Jurnal Gizi dan Dietetik Indonesia
(Indonesian Journal of Nutrition and Dietetics)
Vol. 9, No. 2, 2021: 100-109

Available online at: http://ejournal.almaata.ac.id/index.php/IJND
DOI : http://dx.doi.org/10.21927/ijnd.2021.9(2).100-109

Relationship between food consumption pattern and goitre among
farmers
Ahshaina Ramadhaningtiyas1*, Yulia Lanti Retno Dewi2, Sugihardjo3
Master’s Degree Program in Environmental Science, Graduate School, Universitas Sebelas Maret, Jalan Ir Sutami
No. 36A Jebres, Surakarta, Indonesia
2
Department of Nutrition, School of Medicine Universitas Sebelas Maret, Jalan Kolonel Sutarto Jebres, Surakarta,
Indonesia
3
Department of Social Agricultural Economics, School of Agriculture Universitas Sebelas Maret, Jalan Ir Sutami No.
36A Jebres, Surakarta, Indonesia
*Correpondence: ahshainatiyas@gmail.com

1

ABSTRAK
Latar Belakang: Gangguan Akibat Kekurangan Iodium (GAKI) dapat menghambat peningkatan mutu sumber
daya manusia. Penyebab kekurangan iodium yaitu rendahnya asupan iodium yang dapat menyebabkan
ekskresi hormon tiroid tidak maksimal, paparan polusi lingkungan dan zat goitrogenik alami dalam bahan
makanan. Keadaan alam di Kecamatan Kismantoro didominasi dengan tanah tegalan sebagai lahan
bercocok tanam, sehingga sebagian besar penduduknya bermata pencaharian sebagai petani dan singkong
menjadi tanaman yang paling banyak ditanam.
Tujuan: Penelitian ini bertujuan untuk mengetahui hubungan pola konsumsi makanan sumber iodium dan
sumber goitrogenik dengan kejadian gondok pada petani di Kecamatan Kismantoro.
Metode: Penelitian ini merupakan penelitian observasional analitik dengan desain case control. Jumlah
sampel 82 orang dengan perbandingan 1:1, 41 orang kelompok kasus (positif gondok) dan 41 orang
kelompok kontrol (negatif gondok). Pengumpulan data menggunakan wawancara dengan kuisioner dan
Food Frequency Questionnaire (FFQ). Bahan makanan yang tercantum dalam FFQ ditentukan dengan
cara Focus Group Discussion (FGD) dengan kader kesehatan di Balai Desa Kecamatan Kismantoro.
Data sekunder diambil dari data rekam medis Puskesmas Kecamatan Kismantoro. Teknik sampling yang
digunakan yaitu purposive sampling. Analisis data menggunakan uji statistik chi-square, fisher exact.
Hasil: Pola konsumsi sumber goitrogenik yang berhubungan dengan kejadian gondok pada petani di
Kecamatan Kismantoro adalah singkong (OR= 15,261; CI 95%= 3,242-71,835; p= 0,000) p < 0.05 , sawi
(OR= 4,608; CI 95%= 1,494-14,213; p= 0,005), gatot (OR= 5,556; CI 95%= 1,923-16,046; p= 0,001), dan
tape singkong (OR= 5,205; CI 95%= 2,031-13,337; p= 0,000). Sementara pola konsumsi makanan sumber
iodium yang berhubugan dengan kejadian gondok pada petani yaitu ikan laut (OR= 0,078; CI 95%= 0,0090,638; p= 0,004).
Kesimpulan: Terdapat hubungan pola konsumsi makanan dengan kejadian gondok pada petani di
Kecamatan Kismantoro. Makanan yang paling sering dikonsumsi oleh responden adalah singkong.
Makanan sumber goitrogenik yang berhubungan dengan kejadian gondok adalah singkong, sawi, gatot
dan tape singkong.
KATA KUNCI: goitrogenik; gondok; Iodium, Kecamatan Kismantoro; pola makanan

