{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T07:49:39Z","timestamp":1783151379748,"version":"3.54.6"},"reference-count":39,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2021,5,26]],"date-time":"2021-05-26T00:00:00Z","timestamp":1621987200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"FrieslandCampina, the Netherlands","award":["NN-2013-112"],"award-info":[{"award-number":["NN-2013-112"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Micronutrient deficiencies and stunting are known as a significant problem in most developing countries, including Indonesia. The objective of this study was to analyze the association between micronutrient deficiencies and stunting with socioeconomic status (SES) among Indonesian children aged 6\u201359 months. This cross-sectional study was part of the South East Asian Nutrition Surveys (SEANUTS). A total of 1008 Indonesian children were included in the study. Anemia, iron deficiency, vitamin A deficiency, vitamin D deficiency, and stunting were identified in this study. Structured questionnaires were used to measure SES. Differences between micronutrient parameters and anthropometric indicators with the SES groups were tested using one-way ANOVA with post-hoc test after adjusted for age, area resident (rural and urban), and sex. The highest prevalence of anemia, stunting, and severe stunting were found to be most significant in the lowest SES group at 45.6%, 29.3%, and 54.5%, respectively. Children from the lowest SES group had significantly lower means of Hb, ferritin, retinol, and HAZ. Severely stunted children had a significantly lower mean of Hb concentration compared to stunted and normal height children. Micronutrient deficiencies, except vitamin D, and stunting, were associated with low SES among Indonesian children aged 6\u201359 months.<\/jats:p>","DOI":"10.3390\/nu13061802","type":"journal-article","created":{"date-parts":[[2021,5,26]],"date-time":"2021-05-26T21:56:44Z","timestamp":1622066204000},"page":"1802","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["Micronutrient Deficiencies and Stunting Were Associated with Socioeconomic Status in Indonesian Children Aged 6\u201359 Months"],"prefix":"10.3390","volume":"13","author":[{"given":"Fitrah","family":"Ernawati","sequence":"first","affiliation":[{"name":"Center of Research and Development for Biomedical and Basic Technology of Health, National Institute of Health Research and Development, Jakarta 10560, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9552-2834","authenticated-orcid":false,"given":"Ahmad","family":"Syauqy","sequence":"additional","affiliation":[{"name":"Department of Nutrition Science, Faculty of Medicine, Diponegoro University, Jawa Tengah 50275, Indonesia"},{"name":"Center of Nutrition Research (CENURE), Diponegoro University, Jawa Tengah 50275, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aya Yuriestia","family":"Arifin","sequence":"additional","affiliation":[{"name":"Center of Research and Development for Biomedical and Basic Technology of Health, National Institute of Health Research and Development, Jakarta 10560, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moesijanti Y. E.","family":"Soekatri","sequence":"additional","affiliation":[{"name":"Nutrition Department, Health Polytechnic Ministry of Health of Jakarta II, Jakarta 12120, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandjaja","family":"Sandjaja","sequence":"additional","affiliation":[{"name":"Persatuan Ahli Gizi (PERSAGI), Jakarta 12320, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,5,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1007\/s13280-018-1101-4","article-title":"Sustainable development goal 2: Improved targets and indicators for agriculture and food security","volume":"48","author":"Gil","year":"2019","journal-title":"Ambio"},{"key":"ref_2","first-page":"1207","article-title":"Malnutrition as an underlying cause of childhood deaths associated with infectious diseases in developing countries","volume":"78","author":"Rice","year":"2000","journal-title":"Bull. World Health Organ."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/bs.af2s.2018.09.007","article-title":"The Role of the Sustainable Development Goals to Reduce the Global Burden of Malnutrition","volume":"3","author":"Sabbahi","year":"2018","journal-title":"Advances in Food Security and Sustainability"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2255","DOI":"10.1093\/jn\/136.8.2255","article-title":"Vitamin A Deficiency Is Prevalent in Children Less Than 5 y of Age in Nigeria","volume":"136","author":"Akinyele","year":"2006","journal-title":"J. Nutr."},{"key":"ref_5","unstructured":"World Health Organization (2000). Nutrition for Health and Development: A Global Agenda for Combating Malnutrition, World Health Organization."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Titaley, C.R., Ariawan, I., Hapsari, D., Muasyaroh, A., and Dibley, M.J. (2019). Determinants of the Stunting of Children Under Two Years Old in Indonesia: A Multilevel Analysis of the 2013 Indonesia Basic Health Survey. Nutrients, 11.","DOI":"10.3390\/nu11051106"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"S11","DOI":"10.1017\/S0007114513002109","article-title":"Food consumption and nutritional and biochemical status of 0\u00b75\u201312-year-old Indonesian children: The SEANUTS study","volume":"110","author":"Sandjaja","year":"2013","journal-title":"Br. J. Nutr."