Analisis Hubungan Tingkat Keragaman Pangan Anak dan Rumah Tangga serta Kecukupan Asupan Gizi dengan Stunting pada Balita Usia 6–18 Bulan di Kabupaten Wonosobo

Hanifah Nurul Aulia, Tony Arjuna, M.Nut.Diet., PhD., AN., APD; Dr. dr. Emy Huriyati, M.Kes

2025 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar belakang: Stunting merupakan masalah gizi akibat kondisi kronis dan berpengaruh pada pertumbuhan dan perkembangan balita. Kabupaten Wonosobo mencatat angka stunting tertinggi di Provinsi Jawa Tengah pada tahun 2023. Keragaman pangan sebagai salah satu indikator kualitas makanan, serta kekurangan asupan energi dan protein dikaitkan dengan peningkatan risiko stunting. Tujuan dari penelitian ini yaitu menganalisis hubungan antara keragaman pangan pada balita dan rumah tangga, serta asupan energi dan protein dengan kejadian stunting pada balita usia 6-18 bulan. Metode: Penelitian kuantitatif menggunakan desain cross-sectional dengan data sekunder dari penelitian di Kabupaten Wonosobo. Subjek penelitian merupakan balita usia 6-18 bulan yang memenuhi kriteria inklusi. Analisis statistik meliputi univariat, bivariat, dan multivariat dengan regresi logistik. Hasil: Sebanyak 28,4% responden ditemukan stunting. Analisis bivariat menunjukkan keragaman pangan balita (OR=4,51; 95% CI=1,16–17,54; p=0,030), keragaman pangan rumah tangga (OR=4,26; 95% CI= 1,26–14,33; p=0,019), asupan protein (OR=10,03; 95% CI=2,2–45,76; p=0,003), dan usia anak 12-18 bulan (OR=0,19; 95% CI=0,05–0,74; p=0,017) berhubungan signifikan dengan stunting. Analisis masing-masing komponen pangan pada Dietary Diversity Score menunjukkan kelompok pangan daging-dagingan berhubungan signifikan dengan kejadian stunting (OR=3,95; 95% CI=1,27–12,28; p=0,018). Berdasarkan analisis multivariat keragaman pangan rumah tangga (AOR=5,31; 95% CI=1,19-23,74; p=0,029) dan asupan protein menjadi prediktor stunting yang signifikan (AOR=12,40; 95% CI=2,09-73,59; p=0,006). Kesimpulan: Keragaman pangan rumah tangga dan asupan protein berkaitan signifikan dengan stunting. Balita pada rumah tangga dengan keragaman pangan sedang dan memiliki asupan protein yang tidak cukup, lebih berpeluang mengalami stunting. Diperlukan adanya upaya untuk mendukung akses pangan yang bergizi dan beragam bagi keluarga, terutama protein hewani untuk mencegah stunting pada balita.

Background: Stunting is a nutrition-related issue caused by long-term conditions that impact the growth and development of children. Wonosobo Regency recorded the highest stunting rate in Central Java Province in 2023. Dietary diversity as one of the indicators of food quality and lack of nutrient intake, energy, and protein can be determinant of stunting. The purpose of this study is to examine the relationship between children and household dietary diversity, also energy and protein intake adequacy with stunting. Methods: Cross-sectional quantitative study employing secondary data from the study in Wonosobo Regency. The research subjects were toddlers aged 6-18 months who met the inclusion criteria. Statistical analysis included univariate, bivariate, and multivariate approaches using logistic regression. Results: As many as 28.4% of respondents were found stunted. Bivariate analysis showed that children's dietary diversity (OR=4.51; 95% CI=1.16–17.54; p=0.030), household dietary diversity (OR=4.26; 95% CI=1.26–14.33; p=0.019), protein intake (OR=10.03; 95% CI=2.2–45.76; p=0.003), and child’s age 12-18 months (OR=0.19; 95% CI=0.05–0.74; p=0.017) were significantly associated with stunting. Analysis of each food component in the Dietary Diversity Score showed that the flesh food group was significantly related to stunting (OR=3.95; 95% CI=1.27– 12.28; p=0.018). Based on multivariate analysis, household dietary diversity (AOR=5.31; 95% CI=1.19-23.74; p=0.029) and protein intake are significant predictors of stunting (AOR=12.40; 95% CI=2.09-73.59; p=0.006). Conclusion: Household dietary diversity and protein intake are associated with stunting. Children with medium household dietary diversity and have inadequate protein intake are more likely to be stunted. Support access to nutritious and diverse food for families are needed, especially animal source protein to prevent stunting. 

Kata Kunci : stunting, keragaman pangan, asupan gizi, balita, dietary diversity, nutrient intake, young children