Plant-based Diet and Iron Deficiency Anemia in Sundanese Adolescent Girls at Islamic Boarding Schools in Indonesia

Abstract

Background. Adolescent girls are at risk for iron deficiency anemia (IDA) due to the higher demand of iron for growth and the loss of blood during menstruation. Consumption of foods containing iron that have higher bioavailability can reduce the risk of IDA although diets that are largely plant-based, like those consumed by many Sundanese people, may not contain sufficient bioavailable iron. Here, we investigated the correlation between plant-based diets and IDA in adolescent Sundanese girls who were students at Islamic boarding schools in Indonesia. Methods. A total of 176 girls from seven Islamic boarding schools in Tasikmalaya were recruited. Nutritional intake data were obtained using 24-hr dietary recall. Blood samples were analyzed with a Sysmex-XNL instrument to measure several parameters including hemoglobin, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC). Results. The prevalence of IDA in the study population was 22.2%. Iron intake was 6.59 mg/day, which was lower than the recommended amount. The molar ratio of phytic acid to iron and vitamin C to iron was 8.72 and 0.03, respectively. There was a correlation between heme iron and both hemoglobin ( p = 0.009 ) and hematocrit ( p = 0.018 ). Iron from meat, fish, and poultry was correlated with hemoglobin ( p = 0.009 ) and hematocrit ( p = 0.011 ). Conclusion. The Sundanese plant-based diet did not affect the IDA status. Instead, IDA was associated with consumption of less animal-based foods that have iron with higher bioavailability. Increased access to an animal-based menu at the school cafeteria could be an approach to prevent IDA in students at Islamic boarding schools in Indonesia.

Iron Deficiency Anemia and Associated Factors Among Adolescent Girls and Women in a Rural Area of Jatinangor, Indonesia

“…45 , 46 In the study reported by Rahfiludin, IDA was associated with less animal-based foods characterized by iron with higher bioavailability. 47 This finding can also explain why anemia in this study is more common in adolescents than in adults. One factor that causes anemia is an inadequate nutritional intake.…”

Recommendation on Anemia Issue in Indonesia: Should Be More Meso and Macro Level Interest

“…The majority of publications in other years highlighted the micro levels focus, such as iron pro les as screening 13) , meal patterning for treating Anemia. 4,[14][15][16][17] ) Anemia related obstetric outcome, 18) and correlation with malaria, 19) and also iron-folic acid supplementation anemia, 20) the traditional source of iron supplementation, 21,22) personal adherence to iron supplementation, [23][24][25] role of educational media, or health education. 26) Here, the publication attention lacked Meso-level publication involving the role of organization and community in the successful implementation of iron supplementation program.…”

Correlation of Hemoglobin Levels with Nutritional Status in Adolescent Girls: A Health Promotion Perspective

“…Nutritional status R 0.05 P-value 0.55 N the incidence of anemia in the vegetarian and nonvegetarian groups. 40 Another study of adolescent girls in Jatinangor, using the Chi-square test, also found no significant difference between the distribution of nutritional status and the incidence of anemia. 35 A study using the BMI indicator also found no significant relationship between BMI and the prevalence of anemia in adolescents.…”