ABSTRACT
Background: Iodine Deficiency Disorders (IDD) are one of the public health problems that can hinder the
quality of human resources. The causes of iodine deficiency are low intake of iodine, which can cause the
excretion of thyroid hormones not maximal, exposure to environmental pollution, and natural goitrogenic
substances in foodstuffs. The natural conditions in Kismantoro subdistrict are dominated moorland as
farmland, so that most of the population livelihoods as farmers and cassava become the most widely
planted crops.
Objectives: This study aims to determine the relationship between iodine sources and goitrogenic sources

Relationship of food consumption pattern with goiter incidence in farmers

101

with the incidence of goiter in farmers in the Kismantoro Subdistrict.
Methods: This research is analytical observational research with a case-control design. The sample number
of 82 people with a ratio of 1:1, 41 people case group (positive goiter) and 41 person control group (negative
goiter). Data collection uses interviews with questionnaires and the Food Frequency Questionnaire (FFQ).
The foodstuffs listed in the FFQ are determined by means of Focus Group Discussion (FGD) with health
cadres at Kismantoro Subdistrict Village Hall. Secondary data are taken from the medical record data of
Kismantoro Subdistrict Health Center. The sampling technique used is purposive sampling. Data analysis
using chi-square statistical test, fisher exact.
Result: The consumption pattern of goitrogenic sources related to the incidence of goiter in farmers in
Kismantoro Subdistrict is cassava (OR= 15.261; CI 95%= 3.242-71.835; p= 0.000) p < 0.05 , mustard (OR=
4.608; CI 95%= 1.494-14.213; p= 0.005), gatot (OR= 5.556; CI 95%= 1.923-16.046; p= 0.001), and cassava
tape (OR= 5.205; CI 95%= 2.031-13.337; p= 0.000). While the consumption pattern of iodine source food that
is related to the incidence of goiter in farmers namely sea fish (OR= 0.078; CI 95%= 0.009-0.638; p= 0.004).
Conclusions: There is a relationship of food consumption patterns with the incidence of goiter in farmers
in Kismantoro Subdistrict. The food most often consumed by respondents was cassava. Food sources of
goitrogenic sources associated with the occurrence of goiter are cassava, mustard, gatot and cassava tape.
KEYWORD: dietary patterns; goiter; goitrogenic; Iodium; Kismantoro Subdistrict

Article info:
Article submitted on July 13, 2021
Articles revised on July 31, 2021
Articles received on August 19, 2021
INTRODUCTION
Iodine Deficiency Disorders (IDD) is one of the
public health problems that can hinder the quality of
human resources (1). The most significant impact of
iodine deficiency for humans is the developmental
disorder of the central nervous system, including
intelligence (2). Factors that affect iodium deficiency
can be from physical characteristics such as
topography, soil type, deforestation, high rainfall,
and erosion. Biologic factors include escherichia
coli, intestinal worms, goitrogenic compounds,
nitrogen fertilizers, and iron nutrient anemia.
Cultural elements include community indifference,
agricultural culture, monotonous diet, and how to
cook food, social factors such as low education and
poverty (3).
The causes of iodium deficiency are low intake
of iodine, which can cause the excretion of thyroid
hormones, not maximal, exposure to environmental
pollution (Pb, Hg, Cd, and pesticides). Natural
goitrogenic substances in foodstuffs can inhibit
the taking of iodium from inorganic to organic (4).
The influence of goitrogen factors is classified into
two parts, namely natural goitrogen and synthetic

goitrogen. Natural goitrogens such as cassava
and cabbage plants. At the same time, synthetic
goitrogens are insecticides, organochlorines (DDT,
DDD, and Dieldrin), fungicides, and antibiotics
(tetracycline) (5).
History of pesticide exposure can be
considered a risk factor for thyroid dysfunction
in elementary school-age children in Brebes
agricultural area, Central Java (6). In line with
research conducted by Kongtip P et al., the study
examined the comparison of pesticide effects on
thyroid hormone levels (TSH, T3, T4, FT3, and FT4)
on conventional farmers and organic farmers from
the results of his research showed that TSH, FT3,
T3, and T4 from conventional farmers are higher
than in organic farmers. Exposure to pesticides
can impact the development of metabolic diseases
by altering the endocrine system (thyroid hormone
levels through the Hypothalamic Thyroid Pituitary
(HPT). Marwanto A et al. examined that the history
of pesticide exposure was significantly related to the
incidence of goiter in horticultural areas, Brebes,
Central Java.
Kismantoro is one of the sub-districts in
Wonogiri regency with a natural state that is

