Association between mother’s purchase intention of iron-fortified infant cereal and iron intake among children aged 6-23 months in Tangerang, Indonesia
Abstract
Background: Iron deficiency can lead to anemia, negatively impacting children's cognitive and physical development. Mothers' knowledge of iron and the benefits of fortified complementary foods may have influenced their purchase intentions and decisions. Objective: This study aimed to investigate the association between mothers' purchase intentions, actual purchases of iron-fortified infant cereals, and iron intake in children aged 6–23 months in Tangerang, Indonesia. Research on this topic remained limited, emphasizing the need for further studies to strengthen the existing evidence. Methods: This study employed a cross-sectional design involving 162 mothers in pairs with their children aged 6–23 months, recruited consecutively. Data were collected using validated questionnaires. Data analysis was performed using the non-parametric Mann-Whitney test to compare groups and Spearman's correlation test to assess the strength of relationships between variables. A p-value < 0.05 was considered statistically significant. Results: Mothers showed positive attitudes and intentions towards purchasing iron-fortified cereals, with a notable 51.9% having made recent purchases. While these purchase intentions correlate with actual purchases, they did not directly influence children's iron intake. Instead, factors such as mother’s education, occupation, and household income played significant roles in determining iron intake levels. Conclusion: Purchase intentions were associated with actual purchase intention; however, factors such as gender, mother’s education, occupation, and household income did not exhibit a direct relationship with children's iron intake. This study indicates that while mother’s purchase intentions are associated with actual purchases, they do not directly impact children's iron intake.Downloads
References
Pasricha SR, Tye-Din J, Muckenthaler MU, Swinkels DW. Iron deficiency. Lancet [Internet]. 2021;397(10270):233–48. Available from: http://dx.doi.org/10.1016/S0140-6736(20)32594-0
Ferdi J, Bardosono S, Medise BE. Iron status and developmental delay among children aged 24–36 months. Paediatr Indones. 2022;62(4):256–64.
Stoffel NU, Drakesmith H. Effects of Iron Status on Adaptive Immunity and Vaccine Efficacy: A Review. Adv Nutr [Internet]. 2024;15(6):100238. Available from: https://doi.org/10.1016/j.advnut.2024.100238
Keya TA. Prevalence and Predictors of Anaemia Among Women of Reproductive Age in South and Southeast Asia. Cureus. 2023;15(12).
Astutia Y, Dwihestieb LK ZN. Anemia Dan Kurang E Nergi Kronik (KEK) Pada Ibu Hamil Berhubungan Dengan Kejadian Berat Badan Lahir Rendah (BBLR) Di Wilayah Kerja Puskesmas Kandangan Kabupaten Temanggung. 2024;15(1):9–20.
Bates M, Gupta PM, Cogswell ME, Hamner HC, Perrine CG. Iron content of commercially available infant and toddler foods in the United States, 2015. Nutrients. 2020;12(8):1–9.
Chouraque J. Dietary Approaches to Iron Deficiency Prevention in Childhood—A Critical Public Health Issue. Nutrients [revista en Internet] 2022 [acceso 15 de setiembre de 2023]; 14(8): 1-24. Nutrients [Internet]. 2022;14(1604). Available from: https://pubmed.ncbi.nlm.nih.gov/35458166/
Alexy U, Dilger JJ, Koch S. Commercial Complementary Food in Germany: A 2020 Market Survey. Nutrients. 2022;14(18).
Bassetti E, Blankenship J, White JM, Sweet L, Threapleton D, Pries AM. Benchmarking the nutrient composition and labelling practices of dry or instant cereals for older infants and young children across seven Southeast Asian countries. Matern Child Nutr. 2023;19(S2):1–14.
Champeny M, Yuen-Esco K, Juniza E, Sy NY, Kane R, Badham J, et al. Accuracy of declared nutrient content on labels of commercial complementary food products in Cambodia, Indonesia and Senegal. Matern Child Nutr. 2023;19(3):e13504.
Dreyfuss ML, Green M, Agustino, Hadihardjono DN, Izwardy D, Huffman SL. Commercially produced complementary foods in Bandung City, Indonesia, are often reported to be iron fortified but with less than recommended amounts or suboptimal forms of iron. Matern Child Nutr. 2019;15(S4):1–10.
