Department of Nutrition, Faculty of Medicine, Universitas Indonesia-Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.
Human Nutrition Research Center, Indonesian Medical Education and Research Institute (HNRC IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
PLoS One. 2020 Apr 23;15(4):e0231519. doi: 10.1371/journal.pone.0231519. eCollection 2020.
Poor diet is a risk factor for anemia, overweight, and obesity among adolescent girls. However, comprehensive assessment on dietary quality and habits in this population is limited. We assessed the association of meal patterning, dietary quality, and dietary diversity with both anemia and overweight-obesity.
We conducted a cross-sectional survey in 335 school-going adolescent girls aged 12-19 years from three districts in West Java using multi-stage cluster sampling. Meal patterning, Dietary Quality Index for Adolescents (DQI-A), and Dietary Diversity Score (DDS) were determined using 2-day 24-h recall.
Of the girls, 45% were anemic and 17% overweight or obese. Eating occasions of 3-4 times (AOR 2.68, 95% CI 1.21-5.98) and >4 times (AOR 2.43, 95% CI 1.01-5.83) were associated with greater odds of developing anemia compared to eating occasions of <3 times. Adolescent girls who skipped dinner had greater odds of being overweight or obese (AOR 2.13, 95% CI 1.10-4.10) and were less likely to be anemic (AOR 0.56, 95%CI 0.33-0.95) compared to those who did not skip dinner. Difference in energy intake was found between girls who had dinner and skipped dinner (p = 0.05). Mean total DQI-A score was 44.4% ± 7.71% and DDS was 4.0 out of 9.0. DQI-A score was significantly higher in non-anemic compared to anemic girls. Moreover, each unit increment of 1% of total DQI-A score was associated with a 3.967 g/dL increases of hemoglobin after adjustment for confounders. We found differences in total DQI-A score between normal-weight and overweight or obese girls. DDS score was not significantly different between groups, although lower meat, chicken, and fish consumption were correlated with anemia (p<0.01).
Overall, the girls had poor dietary quality and diversity. The findings therefore indicated the importance of improving dietary quality and diversity in a regular meal pattern, especially meal frequency and meal skipping, to reduce the risk of anemia and overweight-obesity among adolescent girls.
不良的饮食是导致青少年女孩贫血、超重和肥胖的风险因素。然而，针对该人群的饮食质量和习惯的综合评估较为有限。本研究旨在评估膳食模式、饮食质量和饮食多样性与贫血和超重肥胖的关系。
我们采用多阶段整群抽样的方法，在西爪哇省的三个地区选取了 335 名 12-19 岁的在校少女进行了横断面调查。使用 2 天 24 小时回顾法确定膳食模式、青少年饮食质量指数（DQI-A）和饮食多样性得分（DDS）。
在这些女孩中，45%患有贫血，17%超重或肥胖。与<3 次进餐相比，3-4 次（优势比 [OR] 2.68，95%置信区间 [CI] 1.21-5.98）和>4 次（OR 2.43，95%CI 1.01-5.83）的进餐次数与发生贫血的几率增加相关。与不不吃晚餐的女孩相比，不吃晚餐的女孩超重或肥胖的几率更高（OR 2.13，95%CI 1.10-4.10），贫血的几率更低（OR 0.56，95%CI 0.33-0.95）。有晚餐和无晚餐的女孩之间的能量摄入存在差异（p=0.05）。平均总 DQI-A 得分为 44.4%±7.71%，DDS 得分为 4.0 分。无贫血女孩的 DQI-A 得分显著高于贫血女孩。此外，在校正混杂因素后，总 DQI-A 得分每增加 1%，血红蛋白增加 3.967 g/dL。我们发现正常体重和超重或肥胖女孩之间的总 DQI-A 得分存在差异。尽管肉类、鸡肉和鱼类的摄入量较低与贫血有关（p<0.01），但 DDS 得分在两组之间无显著差异。
总的来说，这些女孩的饮食质量和多样性较差。因此，研究结果表明，改善规律膳食模式（尤其是进餐频率和是否进餐）中的饮食质量和多样性，对于降低青少年女孩贫血和超重肥胖的风险非常重要。