},{"key":"ref_8","first-page":"23","article-title":"Economic Status, Stunting and Diet Quality as Important Determinants of Anaemia among Indonesian Children aged 6\u201335 Months Old: A SEANUTS Study","volume":"16","author":"Ernawati","year":"2020","journal-title":"Malays. J. Med. Health Sci."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Soekatri, M.Y.E., Sandjaja, S., and Syauqy, A. (2020). Stunting Was Associated with Reported Morbidity, Parental Education and Socioeconomic Status in 0.5\u201312-Year-Old Indonesian Children. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17176204"},{"key":"ref_10","unstructured":"(2020, December 01). Riset Kesehatan Dasar (RISKESDAS) 2007. Available online: http:\/\/labdata.litbang.kemkes.go.id\/images\/download\/laporan\/RKD\/2007\/lap_rkd07.pdf."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1038\/ejcn.2013.241","article-title":"Relationship between socioeconomic status and anemia prevalence in adolescent girls based on the fourth and fifth Korea National Health and Nutrition Examination Surveys","volume":"68","author":"Kim","year":"2013","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Hu, Y., Chen, J., Wang, R., Li, M., Yun, C., Li, W., Yang, Y., Piao, J., Yang, X., and Yang, L. (2017). Vitamin D Nutritional Status and its Related Factors for Chinese Children and Adolescents in 2010\u20132012. Nutrients, 9.","DOI":"10.3390\/nu9091024"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Galgamuwa, L.S., Iddawela, D., Dharmaratne, S.D., and Galgamuwa, G.L.S. (2017). Nutritional status and correlated socio-economic factors among preschool and school children in plantation communities, Sri Lanka. BMC Public Health, 17.","DOI":"10.1186\/s12889-017-4311-y"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Gunawardena, K., Kumarendran, B., Ebenezer, R., Gunasingha, M.S., Pathmeswaran, A., and De Silva, N. (2011). Soil-Transmitted Helminth Infections among Plantation Sector Schoolchildren in Sri Lanka: Prevalence after Ten Years of Preventive Chemotherapy. PLoS Negl. Trop. Dis., 5.","DOI":"10.1371\/journal.pntd.0001341"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Rahman, M.S., Howlader, T., Masud, M.S., and Rahman, M.L. (2016). Association of Low-Birth Weight with Malnutrition in Children under Five Years in Bangladesh: Do Mother\u2019s Education, Socio-Economic Status, and Birth Interval Matter?. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0157814"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"S2","DOI":"10.1017\/S0007114513002067","article-title":"Design of the South East Asian Nutrition Survey (SEANUTS): A four-country multistage cluster design study","volume":"110","author":"Schaafsma","year":"2013","journal-title":"Br. J. Nutr."},{"key":"ref_17","unstructured":"World Health Organization (2006). WHO Child Growth Standards: Length\/Height-for-Age, Weight-for-Age, Weight-for-Length, Weight-for-Height and Body Mass Index-for-Age: Methods and Development, World Health Organization."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"660","DOI":"10.2471\/BLT.07.043497","article-title":"Development of a WHO growth reference for school-aged children and adolescents","volume":"85","author":"Onyango","year":"2007","journal-title":"Bull. World Health Organ."},{"key":"ref_19","unstructured":"World Health Organization (2001). Iron Deficiency Anemia. Assessment, Prevention, and Control. A Guide Programme Managers, World Health Organization. Available online: https:\/\/www.who.int\/nutrition\/publications\/en\/ida_assessment_prevention_control.pdf."},{"key":"ref_20","unstructured":"Central Bureau of Statistics (Indonesia) (2021, May 07). Indonesia National Socioeconomic Survey 2017. Jakarta, Indonesia: Central Bureau of Statistics (Indonesia) 2018. Available online: http:\/\/ghdx.healthdata.org\/record\/indonesia-national-socioeconomic-survey-2017."},{"key":"ref_21","first-page":"356","article-title":"The effect of socio-demographic variables and dairy use on the intake of essential macro- and micronutrients in 0.5-12-year-old Indonesian children","volume":"25","author":"Widodo","year":"2016","journal-title":"Asia Pac. J. Clin. Nutr."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e182899","DOI":"10.1001\/jamanetworkopen.2018.2899","article-title":"Trends in Socioeconomic Inequalities and Prevalence of Anemia Among Children and Nonpregnant Women in Low- and Middle-Income Countries","volume":"1","author":"Yang","year":"2018","journal-title":"JAMA Netw. Open"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2123","DOI":"10.1016\/S0140-6736(10)62304-5","article-title":"Anaemia in low-income and middle-income countries","volume":"378","author":"Balarajan","year":"2011","journal-title":"Lancet"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"652","DOI":"10.26719\/2001.7.4-5.652","article-title":"Iron status and socioeconomic determinants of the quantity and quality of dietary iron in a group of rural Iranian women","volume":"7","author":"Djazayery","year":"2001","journal-title":"EMJH East. Mediterr. Health J."