Effect of Date Fruit Consumption on Hemoglobin Levels in Anemic Adolescent Girls

Indryani; Mustar; Hasnidar; Pattola; Alda  Anggraini

doi:10.56741/IISTR.jphs.002019

Authors

Indryani
indryani.bidanpendidik@gmail.com
Universitas Sipatokkong Mambo https://orcid.org/0000-0003-4357-0102
Mustar Universitas Sipatokkong Mambo https://orcid.org/0009-0006-7065-4554
Hasnidar Department of Midwifery https://orcid.org/0000-0002-9972-0061
Pattola STIKES Marendeng Majene https://orcid.org/0000-0001-7854-3302
Alda Anggraini Department of Midwifery

Keywords:

Adolescent Girls, Anemia, Date Fruit, Hemoglobin, Nutraceuticals

Abstract

Anemia among adolescent girls remains a persistent public health problem, particularly in low- and middle-income countries, where increased nutritional requirements and menstrual blood loss elevate the risk of iron deficiency. Although iron supplementation is the primary preventive strategy, low adherence among adolescents necessitates complementary approaches. This study aimed to evaluate the effect of date fruit consumption on hemoglobin levels among anemic adolescent girls. A quantitative pre-experimental study with a one-group pretest–posttest design was conducted in a school setting in South Sulawesi, Indonesia. Hemoglobin screening was performed on 70 adolescent girls, and 10 anemic participants were selected using purposive sampling. The intervention consisted of consuming 100 g of date fruit (approximately 7–8 fruits) daily for seven consecutive days. Hemoglobin levels were measured before and after the intervention using a portable hemoglobin analyzer. Data were analyzed using descriptive statistics and the Wilcoxon Signed-Rank Test, with statistical significance set at p < 0.05. Mean hemoglobin levels increased significantly from 11.09 g/dL at baseline to 13.38 g/dL after the intervention, with an average increase of 2.29 g/dL (p = 0.005). These findings suggest that short-term date fruit consumption significantly improves hemoglobin levels among anemic adolescent girls. In conclusion, date fruit represents a feasible, culturally acceptable, food-based nutraceutical intervention that may complement existing anemia prevention programs. Further randomized controlled studies with larger samples and longer follow-up are recommended to confirm these findings and evaluate their long-term effectiveness.

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Author Biographies

Indryani, Universitas Sipatokkong Mambo

is a Lecturer in Midwifery at Sipatokkong University. Mambo was born in Bone on March 25, 1991. Active as a Lecturer since 2016 to date, actively carrying out tridharma activities in teaching, research, and community service in the fields of midwifery, reproductive health, and anemia. (email: indryani.bidanpendidik@gmail.com).

Mustar, Universitas Sipatokkong Mambo

is a Nursing Lecturer born in Majene started his career as a health worker within the scope of the Majene Regency Health Office, has carried out service at the health center in 1993-2001 served as a teacher SPK Depkes Ujung Pandang in 2002-2006 served at the Majene Regional Government Akper, in 2007-2009 Lecturer at the University of West Sulawesi in 2010 until now is listed as a Lecturer at the Higher Education Service Institution in Region IX Sulawesi with a DPK at Sipatokkong Mambo University until now. (email: mustarb01@gmail.com).

Hasnidar, Department of Midwifery

is a lecturer in the Nursing study program and was born in Bone, Sulawesi Selatan. Since 2010, has been listed as a lecturer at the Higher Education Service Institution Region IX Sulawesi, with a DPK at Sipatokkong Mambo University, and has held the position of Rector since 2021. (email: hasnidarjabir77@gmail.com).

Pattola, STIKES Marendeng Majene

is a lecturer in the Bachelor of Nursing Study program, STIKES Marendeng Majene, Sulawesi Barat, Indonesia. Active as a lecturer since 2013 until now, conducting research and community service focusing on stunting and adolescent nutrition. (email: ola.mjn83@gmail.com).

