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Nutrients 2017, 9(8), 868; doi:10.3390/nu9080868

Locally Sustainable School Lunch Intervention Improves Hemoglobin and Hematocrit Levels and Body Mass Index among Elementary Schoolchildren in Rural West Java, Indonesia

1
Graduate Program in Sustainability Science—Global Leadership Initiative, Graduate School of Frontier Sciences, The University of Tokyo, 5-1-5 Kashiwanoha, Kashiwa 277-8563, Japan
2
Department of Community Nutrition, Faculty of Human Ecology, Bogor Agricultural University, Jl. Lingkar Kampus IPB Darmaga, Bogor 16680, Indonesia
3
Japan Wildlife Research Center, 3-3-7 Kotobashi, Tokyo 130-8606, Japan
*
Author to whom correspondence should be addressed.
Received: 24 June 2017 / Revised: 25 July 2017 / Accepted: 3 August 2017 / Published: 12 August 2017
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Abstract

School lunch is not provided in public elementary schools in Indonesia, and students frequently buy and eat snacks at school. We hypothesized that providing a traditional Sundanese meal as school lunch would be beneficial for children in rural West Java. To test this hypothesis, we evaluated the effect of a 1-month school lunch intervention aiming at sustainability and based on children’s nutritional intake, hemoglobin and hematocrit levels, and body mass index (BMI). A lunch (including rice, vegetable dish, animal protein dish, plant protein dish, and fruit) containing one-third of the recommended daily allowance of energy was offered every school day for 1 month, targeting 68 fourth-grade elementary schoolchildren. At baseline, the prevalence of anemia was 33.3%. The prevalence of stunting and underweight were 32.4% and 2.9%, respectively, whereas that of overweight and obesity combined was 17.6%, indicating a double burden of malnutrition among the subjects. During the intervention, intakes of protein (p < 0.05), calcium (p < 0.05), and vitamin C (p < 0.001) significantly increased, while that of fat significantly decreased (p < 0.001). After the intervention, hemoglobin (p < 0.05) and hematocrit (p < 0.05) levels were significantly improved, thereby almost halving the rate of anemia. These changes were significantly larger in the baseline anemic group than the non-anemic group (p < 0.01). BMI significantly increased in the baseline underweight/normal group (p < 0.001) but not in the overweight/obese group. The school lunch intervention significantly improved nutritional intakes and health statuses, implying its potential for reducing anemia and resolving the double burden of malnutrition among rural Indonesian schoolchildren. View Full-Text
Keywords: school lunch; child growth; dietary intake; anemia; Indonesia school lunch; child growth; dietary intake; anemia; Indonesia
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Sekiyama, M.; Roosita, K.; Ohtsuka, R. Locally Sustainable School Lunch Intervention Improves Hemoglobin and Hematocrit Levels and Body Mass Index among Elementary Schoolchildren in Rural West Java, Indonesia. Nutrients 2017, 9, 868.

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