Determinant of Nutritional Status Children

Kuat Sitepu

, Tati Murni Karokaro

, Sari Desi Esta Ulina Sitepu

, Isidorus Jehaman

, and Luci Riani

Br Ginting

Faculty of Nursing and Physiotherapy, Institut Kesehatan Medstra Lubuk Pakam, Indonesia

Faculty, Of Public Health, Institut Kesehatan Medstra Lubuk Pakam, Indonesia

Keywords: Patterns of care, Nutritional status, Toddlers and Nutrient intake.

Abstract: Based on the results of Nutritional Status Monitoring (PSG) in South Tapanuli known nutritional status based

on BB / U = 10.95% poor, 18.9% less, 62.7% good and 7.5% more. Based on the results of Nutritional Status

Monitoring (PSG) in South Tapanuli known nutritional status based on BB / U = 10.95% poor, 18.9% less,

62.7% good and 7.5% more. Based PB / U = 32.3% is very short, 17.9% short, normal 41.3, and 8.5% higher.

Based W / H = 6.9% very Skinny, 8.5% underweight, 64.5% normal, 20.0% fat. This study aims to be analyzed

the determinants of nutritional status of infants in Sipirok District, conducted on May 2017 to September

2017, with the type of survey research with cross sectional study design. The collection of data by

questionnaire and observation sheet. Data were analyzed using Chi-square tests at 95% confidance (α =0,05).

The results obtained by the value of p = (0, 003; 0,000; 0.003; 0.021; 0.009; 0.003; 0.039) <0.05 means that

there is a significant relationship between knowledge of maternal nutrition, mother's occupation, family

income, number of children, history of infectious diseases, nutritional intake, and maintain the nutritional

status of infants. The Head of Puskesmas (public center) Sipirok South Tapanuli, to conduct surveillance

activities and the development of integrated health and should be more often socialized. Encourages mothers

to brought infants to routine IHC and pay attention to the cleanliness of the baby to avoid infectious diseases.

1 INTRODUCTION

The aim of health development towards Healthy

Indonesia 2025 is to increase awareness, willingness

and ability to live healthy for everyone so that the

highest degree of public health can be realized,

through the creation of the people, nation and State of

Indonesia, which is characterized by its population

living with behavior and in the environment healthy

has the ability to reach quality health services, fairly

and equally, and the highest degree of health in all

regions of the Republic of Indonesia (Kemenkes RI),

2017).

Nutrition is one of the most important factors for

the health of an individual or society, because

nutrition has a direct effect on growth, development,

reproduction, and both physically and mentally.

Nutrient deficiency will have very big impact on

growth and development, especially children under

five. In infants who are severely malnourished (poor)

will be able to reduce the Intelligence Question (IQ)

and cause death. Chronic malnutrition from the fetus

to infancy can cause stunted (Sarah E. C., Michael K.

G., 2017. According to UNICEF - WHO - The World

Bank Joint Child Malnutrition Estimates in 2012, an

estimated 165 million children under the age of five

worldwide stunted decreased compared with as many

as 253 million in 1990. The nutritional status of

children under five was measured by age, body

weight (BB) and height (TB). Age, weight and TB

variables are presented in the form of three

anthropometric indicators, namely: body weight

according to age (BW / U), height by age (TB / U),

and weight by height (BW / TB).

According to RISKESDAS 2018, there were

19.6% of malnourished children under five consisting

of 5.7% of underfives with malnutrition and 13.9%

underweight. 4.5% of children under five with over

nutrition. When compared with the national

prevalence rate 2007 (18.4%) and 2010 (17.9%), the

prevalence of malnutrition in infants 2013 was

increase. Underfives of malnutrition in 2010

consisted of 13.0% of under-fives with malnutrition

status and 4.9% of under-nutrition status. The

changes are mainly in the prevalence of malnutrition,

from 5.4% in 2007, 4.9% in 2010, and 5.7% in 2013.

To achieved the MDG target in 2015, which is 15.5%,

Sitepu, K., Karokaro, T., Sitepu, S., Jehaman, I. and Ginting, L.

Determinant of Nutritional Status Children.

DOI: 10.5220/0009470002110219

In Proceedings of the International Conference on Health Informatics and Medical Application Technology (ICHIMAT 2019), pages 211-219

ISBN: 978-989-758-460-2

211

the prevalence of malnutrition-less nationally should

be reduced by 4.1% in the period 2013 to 2015. The

prevalence of underfives nutritional status based on

weight / U North Sumatra, namely: poor nutrition =

8.3%, malnutrition = 14.1%, good nutrition = 72.8%

and more nutrition = 4.8%, Kementerian Kesehatan

RI. (2016).

Other nutritional status indicators, namely height

by age (TB / U) give an indication of chronic

nutritional problems as a result of a long-standing

condition. For example: poverty, unhealthy behavior,

and poor parenting / feeding from the time the child

is born which results in the child becoming short.

Nutritional status indicators based on the BB / TB

index give an indication of acute nutritional problems

as a result of events that occur in a short time. For

example: there is an epidemic of disease and lack of

food (starvation) which causes the child become thin.