Finn K, Quick S, Anater A, Hampton J, Kineman B, Klish W. Breastfed and mixed fed infants who do not consume infant cereal are at risk for inadequate iron intake:data from the feeding infants and toddlers study 2016, a cross-sectional survey. BMC Pediatr [Internet]. 2022;22(1):1–9. Available from: https://doi.org/10.1186/s12887-022-03104-9
Finn K, Callen C, Bhatia J, Reidy K, Bechard LJ, Carvalho R. Importance of dietary sources of iron in infants and toddlers: Lessons from the FITS Study. Nutrients. 2017;9(7):16–9.
Samoggia A, Rossi G, Fantini A, Mouchtaropoulou E, Argiriou N. What drives consumers’ intention towards fairness-oriented products purchasing? An emotion-extended model of theory of planned behaviour. Heliyon [Internet]. 2025;11(1):e41285. Available from: https://doi.org/10.1016/j.heliyon.2024.e41285
Bazhan M, Shafiei Sabet F, Borumandnia N. Factors affecting purchase intention of organic food products: Evidence from a developing nation context. Food Sci Nutr. 2024;12(5):3469–82.
Rachmah Q, Astina J, Atmaka DR, Khairani L. The Effect of Educational Intervention Based on Theory of Planned Behavior Approach on Complementary Feeding: A Randomized Controlled Trial. Int J Pediatr (United Kingdom). 2023;2023.
Kementerian Kesehatan Republik Indonesia. Menteri Kesehatan Republik Indonesia Hasil Survei Status Gizi Indonesia (SSGI) 2022. 2023;1–7.
Badan Pusat Statistik Indonesia “Profil Kesehatan Ibu dan Anak 2022.” [Internet]. JAKARTA; 2022. Available from: Sep 15, 2023 · Jl. Dr. Sutomo 6-8 Jakarta 10710 Indonesia, Telp (62-21) 3841195, 3842508, 3810291,
Sunardi D. Hubungan Antara Pola Pemberian ASI dan MP-ASI Dengan STUNTING Pada Bayi Usia 6-12 Bulan di Tangerang Kajian Kadar Seng Serum Pada Bayi Stunting Usia 6-12 Bulan. Universitas Indonesia; 2008.
Chen YC, Huang YL, Chien YW, Chen MC. The effect of an online sugar fact intervention: Change of mothers with young children. Nutrients. 2020;12(6).
Simatupang YR, Chandra DN, Khusun H. Validation of a questionnaire to assess mothers’ intentions to purchase iron-fortified cereals for children aged 6-23 months. Vol 8 , Suppl 01 , Oct 2024 Nutr Symp 2024 Nutr Adv Healthc from Concept to well-aged Perfect unveiling Nutr ’ s impact Peer Rev Process Advers Policy [Internet]. 2024;8(6):31. Available from: https://doi.org/10.25220/WNJ.V08.S1.0030
Dalimunthe NK, Ekayanti I, Dwiriani CM. Prevalence and Risk Factors of Inadequate Micronutrient Intake among Children Aged 6-23 Months in Indonesia. Amerta Nutr. 2022;6(4):342–50.
Belay DG, Wassie MM, Alemu MB, Merid W, Norman R, Id GAT. Socio-economic and spatial inequalities in animal sources of iron-rich foods consumption among children 6 – 23 months old in Ethiopia : A decomposition analysis. PLOS Glob PUBLIC Heal. 2024;25(C):1–21.
Alemayehu M, Meskele M, Alemayehuid B, Yakob B. Prevalence and correlates of anemia among children aged 6-23 months in Wolaita Zone, Southern Ethiopia. PLoS One. 2019;14(3):1–13.
Pranita RF, Briawan D, Ekayanti I, Triwinarto A. Minimum Acceptable Diet and its Associated Factors among Children Aged 6–23 Months in Indonesia. J Gizi Pangan. 2023;12(28):1–10.
Darsono N, Yahya A, Muzammil A, Musnadi S, Anwar C, Irawati W. Consumer Actual Purchase Behavior for Organic Products In Aceh, Indonesia. 2019;292(Agc):265–75.
