=0.141). Body fat percentage decreased significantly (p=0.002). Conclusion: The nutrition education intervention using MediFan StrokeAware and WhatsApp was associated with improvements in knowledge and adherence to the Mediterranean diet among older adults. However, the increase in saturated fatty acid (SAFA) intake indicates that dietary behavior changes were not yet consistent, highlighting the need for more contextual and longer-duration interventions.
Copyright (c) 2026 Diana Mufarrokhah, Karina Muthia Shanti, Dwipajati http://creativecommons.org/licenses/by-sa/4.0
The importance of folate consumption during pregnancy in preventing neural tube defects: A Literature Review
Background: Neural Tube Defects (NTDs) are severe congenital disorders that can result in lifelong disabilities. These malformations are largely preventable through adequate folic acid intake before conception and during early pregnancy. However, in many settings, including Indonesia, pregnant women’s awareness and adherence to folic acid supplementation remain below optimal levels. Scientific evidence has long demonstrated that folic acid supports proper neural tube formation and lowers the risk of conditions such as spina bifida and anencephaly. However, there is limited discussion in existing reviews about contextual barriers, such as cultural perceptions, healthcare access, and policy limitations, that influence supplementation practices in low- and middle-income countries. This review aims to fill this gap by examining recent evidence on the preventive role of folic acid and exploring the factors that shape its effectiveness. Objectives: This study aimed to evaluate and review the existing evidence on the role of folic acid consumption in preventing Neural Tube Defects (NTD) in pregnant women and to identify factors that influence its effectiveness. Methods: This review was conducted using PubMed and Google Scholar with searches guided by standardized Medical Subject Headings (MeSH) terms: “Folic Acid,” “Pregnant Women,” and “Neural Tube Defects.” The selection process followed the PRISMA guidelines, applying the following criteria: publication between 2020 and 2024, availability of full-text articles, and a primary focus on the relationship between folic acid and NTD prevention in pregnant women. The methodological quality of the included studies was assessed using the Joanna Briggs Institute (JBI) critical appraisal tool. Results: The results of the six studies showed that folic acid deficiency significantly increased the risk of anencephaly and neural tube defects, whereas folic acid supplementation before and during pregnancy reduced the incidence of NTDs. Adequate folic acid levels in pregnant women also reduce the risk of spina bifida, although knowledge and compliance with folic acid consumption among pregnant women remain low. The methodological quality varied from moderate to high, although several studies did not adequately control for confounding factors. Conclusion: Based on these findings, folic acid consumption is crucial for preventing NTDs. However, there is a need to improve education and compliance with folic acid consumption among pregnant women. Further research is required to understand the factors influencing compliance and to design more effective interventions to enhance awareness and implementation of folic acid consumption among pregnant women.
Copyright (c) 2026 Tiara Andhiny, Anita Rahmiwati, Novrikasari http://creativecommons.org/licenses/by-sa/4.0