The Correlations of Body Image, Eating Behavior Types, and Energy and Nutrient Adequacy Level with Anemia Status in Adolescent Girls at SMAN 1 Dramaga, Bogor Regency

Novi Puspita Sari; Lilik  Kustiyah; Hadi  Riyadi

doi:10.56303/jhnresearch.v5i1.932

Authors

Novi Puspita Sari Nutrition Study Program, Faculty of Medicine and Nutrition, IPB University, Indonesia https://orcid.org/0009-0009-1135-0093
Lilik Kustiyah Nutrition Study Program, Faculty of Medicine and Nutrition, IPB University, Indonesia https://orcid.org/0000-0003-0602-0806
Hadi Riyadi Nutrition Study Program, Faculty of Medicine and Nutrition, IPB University, Indonesia https://orcid.org/0000-0002-2166-2340

Keywords:

Anemia, Adolescent Girls, body image, Eating Behaviour, Nutrient adequacy

Abstract

Anemia is a serious global public health issue with the highest prevalence in adolescent girls. This study aimed to analyze the relationships among body image, eating behaviour, and the adequacy of energy and nutrient intake with anemia status in adolescent girls. This study used a cross-sectional design with 105 participants selected through purposive sampling. Data on subject characteristics were collected using a questionnaire, body image was assessed using the Body Shape Questionnaire (BSQ), eating behaviour using the Dutch Eating Behaviour Questionnaire (DEBQ), nutrient adequacy level using 2 × 24 H food recall, and hemoglobin levels were measured using HemoCue 301. Data were analysed using the Spearman Rank test. The results showed that 28.6% of the subjects had anemia. Based on bivariate analysis, there was no correlation between body image and anemia status (r=-0.108, p =0.271). There was also no correlation between emotional eating, external eating, and restrained eating (p>0.05) and anemia status. Similarly, energy (r= 0.133, p=0.177), vitamin B9 (r=0.169, p=0.085), and vitamin C (r=0.016, p=0.873) were not significantly correlation with anemia status. However, adequacy level of protein (r=0.288, p=0.003), iron (r= 0.194, p=0.048), and vitamin B12 (r= 0.216, p=0.027) were significantly positive correlation with anemia status. This study indicates that the majority of subjects had a negative body image, tended to display external eating behavior, and generally had insufficient nutrient intake. Therefore, nutrition education for adolescents is needed, with a focus on promoting healthy and high-quality eating habits.

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References

WHO. World Health Organization. Geneva; 2023. Anaemia. Available from: https://www.who.int/health-topics/anaemia

Sari P, Herawati DMD, Dhamayanti M, Hilmanto D. Anemia among Adolescent Girls in West Java, Indonesia: Related Factors and Consequences on the Quality of Life. Nutrients. 2022;14(18):1–13.

Kementerian Kesehatan RI. Laporan Riskesdas 2018 Nasional [Internet]. Lembaga Penerbit Balitbangkes. 2018. p. hal 156. Available from: https://repository.badankebijakan.kemkes.go.id/id/eprint/3514/1/Laporan Riskesdas 2018 Nasional.pdf

Permatasari T, Briawan D, Madanijah S. Hubungan Asupan Zat Besi dengan Status Anemia Remaja Putri Di Kota Bogor. PREPOTIF J Kesehat Masy. 2020;4(2):95–101.

Dinkes Kota Bogor. Dinas Kesehatan Melakukan Monitoring RAN PIJAR dan Aksi Bergizi Bersama RISE Foundation. Bogor Smart Health. 2024.

Sobari DM, Permatasari TrAE, Purnamawati D. Analisis determinan kejadian anemia remaja putri sekolah menengah atas wilayah kerja puskesmas Sentul Kabupaten Bogor. J Kesehat Reproduksi. 2023;14(2):95–103.

Badan Penelitian dan Pengembangan Kesehatan Kementerian Kesehatan RI. Riset Kesehatan Dasar 2013. 2013. p. 1–304.

Kemenkes RI. Profil Kesehatan Indonesia 2023. Jakarta: Kementerian Kesehatan Republik Indonesia; 2024. 100 p.