BB / TB and BMI / U indicators can be used to

identify thin and fat. The problems with thinness and

fat at an early age can result in the risk of various

degenerative diseases in adulthood Kementerian

Kesehatan RI. (2016), there were 37.2% of children

under five with below normal height which consisted

of 18.0% short toddlers and 19.2% of short toddlers.

Compared to 2010, there was an increase in the

percentage of short and very short toddlers in 2013

from 35.6% to 37.2%. 2013 the prevalence of short

showed a decrease, from 18.8% in 2007 and 18.5% in

2010. Short prevalence increased from 18.0% in 2007

to 19.2% in 2013. Prevalence of underfive nutritional

status based on TB / U North Sumatra, namely: very

short = 22.7%, short = 19.8%, and normal = 57.5%,

Kementerian Kesehatan RI (2016).

Another anthropometric indicator to assess the

nutritional status of children under five is body

weight according to height (BB / TB). In 2013 there

were 12.1% underfive wasting (6.8) consisting of

6.8% underfive and 5.3% very thin. This figure

decreased compared to 2010 with a percentage of

13.3%. The prevalence of thin nationally in 2013 was

still quite high at 5.3%, a decrease compared to 2010

(6.0%) and 2007 (6.2%). Likewise, the thin

prevalence of 6.8 percent also showed a decrease of

7.3 percent (in 2010) and 7.4% (in 2007). Prevalence

of underfive nutritional status based on TB / BB in

North Sumatra, namely: very thin = 12.8%, thin =

72.2%, normal = 7.4% and fat = 7.5%, Kementerian

Kesehatan RI (2016).

Other factors that influence the nutritional status

of children include family economic factors that

affect diet and nutritional adequacy of children;

socio-cultural factors that put the interests of pregnant

women and nursing mothers after the interests of the

father as head of the family, and the child; generally

low educational factors so that the impact on the

mother's limited knowledge about healthy lifestyles

and the importance of nutrients for health and

nutritional status of children.

According to Hardiansyah (2017), one of the

factors that can influence PEM is that mothers who

receive permanent work must leave their toddlers

from morning to evening, toddlers are forced to be

left at home so that they get sick and do not get

attention, and feeding is not done properly.

In the period from 2007 to 2012, South Tapanuli

Regency was one of the biggest contributors to the

prevalence of malnutrition children under five in

Indonesia. From the results of Nutrition Status

Monitoring (PSG) in 2012 it was found that the

nutritional status of children under five based on BB

/ U = 10.95% was poor, 18.9% was lacking, 62.7%

was good and 7.5% was more. Based on PB / U =

32.3% it is very short, 17.9% is short, 41.3 is normal,

and 8.5% is high. Based on body weight / TB = 6.9%

very thin, 8.5% thin, 64.5% normal, 20.0% fat.

Based on the impact caused by malnutrition status

and malnutrition status in South Tapanuli Regency

must be intervened appropriately and focus on the

main or dominant causative factors. The purpose of

this study was to determine the influence of

determinants (maternal nutritional knowledge,

mother's occupation, family income, number of

children, history of infectious diseases, nutrient

intake, and parenting patterns) on nutritional status of

children under five in Sipirok, South Tapanuli

Regency in 2017.

2 RESEARCH METHODS

Research design is a survey with the design of the

implementation of this study with cross-sectional

study or cross section, which was conducted on May

2017 to September 2017. The population of this study

were all mothers of children under five (aged 1-5

years) in the District of Sipirok South Tapanuli

Regency is 2,433 people. Technique Sampling in this

study as research respondents with a sample

technique was proportional allocation. The number of

samples was 181 people. The data collection method

is carried out by weighing and asking the age of

children under five, observation sheet of nutrition

fulfillment using 24-hour recall method.

Classification of the adequacy level of nutritional

intake of infants, including: energy, fat, vitamins and

minerals, categorized as: 1) Good: 100% RDA; 2)

Medium: 80 - 90% RDA; 3) Less: 70 - 80% RDA;

ICHIMAT 2019 - International Conference on Health Informatics and Medical Application Technology

212

and 4) Deficit: <70% RDA. Whereas data collection

for independent variables on mother's nutritional

knowledge, mother's occupation, family income,

number of children, history of infectious diseases, and

patterns of parenting was done by giving a set of

written questions or questionnaires to mothers of

toddlers. In writing questions or statements on a

questionnaire according to Uma Sekaran (1992) in

Sugiyono (2017) must pay attention to the principles

of writing, measurement, and physical appearance. A

set of written questions or questionnaires are

presented in such a way that mothers of children

under five in Sipirok Subdistrict, South Tapanuli

Regency as respondents only give a check mark (√)

in the appropriate column or place called a closed

questionnaire, Arikunto, S. (2017).

The Data analysis used univariate analysis and

bivariate analysis. Univariate analysis aims to

determine the percentage description of each variable

both independent and dependent. While the bivariate

analysis was carried out to find out the correlation

between the independent variable and the dependent

variable, which will be tested with the Chi-square

statistical test, at a 95% degree of confidence that is α

= 0.05 with the provisions that if the value of p <0.05,

then there is an influence meaningful between the two

variables, Sastroasmoro, Ismael, (2016).

