Hubungan antara Asupan Asam Lemak Tidak Jenuh Ganda pada Ibu Menyusui, Kandungannya dalam ASI dan Lingkar Kepala Bayi: Studi pada Periode Awal Postpartum
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Latar Belakang: Tercukupinya kebutuhan asupan asam lemak tidak jenuh ganda (polyunsaturated fatty acids, PUFA) ibu menyusui diketahui memiliki peran penting dalam mendukung pertumbuhan dan perkembangan otakbayi. Peran asupan PUFA ibu menyusui dalam mendukung tumbuh kembang bayi adalah melalui perantara ASI. ASI merupakan sumber utama zat gizi bayi baru lahir, salah satunya adalah PUFA. Studi menunjukkan bahwa asupan PUFA ibu menyusui di Kota Bogor masih sangat rendah terutama EPA dan DHA. Rendahnya asupan PUFA ibu menyusui diduga berpengaruh terhadap pertumbuhan otak bayi yang dalam penelitian ini diestimasi dengan ukuran lingkar kepala.
Tujuan: Penelitian ini bertujuan menganalisis hubungan asupan PUFA ibu menyusui dengan kandungan PUFA ASI dan lingkar kepala bayi baru lahir.
Metode: Analisis data sekunder menggunakan data hasil penelitian hibah BASF South East Asia yang telah dilakukan pada bulan April-Oktober tahun 2018 di Kota Bogor oleh tim SEAFAST CENTER IPB. Subyek merupakan ibu ibu menyusui berusia 18-45 tahun yang melahirkan bayi tunggal . Total terdapat 79 data ibu dan bayinya yang meliputi data asupan PUFA saat menyusui , kandungan PUFA ASI, lingkar kepala bayi, karakteristik ibu dan bayinya, kondisi sosial-ekonomi ibu, dan IMT pra-hamil. Analisis data dilakukan menggunakan uji korelasi Spearman.
Hasil: Rata-rata asupan PUFA ibu saat menyusui tergolong rendah (< 80% tingkat kecukupan) serta belum memenuhi rekomendasi asupan PUFA. Asupan LA ibu berhubungan signifikan positif dengan kandungan LA ASI (p = 0,012), sedangkan asupan ALA ibu memiliki hubungan signifikan negatif dengan kandungan ALA ASI (p = 0,027). Lingkar kepala bayi tidak berhubungan signifikan dengan asupan ibu saat menyusui dan kandungan PUFA ASI (p > 0,05).
Kesimpulan: Asupan PUFA ibu menyusui tidak berhubungan dengan kandungan PUFA ASI dan lingkar kepala bayi.
Calder, P. C. Functional Roles of Fatty Acids and Their Effects on Human Health. J. Parenter. Enter. Nutr. 39, 18S-32S (2015).
Moghadasian, M. H. & Shahidi, F. Fatty Acids. International Encyclopedia of Public Health vol. 3 (Elsevier, 2016).
Brown, J. E. Nutrition Through the Life Cycle, 4th Ed. Fluoride (Wadsworth Cengage Learning, 2011).
Catena, A. et al. On the relationship between head circumference, brain size, prenatal long-chain PUFA/5-methyltetrahydrofolate supplementation and cognitive abilities during childhood. Br. J. Nutr. 122, S40–S48 (2019).
Innis, S. M. Impact of maternal diet on human milk composition and neurological development of infants. Am. J. Clin. Nutr. 99, 734–741 (2014).
Innis, S. M. Maternal Nutrition, Genetics, and Human Milk Lipids. Curr. Nutr. Rep. 2, 151–158 (2013).
Anindya, I. G., Salimo, H. & Retno Dewi, Y. L. Hubungan Pemberian Asi Eksklusif Dan Status Gizi Ibu Dengan Pertumbuhan Lingkar Kepala Bayi Usia 6 Bulan. Amerta Nutr. 3, 263 (2019).
Silva, L. M. et al. Mother's educational level and fetal growth: The genesis of health inequalities. Int. J. Epidemiol. 39, 1250–1261 (2010).
Sutan, R. et al. Trend of head circumference as a predictor of microcephaly among term infants born at a regional center in Malaysia between 2011-2015. Res. Reports Neonatol. 8, 9–17 (2018).
Veena, S. R. et al. Higher maternal plasma folate but not vitamin B-12 concentrations during pregnancy are associated with better cognitive function scores in 9- to 10- year-old children in South India. J. Nutr. 140, 1014–1022 (2010).
Jensen, R. B., Juul, A., Larsen, T., Mortensen, E. L. & Greisen, G. Cognitive ability in adolescents born small for gestational age: Associations with fetal growth velocity, head circumference and postnatal growth. Early Hum. Dev. 91, 755–760 (2015).
Lauritzen, L. et al. DHA effects in brain development and function. Nutrients 8, 1–17 (2016).
Bernard, J. Y. et al. Breastfeeding, Polyunsaturated Fatty Acid Levels in Colostrum and Child Intelligence Quotient at Age 5-6 Years. J. Pediatr. 183, 43-50.e3 (2017).