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Ahshaina Ramadhaningtiyas, Yulia Lanti Retno Dewi, Sugihardjo, Vol 9 No. 2, 2021: 44-53

mostly mountains and tropical climates. The hills
cover almost all villages, the dominance of state
forests and moorland as farmland, with rice fields of
931.9520 ha, moorland of 1,256.2484 ha, buildings
and yards 2,263,7661 ha, state forests of 2,316,1055
ha, and others covering 218,0405 ha (8). The natural
situation that supports the population to cultivate
so that most of the residents in the Kismantoro
subdistrict have a livelihood as farmers, and cassava
becomes the most widely planted crop (8). According
to Saidin S., cassava is one of the foods containing
goitrogenic substances that can interfere with the
absorption of iodium into the body. Local soybeans,
cassava, and cabbage are goitrogenic to rats. Their
anti thyroidal additive effects can be harmful to locals
who eat them (9).
Based on UPT Puskesmas Kismantoro until
2017, goiter sufferers in Kismantoro subdistrict
as many as 147 people. In 2018 as many as 138
sufferers, and in 2020 as many as 128 sufferers.
In 2018, as many as 706 goiter sufferers targeted
implementing activities Wonogiri free goiter with the
most significant number of sufferers, namely from
Kismantoro District as many as 132 people (10).
The exposure illustrates that most of the
Kismantoro population works as farmers closely
related to pesticide use. Some residents make
cassava the leading food ingredient they consume.
Given many farmers, the use of pesticides, and
the incidence of goiter in Kismantoro Subdistrict
Wonogiri, in this case, farmers in Kismantoro
Subdistrict have a significant risk factor to
experience the occurrence of goiter. So it is essential
to get additional information about the relationship
between food consumption patterns in farmers and
the incidence of goiter in Kismantoro Subdistrict,
Wonogiri Regency.
MATERIALS AND METHODS
This research is analytical observational
research with a case-control design with a sample
number of 82 people. The sampling technique used
is purposive sampling, using a 1:1 comparison
between the case and control groups (11). In this
study, the population of cases this study is all

people who were declared positively affected by
goiter and recorded at the Kismantoro Subdistrict
Health Center in 2020 as many as 128 people. The
study was conducted in September-November
2020. The control population is all said negative
goiter and does not live in a house with a group of
cases and has the same risk factors as the case
group. The selection of samples using inclusion
criteria is that samples willing to be respondents
live in Kismantoro Subdistrict and work as farmers
or engage in agricultural activities. Farmers have
high risk factors for getting goiter obtained from
pesticide exposure. Pesticides can interfere with
the process of thyroid hormone synthesis and
metabolism through several mechanisms, one of
which is, disrupting the TSH receptor (TSH-r) in the
thyroid gland, so that TSH that will spur the synthesis
of thyroid hormones cannot enter the gland, and has
an impact on inhibition of thyroid hormone synthesis
and causes goiter (12).
The data collection uses interviews with
questionnaires and Food Frequency Questionnaire
(FFQ) to determine the consumption patterns of
iodine and goitrogenic sources. The foodstuffs
listed in Food Frequency Questionnaire (FFQ)
are determined by Focus Group Discussion
(FGD), which is done to some farmers who are
also Integrated Health Post Cadres in Kismantoro
Sub-District Village Hall. Food ingredients listed
in Food Frequency Questionnaire (FFQ) iodium
sources include sea fish, freshwater fish, salted
fish, anchovies, meat, milk, rice, bread, and eggs.
While the food ingredients listed in Food Frequency
Questionnaire (FFQ) goitrogenic sources include
cassava, gadung chips, bamboo shoots, cassava
leaves, cabbage, papaya leaf, tempeh, tofu,
broccoli, lettuce, cassava chips, mustard green,
water spinach, peanuts, long beans, gambas, purple
eggplant, green beans, gatot, and cassava tape.
Then scoring is done and grouped into
frequent when the total score is above the average
score and grouped into rarely when the total score
is below the average score. Processing techniques
and data analysis using statistical tests chi-square,
fisher exact to know factors related to the incidence
of goiter in farmers. All action has approved all

