Female adolescents are at high risk of anemia due to nutrient deficiencies and unhealthy lifestyle. Fast food consumption and snacking with high calories, carbohydrates and fat are very common in adolescent daily life that can cause inflammation by which macrophage infiltration into adipose tissues leading to hypertrophy and hyperplasia. This situation triggers the release of pro-inflammatory cytokines such as interleukin-6 (IL-6) which inhibits iron metabolism. Therefore, this study aimed to investigate the correlation of fast food consumption and snacking with hemoglobin (Hb) levels in female adolescents. This cross sectional research study was performed among 117 female adolescents of high and vocational schools in Karanganyar Regency, which were selected using the stratified random sampling. Data of fast food consumption and snacking were collected using the Food Frequency Questionnaire (FFQ), and hemoglobin levels were determined using a hematology analyzer. To test data normality, we used the Kolmogorov-Smirnov test. The Spearman rank was used to analyze individual correlation of variables with Hb levels, and all together variables were analyzed using a multiple linear regression test. A total of 17.1 % female adolescents suffered from anemia. Fast food consumption (r = -3.47; p = 0.001) significantly correlated with Hb levels but not for snacking (r = -1.44; p = 0.152). In conclusion, fast food consumption negatively correlates with Hb levels in female adolescents while snacking does not. Education of healthy nutrition is required for prevention of anemia in female adolescents.

Nutritional problem that occurs in adolescents due to higher food intake and less physical activity leads to over- nutrition. Other nutritional problems occur among them is micronutrient deficiency including anemia, mostly in female adolescents. Higher consumption of energy-dense snacks, low physical activity and more pocket money  have contributed to adolescent’s body weight. This study aims to determine the correlation of frequency of snacking, hemoglobin levels, physical activity, and pocket money with the nutritional status of female adolescents. This cross- sectional study was carried out in 117 female adolescents in Karanganyar Regency, Central Java Province. Data of snacking frequency was collected using the Food Frequency Questionnaire (FFQ) and hemoglobin level were measured using a Hematology Analyzer. Physical activity data were collected using the IPAQ questionnaire (International Physical Activity Questionnaire) and were converted to Metabolic Equivalent Tasks (METs). Normally distributed data then analyzed using Pearson test and Spearman test for not normally distributed data to determine correlation between independent with dependent variables and followed by the multiple linear regression test if the p-value < 0.25. Most female adolescents had normal nutritional status, but 6.8% and 17.9% female adolescents were overweight and obesity, respectively. The frequency of snacking (r = 0.207, p = 0.025), physical activity (r = -0.201, p = 0.030), pocket money (r = 0.283, p = 0.002) and hemoglobin level (r = 0.150, p = 0.107) were not correlated with nutritional status. In conclusion, frequency of snacks, physical activity, and pocket money were significantly correlated with nutritional status in female adolescents but no correlation with hemoglobin level.