PERBEDAAN KADAR HEMOGLOBIN DARAH MENURUT KARAKTERISTIK DAN FREKUENSI KONSUMSI TEPUNG TERIGU PENDUDUK INDONESIA UMUR 10 TAHUN KE ATAS

Main Article Content

Rika Rachmalina
Nunik Kusumawardani
Rofingatul Mubasyiroh

Abstract

This study aims to assess hemoglobin (Hb) level difference according to characteristics and wheat flour consumption frequency among Indonesian aged ≥10. This study used national health survey (Riskesdas) 2013 data, involving 42,705 subjects in the analysis. Hb level was the dependent variable and the independent variables included sample characteristics and wheat flour consumption frequency. An independent t-test was used to examine the difference between two categories of variables and one-way analysis of variance for variables ≥3 categories. There were significant differences in Hb level within groups according to gender, age, education, working status, residence, region, wealth index quintile, and wheat flour consumption frequency. Hb level was significantly higher among subjects with consumption of ≥3 times/week (13,435 g/dL) than consumption of <3 times/month or never (13,357 g/dL). By having sex stratification, the highest Hb level was significantly found among those who consumed wheat flour ≥3 times/week, both in women (12,701 g/dL) and men (14,115 g/dL). There was no difference in Hb level according to wheat flour frequency consumption after stratifying the place of residence. By having wealth index quintile stratification, the significant difference was only found among subjects in quintile 2, it showed that Hb level was higher among subjects who consumed wheat flour 1-2 times/week (13,458 g/dL) than <3 times/month or never (13,299 g/dL). Hb level was lower among a group of female, younger age, lower education, unemployed, living in a rural area, living in the eastern region, quintile 1, and wheat flour consumption <3 times/month or never. Maintaining sustainable Fe fortification in wheat flour is important to reduce anemia.

Keywords: anemia, iron fortification, wheat flour consumption

 

ABSTRAK

Studi ini bertujuan untuk mengetahui perbedaan kadar hemoglobin (Hb) darah menurut karakteristik dan konsumsi tepung terigu penduduk ≥10 tahun. Studi ini menggunakan data survei kesehatan nasional (Riskesdas) 2013, dengan total sampel yang dianalisis dalam studi ini yaitu 42.705. Kadar Hb darah adalah variabel dependen dan variabel independen meliputi karakteristik dan frekuensi konsumsi tepung terigu sampel. Uji independent t-test digunakan untuk melihat perbedaan variabel dengan dua kategori dan uji one-way analysis of variance untuk variabel ≥3 kategori. Terdapat perbedaan kadar Hb darah yang signifikan antar kelompok menurut jenis kelamin, umur, pendidikan, status bekerja, tempat tinggal, region, kuintil indeks kepemilikan, dan frekuensi konsumsi tepung terigu. Penduduk yang mengonsumsi tepung terigu ≥3 kali/minggu (13,435 g/dL) secara signifikan memiliki kadar Hb darah lebih tinggi dibandingkan konsumsi <3 kali/bulan atau tidak pernah (13,357 g/dL). Setelah distratifikasi jenis kelamin, kadar Hb darah tertinggi secara signifikan pada penduduk dengan konsumsi tepung terigu ≥3 kali/minggu baik pada perempuan (12,701 g/dL) maupun laki-laki (14,115 g/dL). Tidak terdapat perbedaan kadar Hb darah menurut frekuensi konsumsi tepung terigu setelah distratifikasi tempat tinggal. Setelah distratifikasi kuintil indeks kepemilikan, perbedaan signifikan hanya terlihat pada penduduk di kuintil 2, yaitu kadar Hb darah lebih tinggi pada frekuensi konsumsi tepung terigu 1-2 kali/minggu (13,458 g/dL) dibandingkan konsumsi <3 kali/bulan atau tidak pernah (13,299 g/dL). Kadar Hb darah lebih rendah pada penduduk perempuan, umur lebih muda, pendidikan rendah, tidak bekerja, tinggal di pedesaan, tinggal di region Maluku Papua, dan mengonsumsi tepung terigu <3 kali per bulan/tidak pernah. Mempertahankan keberlanjutan fortifikasi Fe pada terigu berpotensi penting dalam menurunkan anemia.

