Amino acids in enteral formula based on local fermented food for children with protein energy malnutrition


  • Yessie Finandita Pratiwi Diponegoro University. Faculty of Medicine, Department of Nutrition Science, Semarang, Indonesia, 50275, Phone: +6285735375770
  • Mohammad Sulchan Diponegoro University. Faculty of Medicine, Department of Nutrition Science, Semarang, Indonesia, 50275, Phone: +62816655235
  • Diana Nur Afifah Diponegoro University. Faculty of Medicine, Department of Nutrition Science, Semarang, Indonesia, 50275, Phone: +6287770380468
  • Rusdin Rauf Universitas Muhammadiyah Surakarta. Faculty of Health Science, Surakarta, Indonesia, 57162, Phone: +6281328287438



Tempeh gembus flour hydrolysate, amino acid, enteral formula, toddler, PEM


Protein-energy malnutrition still becomes a problem in the world and Indonesia. The enteral formula is needed in the process of fulfilling overall nutrition in the form of a liquid diet in malnourished patients to digest and absorb nutrients without any difficulties. Amino acid lysine, methionine, cysteine, threonine, and tryptophan are often deficits in children's food; even, malnourished children (stunting, wasting, or protein-energy malnutrition) have decreased amino acids. Tempeh gembus, fermented local food, is used as the main ingredient for the enteral formula, and the hydrolysate process is carried out and made into flour, resulting in more amino acids due to the process of protein breakdown. The making of enteral formula from local food fermentation aims to enable the community to optimize local food into more nutritious food so that it can be produced at the household scale. Other supplementary ingredients are isolated soy protein, pumpkin flour, maltodextrin, sugar, and soybean oil. The enteral formula is isocaloric and isoprotein; it is divided into two with different compositions of the hydrolysate of Tempeh gembus flour. This study aims to determine the content of protein, amino acids, and limiting amino acids in the enteral formula. The amino acid analysis was performed using the HPLC method. Amino acid glutamate has the highest content in enteral formulas A and B (2,080 mg.100g-1and 1,950 mg.100g-1). The total amino acid content of enteral formula A is higher than that of enteral formula B with a difference of 210 mg.100g-1. Enteral formula A has a higher average amino acid content (1,400 mg.100g-1) than enteral formula B (1,378 mg.100g-1), and there is no significant difference (p = 0.812) between them. The enteral formula A has a higher amino acid content, but the highest protein content is in enteral formula B. The limiting amino acids in enteral formulas A and B are the methionine amino acids. Enteral formulas A and B can fulfill the needs of amino acids and be an alternative formula for Children with PEM.


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Afifah, D. N., Rahma, A., Nuryandari, S. S., Alviche, L., Hartono, P. I., Kurniawati, D. M., Wijayanti, S. H., Fitranti, D. Y., Purwanti, R. 2019. Nutrition Content, Protein Quality, and Antioxidant Activity of Various Tempeh gembus Preparations. Journal of Food and Nutrition Research, vol. 7, no. 8, p. 605-612.

Afifah, D. N., Sulchan, M., Syah, D., Yanti,Suhartono, M. 2014. Isolation and Identification of Fobrinolytic Protease-Producing Microorganism from Red Oncom and Gembus, Indonesian Fermented Soybean Cakes. Malaysian Journal of Microbiology, vol. 10 no. 4, p. 273-279.

Anggraeny, O., Dianovita, C., Putri, E. N., Sastrina, M., Dewi, R. S. 2016. The Correlation of Low Protein Diet Administration on Status of Protein, Immunity, Hemoglobin and Appetite of Male Wistar Rats Rattus norvegicus. Indonesian Journal of Human Nutrition, vol. 3, no. 2, p. 105-22.

Ariani, D., Angwar, M., Khasanah, Y., Ratnayani, R., Nuraeni, T. 2013. The Feeding of Enteral Nutrition Formulated with Local Food Material Toward the Level of Hemoglobin and Iron in White Rat (Rattus norvegicus). Jurnal Gizi Klinik Indonesia, vol. 10, no. 1, p. 48-54.

