Problem Nutrients in Adolescent Girls With Anemia Versus Nonanemic Adolescent Girls and the Optimized Food-Based Recommendations to Meet Adequacy of These Nutrients in Adolescent School Girls in East Java, Indonesia

Abstract

Background: Inadequate intake of micronutrients in adolescence leads to high risk of nutritional anemia contributing to the intergenerational cycle of malnutrition. Objective: To compare problem nutrients in diet of girls with anemia and nonanemic girls and develop food-based recommendation (FBR) to prevent anemia (hemoglobin <12.0 g/dL) and micronutrient deficiencies among adolescent schoolgirls. Methods: Screening for anemia was conducted among 355 adolescent schoolgirls aged 15 to 18 years in East Java, Indonesia. Food consumption patterns were assessed from 69 girls with anemia and 78 nonanemic girls aged 15 to 18 years using two 24-hour dietary recalls and 5-day food records. Weighing is used to obtain food portion sizes. Linear Programming (LP) approach using Optifood was used to identify problem nutrient(s) and formulate FBRs. Results: Iron and calcium were problem nutrients among nonanemic girls, while iron, calcium, folate, and vitamin A were problem nutrients among anemic girls. Milk and liver were potential nutrient-dense foods identified to fill the nutrient gaps. Six FBRs would ensure the dietary adequacy for 9 of 12 nutrients except for iron, folate, and calcium. Conclusions: Anemic girls had more problem nutrients compared to their nonanemic counterparts. The FBRs developed using LP can meet adequacy of most nutrients except iron, folate, and calcium. Nutrient gap identified from LP analysis suggests that it is advisable to add a mixture of weekly iron and folate supplement for adolescent girls in order to meet adequacy of iron and folate to prevent anemia.

Anaemia among adolescents: assessing a public health concern in Lao PDR

“…Other studies showed that adolescents in early period of adolescence (10-13 years) were about five times more likely to be anaemic compared to older adolescents (17)(18)(19), however, in the results reported here, no age difference for the prevalence of anaemia could be found [6].…”

“…This study focuses on factors which might be associated with anaemia among adolescents, including socio-cultural and economic demographic conditions, body mass index, infectious and parasitic diseases [ 15 – 17 ].…”

Knowledge Gaps in Understanding the Etiology of Anemia in Indonesian Adolescents

“…15 Despite the distinct improvement in iron and vitamin A status, supplementation with vitamin A either did not improve or only marginally improved Hb and iron stores above those achieved with iron supplementation alone. 9 Alongside iron, calcium, and folate, vitamin A was also seen as a problem nutrient in the study by Oy et al 14 Vitamin B2. Vitamin B2 (riboflavin) deficiency may also contribute to anemia through its effects on iron metabolism, including a decrease in iron absorption, an increase in intestinal loss of iron or the impairment of iron utilization for Hb synthesis.…”

“…Also, blood folate concentrations were not reported. However, folate was seen as a problem nutrient in the study by Oy et al 14 Vitamin A deficiency. Lack of vitamin A hampers erythropoiesis and may affect iron metabolism as well.…”

“…Using Optifood, Oy et al revealed that iron was a problem nutrient for both anemic and nonanemic adolescent girls. 14 Folate deficiency. Folate is important in the development of erythrocytes, and the lack of it results in megaloblastic anemia.…”