Relationship of food consumption pattern with goiter incidence in farmers

activities of the ethics committee, faculty of medicine
of Universitas Sebelas Maret Surakarta Indonesia,
No.01/UN27.06.1/KEPK/EC/2021.
RESULTS AND DISCUSSIONS
The characteristics of respondents, namely

103

goiter farmers and not goiter can be seen in Table 1.
There is a relationship between age and gender with
the incidence of goiter in farmers, while there is no
relationship between education and the incidence of
goiter in farmers in Kismantoro Subdistrict, Wonogiri
Regency.

Table 1. Characteristics of goiter and not goiter farmers in Kismantoro Subdistrict Wonogiri Regency
Characteristics
Age
>40 years old
<40 years old
Gender
Male
Female
Education Level
Low
High

Goiter Incidence
Non Goiter
Goiter
n
%
n
%

N

%

38
3

57.6
18.8

28
13

42.4
81.3

66
16

3
38

17.6
58.5

14
27

82.4
41.5

40
1

51.3
25.0

38
3

48.7
75.0

Characteristics of respondents are farmers
who are goiter and not goiter can be seen in Table
1. Based on Table 1 it can be seen that the age
(OR= 5.88; CI 95%= 1.53-22.62; p= 0.005) p < 0.05
and gender (OR= 0.15; CI 95%= 0.04-0.58; p=
0.003) p < 0.05 have a significant association with
the incidence of goiter in farmers. while the level of
education (OR= 3.16; CI95%= 0.32-31.70 p= 0.308)
has no significant relationship with the incidence of
goiter in farmers in Kismantoro Subdistrict. Wonogiri
Regency.
Based on the statistical test chi-square fisher
exact obtained results that the consumption pattern

Total

P-Value

OR

95% CI

80.5
19.5

0.005

5.88

1.53-22.62

17
65

20.7
79.3

0.003

6.15

0.04 – 0.58

78
4

95.1
4.9

0.308

3.16

0.32 – 31.70

of goitrogenic sources related to the incidence of
goiter in farmers in Kismantoro subdistrict is the
pattern of cassava consumption (OR= 15.261; CI
95%= 3.242-71.835; p= 0.000) p < 0.05 . green
mustard (OR= 4.608; CI 95%= 1.494-14.213; p=
0.005). gatot (OR= 5.556; CI 95%= 1.923-16.046;
p= 0.001). and cassava tape (OR= 5.205; CI 95%=
2.031-13.337; p= 0.000). While the consumption
pattern of iodine source food that is related to the
incidence of goiter in farmers namely sea fish (OR=
0.078; CI 95%= 0.009-0.638; p= 0.004). More
information can be found in Table 2.

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Ahshaina Ramadhaningtiyas, Yulia Lanti Retno Dewi, Sugihardjo, Vol 9 No. 2, 2021: 44-53

