Iron Intake and Its Correlation to Ferritin and Hemoglobin Level among Children Aged 24–36 Months in Jakarta in 2020

Main Article Content

Jessica Ferdi
Saptawati Bardosono
Bernie Endyarni Medise


Introduction: Iron is essential for child’s development and growth. Children’s iron requirements are secured from daily food intake that might be affected by Covid-19 pandemic. This study aims to determine iron intake and its relationship with ferritin and hemoglobin levels as indicators of iron status among children in Jakarta.Method: This cross-sectional study was conducted in Kampung Melayu, Jakarta from September to October 2020. Seventy seven healthy children aged 24–36 months were taken using total population sampling method. Interviews were conducted to obtain characteristics data and iron intake using a semi-quantitative-food frequency questionnaire (SQ-FFQ). Blood tests are performed to check the levels of ferritin (controlled by hs-CRP value), and hemoglobin.Pearson’s/Spearman’s correlation test was performed using SPSS version 20.0. Result: Median of iron intake was 9.6 (1.5–40,7) mg/day, in which 33.8% of subjects was below the Indonesian Recommended Dietary Allowance (RDA) recommendation. The median ferritin value was 18.1 (1.4–91.1) 𝜇g/L and the hemoglobin was 11.8 (6.6–15.2) g/dL, in which 40.3% and 27.3% subjects with iron insufficient-deficient and anemia, respectively. There were  positive correlations between iron intake and ferritin (r = 0.328, p = 0.002) and iron intake and hemoglobin (r = 0.308, p = 0.003). A strong positive correlation was found between ferritin and hemoglobin (r = 0.769, p < 0.001).Conclusion: Iron intake of children aged 24–36 months had a weak positive correlation with ferritin and hemoglobin level. Keywords: children 24–36 months, ferritin, hemoglobin, iron intake, Jakarta

Article Details

Author Biographies

Jessica Ferdi, Faculty of Medicine, Universitas Indonesia – Dr. Cipto Mangunkusumo General Hospital

Department of Nutrition

Saptawati Bardosono, Faculty of Medicine, Universitas Indonesia – Dr. Cipto Mangunkusumo General Hospital

Department of Nutrition

Bernie Endyarni Medise, Faculty of Medicine, Universitas Indonesia – Dr. Cipto Mangunkusumo General Hospital Jl Salemba Raya no 6, Jakarta 10430, Indonesia

Department of Child Health


Cerami C. Iron nutriture of the fetus, neonate, infant, and child. Ann Nutr Metab. 2017;71(suppl 3):8–14. DOI: 10.1159/000481447.

Ozdemir N. Iron deficiency anemia from diagnosis to treatment in children. Turk Pediatri Ars. 2015;50(1):11–9. DOI: 10.5152/tpa.2015.2337.

Pfeiffer CM, Looker AC. Laboratory methodologies for indicators of iron status: strengths, limitations, and analytical challenges. Am J Clin Nutr. 2017;106:1606–20. DOI: 10.3945/ajcn.117.155887.

WHO. Serum ferritin concentrations for assessment of iron status and iron deficiency in populations. Vitamin and Mineral Nutrition Information System. Geneva: World Health Organization; 2011.

Nehring SM, Patel BC. C reactive protein. Treasure Island: StatPearls Publishing; 2019. Cited 2019 Oct 15. Available from

C-reactive protein concentrations as a marker of inflammation or infection for interpreting biomarkers of micronutrient status. Vitamin and Mineral Nutrition Information System. Geneva: World Health Organization; 2014. Cited 2019 Oct 15. Available from: WHO_NMH_NHD_EPG_14.7_eng.pdf?ua=1.

Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. Vitamin and Mineral Nutrition Information System. Geneva: World Health Organization; 2011 (WHO/NMH/NHD/MNM/11.1) Cited 2019 Aug 16. Available from

Kemenkes RI. Peraturan Menteri Kesehatan Republik Indonesia Angka kecukupan gizi yang dianjurkan untuk masyarakat Indonesia. 2019

Herawati AN, Palupi NS, Andarwulan N, Efriwati. Kontribusi asupan zat besi dan vitamin c terhadap status anemia gizi besi pada balita Indonesia. Peneliti Gizi dan Makanan. 2018;41(2):65–76.

Cusick S, Georgieff MK. The first 1,000 days of life: the brain’s window of opportunity. UNICEF. Cited 2019 Mar 6. Available from

Eussen S, Alles M, Uijterschout L, Brus F, van der Horst-Graat J. Iron intake and status of children aged 6–36 months in Europe: a systematic review. Ann Nutr Metab. 2015;66:80–92. DOI: 10.1159/000371357.

Badan Pusat Statistik. Keadaan Ketenagakerjaan Indonesia Agustus 2020 [Internet]. Jakarta; 2020 Dec [cited 2020 Dec 10]. Available from:

WHO. WHO Child Growth Standards. 2006. [Internet] Cited 2020 Dec 1. Available from

Garcia-Casal MN, Pena-Rosas JP, Urrechaga E, Escanero JF, Huo J, Martinez RX, et al. Performance and comparability of laboratory methods for measuring ferritin concentrations in human serum or plasma: a systematic review and meta-analysis. PLoS ONE. 2018;13(5): e0196576. DOI: 10.1371/journal.pone.0196576.

Gibson RS. Assessment of iron status. In: Principles of nutritional assessment. Edisi ke-2. New York: Oxford; 2005. p 443–76.

Thompson J, Biggs B-A, Pasricha S-R. Effects of daily iron supplementation in 2- to 5-year-old children: systematic review and meta-analysis. Pediatrics. 2013 Apr 1;131(4). DOI: 10.1542/peds.2012-2256.

Wessling-Resnick M. Iron. In: Ross AC, Caballero B, Cousins RJ, Tucker KL, Ziegler TR, editors. Modern nutrition in health and disease. 11th ed. Baltimore: Lippincott Williams & Wilkins; 2014. p. 176–88.

Timmer TC, de Groot R, Rijnhart JJM, Lakerveld J, Brug J, Perenboom CWM, et al. Dietary intake of heme iron is associated with ferritin and hemoglobin levels in Dutch blood donors: Results from Donor InSight. Haematologica. 2020 Oct 1;105(10):2400-6. DOI: 10.3324/haematol.2019.229450.

Cox KA, Parkin PC, Anderson LN, Chen Y, Birken CS, Maguire JL, et al. Association Between Meat and Meat-Alternative Consumption and Iron Stores in Early Childhood. Acad Pediatr. 2016 Nov 1;16(8):783–91. DOI: 10.1016/j.acap.2016.01.003.

Domellof M. Iron requirements, absorption and metabolism in infancy and childhood. Curr Opin Clin Nutr Metab Care. 2007 May;10(3):329–35. DOI: 10.1097/MCO.0b013e3280523aaf.

Wallace DF. The regulation of iron absorption and homeostasis. Clin Biochem Rev. 2016 May;37(2):51–62.

Cassat JE, Skaar EP. Iron in infection and immunity. Cell Host Microbe. 2013 May;13(5): 509–19. DOI: 10.1016/j.chom.2013.04.010.