Jurnal Gizi Indonesia (The Indonesian Journal of Nutrition)
Jurnal Gizi Indonesia Vol. 11, No. 2, June 2023 (110-118)
Submitted: 27 November 2022, Accepted: 15 February 2023
Online https://ejournal.undip.ac.id/index.php/jgi
1
Undergraduate Program in Applied Nutrition and Dietetics, Department of Nutrition, Politeknik Kesehatan
Kementerian Kesehatan Malang, Indonesia
2
Dietisien Profesional Education Study Program, Department of Nutrition, Politeknik Kesehatan Kementerian
Kesehatan Malang, Indonesia
3
D3 Nutrition Study Program, Department of Nutrition, Politeknik Kesehatan Kementerian Kesehatan Malang,
Indonesia
4
Department of Actuarial Science, Institut Teknologi Sepuluh Nopember, Indonesia
5
School of Nutrition and Health Science, College of Nutrition, Taipei Medical University, Taiwan
*
Correspondence : E-mail: rany_adelina@poltekkes-malang.ac.id
Copyright © 2023; Jurnal Gizi Indonesia (The Indonesian Journal of Nutrition), Volume 11 (2), 2023
e-ISSN : 2338-3119, p-ISSN: 1858-4942
110
DETERMINING THE NUTRIENTS CHANGES AFTER UNDERGOING
NUTRITIONAL COUNSELING AND COOKING ASSISTANCE AMONG
T2DM OUTPATIENTS IN MALANG CITY, INDONESIA
Rany Adelina
1
*, Awalia Nanda Arianto
2
, Sabrina Julietta Arisanty
1
, Rafika Aprillia
3
, Wisnowan Hendy
Saputra
4
, Risa Mafaza
1
, Khairudin
1
, Tapriadi
1
, Rathi Paramastri
5
ABSTRACT
Background: Nutrition and diets are critical factors for T2DM patients to maintain health. Nutrition education are
considered less effective because most patients have not implemented them. This research tries to develop program
innovation by combining nutrition counseling and cooking assistance for T2DM outpatients. This study aimed to know
the risk factors for T2DM and determine the effectiveness of programmed nutrition education (NEP) on changes in
nutrient intake in patients with T2DM.
Methods: A total of 70 participants registered as T2DM outpatients at Kedung Kandang primary healthcare center in
Malang city. Subjects were recruited using a 'quota sampling' technique. The design of this study is a quasi-experiment
study using a comparison of the control (n=32)-treatment group (n=38). This research was conducted from September
to November 2018. Fifty minutes of intensive individual counseling and cooking assistance were provided to T2DM
patients and families. The data were analyzed using independent sample t-test, Wilcoxon Mann Whitney U-test, and
logistic regression. The patients’ 4-d dietary records of 3 normal days and 1 holiday/weekend were assessed after 24
hours.
Results: From this study it can be seen that intake of amino acid lysine was significantly higher in the treatment group
than the control group (p = 0.04). The intake of fiber, MUFA, and PUFA was greater in the intervention group, while
sodium intake was lower in the intervention group. The risk factors of T2DM incidence were age (p = 0.036), education
(p = 0.043), waist circumference (p = 0.015), and carbohydrate intake (p = 0.033).
Conclusion: T2DM patients treated with individual nutrition counseling and cooking assistance gained a higher intake
of fiber, amino acid lysine, and unsaturated fatty acids. The most influential risk factors of T2DM incidence are age,
education, waist circumference, and carbohydrate intake.
Keywords: nutrition counseling, cooking assistance, nutritional intake, T2DM.
BACKGROUND
Diabetes is the new plague of the 21st century developing throughout the world both in developing
and developed countries with the most dramatic increase occuring in type 2 diabetes (T2DM), whose
increase is mainly associated with an increase in the prevalence of sedentary lifestyle and obesity. T2DM is a
metabolic disorder characterized by insulin resistance, dysfunction of β-cells, and increased risk of vascular
diseases which can be caused and influenced by genetic, behavioral, and environmental factors[1,2]. More
specifically, factors of age, lifestyle, and diet are causative to T2DM [3]. Certain types of food intake are
associated with higher or lower insulin resistance and insulin secretion, which can increase the risks of
diabetes and insulin resistance-related diseases [4].
Nutritional recommendations for T2DM patients set by the American Diabetes Association (ADA)
include limiting energy intake to achieve or maintain ideal body weight; limiting total and saturated fat,
cholesterol, and sodium; consuming adequate amounts of carbohydrates from nutrient-dense foods such as
vegetables, fruits, whole grains, and legumes; and consuming enough fiber. Nutritional recommendations for