Jurnal Gizi dan Dietetik Indonesia (Indonesian Journal of Nutrition and Dietetic.
Vol.
Issue 3, 2023: 104-113 Available online at: http:ejournal.
id/index.
php/IJND DOI : http://dx.
org/10.
21927/ijnd.
EAect of moringa (Moringa oleifer.
leaves on increasing hemoglobin level of female adolescents in Madrasah Mu'allimat Muhammadiyah Yogyakarta Fitria Yulastini1*.
SN Nurul Makiyah2.
Retno Mawarti3 Qamarul Huda Badaruddin University of Nusa Tenggara Barat.
Turmuzi Badrudin.
Bagu.
Praya.
Central Lombok Regency.
West Nusa Tenggara.
Indonesia Muhammadiyah University of Yogyakarta.
Jalan Brawijaya.
Geblagan.
Tamantirto.
Kasihan.
Bantul.
Yogyakarta.
Indonesia Aisyiyah University of Yogyakarta.
Jalan Siliwangi Ringroad Barat No.
Area Sawah.
Nogotirto.
Gamping.
Sleman.
Yogyakarta.
Indonesia *Correspondence : Atriayulastini90@gmail.
ABSTRAK
Latar Belakang: Anemia deAsiensi besi merupakan penyebab anemia yang dominan terjadi di dunia dan menjadi masalah gizi utama di Indonesia yang memiliki prevalensi cukup tinggi pada remaja putri yaitu 22,7%.
Daun kelor (Moringa oleifer.
merupakan salah satu tumbuhan yang kaya protein, asam amino, mineral, dan vitamin.
Pemanfaatan daun kelor sebagai pengobatan herbal telah berkembang, salah satunya adalah dapat meningkatkan kadar hemoglobin.
Tujuan: Mengetahui pengaruh pemberian kapsul kelor (Moringa oleifer.
terhadap kadar hemoglobin pada remaja putri.
Metode: Penelitian ini merupakan penelitian eksperimen murni dengan randomized controlled trial design dan menggunakan simple random sampling.
Sampel penelitian adalah 61 remaja putri anemia yang dibagi menjadi 2 kelompok yaitu 31 kelompok perlakuan yang diberikan 500 mg bubuk daun kelor per kapsul dan 30 kelompok kontrol yang diberikan suplementasi zat besi sebesar 60 mg.
Intervensi diberikan selama 21 hari dengan dosis 2 kali per hari.
Penelitian ini dilaksanakan di salah satu asrama Madrasah Mu'allimat Muhammadiyah Yogyakarta dari bulan September - Oktober 2017.
Data berupa kadar hemoglobin dianalisis menggunakan Independent t-test.
Hasil: Kadar hemoglobin pada kelompok perlakuan sebelum intervensi 10,75A0,94 gr/dL dan setelah intervensi meningkat menjadi 12,58A0,99 .
value 0,.
Kadar hemoglobin pada kelompok kontrol juga meningkat yaitu sebelum intervensi 10,73A0,89 dan setelah intervensi 12,13A0,93 .
value 0,.
Rata-rata kenaikan kadar hemoglobin pada kelompok perlakuan adalah 1,82 gr/dL dan kelompok kontrol 1,40 gr/dL.
Terdapat perbedaan yang signiAkan antara kenaikan kadar hemoglobin pada kelompok perlakuan dan kelompok kontrol tersebut dengan p value 0,039 (<0,.
Kesimpulan: Kadar hemoglobin remaja putri pada kelompok yang diberikan kapsul kelor (Moringa oleifer.
lebih tinggi dibandingkan dengan kelompok suplementasi zat besi.
KATA KUNCI : daun kelor (Moringa oleifer.
kadar hemoglobin.
remaja putri.
tablet Fe
ABSTRACT
Background: Iron deAciency anemia is a dominant cause of anemia in the world, and it is one of the major nutritional problems in Indonesia with high prevalence in female adolescents, which reached 22.
Moringa plant (Moringa oleifer.
contains rich amount of protein, amino acid, mineral, and vitamin.
The use of moringa leaves as an herbal treatment has been developed, with one of its main objectives is to increase the hemoglobin level.
Objectives: To analyze the eAect of moringa (Moringa oleifer.
leaves capsule on the hemoglobin level of female adolescents.
Methods: This was a true experimental study with randomized controlled trial design and simple random sampling.
Research samples were 61 anemic female adolescents that were classiAed into two groups.