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1007\/s12519-008-0004-z","article-title":"Vitamin A deficiency and child feeding in Beijing and Guizhou, China","volume":"4","author":"Jiang","year":"2008","journal-title":"World J. Pediatr."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"3804","DOI":"10.1073\/pnas.1713820115","article-title":"The opportunity cost of animal based diets exceeds all food losses","volume":"115","author":"Shepon","year":"2018","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1079\/BJN20031042","article-title":"Factors associated with Hb concentration in children aged 6\u201359 months in the State of Pernambuco, Brazil","volume":"91","author":"Lira","year":"2004","journal-title":"Br. J. Nutr."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Bao, K.L.N., Sandjaja, S., Poh, B.K., Rojroongwasinkul, N., Huu, C.N., Sumedi, E., Aini, J.N., Senaprom, S., Deurenberg, P., and Bragt, M. (2018). The Consumption of Dairy and Its Association with Nutritional Status in the South East Asian Nutrition Surveys (SEANUTS). Nutrients, 10.","DOI":"10.3390\/nu10060759"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1002\/jid.3365","article-title":"Child Malnutrition in Indonesia: Can Education, Sanitation and Healthcare Augment the Role of Income?","volume":"30","author":"Sumarto","year":"2018","journal-title":"J. Int. Dev."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"73","DOI":"10.36457\/gizindo.v38i1.169","article-title":"Status vitamin D terkini anak Indonesia usia 2,0\u201312,9 Tahun","volume":"38","author":"Ernawati","year":"2015","journal-title":"Gizi Indones"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1093\/tropej\/50.3.143","article-title":"Socioeconomic and familial characteristics influence caretakers\u2019 adherence to the periodic vitamin A capsule supplementation program in Central Java, Indonesia","volume":"50","author":"Pangaribuan","year":"2004","journal-title":"J. Trop. Pediatr."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2511","DOI":"10.1017\/S136898001400322X","article-title":"Vitamin A-fortified cooking oil reduces vitamin A deficiency in infants, young children and women: Results from a programme evaluation in Indonesia","volume":"18","author":"Jahari","year":"2015","journal-title":"Public Health Nutr."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1038\/nrendo.2010.146","article-title":"Hypovitaminosis D in developing countries\u2014Prevalence, risk factors and outcomes","volume":"6","author":"Arabi","year":"2010","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e003293","DOI":"10.1136\/bmjopen-2013-003293","article-title":"Vitamin D status in recently arrived immigrants from Africa and Asia: A cross-sectional study from Norway of children, adolescents and adults","volume":"3","author":"Eggemoen","year":"2013","journal-title":"BMJ Open"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e0204504","DOI":"10.1371\/journal.pone.0204504","article-title":"Factors associated with anemia in young children in Brazil","volume":"13","author":"Fawzi","year":"2018","journal-title":"PLoS ONE"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Habib, M.A., Black, K., Soofi, S.B., Hussain, I., Bhatti, Z., Bhutta, Z.A., and Raynes-Greenow, C. (2016). Prevalence and Predictors of Iron Deficiency Anemia in Children under Five Years of Age in Pakistan, A Secondary Analysis of National Nutrition Survey Data 2011\u20132012. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0155051"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2013\/502968","article-title":"Prevalence and Risk Factors of Anemia among Children 6\u201359 Months Old in Haiti","volume":"2013","author":"Ayoya","year":"2013","journal-title":"Anemia"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"541","DOI":"10.9734\/EJNFS\/2015\/20954","article-title":"Vitamin A Supplementation and Stunting Levels among Two Year Olds in Kenya: Evidence from the 2008-09 Kenya Demographic and Health Survey","volume":"5","author":"Ndedda","year":"2015","journal-title":"Eur. J. Nutr. Food Saf."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Imdad, A., and Bhutta, Z.A. (2011). Effect of preventive zinc supplementation on linear growth in children under 5 years of age in developing countries: A meta-analysis of studies for input to the lives saved tool. BMC Public Health, 11.","DOI":"10.1186\/1471-2458-11-S3-S22"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/13\/6\/1802\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:08:01Z","timestamp":1760162881000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/13\/6\/1802"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,26]]},"references-count":39,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2021,6]]}},"alternative-id":["nu13061802"],"URL":"https:\/\/doi.org\/10.3390\/nu13061802","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,26]]}}}