Kata kunci: anemia, fortifikasi Fe, konsumsi tepung terigu

Downloads

Download data is not yet available.

Article Details

Section
Articles

References

Gardner W, Kassebaum N. Global, Regional, and National Prevalence of Anemia and Its Causes in 204 Countries and Territories, 1990–2019. Curr Dev Nutr [Internet]. 2020 Jun 1 [cited 2021 Jan 23];4(Supplement_2):830–830. Available from: https://academic.oup.com/cdn/article/4/Supplement_2/830/5845051

Didzun O, De Neve JW, Awasthi A, Dubey M, Theilmann M, Bärnighausen T, et al. Anaemia among men in India: a nationally representative cross-sectional study. Lancet Glob Heal [Internet]. 2019 Dec 1 [cited 2020 Sep 23];7(12):e1685–94. Available from: www.thelancet.com/lancetgh

World Health Organization. Nutritional anaemias: Tools for effective prevention and control [Internet]. WHO Document Production Services, Geneva, Switzerland, 2017. 2017 [cited 2021 Jan 23]. 83 p. Available from: https://www.who.int/publications/i/item/9789241513067

Kementerian Pertanian. Statistik konsumsi pangan tahun 2018 [Internet]. Jakarta; 2018 [cited 2021 Mar 20]. Available from: http://epublikasi.setjen.pertanian.go.id/download/file/450-statistik-konsumsi-pangan-tahun-2018

Kementerian Perindustrian dan Perdagangan RI. Perubahan atas Keputusan Menteri Perindustrian dan Perdagangan Nomor 153/MPP/Kep/5/2001 tentang penerapan secara wajib SNI tepung terigu sebagai bahan makanan (SNI. 01-3751-2000/Rev. 1995 dan revisinya) [Internet]. 323/MPP/Kep/11/2001 Indonesia; 2001 p. 3. Available from: http://jdih.kemenperin.go.id/site/baca_peraturan/417

Kementerian Kesehatan RI. Keputusan Menteri Kesehatan Republik Indonesia tentang fortifikasi tepung terigu. Indonesia; 2003 p. 2.

Hoogendoorn A, Luthringer C, Parvanta I, Garrett GS. Food fortification Global Mapping Study [Internet]. 2016 [cited 2021 Jan 25]. Available from: https://www.gainhealth.org/resources/reports-and-publications/food-fortification-global-mapping-study-2016

Komisi Fortifikasi Indonesia. Mandated cooking oil fortified with vitamin A [Internet]. Jakarta; 2014 [cited 2021 Jan 25]. Available from: http://kfindonesia.org/newkfi/wp-content/uploads/2016/04/newsletter-v9-rev-12.pdf

Semba RD, Moench-Pfanner R, Sun K, De Pee S, Akhter N, Rah JH, et al. Iron-fortified milk and noodle consumption is associated with lower risk of anemia among children aged 6-59 mo in Indonesia. Am J Clin Nutr. 2010 Jul 1;92(1):170–6.

Diana A, Mallard SR, Haszard JJ, Purnamasari DM, Nurulazmi I, Herliani PD, et al. Consumption of fortified infant foods reduces dietary diversity but has a positive effect on subsequent growth in infants from Sumedang district, Indonesia. PLoS One [Internet]. 2017 Apr 1 [cited 2021 Jan 25];12(4). Available from: https://pubmed.ncbi.nlm.nih.gov/28426828/

Kendrick K, Codling K, Muslimatun S, Pachon H. The Contribution of Wheat Flour Fortification to Reducing Anemia in Indonesia. Eur J Nutr Food Saf [Internet]. 2015 Aug 14 [cited 2021 Jan 25];5(5):446–7. Available from: www.sciencedomain.org

Soekirman, Jus’at I. Food fortification in Indonesia. Malays J Nutr [Internet]. 2017 [cited 2021 Jan 25];23(1):1–7. Available from: https://nutriweb.org.my/mjn/publication/23-1/a.pdf

Kementerian Kesehatan RI. Laporan Riset Kesehatan Dasar (Riskesdas) 2013. Jakarta; 2013.