Interpretation of the correlation coefficient or the

strength of the relationship of each independent

variable with the dependent variable, is: if 0.00 -

0.199 means very low; if 0.20 - 0.399 means low; if

0.40 - 0.599 means medium; 0.60 - 0.799 means

strong; and 0.80 - 1,000 means very strong

Sastroasmoro, Ismael, (2016). Next, a multivariate

analysis was performed to find out which independent

variable was the most dominant influence on the

nutritional status of children under five in Sipirok

Subdistrict, South Tapanuli Regency, using multiple

logistic regression tests. The stages of the

multivariate analysis process are as follows: 1)

Inserting candidate variables in the multivariate

analysis process of multiple logistic regression by

selecting an independent variable that has a value of

p <0.25; 2) Analyze all independent variables

included in the modeling by issuing independent

variables that have a value of p 5 0.05 so that the

initial model is obtained with a determinant variable

that has a value of p <0.05; and 3) Multivariate test

results that have p <0.05 are the final model of

determining variables that affect the nutritional status

of children under five in Sipirok Subdistrict, South

Tapanuli Regency.

3 RESULTS AND DISCUSSION

The results of the study was based on the

characteristics of the disease children under five years

at the Sipirok Health Center in South Tapanuli

Regency, the most diarrhea were 90 people or 49.7%

of 181 respondents. Based on the sex of children

under five in the Sipirok Health Center in South

Tapanuli Regency, the majority were 105 women or

58.0%. Based on the level of parental education of

children under five in Sipirok Health Center, South

Tapanuli Regency, the highest number were 92

people in high schools or 50.8%. The results of

research conducted on 58 respondents, it appears that

there was a correlation between maternal nutritional

knowledge with nutritional status in infants in Sipirok

Subdistrict, South Tapanuli Regency, with a value of

p = 0, 003 <0.05 (Table. 1)

Table 1. The Correlation of Maternal Nutrition

Knowledge to Nutrition Status in News at South

Sipirok District of Tapanuli District

Variabel

Status Gizi

Total Nilai p Sangat

Kurang

Kurang Normal

Asupan

Gizi

n % n % n % n %

0,003

Kurang 16 9,9 17 9,4 32 17,7 65 37,0

Sedang 12 6,6 41

22,7

30 20,4 83 49,7

Baik 5 2,2 7 3,9 21 7,9 33 13,3

The level of knowledge of a person influences

attitudes and behaviors in food selection which will

ultimately affect the nutritional state of the individual

concerned Scaglioni, De Cosmi, Ciappolino, (2018).

Mother is a person who plays an important role in

determining the consumption of food in the family,

especially in children under five. Mother's knowledge

influences family food consumption patterns. Lack of

maternal knowledge about nutrition causes reduced

food diversity. The Families will buy more goods

because the influence of habits, advertising, and the

environment. In addition, nutritional disorders are

also caused by the lack of ability of mothers to apply

information about nutrition in daily life Aritonang,

Siregar, Nasution, (2016). Mother's knowledge is one

of the factors that influence toddlers nutrition and is

most easily intervened and measured. The

intervention can be in the form of counseling to

increase the mother's knowledge about toddlers

nutrition, especially regarding signs of illness in

children, feeding schedule for toddlers, kinds of

nutritious food, balanced types of food and the

benefits of food for toddlers.

Determinant of Nutritional Status Children

213

Beyond medical aspects, nutritional problems can

be caused by poverty, socio-culture, lack of

knowledge and understanding, food procurement and

distribution, and natural disasters Sarah E. C.,

Michael K. G., (2017). The problem of nutrition was

caused poverty is an indicator of the family's

economic level and the measure used is the poverty

line. The nutritional problem because of the socio-

cultural indicator was the stability of the family with

a measure of the frequency of marriage - divorce -

reconciliation, children born in unstable family

environments will be very vulnerable to malnutrition.

Also demographic indicators which include the

composition and pattern of population activities.

Nutrition problems due to lack of knowledge and

skills in the field of cooking, children's consumption,

diversity of ingredients, and diversity of dishes that

affect mental health, such as boredom. Nutrition

problems due to food procurement and distribution,

food supply indicators (food supply) which are

usually taken into account in the form of a food

balance, are translated into nutritional value and

compared with the average value of population

sufficiency. The results of this study are consistent

with the results of Puspasari and Andriani, research in

2017 in Tambak Wedi Health Center, Kenjeran

District, Surabaya City namely there is a correlation

between the level of maternal nutritional knowledge

and toddler eating patterns with the nutritional status

of toddlers.

The results of this study are consistent with the

results of Puspasari and Andriani, research in 2017 in

Tambak Wedi Health Center, Kenjeran District,

Surabaya City namely there was a correlation

between the level of maternal nutritional knowledge

and toddler eating patterns with the nutritional status

of toddlers. The results of this study doesn’t line with

the research of Haqiqih, Nuzrina, Bahar (2018), with

the title of the correlation of the level of family

income, education and knowledge with nutritional

status in toddlers in Parit Baru Village, Kubu Raya

Regency with the result that there was no significant

correlation between maternal knowledge and

nutritional status in toddlers ( p = 0.473). The results

of research conducted on 58 respondents, it appears

that there was a correlation between the work of

mothers with nutritional status in infants in Sipirok

Subdistrict, South Tapanuli Regency, with a value of

p = 0,000> 0.05.

