Mineral and Enzyme Deficiency Diseases Associated With Nutritional Diseases in Society
Conditions: Nutrient Deficiency
Sponsor: Universitas Sumatera Utara

Mineral and Enzyme Deficiency Diseases Associated with 
Nutritional Diseases in Society 
Dina Keumala Sari1*, Rina Amelia2, Dewi Masyithah Darlan3, Kraichat 
Tantakarnapa4 
1Department of Nutrition, Faculty of Medicine, Universitas Sumatera Utara, Medan, 
Indonesia, e-mail address: dina@usu.ac.id; Livedna ID: 62.14510 
2 Public Health Department, Faculty of Medicine, Universitas Sumatera Utara; 
rina2@usu.ac.id 
3Department of Parasitology, Faculty of Medicine, Universitas Sumatera Utara, 
Medan, Indonesia, email: dewi2@usu.ac.id 
4Faculty Medicine, Mahidol University, Thailand, email: kraichat.tan@mahidol.ac.th 
*Corresponding author; Email: dina@usu.ac.id; Cellular phone: +62 81397177693 
Date: November 25th, 2020 
 

Mineral and Enzyme Deficiency Diseases Associated with 
Nutritional Diseases in Society 
Abstract 
Nutritional deficiency disease is a disease caused by nutritional deficiencies, 
including macronutrients and micronutrients. Macronutrient diseases are diseases 
caused by deficiency of protein, fat and carbohydrates. This deficiency will usually 
show clinical symptoms that directly affect nutritional status. This study aims to 
study and examine mineral intake, dietary patterns of research subjects, mineral and 
enzyme levels, and soil condition data. The number of research subjects to be taken 
was 180 subjects with 90 research subjects coming from mothers who had healthy 
children and 90 research subjects came from mothers who had stunted children or 
other nutritional disorders. The research stage will run after going through the 
inclusion of research subjects, namely mothers who have healthy children and 
mothers who have nutritionally deficient children, aged 20-40 years. The research 
stage consisted of two stages. The statistical analysis used is to use the ANOVA test, 
which will then compile a manuscript. 
Keywords: nutritional deficiency, macronutrient, mineral, enzyme, stunting 
Introduction 
Indonesia still has a high number of deficiency disorders, including North Sumatra. 
Several districts include Medan, Deli Serdang, Langkat, Simalungun, Dairi, Pakpak 
Barat, Tapanuli Tengah, Mandailing Natal, Padang Lawas, Padang Lawas Utara, 
Nisa, South Nias, West Nias, North Nias, and Gunung Sitoli. This area is also still 
experiencing a number of diseases due to nutritional disorders such as stunting, 
hydrocephalus, and various other diseases. North Sumatra's stunting rate for 2019 is 
30.11 percent, only down 2.3 percent from 2018. Of course this value creates a desire 
to know what causes it even though various programs have been implemented. 
Nutritional deficiency disease is a disease caused by nutritional deficiencies, 
including macronutrients and micronutrients. Macronutrient diseases are diseases 
caused by deficiency of protein, fat and carbohydrates. This deficiency will usually 
show clinical symptoms that directly affect nutritional status.  
However, micronutrient deficiencies including minerals and vitamins are often not 
detected because they originate from subclinical symptoms, but will cause long-term 
defects. These defects are very fundamental, causing a disturbance in nutritional 

