ABSTRACT
Background: The government has made provisions to improve the nutrition of stunted children under the age of five nationally by providing iron folic acid (IFA) tablet since conception. However, these drugs were not able to reduce the incidence of stunted growth. The aim of this study is to assess the effect of moringa intervention during pregnancy on the incidence of stunted growth in children between the ages of 36 to 42 months.
Design and Methods: This study is a follow-up to an experimental RCT-DB study during pregnancy. The interventions given were PG (Moringa Flour), EG (Moringa Extract) and IG (IFA) which was used as control.
Results: The highest number of children that had stunted growth after taking the PG by IG and EG extracts were 66 (41.5%), 53 (33.3%) and 40 (25.2%), respectively. The stunted risk factor analysis did not show a significant relationship to the stunted incidence. Furthermore, the consumption and dietary patterns of children were based on only fat consumption which was associated with stunted incidence (p<0.05). The results of multivariate analysis showed that the EG extract was effective in reducing the incidence of stunted growth (p<0.005) and as a protective factor of 0.431 times the incidence of stunted growth (LL-UL=0.246-0.754).
Conclusions: The administration of Moringa oleifera extract during pregnancy prevents the incidence of stunted growth in children.
REFERENCES
International Food Policy Research Institute. Global Nutrition Report 2014: Actions and Accountability to Accelerate the World’s Progress on Nutrition. Washington, DC: International Food Policy Research Institute; 2014.
Akombi BJ, Agho KE, Merom D, et al. Child malnutrition in sub-Saharan Africa: A meta-analysis of demographic and health surveys (2006-2016). PLoS One 2017;12:1–11. DOI: https://doi.org/10.1371/journal.pone.0177338
Ministry of Health Republic of Indonesia. Basic Health Research 2018. Jakarta: Ministry of Health Republic of Indonesia; 2018.
Basri H, Hadju V. Breastfeeding and complementary food on nutritional status infants in Indonesia. Enferm Clin 2020;30:191–5. DOI: https://doi.org/10.1016/j.enfcli.2019.10.067
Mahmud NU, Abdullah T, Arsunan AA, et al. Determinants of exclusive breastfeeding in 6 months old infant in Jeneponto District. Indian J Public Heal Res Dev 2019;10:1487. DOI: https://doi.org/10.5958/0976-5506.2019.03047.X
Ramakrishnan U, Goldenberg T, Allen LH. Do Multiple micronutrient interventions improve child health, growth, and development? J Nutr 2011;141:2066–75. DOI: https://doi.org/10.3945/jn.111.146845
Fuglie LJ. The miracle tree: Moringa oleifera: natural nutrition for the tropics. Available from: https://agris.fao.org/agris-search/search.do?recordID=XF2015018648
Idohou-Dossou N, Diouf A, Gueye A, et al. Impact of daily consumption of Moringa (Moringa oleifera) dry leaf powder on iron status of Senegalese lactating women. Afr J Food Agric Nutr Dev 2011;11:4985–99. DOI: https://doi.org/10.4314/ajfand.v11i4.69176
Iskandar I, Hadju V, As ’ad S, et al. Effect of moringa oleifera leaf extracts supplementation in preventing maternal anemia and low-birth-weight. Int J Sci Res Publ 2015;5:1-3.
Muis M, Hadju V, Russeng S, et al. Effect of moringa leaves extract on occupational stress and nutritional status of pregnant women informal sector workers. Int J Curr Res Acad Rev 2014;2:86–92.
Nadimin, Hadju V, As S, et al. The Extract of moringa leaf has an equivalent effect to iron folic acid in increasing hemoglobin levels of pregnant women : A randomized control study in the coastal area of Makassar. Int J Sci Basic Appl Res 2015;22:287–94.