WHO. World Health Organization. Geneva: World Health Organization; [cited 2006 Apr 20]. Adolescent Health. Available from: https://www.who.int/health-topics/adolescent-health#tab=tab_1

Bittar C, Soares A. Media and Eating Behavior in Adolescence. Brazilian J Occup Ther. 2020;28(1):291–308.

Norris SA, Frongillo EA, Black MM, Dong Y, Fall C, Lampl M, et al. Nutrition in Adolescent Growth and Development. In: Adolescent Nutrition 1. 2022. p. 57–79.

Chalise B, Aryal KK, Mehta RK, Dhimal M, Sapkota F, Mehata S, et al. Prevalence and Correlates of Anemia Among Adolescents in Nepal: Findings from a Nationally Representative Cross Sectional Survey. PLoS One. 2018;13(12):1–11.

Batubara JR. Adolescent Development (Perkembangan Remaja). Sari Pediatr. 2016;12(1):21.

Niswah I, Rah JH, Roshita A. The Association of Body Image Perception With Dietary and Physical Activity Behaviors Among Adolescents in Indonesia. Food Nutr Bull. 2021;42(1_suppl):S109–21.

Yusinta AN, Adriyanto. Hubungan Antara Perilaku Makan dan Citra Tubuh dengan Status Gizi Remaja Putri Usia 15-18 Tahun. Amerta Nutr. 2018;2(2):147–54.

Denich AU, Ifdil I. Konsep Body Image Remaja Putri. J Konseling dan Pendidik. 2015;3(2):55–61.

Hutasuhut RM, Supriati. Relationship between Body Image and Dietary Status with Anemia in Adolelescent girl in Dusun III Bakaran Batu Village Batang Kuis District Deli Serdang Regency. Sci Midwifery [Internet]. 2022;10(2):974–9. Available from: www.midwifery.iocspublisher.org

Bodega P, de Cos-Gandoy A, Fernández-Alvira JM, Fernández-Jiménez R, Moreno LA, Santos-Beneit G. Body Image and Dietary Habits in Adolescents: A Systematic Review. Nutr Rev. 2024;82(1):104–27.

Yong C, Liu H, Yang Q, Luo J, Ouyang Y, Sun M, et al. The Relationship between Restrained Eating, Body Image, and Dietary Intake among University Students in China: A Cross-Sectional Study. Nutrients. 2021;13(3):1–15.

Hosmiati, Ro’isah, Ainul Yaqin Salam. Hubungan Perilaku Makan dengan Kejadian Anemia pada Ibu Hamil di Desa Kregenan Kraksaan Probolinggo. Med J Al-Qodiri. 2023;8(1):31–7.

Ayudinanti N. Gambaran Body Image dan Status Gizi dengan Kejadian Anemia Remaja Putri di SMA Negeri 1 Mamuju. J Ilm Maju. 2021;4(1).

Lemeshow S, David J. Besar Sampel dalam Penelitian Kesehatan. Yogyakarta: Gajah Mada University; 1997.

Cooper PJ, Taylor MJ, Zafra C, Fairburn CG. The Development and Validation of the Body Shape Questionnaire. Int J Eat Disord. 1987;6(4):485–94.

Widyakarya Nasional Pangan dan Gizi XI. Percepatan Penurunan Stunting melalui Revitalisasi Ketahanan Pangan dalam Rangka Mencapai Tujuan Pembangunan Berkelanjutan. XI. Jakarta; 2018.

Gibson RS. Principles of Nutrition Assessment 2nd Ed. In: 2nd ed. Dunedin, New Zealand: Oxford University Press; 2005.

WHO. Haemoglobin Concentrations for the Diagnosis of Anaemia and Assessment of Severity. Geneva, Switz World Heal Organ [Internet]. 2011;1–6. Available from: http://scholar.google.com/scholar?hl=en&btnG=Search&q=intitle:Haemoglobin+concentrations+for+the+diagnosis+of+anaemia+and+assessment+of+severity#1

WHO. Nutritional Anaemias : Tools for Effective Prevention. World Health Organization. Geneva: WHO; 2017. 7 p.

