The Effectiveness of Nutrition Education about Local Specific Food-based Balanced Nutrition Recommendation on Dietary Intake Level and Anemia Status in Female Adolescents at the Hidayatullah Arrohmah Islamic Boarding School Malang


Background: Anemia is the biggest nutritional problem in Indonesian adolescents. One of the main risk factors is poor diet. Nutrition education as an intervention method has been shown to significantly improve healthy lifestyle and academic achievement in school-aged children. Objective: To analyze the effectiveness of nutrition education about local specific food-based balanced nutrition recommendation on the knowledge, dietary intake level, and anemia status of female adolescents. Methods: This study was a quasi-experimental research with pre- and post-test design. Eighty-three female students of the Hidayatullah Arrohmah Islamic Boarding School Malang were included as study participants. The nutrition education in the form of class counseling on balanced nutrition guidelines and healthy snacks was given for five consecutive months. Dietary consumption, knowledge, and hemoglobin level were measured before and after the intervention. Data analysis was done using paired t-test and Wilcoxon signed-rank test with p<0.05 considered as significant. Results: There was a significant difference of the protein (p=0.029) and Fe (p=0.021) intake level before and after the intervention, however, this result was not found in the vitamin C and folic acid intake. The nutritional knowledge as well as the hemoglobin level were increased significantly (p=0.001, p=0.04, respectively). Conclusions: Nutrition education about local specific food-based balanced nutrition recommendation is very effective to increase knowledge, dietary intake (protein and iron), and hemoglobin levels in female adolescents.

[1] World Health Organization (WHO). The database on anemia includes data by country on prevalence of anemia and mean hemoglobin. Geneva, Switzerland. WHO, 2008.

[2] Stevens GA, Finucane MM, De-Regil LM, et al. Global, regional, and national trends in haemoglobin concentration and prevalence of total and severe anaemia in children and pregnant and non-pregnant women for 1995–2011: a systematic analysis of population-representative data. The Lancet Global Health 2013; 1(1): e16-e25.

[3] WHO. Prevention of Iron Deficiency Anaemia in Adolescents: Role of Weekly Iron Folic Acid Supplementation: WHO SEARO; 2011.

[4] Van-den RB, Broak NR. Etiology of anemia in pregnancy in South Malawi. Am J Clin Nutr. 2000; 72: 247S-256S.

[5] WHO. Worldwide prevalence of anaemia 1993-2005: WHO global database on anaemia. 2008.

[6] Delisle H, Chandra-Mouli V, de Benoist B. Should Adolescents Be Specifically Targeted for Nutrition in Developing Countries: To Address Which Problems, and How? World Health Organization/International Nutrition Foundation for Developing Countries Available at http://www who int/childadolescenthealth/ New_Publications/NUTRITION/Adolescent_ nutrition_paper pdf 2000

[7] Khasanah, FU. Membangun Kesadaran Remaja Berperilaku Sehat. 2011.

[8] Alaofè H, Zee J, Dossa R, O’Brien HT. Education and improved iron intakes for treatment of mild iron-deficiency anemia in adolescent girls in southern Benin. Food and nutrition bulletin 2009; 30(1): 24-36.

[9] Kersting M, Alexy U, Clausen K. Using the concept of food based dietary guidelines to develop an optimized mixed diet (OMD) for German children and adolescents. Journal of pediatric gastroenterology and nutrition 2005; 40(3): 301-8.

[10] Ferguson EL, Darmon N, Fahmida U, Fitriyanti S, Harper TB, Premachandra IM. Design of optimal food based complementary feeding recommendations and identification of key “problem nutrients” using goal programming. The Journal of nutrition 2006; 136(9): 2399-404.

[11] Maillot M, Vieux F, Amiot MJ, Darmon N. Individual diet modeling translates nutrient recommendations into realistic and individual-specific food choices. The American journal of clinical nutrition 2010; 91(2): 421-30.

[12] Fahmida U, Mustafa A, Adhiyanto C. Panduan Gizi Seimbang berbasis pangan lokal hasil analisa program linier untuk menurunkan anemia pada remaja putri: Pretesting dan baseline Survey. Laporan Penelitian. Seameo Recfon 2016.

[13] Ariyanti, NA. Pengaruh Edukasi Terhadap Tingkat Pengetahuan, Tingkat Konsumsi Zat Gizi (Protein, Vitamin C dan Zat Besi), dan Kadar Hemoglobin Terkait dengan Kejadian Anemia Anak Sekolah Dasar Di SDN Cemorokandang 1 Kota Malang. Skripsi 2017. Poltekkes Kemenkes Malang.

[14] Kusuma NI and Kartini F. Pengaruh Pendidikan Kesehatan Anemia pada Remaja Putri terhadap Tingkat Pengetahuan dan Sikap dalam Mencegah Anemia pada Siswi Kelas X SMA Muhammadiyah 5 Yogyakarta. Skripsi thesis 2014, STIKES ’Aisyiyah Yogyakarta.

[15] Almatsier S. Prinsip Dasar Ilmu Gizi. Gramedia Pustaka Utama 2011, Jakarta.

[16] Sefaya, NR. Pengaruh Pendidikan Gizi terhadap Pengetahuan Gizi dan Tingkat Konsumsi Zat Gizi Terkait Pencegahan Anemia Remaja (Studi pada Siwa Kelas XI SMA Teuku Umar Semarang). Jurnal Kesehatan Masyarakat 2017. Universitas Diponegoro.

[17] Marfuah D, Kusudaryati DPD. Efektifitas Edukasi Gizi terhadap Perbaikan Asupan Protein dan Kadar Hemoglobin pada Remaja Putri. Prosiding Semnas Gizi 2017. Universitas Muhammadiyah Surakarta.

[18] Zulaekah S and Widajanti L. 2010. Pengetahuan Gizi dan Kadar Hemoglobin Anak Sekolah Dasar Penderita Anemia setelah Mendapatkan Suplementasi Besi dan Pendidikan Gizi. Kesmas: National Public Health Journal 2010; 5(1): 36-41.