Table 2. Consumption Patterns of Iodium Sources and Consumption Patterns of Goitrogenic Sources of Goiter
farmers and not Goiter in Kismantoro Subdistrict Wonogiri.
Goiter Incidence
Variabel
Goiter
No Goiter
n
%
N
%
Goitrogenic Consumption Pattern
Cassava
Infrequently
2
2.4
18
22.0
Often
39
47.6
23
28.0
Gadung chips
Infrequently
28
34.1
36
43.9
Often
13
15.9
5
6.1
Bamboo shoot
Infrequently
26
31.7
31
37.8
Often
15
18.3
10
12.2
Cassava leaves
Infrequently
2
2.4
9
11.0
Often
39
47.6
32
39.0
Cabbage
Infrequently
10
12.2
12
14.6
Often
31
37.8
29
35.4
Papaya leaf
Infrequently
16
19.5
18
22.0
Often
25
30.5
23
28.0
Tempeh
Infrequently
3
3.7
5
6.1
Often
38
46.3
36
43.9
Tofu
Infrequently
5
6.1
10
12.2
Often
36
43.9
31
37.8
Broccoli
Infrequently
32
39.0
32
39.0
Often
9
11.0
9
11.0
Lettuce
Infrequently
39
47.6
40
48.8
Often
2
2.4
1
1.2
Cassava chips
Infrequently
28
34.1
33
40.2
Often
13
15.9
8
9.8
Mustard green
Infrequently
5
6.1
16
19.5
Often
36
43.9
25
30.5
Water spinach
Infrequently
3
3.7
7
8.5
Often
38
46.3
34
41.5
Peanuts
Infrequently
30
36.6
34
41.5
Often
11
13.4
7
8.5

Total
N

%

20
62

24.4
75.6

64
18

78.0
22.0

57
25

69.5
30.5

11
71

P-Value

95% CI

OR

Lower

Upper

15.261

3.242

71.835

3.343

1.065

10.489

0.230

1.788

0.688

4.647

13.4
86.6

0.023

5.484

1.105

27.216

22
60

26.8
73.2

0.618

1.283

0.481

3.418

34
48

41.5
58.5

0.654

1.223

.507

2.948

8
74

9.8
90.2

0.457

1.759

0.392

7.902

15
67

18.3
81.7

0.153

2.323

0.717

7.529

64
18

78.0
22.0

1.000

1.000

0.351

2.846

79
3

96.3
3.7

0.556

2.051

0.179

23.550

61
21

74.4
25.6

0.206

1.915

0.694

5.282

21
61

25.6
74.4

0.005*

4.608

1.494

14.213

10
72

12.2
87.8

0.177

2.608

0.624

10.891

64
18

78.0
22.0

0.286

1.781

0.613

5.178

<0.001*
0.033

Relationship of food consumption pattern with goiter incidence in farmers

Long beans
Infrequently
Often
Gambas
Infrequently
Often
Purple eggplant
Infrequently
Often
Green beans
Infrequently
Often
Gatot
Infrequently
Often
Cassava tape
Infrequently
Often
Sources of Iodium
Sea Fish
Infrequently
Often
Freshwater Fish
Infrequently
Often
Salted Fish
Infrequently
Often
Anchovies
Infrequently
Often
Meat
Infrequently
Often
Milk
Infrequently
Often
Rice
Infrequently
Often
Bread
Infrequently
Often
Egg
Infrequently
Often