Zulfa WI. Hubungan Body Image, Kebiasaan Makan, dan Status Gizi dengan Masalah Anemia Gizi pada Remaja Putri di SMA Negeri 1 Sampang. Media Gizi Kesmas. 2023;12(1):344–51.

Putra KAD, Yuliyatni PCD, Sutiari NK. The relationship between body image and tea drinking habits with anemia among adolescent girls in Badung District, Bali, Indonesia. Public Heal Prev Med Arch. 2020;8(1):24–31.

Zakiah S, Toaha A, Abri N, Wahyutri E. The Effect of Nutrition Education on Knowledge, Attitudes, and Iron Intake in Adolescent Girls. J Heal Nutr Res. 2023;2(3):131–9.

Ryu GB, Heo YR. Exploring Emotional, Restrained, and External Eating Behaviors: Impacts on Energy and Nutrient Intakes Among Korean Adults. Nutr . 2025;17(3):1–12.

Karunanayake D, Jayasooriya MWDSM, Vimukthi NDU. Psychological Impact on the Eating Behaviors of University Students. South Asian J Soc Stud Econ. 2020;8(4):132–41.

Daly AN, O’Sullivan EJ, Walton J, McNulty BA, Kearney JM. Eating behaviour styles in Irish teens: A cross-sectional study. Public Health Nutr. 2021;24(8):2144–52.

Akib A, Sumarmi S. Food Consumption Habits of Female Adolescents Related to Anemia: A Positive Deviance Approach. Amerta Nutr. 2017;1(2):105–16.

Agustina R, Nadiya K, El Andini A, Setianingsih AA, Sadariskar AA, Prafiantini E, et al. Associations of Meal Patterning, Dietary Quality and Diversity with Anemia and Overweight-Obesity among Indonesian Schoolgoing Adolescent Girls in West Java. PLoS One [Internet]. 2020;15(4):1–19. Available from: http://dx.doi.org/10.1371/journal.pone.0231519

Zalfa T, Irawan AMA, Umami Z, Rahmawati LA, Yusuf AM. Relationship Between Energy, Protein, Iron, and Calcium Intake with Hemoglobin Levels of Pregnant Women. J Heal Nutr Res. 2024;3(3):177–84.

Sholicha CA, Muniroh L. Hubungan Asupan Zat Besi, Protein, Vitamin C dan Pola Menstruasi dengan Kadar Hemoglobin pada Remaja Putri di SMAN 1 Manyar Gresik. Media Gizi Indones. 2019;14(2):147.

Hidayati Y, Sulastri D, Utami BI. Hubungan Asupan Protein dan Zat Besi dengan Kejadian Anemia. Maj Kedokt Andalas. 2023;46(2):385–93.

Hardiansyah A, Aulia EP, Sugiyanti D. Hubungan Asupan Zat Besi, Vitamin C, dan Persen Lemak Tubuh dengan Kejadian Anemia pada Remaja Putri di Pondok Pesantren Askhabul Kahfi Kota Semarang. Amerta Nutr. 2024;8(3SP):170–9.

Sholihah N, Andari S, Wirjatmadi B. Hubungan Tingkat Konsumsi Protein, Vitamin C, Zat Besi dan Asam Folat dengan Kejadian Anemia pada Remaja Putri SMAN 4 Surabaya. Amerta Nutr. 2019;3(3):135–41.

Siallagan D, Swamilaksita PD, Angkasa D. Pengaruh Asupan Fe, Vitamin A, Vitamin B12, dan Vitamin C terhadap Kadar Hemoglobin pada Remaja Vegan. J Gizi Klin Indones. 2016;13(2):67.

Sarbini D, Darmayanti P, Pratiwi WW. Hubungan Tingkat Asupan Seng dan Vitamin B12 dengan Kejadian Anemia pada Remaja Putri di SMAN 1 Teras Boyolali. Muhammadiyah J Nutr Food Sci. 2024;5(1):54.

Nasrul N, Hafid F, Taqwin T, Hikmah, Risma, Nuswantari A, et al. Iron Supplement Consumption, Dietary Intake, Nutritional Status, and Anemia Among Adolescent Girls in Banawa, Donggala Regency. J Heal Nutr Res. 2025;4(2):892–904.