Ashworth, A. 2017.Facility-Based Treatment of Severe Malnutrition. International Encyclopedia of Public Health, Second Edition, vol. 3, p. 77-83.

Astawan, M., Wresdiyati, T., Saragih, A. M. 2015.Evaluation of protein Nutritional Quality of Tempe and Boiled Soybean Flours by Rats. JurnalMutuPangan, vol. 2, no. 1, p.11-7.

Bhutta, Z. A., Salam, R. A. 2012. While Poverty and Socioeconomic Inequity Remains an Important Factor, in Many Cases, the Presence Of Micronutrient Deficiency is a Factor of Diet Quality. Global Nutrition Epidemiology and Trends. Annals Nutrition and Metabolism, vol. 61, p. 19-27.

Boye, J., Wijesinha-bettoni, R., Burlingame, B. 2012.Protein Quality Evaluation Twenty Years after the Introduction of the Protein Digestibility Corrected Amino Acid Score Method. British Journal of Nutrition, vol.108, no. 52, p. 283-211.

Brown, B., Roehl, K., Betz, M. 2014. Enteral Nutrition Formula Selection: Current Evidence and Implications for Practice. Nutrition in Clinical Practice, vol. 30, no. 1, p. 72-85.

Bujang, A., Taib, N. A. 2014. Changes on Amino Acids Content in Soybean, Garbanzo Bean and Groundnut during Pre-treatments and Tempe Making. SainsMalaysiana, vol. 43, no. 4, p. 551-557.

Chusnatayaini, A., Nurikasari, M., Zahroti, A. 2018.Acceptance of Additional Foods Moringa Leaf Modisco Modification. The 2nd Joint international Conferences, p. 99-104. ISBN 978-602-5842-03-0.

Cooper, P. A. 2010. The Clinical Challenge of Preventing and Treating Malnutrition. Clinical Nutrition, vol. 66, p. 31-40.

Damayanti, R., Dewi, E., M, M., Soedarjati, S. 2012. Pediatric Nutrition and Metabolic Disease. Volume I. Jakarta: IDAI, p. 51.

Dewi, R. S., Huda, N., Ahmad, R., Abdullah, W. N W. 2010. Protein Quality of Shark Jerky Processed with Different Drying Methods. Jurnal Pascapanendan Bioteknologi Kelautandan Perikanan, vol. 5, no. 1, p. 87-92.

Dietitians Association of Australia. 2018. Enteral Nutrition Manual for Adults in Health Care Facilities. Available at:

FAO Food and Nutrition. 2013. Dietary Protein Quality Evaluation in Human Nutrition. Report of an FAO Expert Consultation.Food and Agriculture Organization of the United Nations. Rome, p. 95. Available at:

Ghosh, S., Uauy, R. 2016.Protein Quality and Amino Acids in Maternal and Child Nutrition and Health. Encyclopedia of Food and Health, p. 516-523.

Gropper, S. S., Smith, J. L. 2013. Advanced Nutrition and Human Metabolism. 6th Ed. Belmont, USA : Yolanda Cossio, p. 390-399. ISBN-13 978-1-133-10405-6.

Hall, N. G., Schӧnfeldt, H. C. 2013. Total Nitrogen vs Amino-acid Profile as Indicator of Protein Content of Beef. Food Chemistry, vol. 140, no. 3, p. 608-612.

Hughes, G. J., David, J. R., Ratna, M., Charles, S. S. 2011. Protein Digestibility-Corrected Amino Acid Score (PDCAAS) for Soy Protein IsolatedandConcentrate : Criteria for Evaluation. Journal of Agricultural and Food Chemistry, vol. 59, no. 23, p. 12707-12712.

Jiang, B., Tsao, R., Li, Y., Miao, M. 2014. Food Safety: Food Analysis Technologies/Techniques. Encyclopedia of Agriculture and Food Systems, vol. 3, p. 273-288.

Jonker, R., Engelen, M. P. K. J., Deutz, N. E. P. 2012. Role of Specific Dietary Amino Acids in Clinical Conditions. British Journal of Nutrition, vol. 108, no. 52, p. 139-148.