31 girls were selected as treatment group where they consumed EAect of moringa .
oringa oleifer.
leaves on increasing hemoglobin level of female.
500 mg of moringa leaves capsules, and the other 30 girls received 60 iron supplements in control group.
The intervention was done twice per day for 21 days.
This study was conducted in one of the dormitories of Madrasah Mu'allimat Muhammadiyah Yogyakarta from September to October 2017.
Data of hemoglobin level was analyzed using independent t-test.
Results: Hemoglobin level in treatment group before the intervention was 10.
75A0.
94 gr/dL and it increased to 12.
58A0.
-value= 0.
after the intervention.
Hemoglobin levels in the control group also increased, namely before the intervention was 10.
73A0.
89 and after 13A0.
943 with the p-valueof 0.
The mean hemoglobin level increase in treatment and control groups were 1.
82 gr/dL and 1.
40 gr/dL, respectively.
There was a signiAcant diAerence between hemoglobin level increase between both groups with the pvalueof 0.
039(<0.
Conclusion: The hemoglobin level of female adolescents who consumed moringa (Moringa oleifer.
leaves capsules was higher than the ones who only took iron supplements.
KEYWORDS: female adolescent.
hemoglobin level.
iron supplement.
moringa leaves (Moringa oleifer.
Article info:
Article submitted on April 15, 2023
Articles revised on June 05, 2023
Articles received on October 18, 2023
INTRODUCTION
Iron deAciency anemia is a dominant Sustainable Development Goals (SDG.
cause of anemia in the world, and it is one of program .
The development of science the four major nutritional problems in and technology supports many studies of Indonesia with high prevalence in herbs that can be used as medicine, therapy adolescents .
Iron deAciency anemia and even prevention of various diseases.
aAects more than two billion people around Therefore, the utilization of these herbs is the world.
It is not only found in children and One of the herbs is the moringa women in reproductive age, but also in plant (Moringa oleifer.
that can increase the adolescents, which has a signiAcant eAect in iron level and hemoglobin .
the decreased human resource quality Moringa oleifera or moringa plant is a .
,4,.
In 2013.
Basic Health Research plant that is easy to And in Indonesia and (BHR) reported that anemia prevalence in It contains rich amount of protein, girls aged 13 Ae 18 years old and women in a amino acid, mineral, and vitamin.
Every 100 reproductive age of 15 Ae 49 years old was gram of moringa leaves contain iron 25 times 7% .
larger than spinach and vitamin C seven Various methods have been developed times more than an orange.
The high vitamin to address iron deAciency anemia, including a C content also helps iron absorption.
screening of anemia in adolescents, therefore, consuming moringa leaves to treat supplying iron supplements, conducting the anemia does not necessarily need the campaign of AuIndonesia Anemia Free,Ay and addition of vitamin C as a reducer to help iron placing treatment of anemia as one of absorption .
Moringa leaves also 106 Fitria Yulastini.
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Issue 3, 2023: 104-113 contains 539 compounds known in Africa and female adolescents in the sixth grade in one India, and it has been used as a traditional of the dormitories of Madrasah Mu'allimat medicine that can prevent more than 300 Muhammadiyah Yogyakarta.
They were diseases .
selected randomly based on inclusion and Ghebreselassie et al .
reported that exclusion criteria.
Inclusion criteria of this giving moringa leaf extract as musch as 600 study were female adolescent aged 17-19 mg/day for 30 days can increase erythrocytes years, who had regular menstrual cycles .
- by aorund 30%.
This is in line with the study of 35 day.
and mild-moderate anemia .
Nadimin et al .
conducted in the coastal gr/dL).
area of Makassar.
South Sulawesi Province.
The exclusion criteria in this study were This study used a Randomized Double Blind female adolescent who had a history of design, pretest-posttest controlled by using a severe disease aAecting hemoglobine levels sample of non-anemic pregnant women .
idney failure, lung disease, lymphatic divided into two groups.
The Arst group disorders, cancer and malari.
and received the intervention of Moringa leaf experienced menstrual disorders including extract and the second received supple- metrorrhagia, hypermenorrhea, polimenorr- mentation of folic iron.
Before and after hea, oligomenorrhea and amenorrhea.
intervention performed hemoglobin level Sampling was conducted using simple Intervention performed during random sampling to obtain 66 participants 12 weeks.
