Keterampilan Pangan Ibu dan Masalah Stunting pada Anak Baduta di Kota Bogor, Jawa Barat

Abstract

Kajian mengenai hubungan keterampilan pangan ibu dengan kejadian stunting di wilayah perkotaan Indonesia masih sangat terbatas. Sebagian besar penelitian sebelumnya lebih berfokus pada faktor ketersediaan pangan, kondisi sosial ekonomi, dan praktik pemberian makan, sementara keterampilan pangan ibu sebagai faktor perilaku yang dapat dimodifikasi masih jarang dikaji secara komprehensif. Selain itu, belum tersedia instrumen yang sesuai dengan konteks sosial-budaya Indonesia untuk mengukur keterampilan pangan secara menyeluruh. Oleh karena itu, penelitian ini bertujuan untuk menganalisis perbedaan karakteristik keluarga, keterampilan pangan ibu, praktik pemberian makan, ketahanan pangan rumah tangga, dan asupan zat gizi baduta stunting dan normal, serta menganalisis hubungan keterampilan pangan ibu dengan praktik pemberian makan, ketahanan pangan rumah tangga, asupan zat gizi, dan status gizi baduta di Kota Bogor. Penelitian ini menggunakan desain comparative cross-sectional study yang dilaksanakan pada Januari–April 2026 di Kota Bogor, Jawa Barat, dan telah memperoleh persetujuan etik dari Komisi Etik Penelitian yang Melibatkan Subjek Manusia IPB University (No. 2129/IT3.KEPMSM-IPB/SK/2026). Sebanyak 136 baduta terdiri atas 68 baduta stunting dan 68 baduta normal dipilih menggunakan teknik multistage sampling dengan kombinasi purposive sampling dan simple random sampling. Data yang dikumpulkan meliputi karakteristik keluarga dan anak, keterampilan pangan ibu, praktik pemberian makan, ketahanan pangan rumah tangga, asupan zat gizi menggunakan repeated 2×24-hour dietary recall, dan status gizi baduta. Analisis data dilakukan menggunakan uji bivariat berpa uji independent t-test, Mann–Whitney, Chi-square, dan spearman. Selanjutnya dilakukan uji multivariat dengan uji SEM-PLS. Hasil analisis menunjukkan bahwa terdapat beberapa karakteristik yang berbeda secara signifikan antara kelompok baduta stunting dan normal. Kelompok baduta stunting memiliki proporsi yang lebih tinggi pada usia 12–23 bulan, riwayat berat badan lahir rendah (BBLR), riwayat panjang badan lahir rendah (< 48 cm), pendapatan keluarga di bawah Upah Minimum Kota (UMK), serta riwayat penyakit infeksi dibandingkan kelompok normal (p<0,05). Pada aspek keterampilan pangan ibu, hanya domain pengelolaan anggaran yang berbeda secara signifikan, dengan skor yang lebih tinggi pada kelompok normal (p<0,05). Praktik pemberian makan juga menunjukkan perbedaan signifikan pada indikator Minimum Meal Frequency (MMF), Minimum Acceptable Diet (MAD), dan Zero Vegetable and Fruit Consumption (ZVF), di mana kelompok normal memiliki proporsi pemenuhan MMF dan MAD yang lebih tinggi serta proporsi ZVF yang lebih rendah dibandingkan kelompok stunting (p<0,05). Selain itu, tingkat kecukupan energi, protein, lemak, karbohidrat, kalsium, dan zink berbeda secara signifikan antara kedua kelompok, dengan kelompok normal memiliki tingkat kecukupan yang lebih tinggi (p<0,05), sedangkan