Eriksen, K. G., Christensen, S. H., Lind, M. V. & Michaelsen, K. F. Human milk composition and infant growth. Curr. Opin. Clin. Nutr. Metab. Care 21, 200–206 (2018).
Bzikowska-Jura, A. et al. Maternal nutrition and body composition during breastfeeding: Association with human milk composition. Nutrients 10, 1379 (2018).
Nahrowi, N. S. Keragaman kandungan asam lemak esensial asi dan tingkat kecukupannya pada bayi di indonesia. (Institut Pertanian Bogor, 2015).
Segura, S. A., Ansótegui, J. A. & Marta Díaz-Gómez, N. The importance of maternal nutrition during breastfeeding: Do breastfeeding mothers need nutritional supplements? An. Pediatr. 84, 347.e1-347.e7 (2016).
Aumeistere, L., CiproviÄa, I., Zavadska, D. & Volkovs, V. Fish intake reflects on DHA level in breast milk among lactating women in Latvia. Int. Breastfeed. J. 13, (2018).
Nishimura, R. Y., De Castro, G. S. F., Jordí£o, A. A. & Sartorelli, D. S. Breast milk fatty acid composition of women living far from the coastal area in Brazil. J. Pediatr. (Rio. J). 89, 263–268 (2013).
Kim, H. et al. Breast milk fatty acid composition and fatty acid intake of lactating mothers in South Korea. Br. J. Nutr. 117, 556–561 (2017).
Yustiani. Asupan dan Status Asam Lemak Tak Jenuh Ganda pada Ibu Hamil Kaitannya dengan Status Gizi Bayi Baru Lahir dan ASI di Kota Bogor. (Institut Pertanian Bogor, 2019).
Badan Pengawasan Keuangan dan Pembangunan. Peraturan Pemerintah Republik Indonesia No. 47 Tahun 2008. (2008).
Badan Pusat Statistik. Berita Resmi Statistik: Profil Kemiskinan di Indonesia Maret 2019. (2019).
Departemen Kesehatan RI. Pedoman praktis memantau status gizi orang dewasa. (Departemen Kesehatan RI, 1994).
Kementerian Kesehatan RI. Buku Saku Pelayanan Kesehatan Neonatal Esensial. (Kementerian Kesehatan RI, 2010).
Kementerian Kesehatan RI. Peraturan Menteri Kesehatan No. 28 Tahun 2019 tentang Angka Kecukupan Gizi yang Dianjurkan untuk Masyarakat Indonesia. (Kementerian Kesehatan RI, 2019).
Food and Agriculture Organization. Fats and fatty acids in human nutrition. Report of an expert consultation. FAO Food Nutr. Pap. 91, 1–166 (2010).
Forsyth, S., Gautier, S. & Salem, N. Global estimates of dietary intake of docosahexaenoic acid and arachidonic acid in developing and developed countries. Ann. Nutr. Metab. 68, 258–267 (2016).
Sulaeman, A; Hardinsyah; Setiawan, B; Mulyani, R. Kandungan Asam Lemak Pangan Indonesia. (2015).
Food Standard Australia and New Zealand. NUTTAB 2010. https://www.foodstandards.gov.au/science/monitoringnutrients/afcd/Pages/downloadableexcelfiles.aspx (2011).
Food Standard Australia and New Zealand. AUSNUT 2011-13 food nutrient database. https://www.foodstandards.gov.au/science/monitoringnutrients/ausnut/ausnutdatafiles/Pages/foodnutrient.aspx.
Patra, K., Greene, M. M., Patel, A. L. & Meier, P. Maternal Education Level Predicts Cognitive, Language, and Motor Outcome in Preterm Infants in the Second Year of Life. Am. J. Perinatol. 33, 738–744 (2016).
Qian, J., Chen, T., Lu, W., Wu, S. & Zhu, J. Breast milk macro- and micronutrient composition in lactating mothers from suburban and urban Shanghai. J. Paediatr. Child Health 46, 115–120 (2010).
De La Garza Puentes, A. et al. The effect of maternal obesity on breast milk fatty acids and its association with infant growth and cognition-The PREOBE follow-up. Nutrients 11, 2154 (2019).
Liu, G. et al. Relationship between polyunsaturated fatty acid levels in maternal diets and human milk in the first month post-partum. J. Hum. Nutr. Diet. 29, 405–410 (2016).
Huffman, S. L., Harika, R. K., Eilander, A. & Osendarp, S. J. M. Essential fats: How do they affect growth and development of infants and young children in developing countries? A literature review. Matern. Child Nutr. 7, 44–65 (2011).
Urwin, H. J. et al. Immune factors and fatty acid composition in human milk from river/lake, coastal and inland regions of China. Br. J. Nutr. 109, 1949–1961 (2013).
Floris, L. M., Stahl, B., Abrahamse-Berkeveld, M. & Teller, I. C. Human milk fatty acid profile across lactational stages after term and preterm delivery: A pooled data analysis. Prostaglandins Leukot. Essent. Fat. Acids 156, (2020).
Wu, K. et al. Fatty acid positional distribution (sn-2 fatty acids) and phospholipid composition in Chinese breast milk from colostrum to mature stage. Br. J. Nutr. 121, 65–73 (2019).
