DIETARY HABITS AS INDEPENDENT PREDICTORS OF ANEMIA AMONG FEMALE ADOLESCENT STUDENTS  AT SENIOR HIGH SCHOOL 1 AJIBARANG

Difa Ifa Khairunnisa; Hafiidhaturrahmah Hafiidhaturrahmah; Tri Lestari; Qodri Santosa

doi:10.20884/1.mandala.2026.19.1.19847

Difa Ifa Khairunnisa Faculty of Medicine, Jenderal Soedirman University
Hafiidhaturrahmah Hafiidhaturrahmah Department of Pediatric, Faculty of Medicine, Jenderal Soedirman University
Tri Lestari Department of Clinical Pathology, Faculty of Medicine, Jenderal Soedirman Univesity
Qodri Santosa Department of Pediatric, Faculty of Medicine, Jenderal Soedirman Univesity

DOI: https://doi.org/10.20884/1.mandala.2026.19.1.19847

Abstract

Anemia remains a major public health problem, affecting approximately 29.9% of adolescents globally. Dietary habits are a major modifiable risk factor; however, their role as an independent predictor in rural Southeast Asian settings is not yet fully documented. This study aimed to identify dietary habits and evaluate them as an independent predictor of anemia among female adolescents at Senior High School 1 Ajibarang, Central Java, Indonesia. A cross-sectional study was conducted involving 261 participants (aged 14–17 years) recruited through total sampling. Dietary habits were assessed using a semi-quantitative Food Frequency Questionnaire (FFQ), while anemia status was determined by hemoglobin levels measured via a Point of Care Testing (POCT) device. The prevalence of anemia was 41.0%, with 58.2% of respondents exhibiting poor dietary habits. Bivariate analysis showed a significant association between dietary habits and anemia (p = 0.027; OR = 1.777; 95% CI: 1.067–2.962). The multivariate logistic regression analysis, adjusted for age and socioeconomic confounders, revealed that dietary habits emerged as the sole independent predictor of anemia (p = 0.024). Respondents with poor dietary habits were 1.79 times more likely to be anemic compared to those with good habits (AOR = 1.793; 95% CI: 1.075–2.991). In conclusion, dietary habits are the primary independent predictor of anemia among female adolescents in this rural Indonesian setting.

Author Biographies

Difa Ifa Khairunnisa, Faculty of Medicine, Jenderal Soedirman University

Hafiidhaturrahmah Hafiidhaturrahmah, Department of Pediatric, Faculty of Medicine, Jenderal Soedirman University

Tri Lestari, Department of Clinical Pathology, Faculty of Medicine, Jenderal Soedirman Univesity

Qodri Santosa, Department of Pediatric, Faculty of Medicine, Jenderal Soedirman Univesity