Mother does not have much time to prepare food

and cause less attention and affection, so can affect

both nutritional status, parenting, and development in

infants. Conversely, a mother who is not working can

take good care of her child and express her love,

Setiyaningrum, (2017). The results of this study are

in line with the results of the 2005 Cindar Bumi study

on the influence of working mothers on the nutritional

status of children under five in Mangunjiwan, Demak

Regency in 2005, like working mothers will influence

the feeding patterns of their toddlers. There was a

positive relationship between the level of energy

consumption with the nutritional status of children

under five.

The results of this study are not in line with the

results of Adelina, Widajanti, Nugraheni, research in

2018, in Duren Health Center, Semarang Regency is

not related to the nutritional status of toddlers in farm

laborers' families. Likewise the results of the Pratasis,

Malonda, Kapantow research, 2018 in Ongkaw

Village, Kecamatan Sinonsa yang, Minahasa Selatan

District with a cross sectional design that found there

was no significant correlation between maternal work

and the nutritional status of children with a value of p

= 0.419.

Relationship of Family Income with Nutrition

Status in Toddlers in Sipirok Subdistrict, South

Tapanuli Regency, the results of research conducted

on 58 respondents, it appears that there was a

correlation between family income and nutritional

status of children under five in Sipirok Subdistrict,

South Tapanuli Regency, with a value of p = 0.003

<0.05.

According to Kemenkes, 2017 in the Value of

Children’s nutritional status, stated that family

income would affect the purchasing power of families

so that it would affect health status. The ability of

families to purchase foodstuffs, among others,

depends on the size of the family's income, the price

of the food itself, and the level of land and yard

resource management. Families limited income will

most likely be less able to meet their food needs in

accordance with the nutrients needed by the body.

The results of this study are in line with the results

of the Hidayah, Kasman, Mayasari, 2018, namely that

there was a There is a significant difference between

the nutritional status of the high income group and the

nutritional status of the low opinion group. High

income for families is a big fulfillment of nutrients to

families in toddlers in everyday life. The high income

needed will increase the purchasing power of the food

that will be paid for and is suitable for nutrients.

Ordinary Low Income no longer pays attention to

food spent by considering nutritional value, but

material value is more a consideration. But do not

close about low-income families can spend food that

has good nutritional value.

The results of this study are not in line with the

results of research Alamsyah, Mexitalia, Margawati,

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214

et all, 2017, there was no relationship between high

and low income with the nutritional status of toddlers.

Also the results of this study are not in line with the

research of Haqiqih, Nuzrina, Bahar 2018, with the

title of the relationship of family income level,

education and knowledge with nutritional status in

toddlers in Parit Baru Village, Kubu Raya Regency

with the result that there was no significant

relationship between the level of family income and

nutritional status at toddlers (p = 0.299). One of the

causes of the low nutritional status of children under

five starting at the age of 6 months is the start of

supplementary supplementary feeding at that age, so

the quality of food consumed by infants is very

dependent on their parents. One of the influencing

factors is the socio-economic condition of parents,

with limited economic conditions usually the

fulfillment of nutrition in infants is neglected. In this

study it was found that family expenditure was not

related to the nutritional status of children under five.

Hodder, R. K., Stacey, F. G., O'Brien, K. M., et

all, 2018 states that nutrition / food and nutritional

status are both influenced and caused by individual

household income. Nutritional status is also

influenced by the amount and type of food consumed,

as well as maternal knowledge that is still low on

health and nutrition.

The results of research conducted on 58

respondents, it appears that there was a correlation

between the number of children with nutritional status

in children under five in Sipirok Subdistrict, South

Tapanuli Regency, with a value of p = 0.021 <0.05.

According to Bengoa, which is a quote from

Gerritsen, S., Dean, B., Morton, S. M. B., & Wall, C.

R., 2017., malnutrition is an ecological problem as a

result of multiple overlapping. According to

Gerritsen, S., Dean, B., Morton, S. M. B., & Wall, C.

R., 2017., ecological factors related to the causes of

nutritional problems were divided into 6 (six) groups,

namely the state of infection, food consumption,

cultural, socio-economic influences, food production,

and health and education. For family conditions

starting from the size or number of family members,

the relationship and birth distance fall into a group of

socioeconomic factors (Aritonang, Siregar, Nasution,

2016).

The results of this study are also in line with the

results of the research of Nuriah, 2017, in Cilacap

Regency, that the number of family members is

related to the nutritional status of toddlers in farm

laborers' families. The results of this study are

supported by the research of Mutika, Syamsul, 2018,

on the Analysis of Problems with Malnutrition in

Toddlers in the Teupah Selatan Health Center in

Simeuleu Regency. In the study, it was found that

there was an influence of the number of children on

the Toddler Nutrition Status in the Work Area of

Payung Sekaki Health Center, Pekanbaru.