status, especially in children, which will last until adulthood. The influential 
micronutrients are minerals, these minerals are metal and inorganic compounds 
whose cycle starts from the soil as the main source. The land around the area will 
provide a source of nutrition for plants and animals to the surrounding population. 
Plants that contain sufficient mineral nutrients will provide a good source for the 
surrounding community. In addition, humans cannot consume and digest food if 
there are no enzymes in the digestive tract. Humans really need these minerals and 
enzymes to be digested properly. 
Literature review 
Growth and development are important health parameters in children. The problem 
of growth disruption, one of which is stunting, occurs in many developing countries 
including Indonesia and is a major problem for the progress of a country because of 
its impact in the future. Stunting is a linear growth disorder caused by chronic 
nutritional deficiency and / or recurrent and chronic infectious diseases. Stunting 
and severely stunting is a condition of short and very short children, which is 
indicated by the size of the body length for age (PB / U) or height for age (TB / U) 
with a z-score value less than -2 standard deviation (SD) and -3 SD World Health 
Organization (WHO) Child Growth Standards 2006 (WHO, 2008; Keane, 2016; 
Asworths 2016; Ministry of Health RI, 2018). 
In 2017, 22.2% or around 150.8 million children under five in the world were stunted. 
More than half of stunted children in the world come from Asia (55%), while more 
than one third (39%) are in Africa. Of the 83.6 million stunting children under five in 
Asia, the proportion in Southeast Asia is 14.9%. Compared to several neighboring 
countries, the prevalence of stunting in Indonesia in 2015 (36.4%) was the second 
highest after Laos (43.8%), Myanmar (35.1%), Vietnam (19.4%), Malaysia (17.2%). ), 
Thailand (16.3%) and Singapore (4%) (WHO, 2018). According to data from the basic 
health research (Riskesdas) of the Ministry of Health of the Republic of Indonesia in 
2018, reported that the national prevalence of short children under five in Indonesia 
is 30.8% consisting of 19.3% short and 11.5% very short, with an estimated number 
of 8.9 million children from 23,848,283 people under five. One in three children 
under five is stunted (Kemenkes RI, 2018). This figure decreased from the 2013 
Riskesdas report (37.2%) (Ministry of Health RI, 2013). The prevalence of stunting in 
North Sumatra in 2018 is around 35%, including the high category (Kemenkes RI, 
2018). Data from the North Sumatra Provincial Health Office in 2017 reported the 
highest number of children under five with stunting and severely stunting in five 
districts in North Sumatra, respectively West Nias 45.7% (25.5%; 20.2%), North Nias 

41.6% (24.8%; 16.8%), Nias 41.6% (17.3%; 24.3%), Humbang Hasundutan 41.5% 
(23.6%; 17.9%) and Padang Lawas 40 , 5% (24.7%; 15.8%) (Dinkesprovsu, 2018). 
According to WHO, the prevalence of stunting is a public health problem if the 
prevalence is 20% or more (UNICEF, 2018). The Sustainable Development Goals 
(SDGs) target to reduce 40% of the number of stunting under five in Indonesia by 
2025 and end all types of malnutrition by 2030 (WHO, 2014; Indonesian Ministry of 
Health, 2018). 
Stunting describes chronic nutritional problems, which are influenced by the 
condition of the mother / expectant mother, fetal period, infancy and toddlerhood. 
Growth and development is very rapid and determines the quality of life starting 
from the beginning of conception through to the age of 2 years. Stunting is a 
condition that occurs due to chronic nutritional deficiencies, especially in the first 
1000 days of life (HPK). The period of 1000 HPK is calculated from the time the child 
is in the womb (270 days) and after birth (730 days). Malnutrition that occurs in 1000 
HPK has an impact on growth and development problems, increased morbidity and 
mortality, and in the long term can interfere with intellectual abilities and 
proficiency in academic capacity (WHO, 2010; Ministry of Health RI, 2016). In 
developing countries, malnutrition in pre-pregnancy and pregnant women has an 
impact on the birth of children with intrauterine growth restriction (IUGR). Almost 
half of the IUGR conditions are related to the nutritional status of the mother, both 
macronutrients and micronutrients (Unterscheider et al., 2014; Divon et al., 2017). 
Ethical approval 
This research was conducted following the ethics committee protocol, and was approved by 
the ethics committee of the Universitas Sumatera Utara (number 423/KEP/USU/2020). 
Methods 
This research is a case control study, with primary data collection, is a laboratory 
clinical trial study on the subject of mothers who have children aged 2-3 years, aged 
20-40 years. This research will be conducted in 4 locations, namely cities and 
regencies with high stunting rates, namely Medan, Deli Serdang, Langkat, 
Simalungun. This study aims to study and examine mineral intake, dietary patterns 
of research subjects, mineral and enzyme levels, and soil condition data. The number 
of research subjects to be taken was 180 subjects with 90 research subjects coming 
from mothers who had healthy children and 90 research subjects came from mothers 
who had stunted children or other nutritional disorders. The affordable population 

is women aged 20-40 years who are in stunting areas including 15 districts in North 
Sumatra during September 2020.  
The research stage consisted of two stages, the first stage was the initial screening of 
the primary data of the research subjects, namely by analyzing food intake including 
mineral intake data, the diet of the research subjects, mineral and enzyme levels, and 
data on soil conditions in the area. The second stage was to analyze the relationship 
between the existing variables so that the most significant relationship was seen 
between the differences in diet, mineral content, enzyme levels, and soil content 
between the two groups. The statistical analysis used was to use the ANOVA test. 
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