Sari K, Sartika RAD. The Impact of Iron Supplementation During Pregnancy and Change of Consumption among Stunting Children Aged 6‑24 Months During the COVID‑19 Pandemic in Indonesia. Int J Prev Med. 2023;8:1–7.
Zlotkin S, Dewey KG. Perspective: Putting the youngest among us into the nutrition “call for action” for food fortification strategies. Am J Clin Nutr. 2021;114(4):1257–60.
Gibson SA. Iron intake and iron status of preschool children: Associations with breakfast cereals, vitamin C and meat. Public Health Nutr. 1999;2(4):521–8.
Sanders LM, Zhu Y, Jain N, Normington J, Holschuh N, Nechanicky M, et al. Ready-to-eat cereal consumption is associated with improved nutrient intakes and diet quality in Canadian adults and children across income levels. Front Nutr. 2023;10(January):1–9.
World Health Organization. Guideline Daily Iron. Dly Iron Supplementation infants Child. 2016;44.
Sanders LM, Zhu Y, Jain N, Normington J, Holschuh N, Nechanicky M, et al. Ready-to-eat cereal consumption is associated with improved nutrient intakes and diet quality in Canadian adults and children across income levels. Int Arch Integr Med. 2021;2(1):223–31.
Gibson RS, Hotz C, Temple L, Yeudall F, Mtitimuni B, Ferguson E. Dietary strategies to combat deficiencies of iron, zinc and vitamin A in developing countries: Development, implementation, monitoring, and evaluation. Food Nutr Bull. 2000;21(2):219–31.
Anin SK, Saaka M, Fischer F, Kraemer A. Association between infant and young child feeding (Iycf) indicators and the nutritional status of children (6–23 months) in Northern Ghana. Nutrients. 2020;12(9):1–18.
Agho KE, Chitekwe S, Rijal S, Paudyal N, Sahani SK, Akombi-inyang BJ. Association between Child Nutritional Anthropometric Indices in Nepal. Nutrients. 2024;(Lmic):1–14.
Suryana S, Fitri Y, Yunianto A, Bustami B, Lusiana S. Nutritional education to the nutritional maternal knowledge and iron intake among Toddlers with Anemia. Open Access Macedonian Journal of Medical Sciences [revista en Internet] 2022 [acceso 4 de mayo de 2023]; 10(E): 1434-1439. 2022;10:1434–9. Available from: https://oamjms.eu/index.php/mjms/article/view/7017/7929
Al-Suhiemat AA, Shudifat RM, Obeidat H. Maternal Level of Education and Nutritional Practices Regarding Iron Deficiency Anemia Among Preschoolers in Jordan. J Pediatr Nurs [Internet]. 2020;55:e313–9. Available from: https://doi.org/10.1016/j.pedn.2020.08.019
Lotfipur Rafsanjani SS, Masoomi M, Askari F, Abdolkarimi M. Consumption of Iron Supplements, based on the Structures of the Health Belief Model, in Children Aged 6 to 24 Months in the Southeast of Iran. Univ Médica. 2024;65:1–10.
Rahma IM, Mutalazimah M. Correlation between Family Income and Stunting among Toddlers in Indonesia: A Critical Review. Proc Int Conf Heal Well-Being (ICHWB 2021). 2022;49(Ichwb 2021):78–86.
Oh H, Kim J, Huh Y, Kim SH, Jang SI. Association of household income level with vitamin and mineral intake. Nutrients. 2022;14(1):1–14.
Bayoumi I, Parkin PC, Birken CS, Maguire JL, Borkhoff CM. Association of Family Income and Risk of Food Insecurity with Iron Status in Young Children. JAMA Netw Open. 2020;3(7):1–16.
Submitted
Copyright (c) 2025 Yustina Rossa Simatupang, Dian Novita Chandra, Helda Khusun, Judhiastuty Februhartanty, Dwi Nastiti Iswarawanti, Okky Lupita Sari
This work is licensed under a Creative Commons Attribution 4.0 International License.
World Nutrition Journal provides immediate open access to its content under the Creative Commons Attribution License (CC BY 4.0). This permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