The results of research conducted on 58

respondents, it appears that there was a correlation

between the history of infectious diseases with

nutritional status in infants in Sipirok Subdistrict,

South Tapanuli Regency, with a p value = 0.009

<0.05. According to Andadari, Mahmudiono,

(2017),

the factors that cause malnutrition or that affect a

person's nutritional status directly are children's food

and infectious diseases that children may suffer from.

The emergence of malnutrition is not only due to lack

of food, but also because of disease. Children who get

good enough food, but are often attacked by diarrhea

or fever, can eventually suffer from malnutrition.

Likewise in children who eat not good enough, then

their immune system will weaken. In such

circumstances susceptible to infection that can reduce

appetite, and ultimately can suffer from malnutrition.

In fact both food and infectious diseases together are

causes of malnutrition. Infectious diseases greatly

affect the nutritional status of children under five.

Children who get enough food, but are often attacked

by infectious diseases can eventually be weakened so

that the body is so easily attacked by infectious

diseases Andadari, Mahmudiono,

(2017). The results

of this study are in line with the results of Nengsi,

Risma, research, 2017 about the Relationship of

Infectious Diseases and Nutritional Status of

Toddlers in the Work Area of Anreapi Health Center,

Polewali Mandar District, with the result that there is

a correlation between infectious diseases and

nutritional status in toddlers in the Anreapi Health

Center working area with a value of p = 0.027 <0 .5

The results of research conducted on 58

respondents, it appears that there is a relationship

between nutritional intake and nutritional status in

infants in Sipirok Subdistrict, South Tapanuli

Regency, with a p value = 0.003 <0.05. Food intake

is a direct cause of the nutritional status of children

under five (Matwiejczyk, L., Mehta, K., Scott, J., et

all, 2018). Research Aidid, Sulaiman and Syafruddin

S. 2017, on the Effects of Providing Healthy Food

Patterns on the Nutritional Status of Children of

Bunga Asya Kindergarten Students, found that the

application of healthy eating provisions for young

children is a very wise action, in addition to meeting

nutritional needs, food provision is a way avoid

snacks that are not necessarily healthy. The rise of the

use of hazardous chemicals in snacks, such as dyes,

flavorings to preservatives need to be aware of. One

Determinant of Nutritional Status Children

215

way to avoid unhealthy snacks by providing children

with healthy food.

The results of this study are consistent with the

opinion of the Ministry of KEMENKES RI, 2017

that, intake of consumption affects the nutritional

status of a person. Good nutritional status can be

achieved if the body gets enough nutrients to be used

efficiently, so as to enable physical growth, brain

development, to achieve optimal health levels. A

study conducted among indigenous children revealed

that daily energy and protein intake were below the

RDI (Recommended Daily Intake) and were

significantly associated with malnutrition (Rajoo Y,

Ambu S, Lim Y.A.L et al. 2017). The results of this

study are not in line with the results of the 2016 Adani,

Pangestuti, Rahfiludin research at Lusendra Children's

Daycare Park in Semarang There is no relationship

between carbohydrate intake, protein intake and fat

intake in Day Care with the nutritional status of infants

and toddlers (W / A, H / A, W / H). There is no

relationship between total carbohydrate intake, total

protein intake and total fat intake with the nutritional

status of infants and toddlers (W / A, H / A, W / H).

There is no relationship between carbohydrate

intake and nutritional status due to statistical test

results of p value of 0.642. The results of research

conducted on 58 respondents, it appears that there is

a relationship between parenting patterns and

nutritional status in toddlers in Sipirok Subdistrict,

South Tapanuli Regency, with a value of p = 0.039

<0.05.

According to Luque, V., Escribano, J., Closa-

Monasterolo, R., et all, 2018 parenting patterns are

the ability of families to provide time, attention and

support for toddlers to grow and develop as well as

physically, mentally and socially. Patterns of

parenting in the form of attitudes and other parenting

practices in proximity to children, caring, how to feed

and love. Based on this understanding parenting is

basically a practice carried out by older adults

towards infants associated with meeting the needs of

food / nutrition, basic care (including immunization,

treatment if sick), a proper home or place, personal

hygiene, environmental sanitation, clothing, physical

fitness Setiyaningrum, (2017). The role of parenting

children on nutritional status is very important. In the

UNICEF, 2019 inadequate care patterns are an

indirect cause of malnutrition. In this study it was

found that nutritional status is not influenced by

parenting. This is supported by Muslim research,

2008 that the pattern of feeding children depends on

eating habits, socio-economic conditions,

understanding and awareness about nutrition, and

local food supply. According to Carson, V., Lee, E.

Y., Hewitt, L., et all, 2017 parenting is a practice of

households that are required by the availability of

food and health care for the affordability of life,

growth, and development. The pattern of

psychosocial care for children in the form of the

attitude of the mother's treatment in terms of its

closeness to the child, providing food, caring,

maintaining health and hygiene, and giving love.