This study showed an increase in that were divided evenly into two groups, hemoglobin before and after intervention in treatment and control.
Participants in the both groups.
This study state that moringa treatment group received moringa leaves leaves extract can be used as an alternative capsule while the ones in control group to prevent anemia during pregnancy.
This consumed iron supplement.
This study is a study aimed to analyze the eAect of moringa single blind, that the research subject do not leaves (Moringa oleifer.
capsules on know which capsules was consumed.
hemoglobin level of female adolescents.
Data were collected using a form of subject characteristic.
One week before the MATERIALS AND METHODS intervention, all subjects received antihelmin- This wasa true experimental study with thic .
yrantel pamoate 250 m.
capsule to randomized controlled trial design.
The prevent parasite infection.
Pre- and post- studied independent variable was the measurement of hemoglobin level used treatment of moringa leaves (Moringa Sysmex KX-21.
Participants in both groups oleifer.
capsule, and the dependent variable received two capsules per day for 21 days.
was hemoglobin level of female adolescents.
They received the capsules once in a week.
This study was conducted in one of the The moringa plant capsule contains 500 mg dormitories of Madrasah Mu'allimat of moringa leaves powder, and it contains 60 Muhammadiyah Yogyakarta from September mg of iron.
It is the same amount of iron to October 2017.
The research samples were supplement received by participants in EAect of moringa .
oringa oleifer.
leaves on increasing hemoglobin level of female.
this study were considered the same because control groups.
Five subjects dropped out in intervention.
their diet and daily physical activity were The total number of subjects at the end of the controlled by taking subjects who lived in one study was 31 participants in the treatment dormitory, so that an increase in hemoglobin group and 30 participants in the control group.
levels was expected from the intervention The data were analyzed using independent t- Inhibitors factors .
actors that inhibit test with conAdence interval (CI) 95%.
Ethical iron absorptio.
such as types of food clearance was granted by Research Ethics containing tannins .
, phytic acid.
Committee of Universitas 'Aisyiyah Yog- oxalic acid, phosphate and calcium in milk are yakarta number 19/KEP-UNISA/IX/2017.
not allowed to be consumed during the As can be seen in Table 1, the RESULTS AND DISCUSSION Characteristics of the Research Subjects majority of all respondents aged 18 years old.
The characteristics of the subjects in had normal BMI, had mild-moderate anemia.
Table 1.
Characteristic of the reserach subjects .
Variable Mean Median Min Max Age Body Mass Index (BMI) Hemoglobin level pretest Table 2.
Frequency distribution of moringa leaves intervention and the increase of hemoglobin level of research subjects Variable Treated with moringa Yes n (%) Treatment Mean A Median .
in-ma.
Control Mean A Median .
in-ma.
Hemoglobin level .
r/d.
Before intervention 75 A 0.
73A0.
After intervention 58A 0.
13A0.
Source: developed from primary data, 2017.
108 Fitria Yulastini.
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Issue 3, 2023: 104-113 Distribution of Subject and Increase in .
8%) received moringa leaves and the Hemoglobin Level other 30 .
did not.
The respective mean The total number of subjects at the hemoglobin levels in treatment and control end of the study was 31 participants in the groups before intervention were 10.
75 gr/dL treatment group and 30 participants in the 73 gr/dL.
Meanwhile, the mean control group.
Data on hemoglobin levels hemoglobin levels in treatment and control before and after intervention in treatment and groups after intervention were 12.
58 gr/dL control group can be seen in Table 2.
13 gr/dL, respectively.
Table 2 shows that 31 subjects Table 3.
Paired T-test results of hemoglobin level before and after intervention in treatment and control groups Variable Hemoglobin MeanASD i Mean t-test p-value Treatment group Before intervention 578A0.
After intervention 581A0.
Control group Before intervention 730A0.
After intervention 130A0.
Source: developed from primary data, 2017.
The EAect of Moringa (Moringa oleifer.
Randomized Double Blind design, pretest- Leaves on Increasing Hemoglobin Levels posttest controlled by using a sample of Analysis of the increase in hemoglobin pregnant women informal workers and levels in the treatment group and control housewives who were divided into three group after intervention can be seen Table 3 The Arst group were pregnant women and Table 4.
working in the informal sector received the The statistic test results in Table 3 shows intervention of Moringa leaf extract, the that after the intervention, the mean of second group were pregnant women working hemoglobin level in treatment group rose in the informal sector received a placebo as 578A0.
