THE EFFECT OF ENRICHED L-GLUTAMINE COMPLEMENTARY FOOD ON CELLULAR IMMUNITY PROFILE AND MORBIDITY SCORE OF UNDERWEIGHT 6 MONTH INFANTS

Abstract

Growth faltering is widely prevalent in developing world including Indonesia. The prevalence of mild and moderate Protein Energy Malnutrition is also extremely high reaching more than 20 % in Indonesia. Faltering in weight begins at about age 3 mo and continues rapidly until about 12 mo. Thereafter, it continues to decline at a slower pace until about 18 mo with a subsequent catch-up pattern. The enriched L-Glutamine Complementary Food containing 0.3 g/kg body weight or 2.5g/ 25 g CF was developed from cereals, milk protein, mungbean, milk fat and mixture of vegetable oils. Using animal rat experimental, additional L-Glutamine CF could enhance better infegrity of jejunum in which improve the lymphoid proliferation and further prevent E coli penetration. The experimental study using double blind randomized trial was conducted in 19 villages supervised by medical doctors of 6 community health centres in 4 sub districts of Bogor, West Java. Three groups of totally 143 infants of 6 months ± 1 week were involved in the study. The respective infants were healthy infants with slightly underweight. Each group were assigned to receive different intervention during 3 mo i.e MPG (Enriched L-Glutamine CF), MPK ( Control CF) and MPP (No Enriched L-Glutamine CF). The CF was given daily after reconstituted with boiled water, 7 days a week, 2 packs @ 25g CF per day for 12 weeks (3 mo duration). Cellular Immunity Profiles indicated by lymphocytes T, lymphocytes B and natural killer. Enriched L-Glutamine CF (MPG) improved lymphocytes T, T helper and T suppressor better compared to MPK and MPP designated by percentage differences of the cellular immunity profiles between beginning and ending of the intervention. Though protein influenced the blood profiles particularly leucocytes, erythrocytes and haemoglobins development, enrichment LGlutamine in MPG postulated beneficial improving on Iron Deficiency Anaemia reduction 42,8 % better than 14,2 % in case of MPP, while MPK no change in prevalence. Improvement of the cellular immunity profiles in MPG could reduces morbidity score significantly (p<0.05) by 239 ± 302; better than MPP (314 ± 357) and MPK (345 ± 468). Morbidity score calculated using portfolio by multiplying scare of disease risk with duration of illness. From logistic regression analysis point of view , L-Glutamine CF has potential opportunity in improving immunity 4.3 times compared to control. Besides L-Glutamine CF, morbidity score negative influenced by care giving behaviour (OR 0.46), mother's education (OR 0.43) and CF intake (OR 0.'30).