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Introduction: Iron deficiency anemia (IDA) is a highly prevalent nutritional deficiency among children worldwide, primarily driven by inadequate iron intake. Iron intake is influenced by a household’s ability to access food and the diversity of foods consumed. Households that are constantly unable to meet their food requirements are affected by the quality of nutrients absorbed by the body. Food insecurity is the inability of a household to meet its nutritional needs due to food unavailability. This study aimed to investigate the relationship between household food insecurity and dietary diversity and the incidence of anemia among toddlers.
Method: This cross-sectional study was conducted in Kawalu, Tasikmalaya, West Java, Indonesia, involving 142 toddlers aged 24-59 months selected using proportional random sampling. This study collected data on household food insecurity using the Food Insecurity Experience Scale (FIES) questionnaire, food diversity using the Household Dietary Diversity Score (HDDS) questionnaire, and iron intake using a Semi-Quantitative Food Frequency Questionnaire (SQ-FFQ). Additionally, the incidence of anemia was determined using blood samples analyzed with a hematology analyzer. Data analysis was performed using SPSS software for univariate, chi-square, and logistic regression tests (p-values ≤ 0.05).
Results: This study found that Household-level food insecurity was associated with anemia incidence in toddlers (p = 0.049). Additionally, household dietary diversity was significantly related to anemia incidence (p = 0.037), and there was a relationship between toddler iron intake and anemia incidence (p = 0.050). However, multivariate logistic regression revealed that iron intake was the only significant determinant of anemia incidence (p = 0.050). Adequate iron intake demonstrated a protective effect against anemia (OR = 0.363, 95% CI: 0.132 – 1.000), whereas household food insecurity and dietary diversity did not show statistically significant effects in the multivariate model.
Conclusion: Iron intake is the most critical determinant of anemia in toddlers and offers a protective effect. Household food insecurity and dietary diversity were statistically significant risk factors. Interventions should focus on enhancing family food security and educating on iron-rich diets. Further research exploring other nutritional factors, such as protein, vitamin B12, and folic acid, is warranted to establish a comprehensive framework for anemia prevention.