946 to 12.
581A0.
control gorup I and the third group were Meanwhile, the mean in control group grew housewives who did not receive intervention 730A0.
890 to 12.
130A0.
Both as control group II.
This study was conducted groups had p-value lower than 0.
for 3 months by looking at changes in which means that there was a signiAcant hemoglobin levels, upper arm circumference diAerence between and after intervention in and DNA damage.
This study reported that both treatment .
oringa leave.
and control there was a signiAcant diAerence in work This Anding is in line with a study stress level.
DNA damage, and hemoglobin conducted by Muis .
This study used a level before and after treatment of moringa EAect of moringa .
oringa oleifer.
leaves on increasing hemoglobin level of female.
leaves extract with p-value lower than 0.
where they reported that 100 gram of moringa After 21 days of intervention, the mean of leaves contain a high vitamin C content that is the hemoglobin level increase in the seven times more than vitamin C content in an treatment group .
8 gr/dL) was higher than Therefore, consuming moringa the control group .
4 gr/dL).
This could be leaves capsule does not require an addition of caused by the apart from a high amount of vitamin C supplement as a reducer to help iron, moringa leaves also have high vitamin C iron absorption.
content, which is one of the nutrients that The absorption of non-heme iron is highly increase iron absorption .
Moringa inCuenced by binding agents that can leaves capsule used in this study contain facilitate or inhibit absorption.
It requires 85 mg iron and 45.
82 mg vitamin C per substances to maintain iron in a state of 100 gram.
These numbers are higher than the Moringa leaf is a source of non- natural iron content in fresh moringa leaves or heme iron, but it also contains a high amount other green vegetables, such as spinach and of protein and amino acid, which improve iron katuk or star gooseberry (Sauropus absorption by producing soluble chelate that androgynu.
This result is similar with helps to prevent polymerization and iron results of Sreelatha & Padma .
study, precipitation .
Table 4.
Independent T-test results of hemoglobin level diAerence before and after intervention in treatment and control groups Variable Hemoglobin level i Mean t-test p-value meanASD Treatment group 822A0.
Control group 400A0.
Source: developed from primary data, 2017.
Table 4 shows the diAerence between over a period of three months from April to the hemoglobin level increase in treatment June 2012.
A simple random sampling of 60 and control groups had t-value of 2.
113 and p- women with moderate anemia suAering was value of 0.
The results show that the taken where 30 women were treatment group signiAcance level was lower than 0.
05, which and 30 the control group.
Treatment group means that there was a signiAcant diAerence was given 100 gr/day of Moringa oleifera and of hemoglobin level increase between Jaggery .
ry weigh.
in the ratio 80:20 for treatment and control groups.
Therefore, it thirty days.
Control group was advise to can be concluded that consumption of continue normal diet.
After thirty days the moringa leaves capsule increases the results show that the treatment of moringa hemoglobin level in female adolescents.
leaves powder signiAcantly increased the A similar study was conducted by Sindhu hemoglobin level of women in reproductive et al .
in rural and sub urban Bangalore age with anemia.
The p-value of the study was 110 Fitria Yulastini.
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Retno Mawarti.
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Issue 3, 2023: 104-113 lower than 0.
providing iron supplements for female In line with the randomized study was adolescents, because it is cheap and its conducted by Idohou et al .
to test eEcacy leaves can be processed as a vegetable dish of Moringa powder on iron status and weight to reduce side eAects such as nausea and gain in lactating women in the Region of Apart from its leaves, other parts of Ziguinchor in South Western Senegal from moringa plant also have medicinal properties July-October 2001.
Data from 64 lactating ranging from roots, stems, seeds.
Cowers and women received a weekly dose of either .
bark from this plant has been proven to have people treatment group received 100 mg of eEcacy for treatment .
,23,.
Moringa powder and 31 people control group Anemia in female adolescent aAects their received 120 mg iron sulfat with 0,5 mg folic growth, lower learning achievement due to The results of the study showed that fatigue, loss of Cuid, and decreased after three months of moringa leaves powder Thus, anemic patients should intervention, the average concentration of consume 60 Ae 120 mg of iron per day and hemoglobin level improved signiAcantly.
increase intake of iron-rich foods.
Then, their Female adolescents are a group hemoglobin level is checked after one month susceptible to iron deAciency because of of treatment.
If the hemoglobin level imbalance between iron intake from foods increases 1-2 g/dL, then the treatment is and increasing iron demand due to their continued for the next two months, even accelerated growth and menstruation.