Kamalia, A., Sulistyaningsih, E. 2014. The Nutritive Therapy of Modified Modisco with Pineapple Extract Increase Haemoglobin on Severe Protein Energy Malnutrition Rat. e-Jurnal Pustaka Kesehatan, vol. 2, no. 1, p. 17-22.

Karyadi, J. N. W., Primawati, Y. F., Bintoro, N. 2012. Drying Process of Grated Cassava (Manihotesculentacrantz) with Pneumatic Drying. In: Proceeding Perteta National Seminar. Aceh, p. 96-104.

Knapp, A. W. 2016. Basic Algebra. Digital Second Editions. Published by the Author, East Setauket, New York, p. 248-295.

Kumaunang, M., Kamu, V. 2010. The Activity Of Bromelain Enzyme Isolated From Pineapple (Anenascomosus) Fruit Skin. Jurnal Ilmiah Sains, vol. 11, no. 2, p. 198-201.

Kurniasari, R., Sulchan, M., Afifah, D. N., Anjani, G., Rustanti, N. 2017. Influence Variation of Tempe Gembus (an Indonesian Fermented Food) on Homocysteine and Malondialdehyde of Rats Fed an Atherogenic Diet. Romanian Journal of Diabetes Nutrition and Metabolic Disease, vol. 24, no. 3, p. 203-11.

Kusumaningtyas, E., Widiastuti, R., Kusumaningrum, H. D., Suhartono, M. T. 2015. Antibacterial and Antioxidant Activity of Hydolyzate as a Result of Protein Hydrolysis of Goat Milk with Bromelin Rough Extract. JurnalTeknologidanIndustriPangan, vol. 26, no. 2.

Luiking, Y. C., Deutz, N. E. P., Jakel, M., Soeters, P. B. 2005. Casein and Soy Protein Meals Differentially Affect Whole Body and Splanchnic Protein Metabolism in Healthy Humans. Journal Nutrition, vol. 135, no. 5, p. 1080-1087.

Mariotti, F., Tome, D., Mirand, P. P. 2008.Converting Nitrogen into Protein Beyond 6.25 and Jones’ Factors. Critial Reviews in Food Science and Nutrition, vol. 48, no. 2, p. 177-184.

Mӕhre, H. K., Dalheim, L., Edvinsen, G. K., Elvevoll, E. O., Jensen, I. 2018. Protein Determination-Method Matters. Foods, vol. 7, no. 5, p. 1-11.

Nakon, P. P. S., Jangchud, K., Jangchud, A., Prinyawiwatkul, W. 2017. Comparisons of Physiochemical Properties and Antioxidant Activities among Pumpkin (Cucurbita moschata L) Flour and Isolated Starches from Fresh Pumpkin or Flour. International Journal of Food Science and Technology, vol. 52, no. 11, p. 1-9.

Ngo, J., Serra-Majem, L. 2018. Hunger and Malnutrition. Amsterdam, Netherland : Elsevier, p. 1-21.

Pratiwi, L. E., Noer, E. R. 2014. Microbiology Quality Analysis and Viscosity Test of Enteral Formula based on Pumpkin (Curcubita moschata) and Duck Eggs. Journal of Nutrition College, vol. 3, no. 4, p. 951-957.

Rauf, R., Utami, A. 2020. Nutrition Value and Viscosity of Polymeric Enteral Nutrition Products based on Purple Sweet Potato Flour with Variation of Maltodextrin Levels. The Indonesian Journal of Nutrition, vol 8, no.2, p. 119-125.

Ribarova, F. 2018. Amino Acids: Carriers of Nutritional and Biological Value Foods. In Grumezescu, A. M., Holban, A. M. Food Processing for Increased Quality and Consumption. Amsterdam, Netherland : Elsevier, p. 287-311.

Semba, R. D., Shardell, M., Ashour, F. A. S., Moaddel, R., Trehan, I., Maleta, K. M., Ordiz, M. I., Kraemer, K., Khadeer, M. A., Ferruci, L., Manary, M. J. 2016. Child Stunting is Associated with Low Circulating Essential Amino Acids. Ebio Medicine, vol. 6, p. 246-252

Serna-saldivar, S. O., Perez-carrillo, E., Heredia-olea, E. 2019.Soybean-Fortified Wheat Flour Tortillas. In Preedy, V. R., Watson, R. R. Flour and Breads and their Fortification in Health and Disease Prevention. 2nd ed. Amsterdam, Netherland : Elsevier, p. 291-306.