This is consistent with what was stated by Savoie-

Roskos, M. R., Wengreen, H., & Durward, C., 2017,

that the purpose of feeding children is to meet the

needs of sufficient nutrients in survival, recovery of

health that is sick, for activity, growth and

development. With preparation and feeding, children

are also educated so that they can receive, like, choose

good food and determine the amount of food that is

adequate and of good quality.

In Dariush Mozaffarian, 2018, it was stated that

children experience malnutrition due to lack of food

at the household level, ways of providing food that is

not good, and because children do not want to eat.

Children can refuse if the food served does not meet

their tastes. Therefore, parents must be democratic to

serve food that is the child's favorite.

The results of this study are in line with the results of

Gerritsen, S., 2016, there is a tendency for parenting

with nutritional status. The better parenting for

toddlers, the proportion of good nutrition in toddlers

will also be even greater. In other words, if the pattern

of care for children under five in the family is getting

better of course the level of consumption of toddler

food will also be better and will ultimately affect the

nutritional status of children

4 CONCLUSIONS

The results of the study concluded that the factors

significantly related to the nutritional status of

children under five in Sipirok Subdistrict, South

Tapanuli Regency were nutrition knowledge, work,

family income, number of children, nutrient intake,

parenting patterns, number of children. The

knowledge variable had an influence of 3,298 times

(95% Cl 1,626; 4,222) on nutritional status of

children under five in Sipirok Subdistrict, South

Tapanuli Regency. The results of this study indicate

the accident of malnutrition is higher. Therefore, the

incidence of malnutrition in this region needs to

receive serious attention from all elements of society,

government and health workers.

The results of this study hope to provide the

information to all elements of society including health

workers able to improve good nutrition programs for

ICHIMAT 2019 - International Conference on Health Informatics and Medical Application Technology

216

the community. We have to giving education and

socialization to the community regarding nutrition in

infants and changes the family behavior to nutrition

conscious families.

ACKNOWLEDGEMENTS

Thank you sent to:

• To all Sipirok Subdistricts, South Tapanuli

Regency who have agreed to become a research

sample, especially mothers who have children

under five.

• The head of the Tapanuli district government,

who has given the permission to carry out this

research in the Sipirok sub-district, South

Tapanuli district

• Head of Sipirok Puskesmas, Sipirok Subdistrict,

South Tapanuli Regency, who phallized the

study sample.

• Chancellor of the Medical Institute Medistra

Lubuk Pakam who has provided financial

support and facilities so that research can be

carried out properly and smoothly

REFERENCES

Adani, Pangestuti, Rahfiludin, 2016. Hubungan asupan

makanan (karbohidrat, protein dan lemak) dengan

status gizi bayi dan balita (studi pada taman penitipan

anak lusendra kota semarang tahun 2016). Jurnal

Kesehatan Masyarakat (e-Journal). Volume 4, Nomor

Adelina, Widajanti, Nugraheni, 2018. Hubungan

pengetahuan gizi ibu, tingkat konsumsi gizi, status

ketahanan pangan keluarga dengan balita stunting

(studi pada balita usia 24-59 bulan di wilayah kerja

puskesmas duren kabupaten semarang). Jurnal

Kesehatan Masyarakat (e-Journal). Volume 6, Nomor

Aidid, Sulaiman and Syafruddin S. 2017. Pengaruh

pemberian pola makanan sehat terhadap status gizi anak

anak didik TK Bunga Asya. Jurnal Scientific Pinisi,

Volume 3, Nomor 1

Alamsyah, Mexitalia, Margawati, et all, 2017. Beberapa

faktor risiko gizi kurang dan gizi buruk pada balita 12-

59 bulan (studi kasus di Kota Pontianak). Jurnal

Epidemiologi Kesehatan Komunitas..

Albino, J., & Tiwari, T., 2016. Preventing childhood caries:

A review of recent behavioral research. Journal of

Dental Research, 95 (1), 35-42

Andadari, Mahmudiono, 2017. Keragaman pangan dan

tingkat kecukupan energi serta protein pada balita

Annigan J, Media D., 2016. What Does Food Provide in the

Human Body. SF Gate.

Arikunto, S., 2017. Pengembangan instrumen penelitian

dan penilaian program.Yogyakarta: Pustaka Pelajar

Aritonang, Siregar, Nasution, 2016. The relationship of

food consumption and nutritional status on employee of

health polytechnic directorate health ministry Medan.

Vol.6, No. 1

Britto, P. R., Lye, S. J., Proulx, K., et al. (2017). Nurturing

care: Promoting early childhood development. Lancet,

389 (10064), 91-102.

Black, M. M., Walker, S. P., Fernald, L.C.H., et all., 2017.

Early childhood development coming of age: Science

through the life course. Lancet, 389 (10064), 77-90.

Byra, S., Zyta, A., & Cwirynkalo, K. (2017). Posttraumatic

growth in mothers of children with disabilities.

Supplement, 53, 15-27

Carson, V., Lee, E. Y., Hewitt, L., et all, 2017. Systematic

review of the relationships between physical activity

and health indicators in the early years (0-4 years).

BMC Public Health, 17 (Suppl 5), 854.