ketahanan pangan rumah tangga, skor total keterampilan pangan ibu, serta kecukupan zat besi, vitamin A, dan vitamin C tidak menunjukkan perbedaan yang signifikan (p>0,05). Hasil analisis hubungan menunjukkan bahwa keterampilan pangan ibu berhubungan positif dengan praktik pemberian makan baduta, terutama pada indikator kualitas diet, yaitu Minimum Dietary Diversity (MDD) dan Egg and/or Flesh Food Consumption (EFF), serta berhubungan dengan tingkat kecukupan protein baduta (p<0,05). Hubungan signifikan juga ditemukan antara domain pengelolaan anggaran dengan tingkat kecukupan kalsium serta domain berbelanja dengan tingkat kecukupan zat besi (p<0,05). Secara umum, hubungan yang ditemukan memiliki kekuatan korelasi yang lemah. Hasil analisis SEM-PLS menunjukkan bahwa keterampilan pangan ibu berhubungan positif dengan praktik pemberian makan baduta (ß=0,208; p=0,024) dan ketahanan pangan rumah tangga (ß=0,232; p=0,022). Praktik pemberian makan baduta (ß=0,275; p<0,001) dan ketahanan pangan rumah tangga (ß=0,191; p=0,015) berhubungan positif dengan kecukupan zat gizi makro, serta kecukupan zat gizi makro berhubungan positif dengan status gizi baduta (ß=0,154; p<0,001). Selain itu, ditemukan hubungan tidak langsung yang signifikan antara keterampilan pangan ibu dengan kecukupan zat gizi makro melalui praktik pemberian makan baduta (ß=0,057; p=0,041), praktik pemberian makan baduta dengan status gizi baduta melalui kecukupan zat gizi makro (ß=0,085; p=0,016), serta ketahanan pangan rumah tangga dengan status gizi baduta melalui kecukupan zat gizi makro (ß=0,059; p=0,045). Total hubungan tidak langsung antara keterampilan pangan ibu dengan status gizi baduta juga ditemukan adanya hubungan yang signifikan (ß=0,032; p=0,020). Model memiliki predictive relevance, namun kemampuan prediksinya masih tergolong rendah (low predictive power). Penelitian ini menunjukkan bahwa pada kelompok baduta stunting yang dianalisis lebih banyak berada pada kelompok usia 12–23 bulan, memiliki riwayat BBLR, panjang badan lahir rendah, berasal dari keluarga dengan pendapatan di bawah UMK, serta memiliki riwayat penyakit infeksi dibandingkan baduta normal. Kelompok stunting juga memiliki tingkat kecukupan energi, protein, lemak, karbohidrat, kalsium, dan zink yang lebih rendah, serta lebih sedikit yang memenuhi indikator praktik pemberian makan berupa MMF dan MAD dan memiliki konsumsi buah dan sayur yang lebih baik dibandingkan kelompok normal. Tidak terdapat perbedaan yang signifikan pada skor total keterampilan pangan ibu dan ketahanan pangan rumah tangga antara kedua kelompok, meskipun domain pengelolaan anggaran keterampilan pangan ibu lebih baik pada kelompok normal. Keterampilan pangan ibu menunjukkan hubungan dengan beberapa indikator praktik pemberian makan dan kecukupan zat gizi baduta. Hasil analisis SEM-PLS menunjukkan adanya hubungan tidak langsung antara keterampilan pangan ibu dengan kecukupan zat gizi makro melalui praktik pemberian makan, yang kemudian praktik pemberian makan dengan status gizi baduta melalui kecukupan zat gizi makro.