Kilari, A. S. et al. Long chain polyunsaturated fatty acids in mothers and term babies. J. Perinat. Med. 37, 513–518 (2009).
Kawabata, T. et al. Polyunsaturated fatty acid levels in maternal erythrocytes of japanese women during pregnancy and after childbirth. Nutrients 9, 245 (2017).
Ferreira, H. D. S., Xavier Júnior, A. F. S., De Assunçí£o, M. L., Dos Santos, E. A. & Horta, B. L. Effect of breastfeeding on head circumference of children from impoverished communities. Breastfeed. Med. 8, 294–301 (2013).
Nellhaus, G. Head Circumference from Birth to Eighteen Years: Practical Composite International and Interracial Graphs. 41, 106–114 (1968).
Chang, C.-Y., Ke, D.-S. & Chen, J.-Y. Essential fatty acids and human nutrition. Acta Neurol Taiwan 18, 231–241 (2009).
Michaelsen, K. F. et al. Food sources and intake of n-6 and n-3 fatty acids in low-income countries with emphasis on infants, young children (6-24 months), and pregnant and lactating women. Matern. Child Nutr. 7, 124–140 (2011).
Brenna, J. T. & Lapillonne, A. Background paper on fat and fatty acid requirements during pregnancy and lactation. Ann. Nutr. Metab. 55, 97–122 (2009).
Catalano, P. & Demouzon, S. H. Maternal obesity and metabolic risk to the offspring: Why lifestyle interventions may have not achieved the desired outcomes. Int. J. Obes. 39, 642–649 (2015).
Glaser, C., Lattka, E., Rzehak, P., Steer, C. & Koletzko, B. Genetic variation in polyunsaturated fatty acid metabolism and its potential relevance for human development and health. Matern. Child Nutr. 7, 27–40 (2011).
Barrera, C. et al. The impact of maternal diet during pregnancy and lactation on the fatty acid composition of erythrocytes and breast milk of chilean women. Nutrients 10, (2018).
Moltó-Puigmartí, C. et al. FADS1 FADS2 gene variants modify the association between fish intake and the docosahexaenoic acid proportions in human milk. Am. J. Clin. Nutr. 91, 1368–1376 (2010).
Antonakou, A. et al. Erratum to: Breast milk fat concentration and fatty acid pattern during the first six months in exclusively breastfeeding Greek women (Eur J Nutr, (2013), 52, (963-973), 10.1007/s00394-012-0403-8). Eur. J. Nutr. 55, 2177 (2016).
Marc, I. et al. Early docosahexaenoic acid supplementation of mothers during lactation leads to high plasma concentrations in very preterm infants. J. Nutr. 141, 231–236 (2011).
Collins, C. T. et al. Pre- and post-term growth in pre-term infants supplemented with higher-dose DHA: A randomised controlled trial. Br. J. Nutr. 105, 1635–1643 (2011).
Delgado-Noguera, M. F., Calvache, J. A., Bonfill Cosp, X., Kotanidou, E. P. & Galli-Tsinopoulou, A. Supplementation with long chain polyunsaturated fatty acids (LCPUFA) to breastfeeding mothers for improving child growth and development. Cochrane Database Syst. Rev. 2015, (2015).
Meldrum, S. J. et al. Determinants of DHA levels in early infancy: Differential effects of breast milk and direct fish oil supplementation. Prostaglandins Leukot. Essent. Fat. Acids 86, 233–239 (2012).
Makrides, M., Smithers, L. G. & Gibson, R. A. Role of long-chain polyunsaturated fatty acids in neurodevelopment and growth. in Nestle Nutrition Workshop Series: Pediatric Program vol. 65 123–136 (Nestle Nutr Workshop Ser Pediatr Program, 2010).
Herba, C. M. et al. Breastfeeding and early brain development: The Generation R study. Matern. Child Nutr. 9, 332–349 (2013).
Van de Lagemaat, M., Rotteveel, J., Muskiet, F. A. J., Schaafsma, A. & Lafeber, H. N. Post term dietary-induced changes in DHA and AA status relate to gains in weight, length, and head circumference in preterm infants. Prostaglandins Leukot. Essent. Fat. Acids 85, 311–316 (2011).
Heaton, A. E., Meldrum, S. J., Foster, J. K., Prescott, S. L. & Simmer, K. Does docosahexaenoic acid supplementation in term infants enhance neurocognitive functioning in infancy? Front. Hum. Neurosci. 7, (2013).
Caspi, A. et al. Moderation of breastfeeding effects on the IQ by genetic variation in fatty acid metabolism. Proc. Natl. Acad. Sci. U. S. A. 104, 18860–18865 (2007).
Ronnenberg, A. G. et al. Low Preconception Body Mass Index Is Associated with Birth Outcome in a Prospective Cohort of Chinese Women. J. Nutr. 133, 3449–3455 (2003).
Voss, W., Jungmann, T., Wachtendorf, M. & Neubauer, A. P. Long-term cognitive outcomes of extremely low-birth-weight infants: The influence of the maternal educational background. Acta Paediatr. Int. J. Paediatr. 101, 569–573 (2012).
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