105

24
17

29.3
20.7

23
18

28.0
22.0

47
35

57.3
42.7

0.823

0.905

0.377

2.172

29
12

35.4
14.6

32
9

39.0
11.0

61
21

74.4
25.6

0.448

1.471

0.541

3.998

26
15

31.7
18.3

22
19

26.8
23.2

48
34

58.5
41.5

0.370

0.668

0.276

1.616

26
15

31.7
18.3

23
18

28.0
22.0

49
33

59.8
40.2

0.499

0.737

0.304

1.787

6
35

7.3
42.7

20
21

24.4
25.6

26
56

31.7
68.3

0.001*

5.556

1.923

16.046

12
29

14.6
35.4

28
13

34.1
15.9

40
42

48.8
51.2

0.000*

5.205

2.031

13.337

40
1

48.8
1.2

31
10

37.8
12.2

71
11

86.6
13.4

0.004*

0.078

0.009

0.638

40
1

48.8
1.2

32
9

39.0
11.0

72
10

87.8
12.2

0.007

0.089

0.011

0.739

40
1

48.8
1.2

35
6

42.7
7.3

75
7

91.5
8.5

0.048

0.146

0.017

1.271

38
3

46.3
3.7

34
7

41.5
8.5

72
10

87.8
12.2

0.177

0.383

0.092

1.601

37
4

45.1
4.9

32
9

39.0
11.0

69
13

84.1
15.9

0.131

0.384

0.108

1.368

39
2

47.6
2.4

30
11

36.6
13.4

69
13

84.1
15.9

0.007

0.140

0.029

0.679

11
30

13.4
36.6

1
40

1.2
48.8

12
70

14.6
85.4

0.002*

0.068

0.008

0.557

26
15

31.7
18.3

24
17

29.3
20.7

50
32

61.0
39.0

0.651

0.814

0.335

1.981

24
17

29.3
20.7

24
17

29.3
20.7

48
34

58.5
41.5

1.000

1.000

0.415

2.408

106

Ahshaina Ramadhaningtiyas, Yulia Lanti Retno Dewi, Sugihardjo, Vol 9 No. 2, 2021: 44-53

Based on the statistical test chi-square.
fisher exact shows that the characteristics of
farmers. namely age and gender. have a significant
relationship with the incidence of goiter in farmers
in Kismantoro Subdistrict Wonogiri. Gender and age
play a role in determining the occurrence of thyroid
disease (13).
Thyroid hormones are under the control of
TSH levels making the latter a sensitive marker of
thyroid function. The aging process leads to reduced
absorption and organization of iodine with an altered
thyroid response to TSH. This is what causes old age
to be more susceptible to goiter disease than at a
young age (14). Research conducted by Barbesino
at Massachusetts General Hospital. Harvard Medical
School shows that the pattern that arises is a
decrease in thyroid function in the elderly. leading to
slightly higher levels of thyroid-stimulating hormone
(TSH) compared to young age. The incidence of
mild hyperthyroidism also increases in adulthood.
especially in populations with a history of iodium
deficiency.
In endemic goiter areas such as Kismantoro
Subdistrict with low iodium content. the thyroid
usually begins to grow at a young age and develops
into multinodular when adulthood (16). However.
patients recorded in Public health Centers average
only age >40years and above. This is because
most sufferers do not complain of symptoms such
as hypothyroidism or hyperthyroidism. They only
treat or check with a doctor and midwife if they feel
pain or extreme changes in their neck (a lump or
enlargement). which are usually not felt at a young
age.
Based on research conducted by Calcaterra
et al. on Gender Differences at the Onset of
Autoimmune Thyroid Diseases in Children and
Adolescents in Pavia. Italy found that women are
more susceptible to Autoimmune Thyroid Diseases
(ATD) during puberty. This is due to the influence
of the hormone estrogen can increase levels of
Thyroid-Binding Globulin (TBG) that works as
transport of T4 and T3 in the blood. So that there is a
decrease in levels of free T4 and free T3 (18). In line
with research conducted by Meng et al. in China.
women with high TSH and FT3 high have a higher

risk of metabolic syndrome than men.
Based on data obtained from FFQ can be
known that the most consumed food by farmers in
the Kismantoro subdistrict is cassava. At the same
time. based on the test chi-square. exact fisher
known that goitrogenic food sources related to the
incidence of goiter in farmers in the Kismantoro
subdistrict are cassava. mustard green. gatot. and
cassava tape.
This is because the most widely planted plants
for consumption in the Kismantoro subdistrict are
cassava. So often. people there make cassava and
various processed cassava such as gatot. cassava
tape. and tiwul as the main ingredients of their food
or staple food.
Cassava is one of the foods containing
goitrogenic substances that can interfere with the
absorption of iodium into the body. Cassava is a
natural source of goitrogen group thiocyanate or
thiocyanate-like compounds that primarily inhibit
the mechanism of active transport of iodium into the
thyroid gland. Other foods high in thiocyanate are
corn. bamboo shoots. sweet potatoes. green beans
(5). Bamboo shoots. sweet potatoes. and green
beans are also foods that people in Kismantoro often
consume.
Research conducted by Dewi YLR et al. that is
testing local soybeans. cassava. and cabbage grown
in iodine-deficient areas in Ngargoyoso Central Java
against rats mentions local soybeans. cassava. and
cabbage are goitrogenic to rats. The anti thyroidal
additive effects of soy. cassava. and local cabbage
can harm the locals who eat them. This is in line
with Izati and Mahmudiono. which found that tiwul
is the most commonly consumed goitrogenic food
by school-age children in Ponorogo and has a
significant relationship with the incidence goiter in
Ponorogo.
Another study by Crosby et al. on thyroid
disorder patients at RSUP. Prof. Dr. R. D. Kandau
Manado. found that the average thyroid patient
resides in a mountainous area of 66.7. The things
that cause people in the mountains who suffer from
IDD are due to soil erosion. Water and plants that
grow poor iodium. coupled with the consumption of
goitrogenic source foods. cassava. corn. bamboo