Research examining the association between maternal food skills and stunting among children in urban areas of Indonesia remains limited. Previous studies have largely focused on food availability, socioeconomic conditions, and child feeding practices, while maternal food skills, as one of the modifiable behavioral factors, have received relatively little comprehensive attention. In addition, an instrument specifically adapted to the Indonesian sociocultural context for comprehensively assessing food skills is not yet available. Therefore, this study aimed to analyze differences in family characteristics, maternal food skills, child feeding practices, household food security, and nutrient intake between stunted and normal children, as well as to examine the associations of maternal food skills with child feeding practices, household food security, nutrient intake, and nutritional status among children in Bogor City. This study used a comparative cross-sectional study design and was conducted from January to April 2026 in Bogor City, West Java. Ethical approval was obtained from the IPB University Research Ethics Committee for Research Involving Human Subjects (No. 2129/IT3.KEPMSM-IPB/SK/2026). A total of 136 children aged 6–23 months, comprising 68 stunted and 68 normal children, were selected using multistage sampling with a combination of purposive sampling and simple random sampling. Data collected included family and child characteristics, maternal food skills, child feeding practices, household food security, nutrient intake assessed using repeated 2×24-hour dietary recalls, and child nutritional status. Data were analyzed using bivariate tests, including the independent t-test, Mann–Whitney, Chi-square, and Spearman correlation tests. Multivariate analysis was subsequently conducted using SEM-PLS. The results showed significant differences in several characteristics between the stunted and normal groups. The stunted group had higher proportions of children aged 12–23 months, a history of low birth weight (LBW), a birth length of less than 48 cm, family income below the City Minimum Wage (UMK), and a history of infectious diseases compared with the normal group (p<0.05). Regarding maternal food skills, only the budgeting domain differed significantly between the groups, with a higher score in the normal group (p<0.05). Child feeding practices also differed significantly in the Minimum Meal Frequency (MMF), Minimum Acceptable Diet (MAD), and Zero Vegetable and Fruit Consumption (ZVF) indicators. The normal group had a higher proportion meeting MMF and MAD and a lower proportion reporting ZVF compared with the stunted group (p<0.05). In addition, the adequacy levels of energy, protein, fat, carbohydrates, calcium, and zinc differed significantly between the groups, with higher adequacy levels observed in the normal group (p<0.05). In contrast, household food security, total maternal food skills scores, and the adequacy levels of iron, vitamin A, and vitamin C did not differ significantly between the groups (p>0.05). The relationship analysis showed that maternal food skills were positively associated with feeding practices among young children, particularly diet quality indicators, namely Minimum Dietary Diversity (MDD) and Egg and/or Flesh Food Consumption (EFF), as well as with the adequacy of protein intake (p<0.05). Significant associations were also found between the budgeting domain and calcium intake adequacy, and between the shopping domain and iron intake adequacy (p<0.05). Overall, the observed associations were characterized by weak correlation strength. The SEM-PLS analysis showed that maternal food skills were positively associated with child feeding practices (ß=0.208; p=0.024) and household food security (ß=0.232; p=0.022). Child feeding practices (ß=0.275; p<0.001) and household food security (ß=0.191; p=0.015) were positively associated with macronutrient adequacy, which was subsequently positively associated with child nutritional status (ß=0.154; p<0.001). Significant indirect associations were found between maternal food skills and macronutrient adequacy through child feeding practices (ß=0.057; p=0.041), between child feeding practices and child nutritional status through macronutrient adequacy (ß=0.085; p=0.016), and between household food security and child nutritional status through macronutrient adequacy (ß=0.059; p=0.045). The total indirect association between maternal food skills and child nutritional status was also significant (ß=0.032; p=0.020). The model demonstrated predictive relevance, although its predictive capability was classified as low. Overall, the stunted group had a higher proportion of children aged 12–23 months, a history of LBW, shorter birth length, family income below the UMK, and a history of infectious diseases compared with the normal group. The stunted group also had lower adequacy levels of energy, protein, fat, carbohydrates, calcium, and zinc, as well as a lower proportion meeting the MMF and MAD indicators and a higher proportion reporting zero vegetable and fruit consumption. No significant differences were found in total maternal food skills scores or household food security between the two groups, although the budgeting domain of maternal food skills was higher in the normal group. Maternal food skills were associated with several indicators of child feeding practices and nutrient adequacy. The SEM-PLS analysis indicated an indirect association between maternal food skills and macronutrient adequacy through child feeding practices, followed by an indirect association between child feeding practices and child nutritional status through macronutrient adequacy.