References

Ayele K and Demisew M. 2024. Dietary Factors Associated with Anaemia among Pregnant Women Attending Antenatal Care Clinics in Sekota town, Northern Ethiopia: a facility-based cross-sectional study. BMJ Public Health 2(1): e000368.
Banyumas District Health Office. 2023. Laporan Profil Kesehatan Kabupaten Banyumas 2023. Dinas Kesehatan Kabupaten Banyumas. Purwokerto. https://static.banyumaskab.go.id/website/documents/dinkes/2024/PROFIL%20KESEHATAN%20KABUPATEN%20BANYUMAS%20TAHUN%202023%20RILIS.pdf [Accessed March 1, 2026].
Bhadra P and Deb A. 2020. A Review on Nutritional Anemia. Indian Journal of Natural Sciences, 10 (59), 18451-18458.
Butar Butar AH. 2024. Literature Review: Pola Makan Sehat dalam Masyarakat Terhadap Kesehatan dan Gizi. Jurnal Kesehatan. 2(2): 119-124.
Dibyanshu D, Moses M, Lakra P, Pise RR, Vineeta V, Shubham D, Kumar A, and Kasturwar NB. 2026. Prevalence and Determinants of Anemia Among Adolescent Girls: A Community-Based Cross-Sectional Study in a Rural Field Practice Area of a Tertiary Hospital, India. Cureus 18(1): e101423.
Dorland WAN. 2020. Dorland's Illustrated Medical Dictionary (32nd ed.). Elsevier. Philadelphia.
Fentie K, Wakayo T, and Gizaw G. 2020. Prevalence of anemia and associated factors among secondary school adolescent girls in Jimma Town, Oromia Regional State, Southwest Ethiopia. Anemia. 2020: 5043646.
Fu J, Zhao X, and Zhang J. 2024. Dietary Patterns and Anemia among Children and Adolescents in Rural Southern China. Nutrients 15(19): 4133.
Gardner WM and Kassebaum NJ. 2023. Prevalence, Years Lived with Disability, and Trends In Anaemia Burden by Severity and Cause, 1990–2021: findings from the Global Burden of Disease Study 2021. The Lancet Haematology 10(9): e713-e734.
Gibson RS, Raboy V, and King JC. 2018. Implications of Phytate in Plant-Based Foods for Iron and Zinc Bioavailability, setting dietary requirement, and formulating programs and policies. Nutrition Reviews, 76 (11), 793-804
Habtegiorgis SD, Petrucka P, Telayneh AT, Getahun DS, Getacher L, Alemu S, and Birhanu MY. 2022. Prevalence and associated factors of anemia among adolescent girls in Ethiopia: A systematic review and meta-analysis. PLOS ONE 17(3): e0264063.
Hardiansyah A, Aulia EP, and Sugiyanti D. 2024. Hubungan Asupan Zat Besi, Vitamin C, dan Persen Lemak Tubuh dengan Kejadian Anemia pada Remaja Putri di Pondok Pesantren Askhabul Kahfi Kota Semarang. Amerta Nutrition. 8(3SP): 170-179
Hasan Syah MN, Asna AF, Perdana SM, and Utah-Iheanyichukwu C. 2025. Anemia Status of Girls Adolescent and It’s Contributing Factors at Bekasi City, Indonesia. Buletin Penelitian Kesehatan 53(2): 49-60.
Indartanti D and Kartini A. 2014. Hubungan status gizi dengan kejadian anemia pada remaja putri. Journal of Nutrition College, 3(2), 33–39.
Ma J, Huang J, Zeng C, Zhong X, Zhang W, Zhang B, and Li Y. 2023. Dietary patterns and association with anemia in children aged 9–16 years in Guangzhou, China: A cross-sectional study. Nutrients, 15(19), 4133.
Mantadakis E, Chatzimichael E, and Zikidou P. 2020. Iron Deficiency Anemia in Children Residing in High and Low-Income Countries: Risk Factors, Prevention, Diagnosis and Therapy. Mediterranean Journal of Hematology and Infectious Diseases, 12(1), e2020041.
Ministry of Health Republic of Indonesia. 2019. Indonesia National Health Research (Riskesdas) 2018: Final Report. NIHRD Press. Jakarta.
Pasricha SR, Tye-Din J, Muckenthaler MU, and Swinkels DW. 2021. Iron deficiency. The Lancet, 397(10270), 233–248.
Pibriyanti K, Nufus NT, and Luthfiya L. 2021. The relationship of the menstrual cycle, menstrual length, frequency of menstruation, and physical activities with the incident of anemia in adolescents’ girls at Islamic boarding school. Journal of Nutrition College, 10(2), 112–119.
Santrock JW. 2021. Adolescence (18th ed.). McGraw-Hill Education. New York.
Siska Y and Masluroh. 2024. Hubungan Pola Makan dengan Kejadian Anemia pada Remaja Putri SMAN 6 Bogor di Bogor. Malahayati Nursing Journal, 6 (5): 1992-2002.
World Health Organization. 2023. Accelerating Anaemia Reduction: A Comprehensive Framework for Action. World Health Organization. https://www.who.int/publications/i/item/9789240074033 [Accessed March 12, 2026].