Low‐cost local food supplements could improve maternal and birth outcomes in Indonesia: A pilot randomised controlled trial

2021 ◽  
Vol 46 (3) ◽  
pp. 321-331
Author(s):  
Kun A. Susiloretni ◽  
Dyah Nur Subandriani ◽  
Elisa Ulfiana ◽  
Sunarto Sunarto ◽  
Trina Astuti ◽  
...  
2020 ◽  
Author(s):  
Kun Aristiati Susiloretni ◽  
Dyah Nur Subandriani ◽  
Elisa Ulfiana ◽  
Trina Astuti ◽  
Sunarto Sunarto ◽  
...  

Objectives. Maternal nutrition plays a crucial role in influencing fetal growth and birth outcomes. The government of Indonesia has provided a manufactured fortified food supplementation program for undernourished pregnant mothers. We hypothesized a low-cost local food supplementation (LFS) would improve maternal and birth outcomes compared with government food supplementation (GFS). Methods. We conducted a randomized control trial. We enrolled 54 pregnant mothers with MUAC<23.5cm who were assigned into two groups. The intervention group received LFS and multiple micronutrient supplements (MMS). The control group received the GFS and iron and folic acid supplements (IFA). LFS was a balanced energy protein food supplement made from nuts and fish. LFS and GFS contained approximately 500kcal energy and 10grams protein. We compared the effectiveness of these two interventions using logistic and linear regression. Results. At the baseline, the two groups had similar characteristics. After 60 days of treatment, mothers in the LFS group were 2.28 folds more likely to increase MUAC (RR 2.28; 95%CI 1.58,3.27, p<0.001) and 4.73 folds to increase gestational weight (RR 4.73; 95%CI 1.37,16.3, p=0.015) than were mothers in the GFS group. For birth outcomes, in the LFS group had reduction of birthweight <3000grams (RR 0.15; 95%CI 0.023,0.98; p=0.048), short birth length (RR 0.068; 95%CI 0.005,0.93; p=0.044), and cesarean delivery (RR 0.11; 95%CI 0.022,0.61, p=011) as compared to the GFS group. Conclusions for Practice. Local foods and MMS supplementation can improve maternal and birth outcomes. Therefore, local food supplements can be considered for food supplementation programs to undernourished pregnant mothers.


Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 769
Author(s):  
Abrar M Babateen ◽  
Oliver M Shannon ◽  
Gerard M O’Brien ◽  
Edward Okello ◽  
Anmar A Khan ◽  
...  

Nitrate-rich food can increase nitric oxide production and improve vascular and brain functions. This study examines the feasibility of a randomised controlled trial (RCT) testing the effects of prolonged consumption of different doses of dietary nitrate (NO3-) in the form of beetroot juice (BJ) in overweight and obese older participants. A single-blind, four-arm parallel pilot RCT was conducted in 62 overweight and obese (30.4 ± 4 kg/m2) older participants (mean ± standard deviation (SD), 66 ± 4 years). Participants were randomized to: (1) high-NO3- (HN: 2 × 70 mL BJ/day) (2) medium-NO3- (MN: 70 mL BJ/day), (3) low-NO3- (LN: 70 mL BJ on alternate days) or (4) Placebo (PL: 70 mL of NO3--depleted BJ on alternate days), for 13 weeks. Compliance was checked by a daily log of consumed BJ, NO3- intake, and by measuring NO3- and NO2- concentrations in plasma, saliva, and urine samples. Fifty participants completed the study. Self-reported compliance to the interventions was >90%. There were significant positive linear relationships between NO3- dose and the increase in plasma and urinary NO3- concentration (R2 = 0.71, P < 0.001 and R2 = 0.46 P < 0.001, respectively), but relationships between NO3- dose and changes in salivary NO3- and NO2- were non-linear (R2 = 0.35, P = 0.002 and R2 = 0.23, P = 0.007, respectively). The results confirm the feasibility of prolonged BJ supplementation in older overweight and obese adults.


Healthcare ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 910
Author(s):  
Dorthe Djernis ◽  
Mia S. O’Toole ◽  
Lone O. Fjorback ◽  
Helle Svenningsen ◽  
Mimi Y. Mehlsen ◽  
...  

Here, we developed and examined a new way of disseminating mindfulness in nature to people without meditation experience, based on the finding that mindfulness conducted in natural settings may have added benefits. We evaluated a 5-day residential programme aiming to reduce stress and improve mental health outcomes. We compared an indoor and an outdoor version of the programme to a control group in a pilot randomised controlled trial (RCT). Sixty Danish university students experiencing moderate to high levels of stress were randomised into a residential mindfulness programme indoors (n = 20), in nature (n = 22), or a control group (n = 18). Participants completed the Perceived Stress Scale and the Self-Compassion Scale (primary outcomes) along with additional secondary outcome measures at the start and end of the program and 3 months after. Stress was decreased with small to medium effect sizes post-intervention, although not statistically significant. Self-compassion increased post-intervention, but effect sizes were small and not significant. At follow-up, changes in stress were not significant, however self-compassion increased for both interventions with medium-sized effects. For the intervention groups, medium- to large-sized positive effects on trait mindfulness after a behavioural task were found post-intervention, and small- to medium-sized effects in self-reported mindfulness were seen at follow-up. Connectedness to Nature was the only outcome measure with an incremental effect in nature, exceeding the control with a medium-sized effect at follow-up. All participants in the nature arm completed the intervention, and so did 97% of the participants in all three arms. Overall, the results encourage the conduct of a larger-scale RCT, but only after adjusting some elements of the programme to better fit and take advantage of the potential benefits of the natural environment.


BMJ Open ◽  
2015 ◽  
Vol 5 (4) ◽  
pp. e006874-e006874 ◽  
Author(s):  
A. R. Neilson ◽  
H. Bruhn ◽  
C. M. Bond ◽  
A. M. Elliott ◽  
B. H. Smith ◽  
...  

BMJ Open ◽  
2017 ◽  
Vol 7 (7) ◽  
pp. e017602 ◽  
Author(s):  
Bram Rochwerg ◽  
Tina Millen ◽  
Peggy Austin ◽  
Michelle Zeller ◽  
Frédérick D’Aragon ◽  
...  

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