Hastuti, Veni H, Citrakesumasari, et al. Children’s nutrition status 7-12 months based on age, education and job of their mother in South Sulawesi. Indian J Public Heal Res Dev 2019;10:1598. DOI: https://doi.org/10.5958/0976-5506.2019.03068.7
Abdullah T, Bahar B, Jafar N, et al. Factors associated with the appropriate time of complementary feeding among infants in Jeneponto Districs South Sulawesi. Indian J Public Heal Res Dev 2019;10:1498–502. DOI: https://doi.org/10.5958/0976-5506.2019.03049.3
Nurdin MS, Hadju V, Ansariadi, et al. The effect of moringa leaf extract and powder to haemoglobin concentration among pregnant women in Jeneponto regency. Indian J Public Heal Res Dev 2018;9:262–7. DOI: https://doi.org/10.5958/0976-5506.2018.00130.4
Koletzko B, Godfrey KM, Poston L, et al. Nutrition during pregnancy, lactation and early childhood and its implications for maternal and long-term child health: The early nutrition project recommendations. Ann Nutr Metab 2019;74:93–106. DOI: https://doi.org/10.1159/000496471
Shindu S, Mangala S, Sherry B. Efficacy of Moringa oleifera in treating iron deficiency anemia in women of reproductive age group. Int J Phyther Res 2013;3:15–20.
Shija AE, Rumisha SF, Oriyo NM, et al. Effect of Moringa oleifera leaf powder supplementation on reducing anemia in children below two years in Kisarawe District, Tanzania. Food Sci Nutr 2019;7:2584–94. DOI: https://doi.org/10.1002/fsn3.1110
Saini RK, Manoj P, Shetty NP, et al. Dietary iron supplements and Moringa oleifera leaves influence the liver hepcidin messenger RNA expression and biochemical indices of iron status in rats. Nutr Res 2014;34:630–8. DOI: https://doi.org/10.1016/j.nutres.2014.07.003
Wasonowati C, Sulistyaningsih E, Indradewa D, et al. [Analisis fitokimia ekstrak daun kelor (moringa oleiferalamk) di madura].[Article in Indonesian]. Proc SEMNASDAL (Seminar Nas Sumber daya Lokal 2019;2:421–7.
Black RE, Victora CG, Walker SP, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet 2013;382:427–51. DOI: https://doi.org/10.1016/S0140-6736(13)60937-X
Adair LS. Long-term consequences of nutrition and growth in early childhood and possible preventive interventions. Nestle Nutr Inst Workshop Ser 2014;78:111–20. DOI: https://doi.org/10.1159/000354949
Zongo U, Zoungrana SL, Savadogo A, et al. Nutritional and clinical rehabilitation of severely malnourished children with Moringa oleifera leaf powder in Ouagadougou (Burkina Faso). Food Nutr Sci 2013;04:991–7.
Fahey JR. Moringa oleifera: A review of the medical evidence for its nutritional, therapeutic, and prophylactic properties. Trees Life J 2005;1:1–16.
Nnam NM. Moringa oleifera leaf improves iron status of infants 6-12 months in Nigeria. Int J Food Safety, Nutr Public Heal 2009;2:158. DOI: https://doi.org/10.1504/IJFSNPH.2009.029281
Andrew A. Effect of moringa oleifera leaf powder supplement to improve nutritional status of severely malnourished children aged 6-24 months in Arusha region. Tanzania: Sokoine University of Agriculture; 2010.
Srikanth VS, Mangala S, Subrahmanyam G. Improvement of protein energy malnutrition by nutritional intervention with Moringa oleifera among Anganwadi children in rural area in Bangalore, India. International J Sci Study 2014;2:32–5.
Gbadebo AO, Okareh OT, Ogunjobi AA, et al. Effects of Moringa oleifera lam. leaf powder on bifidobacteria and escherichia coli in the gut of albino rats. J Adv Microbiol 2019;18:1–11. DOI: https://doi.org/10.9734/jamb/2019/v18i230168
Khuzaimah A, Hadju V, As S, et al. Effect of honey and Moringa oleifera leaf extracts supplementation for preventing DNA damage in passive smoking pregnancy. Int J Sci Basic Appl Res 2015;24:138–45.
Karmila S, Saifuddin S, Tahir A, et al Determinant factors affecting the development of motor, cognitive and socioemotional children ages 18-12 months in the District Jeneponto, Indonesia. Indian J Public Heal Res Dev 2019;10:1564. DOI: https://doi.org/10.5958/0976-5506.2019.03062.6
Prado EL, Larson LM, Cox K, et al. Do effects of early life interventions on linear growth correspond to effects on neurobehavioural development? A systematic review and meta-analysis. Lancet Glob Health 2019;7:e1398–413. DOI: https://doi.org/10.1016/S2214-109X(19)30361-4