To reduce the burden of early-life linear growth faltering in low- and middle-income countries, interventions have focused on nutrition strategies, sometimes combined with water quality, sanitation, and hygiene (WASH). However, even when combined, their effects on linear growth have been inconsistent. Here, we investigate potential predictors of length-for-age z-scores (LAZ) in a cohort of resource-poor rural Indonesian infants to inform the optimal strategies to reduce linear growth faltering. Apparently healthy rural breastfed Indonesian infants were randomly selected from birth registries at age 6 months (n = 230) and followed up at 9 (n = 202) and 12 (n = 190) months. Using maximum likelihood estimation, we examined longitudinal relationships among socio-demographic status, maternal height, infant sex, age, water source, sanitation facility, energy, protein, micronutrient intakes and biomarkers (serum ferritin, zinc, retinol binding protein (RBP), selenium–adjusted for inflammation), and α-1-acid glycoprotein (AGP) and C-reactive protein (CRP) (systemic inflammation biomarkers) at age 6 and 9 months on LAZ at age 9 and 12 months. Stunting (LAZ <-2) at 6, 9, and 12 months was 15.7%, 19.3%, and 22.6%, respectively. In the full model, the predictor variable at age 6 months that was most strongly associated with infant LAZ at 9 months was maternal height (0.18 (95% CI 0.03, 0.32) SD). At age 9 months, the strongest predictors of LAZ at 12 months were improved drinking water source (-0.40 (95% CI -0.65, -0.14) vs. not improved), elevated AGP compared to not elevated (0.26 (95%CI -0.06, 0.58), maternal height (0.16 (95% CI 0.02, 0.31) SD), sex (0.22 (95% CI -0.02,0.45) female vs. male), serum RBP (0.12 (95% CI -0.01, 0.25) SD), and protein intake (0.17 (95% CI -0.01, 0.35) SD). Health promotion that includes exclusive breastfeeding up to the first six months and follows microbial water quality guidelines to ensure water intake is always safe should be considered.

ABSTRAKKebugaran jasmani yang baik pada atlet sangat penting agar tampil maksimal saat pertandingan. Faktor yang mempengaruhi kebugaran jasmani diantaranya adalah asupan gizi, status gizi dan usia. Usia remaja memerlukan asupan gizi yang cukup untuk pertumbuhan dan menjalankan aktifi tas fi siknya dalam kehidupan sehari-hari. Peran karbohidrat dalam olahraga sangat penting yaitu sebagai cadangan glikogen otot saat berolahraga. Tujuan penelitian ini adalah menganalisis hubungan asupan karbohirat, status gizi dengan kebugaran jasmani pada atlet basket remaja Sekolah Menengah Pertama. Penelitian ini menggunakan desain penelitian cross sectional. Besar sampel dalam penelitian ini menggunakan total populasi sebanyak 37 orang yang merupakan anggota tim basket di SMPN 2 Ngamprah Kabupaten Bandung Barat. Pengumpulan data asupan karbohidrat diperoleh melalui metode semi quantitative food frequency questionnaire. Status gizi diperoleh dengan mengukur berat badan menggunakan alat timbangan injak digital dan mengukur tinggi badan menggunakan alat microtoise. Rata-rata asupan karbohidrat responden sebesar 375,4 gram dimana sebanyak 29,7% memiliki asupan karbohidrat kurang dan 70,3% termasuk kategori asupan karbohidrat baik. Rata-rata z-score IMT/U -0,166 SD. Sebanyak 2,7% termasuk sangat kurus, 5,4% kurus, 70,3% normal, 13,5% gemuk dan 8,1% obesitas. Rata-rata skor kebugaran sebesar 14,9 (range 5-20), artinya rata-rata termasuk kategori baik. Sebanyak 13,5% termasuk kategori kurang dan 86,5% termasuk kategori baik. Hasil uji statistik Spearman Rank Test menunjukkan terdapat hubungan antara asupan karbohidrat (p=0,038 dan r=0,342) dan status gizi (p=0,025 dan r= -0,367) dengan tingkat kebugaran. Kesimpulan dari penelitian ini adalah asupan karbohidrat dan status gizi berhubungan dengan kebugaran jasmani atlet basket remaja. Atlet basket remaja disarankan untuk mencukupi asupan karbohidrat dan menjaga status gizinya pada kategori normal agar memiliki kebugaran jasmani yang baik. Kata kunci: karbohidrat, kebugaran jasmani, status gizi ABSTRACT Good physical fi tness in athletes is essential in order to

Background: Indonesia ranks fifth in terms of the number of stunted children and there has been little change in the stunting prevalence in the last decade. In earlier observational studies conducted in 2014-2015, we identified several key underlying problems with the potential to impact stunting in Sumedang district, West Java, Indonesia. Deficits in intakes of growth-limiting micronutrients were observed, most notably calcium, iron, zinc, and vitamin A, emphasizing the need for a food-based intervention to overcome these micronutrient deficits in the diets of mothers and their infants. Methods: A double-blind placebo-controlled cluster randomised trial comparing the effect of daily consumption of 75 grams of locally produced micronutrient-enriched crackers (MEC) (intervention group) compared to placebo crackers (control group) by mothers at two-time intervals: (i) from the 8-14 weeks of pregnancy to delivery (i.e., 28-34 weeks of consumption of MEC) on birth length, and (ii) from the 8-14 weeks of pregnancy to 5 months post-partum on attained linear growth and linear growth velocity of breast-fed infants. A total of 324 pregnant women from 28 clusters (villages) located in 3 sub-districts in Sumedang district, West Java, Indonesia, will be randomly assigned to either intervention (n=14 villages) or control (n=14 villages). Discussion: This will be the first study in Indonesia to use crackers based on powdered eggshells and chicken liver, in a form which is acceptable, safe, and has a long shelf life. If daily consumption of MEC for 6 months during pregnancy can enhance birth length, or their continued daily consumption for 5 months postpartum improves both attained and incremental linear growth at 5 months of age, then scaling-up in Indonesia may be considered. Trial Registration: https://clinicaltrials.gov/ct2/show/NCT04564222; 25th September 2020