1.Soy flour snack bars lower glycaemic response in type 2 diabetes mellitus subjects: A randomised cross-over design
Naufal Muharam Nurdin ; Hana Fitria Navratilova ; Karina Rahmadia Ekawidyani ; Mohamad Yulianto Kurniawan
Malaysian Journal of Nutrition 2022;28(No.2):163-175
Introduction: Low glycaemic snacks may help to improve blood glucose control.
However, data on the effect of soybean snack bars on postprandial glucose levels
of the diabetic population is scarce. Therefore, the current study aimed to examine
the effect of consuming soy flour snack bars on glycaemic response (GR) over a
180-minute period in individuals with diabetes by estimating postprandial glucose
levels variation and total area under the curve (AUC). Methods: Nine subjects (age:
54.6±4.0 years; BMI: 25.0±2.5 kg/m2) with type 2 diabetes mellitus (T2DM) diagnoses
without complication enrolled in this randomised, open-label, cross-over trial. On
three separate sessions, they consumed glucose standard solution, soy flour snack
bar (SF), and wheat flour snack bar (WF) containing 25 g of available carbohydrate,
respectively. Finger prick capillary method was executed to measure blood glucose
levels at 30, 60, 90, 120, 150, 180 minutes after test product ingestion. Results:
Overall, significantly lower postprandial glucose levels were observed at 30, 60, 90,
and 120 minutes (122.3±17.6, 136.3±24.9, 125.7±25.3, and 107.2±24.1 mg/dL;
p<0.001) in those who consumed SF snack bars than WF snack bars (147.9±41.3,
168.0±43.6, 152.6±30.0, and 140.6±33.4 mg/dL). The AUC level after the ingestion
of SF snack bar was 2044.8±503.1 mg.min/dL, >20% lower compared to ingestion
of WF snack bar (4735.0±666.8 mg.min/dL), p<0.001. These glycaemic control
benefits can be explained due to the high fibre and protein content linked to the
physicochemical properties of SF. Conclusion: With high nutritional properties, SF
snack bar has a low GR and might help control blood glucose in T2DM subjects.
2.Barriers of Implementing a Nutrition Education Program for Adolescents in Rural Indonesian Schools
Purnawati Hustina Rachman ; Anna Vipta Resti Mauludyani ; Karina Rahmadia Ekawidyani ; Judhiastuty Februhartanty
Malaysian Journal of Medicine and Health Sciences 2020;16(Supp 6, Aug):34-45
Introduction: Nutrition education (NE) is a promising intervention in promoting behavior change. However, in developing countries where it is not included in the national curriculum, many barriers arise. The study aimed to explore the teachers’ perceived barriers of implementing a nutrition education program for adolescents in rural Indonesian schools. Methods: A qualitative participatory action research approach was applied in three selected schools in Bogor, Indonesia. Focus group discussion was used as the main method of data collection, involving 12 teachers who have implemented the Health and Nutrition Program for Adolescents. Triangulation was conducted through observation and feedback questionnaire from students. Data from multiple sources were coded, categorized, and thematically analyzed. Results: Three themes and six subthemes emerged, these include 1) capacity of teachers (lack of training and lack of nutrition knowledge), 2) school support (time constraints and lack of funding), and 3) external environment (unhealthy street vendors and parent’s lack of nutrition awareness). These identified barriers could be minimized by establishing a strong commitment of school principals, the inclusion of street-food vendors and parents, and also ensuring sufficient training of teachers. Conclusion: This study highlights the need for schools and program implementers to identify potential barriers prior to commencing NE and also strengthen opportunities within it. The barriers found in this study emphasizes the need for advocacy, sufficient training of teachers, and consideration of the external food environment. Further studies are suggested to confirm these findings, involving more informants and different settings, such as in the urban population.