Dariush Mozaffarian, 2018. Role of government policy in

nutrition—barriers to and opportunities for healthier

eating

Didit D., Pritasari, Nugraheni T. L, 2017. Gizi dalam daur

kehidupan. Kementerian Kesehatan Republik

Indonesia,

Dinas Kesehatan Tapanuli Selatan, 2015. Profil Puskesmas

Sipirok Kabupaten Tapanuli Selatan Tahun 2015.

Tapanuli Selatan Dodds, S., 2016. Health and early

years, children and young people: A GCPH

synthesis.Glasgow: Glasgow Centre for Population

Health. Retrieved from

www.gcph.co.uk/assets/0000/5914/Health_and_Early_

Years_web.pdf.

Finch, M., Jones, J., Yoong, S., et all, 2016. Effectiveness

of centre-based childcare interventions in increasing

child physical activity: A systematic review and meta-

analysis for policymakers and practitioners. Obesity

Reviews, 17 (5), 412-428.

Figueroa, R., An, R.,2017. Motor skill competence and

physical activity in preschoolers: A review. Maternal

and Child Health Journal, 21(1), 136-146.

Gerritsen, S., Anderson, S. E., Morton, S. M., et all, 2018.

Pre-school nutrition-related behaviours at home and

early childhood education services: Findings from the

Growing Up in New Zealand longitudinal study. Public

Health Nutrition, 1-10.

Gerritsen, S., 2016. Nutrition education for early childhood

managers, teachers and nursery cooks: A prerequisite

for effective obesity prevention. Public Health, 140, 56-

58.

Gerritsen, S., Dean, B., Morton, S. M. B., & Wall, C. R.,

2017. Do childcare menus meet nutrition guidelines?

Quantity, variety and quality of food provided in New

Zealand Early Childhood Education services.

Australian and New Zealand Journal of Public Health,

41(4), 345-351.

GERMAS, 2018. Buku Saku. Pemantauan Status Gizi

(PSG). Kementerian Kesehatan Republik Indonesia.

Harti AS, dan Soebiyanto, 2017. Biokimia Kesehatan.

Jakarta: Trans Info Media.

Determinant of Nutritional Status Children

217

Hardiansyah, 2017. Ilmu Gizi Teori dan Aplikasi Original,

EGC, Yogyakarta.

Haqiqih, Nuzrina, Bahar 2018. Hubungan pengetahuan ibu,

status sosial ekonomi, pemberian asi eksklusif dan Mp-

Asi dengan status gizi anak usia 6-24 Bulan Di Desa

Gobang Kabupaten Bogor.

https://digilib.esaunggul.ac.id/

Hidayah, Kasman, Mayasari, 2018. Faktor-faktor yang

berhubungan dengan status gizi di wilayah kerja upt.

Puskesmas kertak hanyar kabupaten banjar.

Hobbs, M. R., Morton, S. M., Atatoa-Carr, P., et all., 2017.

Ethnic disparities in infectious disease hospitalisations

in the first year of life in New Zealand. Journal of

Paediatrics and Child Health, 53 (3), 223-231.

Hodder, R. K., Stacey, F. G., O'Brien, K. M., et all, 2018.

Interventions for increasing fruit and vegetable

consumption in children aged five years and under.

Cochrane Database of Systematic Reviews, 1

(CD008552)

HPA, & MelNet, 2017. New Zealand Skin Cancer primary

prevention and early detection strategy 2017 to 2022.

Wellington: Health Promotion Agency. Retrieved from

www.sunsmart.org.nz/sites/default/files/documents/FI

NAL-Strategy-28Mar2017.PDF

Kvalsvig, A., D’Souza, A., Duncanson, M., et all, 2016.

Pathways to child health, development and wellbeing:

Optimal environments for orchids and dandelions. An

overview of the evidence. Wellington:

Kementerian Kesehatan RI. 2016. Profil Kesehatan

Indonesia 2016. Jakarta:

Kementerian Kesehatan Republik Indonesia (KEMENKES

RI), 2017. Buku Saku Pemantauan Status Gizi Tahun

2017. Jakarta: Kementerian Kesehatan RI.

Kemenkes. Penilaian Status Gizi Anak, 2017. p.42.

Luque, V., Escribano, J., Closa-Monasterolo, R., et all,

2018. Unhealthy dietary patterns established in infancy

track to mid-childhood: The EU Childhood Obesity

Project. Journal of Nutrition, 148(5), 752-759

Machel, G., 2017. Good early development -the right of

every child. Lancet, 389 (10064), 13-14.

Mary F., Jiri B., Cristina C., 2017. Complementary

Feeding: A Position Paper by the European Society for

Paediatric Gastroenterology, Hepatology, and Nutrition

(ESPGHAN) Committee on Nutrition

Mardalena, I., Eko S., 2016. Ilmu Gizi. Jakarta:

Kementerian Kesehatan RI..

Matwiejczyk, L., Mehta, K., Scott, J., et all, 2018.

Characteristics of effective interventions promoting

healthy eating for pre-schoolers in childcare settings:

An umbrella review. Nutrients, 10 (3).