The though the level has increased.
The iron level in the body can be observed by eAectiveness of moringa (Moringa oleifer.
measuring the hemoglobin level.
Normal leaves in treating anemia is also reported by hemoglobin level in female adolescents is 12 Suzana et al .
They conducted a pure g/dL .
,4,.
experiment study with studied randomized The government has provided iron controlled double-blind design to analyze 35 supplement as one method to treat anemia in anemic women.
The results show that Many studies have reported the moringa leaves extract could be used as a eAectiveness of the iron supplement.
treatment for iron deAciency anemia with p- However, it still has several side eAects, such value of 0.
as nausea, abdominal bloating and black Apart from anemia treatment, moringa stools that cause discomfort that ends with plant can also be used as a supplement for disobedience in consuming it .
nutritional improvement.
This eAect was Moringa (Moringa oleifer.
plant contains analyzed by a study conducted by Sambou high nutrients, including antioxidant, macro .
in Tanzania with the treatment of moringa .
and micronutrients, such as vitamin leaves powder on pregnant and lactating A, vitamin B, vitamin C, calcium, potassium, women for six weeks.
The results show that and iron, which are easily digested and for pregnant women, the treatment was able assimilated by the human body.
The moringa to cure anemia and only 10 out of 32 pregnant plant can be used as an alternative for women gave birth to babies with low birth EAect of moringa .
oringa oleifer.
leaves on increasing hemoglobin level of female.
weight, including eight mothers who gave birth to twins.
Meanwhile, for lactating Suplementation.
Ahankari A.
Leonardi-Bee J.
Maternal women, the treatment was able to increase Hemoglobin and Birth Weight :
the production of breast milk so that exclusive Systematic Review and Meta-Analysis.
breastfeeding can be achieved as well as International Journal of Medical Science improved maternal health status.
The study and Public Health.
2015 Apr 1.
:435-5.
also states the need for socialization or Takatera K.
Miyake Y.
Hiramitsu M.
Inoue seminar to introduce the nutrients contained T.
Katagiri T.
EAects of Citric Acid and in the moringa leaves (Moringa oleifer.
that Lemon Juice on Iron Absorption and could be used to eradicate malnutrition Improvement of Anemia in Iron-DeAcient problems at the family and community level.
R a t s .
F o o d S c i e n c e Te c h n o l o g y Research.
: 127Ae130.
CONCLUSION AND RECOMMENDATIONS
De Andrade Cairo RC.
Silva.
LR.
Bustani.
Based on the results, it can be concluded C.
Marques.
Iron DeAciency that there was a signiAcant diAerence in Anemia in Adolescents.
a Literatur hemoglobin level increase between treatment R e v i e w.
N u t r i c i o n H o s p i t a l a r i a .
and control groups.
This means that 29.
: 1240-1249.
hemoglobin level of female adolescent who Tsegaye A.
Tsefaye G.
Prevalence of consumed moringa (Moringa oleifer.
leaves Anemia Among Pregnant Women In capsule was higher than the ones who took Ethiopia and Management : A Review.
iron supplement.
Therefore, moringa International Research Journal of (Moringa oleifer.
leaves capsule can be Pharmacy.
:737-750.
used as an alternative to increase hemoglobin (RISKESDAS).
ttp://w.
level and prevent iron deAciency anemia.
laporan_Riskesdas2013.
Jakarta.
We expect the results of this study Accessed March 27, 2017.
provide information for the need of socialization of nutrients contained in moringa Kemenkes RI.
Riset Kesehatan Dasar Rakorpop Kementerian Kesehatan RI.
leaves and their beneAts particularly in Kesehatan Dalam Kerangka Sustainable treating and preventing iron deAciency Development Goals (SDG.
DIRJEN
anemia for female adolescents.
Moreover, the BINA GIZI KIA.
Sekretariat results can also be used as a reference for Pembangunan Kesehatan Pasca-2015 future studies by adding variables related to Kementerian Kesehatan RI Keputusan micronutrients from plants, which can be used Menteri Kesehatan No.
97 Tahun 2015.
Perhimpunan Dokter Gizi Medik Indonesia.
Perhimpunan Dokter Gizi Medik Indonesia Luncurkan Kampanye AuIndonesia Bebas AnemiaAy.
Jakarta.
to increase the hemoglobin level.
REFERENCES