Sholihah, Z., Noer, E. R. 2014. Analysis of Nutrient Content and Acceptability of Enteral based for Pumpkin and Duck Eggs. Journal of Nutrition College, vol. 3, no. 4, p.855-861.

Sousa, L. R. M., Ferreira, S. M. R., Schieferdecker, M. E. M. 2014. Physiochemical and Nutritional Characteristic of Handmade Enteral Diets. Basil. NutricionHospitalaria, vol. 29, no. 3, p. 568-574.

Sulchan, M., EndangNur, W. 2007.Nutritional Value and Amino Acid Composition of Tempe Gembus and Its Effect on Growth of Rats. Majalah Kedokteran Indonesia, vol. 57, no. 3, p. 80-85.

Thrane, M., Paulsen, P. V., Orcutt, M. W., Krieger, T. M. 2017. Soy Protein: Impacts, Production, and Applications. In Nadathur, S. R., Wanasundara, J. P. D., Scanlin, L. Sustainable Protein Sources. Amsterdam, Netherland :Elsevier, p. 23-45.

UNICEF, WHO., World Bank Group. 2019. Malnutrition Rates Remaining Alarming: Stunting is Declining too Slowly while Wasting Still Impact the Lives of Far too Many Young Children. Available at:

UNICEF, WHO., World Bank Group. 2020. Malnutrition Rates Remaining Alarming: Stunting is Declining too Slowly while Wasting Still Impact the Lives of Far too Many Young Children. Available at:

USDA. 2018. United States Department of Agriculture.Agricultural Research Service. USDA Branded Food Products Database. United States. Available at:

Utami, P., Lestari, S., Lestari, S. D. 2016.Effects of Cooking Methods on Chemical Composition and Amino Acids Composition of Freshwater Fish (Rasboraargyrotaenia). Jurnal Teknologi Hasil Pertanian, vol. 5, no. 1, p. 73-84.

WHO., FAO., UNU Expert Concultation. 2007. Protein and Amino Acid Requirements in Human Nutrition. Report of a Joint WHO/FAO/UNU Expert Consultation. United Nations University.

Widjaja, N. A., Hidayati, S. N., Irawan, R. 2013. The Influence of Infectious Diseases on Severe Malnutrition in Children’s Albumin Levels. Sari Pediatri, vol. 15, no. 1, p. 46-50.

Widya, F. C., Anjani, G., Syauqy, A. 2019. Analysis of Protein Levels, Amino Acids and Receiving Food on Supplementary Food (PMT-P) based on Yellow Pumpkin (Cucurbita moschata) for Toddler Malnutrition. Journal of Nutrition College, vol. 8, no. 4, p. 207-218.

Wijaya, J. C., Yunianta, Y. 2015. The Effect of Different Bromelain Enzyme Concentration and Incubation Period toward Tempe Gembus’s Chemical and Organoleptical Characteristics. Jurnal Pangandan Agroindustri, vol. 3, no. 1, p. 96-106.

Wilson, K., Walker, J. 2010. Principles and Techniques of Practical Biochemistry. Cambridge, UK : Cambridge University Press, p. 300-351.

Wolfe, R. R. 2012. The Role of Dietary Protein in Optimizing Muscle Mass, Function and Health Outcomes in Older Individuals. British Journal of Nutrition, vol. 108, no. 52, p. 88-93.

WHO. 2009. PelayananKesehatanAnak di RumahSakit [Children's Health Services at the Hospital]. Jakarta: WHO Indonesia. Available at:

Wu, G. 2009. Amino Acids: Metabolism, Functions and Nutrition. Amino Acids, vol. 37, p. 1-17.



How to Cite

Pratiwi, Y. F. ., Sulchan, M. ., Afifah, D. N., & Rauf, R. (2021). Amino acids in enteral formula based on local fermented food for children with protein energy malnutrition. Potravinarstvo Slovak Journal of Food Sciences, 15, 254–261.

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