Relationship of food consumption pattern with goiter incidence in farmers

shoots. sweet potatoes. and green beans.
Research conducted by Hariyanti and
Indrawati in elementary school-age children in
Kendal Subdistrict Ngawi district. Found that IDD
has a strong relationship with knowledge about
food processing. food consumption patterns. and
goitrogenic substances. namely cabbage. mustard
green. cauliflower. sweet potatoes. and chayote.
Another study by Pebriana et al. in the
children of Pringapus Primary School and Kataan
Primary School. Ngadirejo Subdistrict. Temanggung
District. found a relationship between goitrogenic
food consumption patterns and IDD incidence in
elementary school-age children. The most commonly
consumed foodstuffs such as cabbage. mustard
green. green beans. papaya leaves. cassava leaves.
respondents consumed these foodstuffs 6-7 times
per week.
The most infrequently source of iodium food
consumed by respondents in the Kismantoro
subdistrict is sea fish. This is because of the
location of Kismantoro Subdistrict. which is located
in the mountains. far from the sea. The distance
of some homes very far from the market causes
the community to be limited to the food available.
They usually only grow vegetables such as mustard
green. cabbage. green beans. and cassava in their
yard. While the iodine content in sea fish is very high.
Research conducted by Alfitri et al. on
factors that influence the incidence of IDD in
pregnant women in Tabunganen Barito Kuala.
South Kalimantan. found a significant relationship
between the consumption of sea fish iodium based
on FFQ with IDD status of goiter. Respondents with
infrequently sea fish consumption were 8.0 times
more likely to suffer from IDD. This is in line with
research conducted by Patuti et al.. which found that
low consumption of protein sources causes a person
to suffer from IDD 30.6 times greater than someone
who often consumes protein sources.
Low iodium intake and accompanied by a high
intake of goitrogenic substances cause a greater
chance of developing goiter disease. Kismantoro
Subdistrict is an area with a low water content of
iodine. so growing plants also have a low iodine
content. This causes Kismantoro Subdistrict to

107

become an endemic goiter area from time to time.
People should get iodium supplementation from
consuming foods containing high iodine. such as
sea fish. salted fish. milk. eggs. and iodium salt.
CONCLUSIONS AND RECOMMENDATIONS
Based on the study results. there is a
relationship between food consumption patterns
of iodine sources and consumption patterns of
goitrogenic sources with the incidence of goiter in
farmers in Kismantoro Subdistrict Wonogiri. The
food most commonly consumed by respondents is
cassava. Food sources of goitrogenic associated
with goiter incidence in farmers are cassava. mustard
green. gatot. and cassava tape. At the same time.
the food source of iodine related to the incidence
of goiter in farmers is sea fish. Farmers who rarely
consume sea fish are at greater risk of getting goiter
than farmers who often consume sea fish.
Recommendations for the community should
also be more aware of the importance of food sources
of iodine sources; education and socialization for
the community about the consumption of iodine
source food should also continuously monitoring by
local authorities. Program efforts from the provincial
government to ensure the adequacy of iodium intake
in endemic areas of goiter need to be maintained.
The next researcher was expecting to add variables
such as intake of iodine salt to get a complete picture
of the cause of goiter in farmers in the Kismantoro
Subdistrict.
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