Ministry for Vulnerable Children Oranga Tamariki,

Ministry of Health, & Ministry of Education. (2017).

Hand in Hand Book: Information on health and

education universal services for 0-18 year olds.

Wellington: Ministry for Vulnerable Children, Oranga

Tamariki. Retrieved from

www.mvcot.govt.nz/assets/Uploads/Caregiver-

resources/Hand-in-Hand-Book-July17.pdf

Mutika, Syamsul, 2018. Analisis permasalahan status gizi

kurang pada balita di Puskesmas Teupah Selatan

Kabupaten Simeuleu. Jurnal Kesehatan Global, Vol. 1,

No. 3.

Nengsi, Risma, 2017. Hubungan penyakit infeksi dengan

status gizi balita di wilayah kerja Puskesmas Anreapi

Kabupaten Polewali Mandar. J-Kesmas. Vol. 3, No. 1.

Nuriah, 2017. Studi positif deviance status gizi balita pada

masyarakat miskin di Kabupaten Cilacap. Skripsi,

Bogor Agricultural. ITB Bogor.

Ohly, H., Gentry, S., Wigglesworth, R., 2016. A systematic

review of the health and well-being impacts of school

gardening: Synthesis of quantitative and qualitative

evidence. BMC Public Health, 16, 286

Puspasari, Andriani, 2017. Hubungan pengetahuan ibu

tentang gizi dan asupan makan balita dengan status gizi

balita (BB/U) Usia 12-24 Bulan

Pratasis, Malonda, Kapantow, 2018. Hubungan antara

karakteristik ibu dengan status gizi pada balita Didesa

Ongkaw Kecamatan Sinonsayang Kabupaten Minahasa

Selatan Jakarta.

Poari H.W, 2018. Prepared for the early childhood health

promoter, communities teamby the information team

community & public health. Canterbury District Health

Board.

Pritasari. Didit D., dan Nugraheni T L. 2017. Gizi dalam

daur kehidupan. Jakarta: Pusat Pendidikan Sumber

Daya Manusia Kesehatan

Rajoo Y, Ambu S, Lim Y.A.L et al. 2017. Neglected

intestinal parasites, malnutrition and associated key

factors: A population based cross-sectional study

among indigenous communities in sarawak, Malaysia.

PLoS One. 2017;12(1):1–17

RISKESDAS, 2018. Laporan hasil riset kesehatan dasar

(Rikesdas) Nasional. Jakarta

Rush, E., Obolonkin, V., Young, et all, (2017). Under 5

Energize: Tracking progress of a preschool nutrition

and physical activity programme with regional

measures of body size and dental health at age of four

years. Nutrients, 9 (5)

RISKESDAS, 2018. Laporan hasil riset kesehatan dasar

(Rikesdas) Nasional. Jakarta

Zuliyana, Yanwirasti, Yanti., 2018. Relationship of Ferritin

Levels of Pregnant Women Who Had Fe Deficiency

Anemia with Ferritin Levels and APGAR of the

Neonates. Journal of Midwifery Vol 3: No 2

Sarah E. C., Michael K. G., 2017. The role of nutrition in

brain development: the golden opportunity of the “First

1000 Days. HHS Public Access

Sastroasmoro, Ismael, 2016. Dasar-dasar metodologi

penelitian klinis. Sagung Seto,

Savoie-Roskos, M. R., Wengreen, H., & Durward, C.,

2017. Increasing fruit and vegetable intake among

children and youth through gardening-based

interventions: A systematic review. Journal of the

Academy of Nutrition and Dietetics, 117 (2), 240-250

Setiyaningrum, 2017. Buku ajar tumbuh kembang anak usia

0-12 Tahun. Indomedia Pustaka, Sidoarjo.

ICHIMAT 2019 - International Conference on Health Informatics and Medical Application Technology

218

Scaglioni, De Cosmi, Ciappolino, 2018. Factors

influencing children’s eating behaviours. nutrients,10,

706; doi:10.3390/nu10060706

Simpson, J., Duncanson, M., Oben, et all, 2017. Te Ohonga

Ake: The health status of Māori children and young

people in New Zealand. Series Two. Dunedin: New

Zealand Child and Youth Epidemiology Service,

University of Otago Retrieved from

http://hdl.handle.net/10523/7390.

Sugiyono 2017. Metode penelitian kuantitatif, kualitatif,

dan R&D. Bandung : Alfabeta, CV

UNICEF, 2019. Children, food and nutrition. Growing well

in a changing World. The State Of The World's

Children.

UNICEF. (2017). Building the future: Children and the

Sustainable Development Goals in rich countries.

Innocenti Report Card 14. Florence: UNICEF Office of

Research

Willmott, M., Nicholson, A., Busse, et all, 2016.

Effectiveness of hand hygiene interventions in reducing

illness absence among children in educational settings:

A systematic review and meta-analysis. Archives of

Disease in Childhood, 101(1), 42-50

Wirawan, Rahmawti, Moslihah dkk, 2017. Buku Metode

Perencanaan Intervensi Gizi Di Masyarakat. UB Press,

Malang.

Determinant of Nutritional Status Children

219