Kementerian Kesehatan RI. Pedoman pemeriksaan biomedis di lapangan. Jakarta; 2013. p. 101.

WHO. Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity [Internet]. Geneva, Switzerland: World Health Organization. 2011 [cited 2020 Sep 23]. 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

Kassebaum NJ, Fleming TD, Flaxman A, Phillips DE, Steiner C, Barber RM, et al. The Global Burden of Anemia. Hematol Oncol Clin North Am [Internet]. 2016 Apr 1 [cited 2020 Nov 30];30(2):247–308. Available from: https://pubmed.ncbi.nlm.nih.gov/27040955/

Abdo N, Douglas S, Batieha A, Khader Y, Jaddou H, Al-Khatib S, et al. The prevalence and determinants of anaemia in Jordan. East Mediterr Heal J [Internet]. 2019 [cited 2020 Dec 1];25(5):341–9. Available from: https://doi.org/10.26719/emhj.18.047

Kocaoz S, Cirpan R, Degirmencioglu AZ. The prevalence and impacts heavy menstrual bleeding on anemia, fatigue and quality of life in women of reproductive age. Pakistan J Med Sci [Internet]. 2019;35(2):365–70. Available from: www.pjms.org.pk365

Stang J, Story M. Guidelines for Adolescent Nutrition Services. 2005.

World Health Organization. Guideline: Implementing Effective Actions for Improving Adolescent Nutrition [Internet]. Who. 2018 [cited 2020 Dec 1]. Licence: CC BY-NC-SA 3.0 IGO. Available from: http://apps.who.int/iris/bitstream/handle/10665/260297/9789241513708-eng.pdf;jsessionid=19D1CBFA434795BA1645CC009FFE99A4?sequence=1

Shaka MF, Wondimagegne YA. Anemia, a moderate public health concern among adolescents in South Ethiopia. PLoS One [Internet]. 2018;13(7):1–14. Available from: https://doi.org/10.1371/journal.pone.0191467

Haverkate M, Smits J, Meijerink H, van der Ven A. Socioeconomic determinants of haemoglobin levels of african women are less important in areas with more health facilities: A multilevel analysis. J Epidemiol Community Health [Internet]. 2014 [cited 2021 Jan 23];68(2):116–22. Available from: https://pubmed.ncbi.nlm.nih.gov/24098045/

Chaparro CM, Suchdev PS. Anemia epidemiology, pathophysiology, and etiology in low- and middle-income countries. Ann N Y Acad Sci [Internet]. 2019 [cited 2021 Jan 19];1450(1):15. Available from: /pmc/articles/PMC6697587/?report=abstract

APTINDO. Indonesia wheat flour consumption and growth [Internet]. Jakarta; 2016 [cited 2021 Jan 18]. Available from: http://aptindo.or.id/2016/10/28/indonesia-wheat-flour-cunsumption-growth/

Kementerian Kesehatan RI. Studi diet total: Survei Konsumsi Makanan Individu Indonesia. Indonesia; 2014.

Sadighi J, Nedjat S, Rostami R. Systematic review and meta-analysis of the effect of iron-fortified flour on iron status of populations worldwide. Public Health Nutr [Internet]. 2019 [cited 2021 Jan 18];22(18):3465–84. Available from: https://www.cambridge.org/core.

Barkley JS, Wheeler KS, Pachón H. Anaemia prevalence may be reduced among countries that fortify flour. Br J Nutr [Internet]. 2015;114(2):265–73. Available from: https://doi.org/10.1017/S0007114515001646

Field MS, Mithra P, Estevez D, Peña-Rosas JP. Wheat flour fortification with iron for reducing anaemia and improving iron status in populations. Cochrane Database Syst Rev. 2020 Jul 17;2020(7).

Kementerian Kesehatan RI. Peraturan Menteri Kesehatan Republik Indonesia tentang standar produk suplementasi gizi. Indonesia; 2016 p. 22.