The Importance of Nutritional Intake to Prevent Stunting

Stunting problem is still major issue in Indonesia. Based on Riset Kesehatan Dasar (Riskesdas) / Basic Health Research, in 2018, the prevalence of stunting in Indonesia reached 30,8%. Even though this number is lower than in 2013, which is about 37,2%, this number is still considered to be high as it exceeds the threshold from WHO, 20%.

Dr. dr. Dian Novita Chandra, M. Gizi, a lecture from Medical Nutrition Deparment FMUI, said that stunting is a condition when the growth of a child is restricted due to chronic manifestation of malnutrition or experiencing malnutrition for quite a long time.

“Stunting indicators are assessed based on height/body length to age based on a standard growth curve according to sex. A child is categorized to be stunted if their height index to age is less than minus two standard deviations from the median growth standard curve.” She said

The characteristics of a child who is categorized for stunting include the increase in height is not in accordance with the standard growth curve based on age and sex. In other words, his height is shorter than other children with his age in the same population or the rate of height increase slower than other children with his age in the same population. Therefore, the child’s growth and development must be monitored and measured in height every month until the age of two years. Monitoring is then continued periodically for 6-12 months after two years old.

The Cause of Stunting

The risk of stunting is multifactorial. The main cause is chronic malnutrition the first 1.000 days of life, since the conception until 2 years of age. Malnutrition can be in the form of a lack of food intake or poor food quality, such as lack of food variety. Other factors that play a role in the risk of stunting include maternal health during pregnancy, parenting and child health or the frequency of experiencing infectious diseases, socio-economic conditions and the environment.

“Infectious diseases can reduce the absorption of nutrients from the intestine, direct loss of nutrients (for example in diarrhea), and increase the need for nutrients for recovery so that nutrients are not used for growth,” said dr. Dian.

Stunting will certainly have a negative impact on a child, both in short-term and long-term. Children with chronic malnutrition early in life, their brain development is hampered. Thus, their intelligence and educational performance will later be less than normal children. In addition, height growth and muscle composition of the body will also be hampered which will ultimately reduce the body’s immune system (easily got sick) and work performance in adulthood.

Lack of energy and nutrients will also force the body’s metabolic processes to adapt. Hence, it increases the risk of getting metabolic diseases in adulthood, such as diabetes, obesity, and high blood pressure. In conclusion, stunting will have a major negative impact on children’s the quality of life in their adult life.

The Prevention of Stunting

Fulfillment of nutrition, especially in the first 1,000 days of life, is the first attempt to avoid stunting. The fulfillment of these nutrients includes nutrition during pregnancy and childhood until the age of two years. The health of pregnant women and children should also be maintained by applying a healthy life style, thus it may reduce the possibility of getting infection in pregnancy and during childhood.

Regular monitoring of the child’s growth and development is also important. Since pregnancy, every month after birth until two years old, and every 6-12 months after 2 years old. With this, delay development could be detected and prevented.

“It should also be remembered that all nutrients essential for growth and development of a child. This is especially protein, and other micronutrients such as zinc, iodine, iron, vitamin A, vitamin D, vitamin B12, folic acid. Energy needs is also must be fulfilled. Thus, the protein is not used as an energy source by the body and can be used for growth. In addition, it is important to pay attention to the quality and diversity of the nutrients to ensure all requirement nutrition fulfilled. “explained dr. Dian.

Nowadays, handling stunting in Indonesia is not easy. The multifactorial risk makes it a challenge for the stunting alleviation program. A recent study found that mothers’ height is one of the factors which plays a role in development of stunting.

“Considering that the nutrition of the first 1,000 days of life is crucial since the beginning of pregnancy, while we do not know exactly when the pregnancy will be occurred, then a good nutritional intake throughout the lifetime is important. It is also necessary to do nutrition intervention for adolescent girls. Since adolescence period is the last rapid growth in human, it is hoped that in adulthood, the girls will reach optimal height. In addition, nutritional intervention is also needed for women who are less than 150 cm and is already married. Thus, the nutrient intake of her child is fulfilled since the beginning of pregnancy.” Closed dr. Dian.

(Public Relations of FMUI)