Alda Anggraini, Department of Midwifery

is a student of the DIII (Diploma) Midwifery Study program. Born in Bone on December 18, 2003, has been active as a D3 Midwifery student at Universitas Sipatokkong Mambo, Indonesia since 2022, is involved in the tridharma of research with lecturers, and completed her education in 2026. (email: anggrianialda16@gmail.com).

References

R. Soni, D. Verma, R. Chopra, V. Singh, and D. Goswami, “Demystifying intricate factors of nutritional anemia beyond iron deficiency–A narrative review,” Clin. Nutr. ESPEN, vol. 69, pp. 745–764, Oct. 2025, doi: 10.1016/j.clnesp.2025.08.034. DOI: https://doi.org/10.1016/j.clnesp.2025.08.034

A. T. Mulyani, M. A. Khairinisa, A. Khatib, and A. Y. Chaerunisaa, “Understanding Stunting: Impact, Causes, and Strategy to Accelerate Stunting Reduction—A Narrative Review,” Nutrients, vol. 17, no. 9, p. 1493, Apr. 2025, doi: 10.3390/nu17091493. DOI: https://doi.org/10.3390/nu17091493

S. H. Atkinson et al., “Getting back on track to meet global anaemia reduction targets: a Lancet Haematology Commission,” Lancet Haematol., vol. 12, no. 9, pp. e717–e767, Sep. 2025, doi: 10.1016/S2352-3026(25)00146-2. DOI: https://doi.org/10.1016/S2352-3026(25)00146-2

S. Mehta et al., “Application of an Ecological Approach to Assessment of Nutrition in School-Aged Children—A Report from the ‘Biomarkers of Nutrition for Development: Knowledge Indicating Dietary Sufficiency (BOND-KIDS)’ Project Working Group 3,” J. Nutr., p. 101217, Oct. 2025, doi: 10.1016/j.tjnut.2025.10.030. DOI: https://doi.org/10.1016/j.tjnut.2025.10.030

S. A. Norris et al., “Nutrition in adolescent growth and development,” Lancet, vol. 399, no. 10320, pp. 172–184, Jan. 2022, doi: 10.1016/S0140-6736(21)01590-7. DOI: https://doi.org/10.1016/S0140-6736(21)01590-7

A. K. C. Leung, J. M. Lam, A. H. C. Wong, K. L. Hon, and X. Li, “Iron Deficiency Anemia: An Updated Review,” Curr. Pediatr. Rev., vol. 20, no. 3, pp. 339–356, Aug. 2024, doi: 10.2174/1573396320666230727102042. DOI: https://doi.org/10.2174/1573396320666230727102042

S. B. Kumar, S. R. Arnipalli, P. Mehta, S. Carrau, and O. Ziouzenkova, “Iron Deficiency Anemia: Efficacy and Limitations of Nutritional and Comprehensive Mitigation Strategies,” Nutrients, vol. 14, no. 14, p. 2976, Jul. 2022, doi: 10.3390/nu14142976. DOI: https://doi.org/10.3390/nu14142976

E. S. Elmira and A. Suryahadi, “The impact of super apps on the nutrition transition in low- and middle-income countries: Evidence from Indonesia,” Econ. Hum. Biol., vol. 59, p. 101524, Dec. 2025, doi: 10.1016/j.ehb.2025.101524. DOI: https://doi.org/10.1016/j.ehb.2025.101524

D. Paul, P. Mishra, and C. Chakraborti, “Nutritional status and social behavior among adolescent girls: The mediating effect of socio-demographic and economic environment an evidence from rural West Bengal,” Food Humanit., vol. 5, p. 100948, Dec. 2025, doi: 10.1016/j.foohum.2025.100948. DOI: https://doi.org/10.1016/j.foohum.2025.100948

I. Kamaruddin, S. Suryaningsi, N. Wahdah, and R. Munir, “Nutritional Implications on Adolescent Health and Development in Bontang City: An Educational, Social, Legal, and Public Health Analysis,” In Proc. Int. Conf. Neurosci. Learn. Technol. (ICONSATIN 2025), pp. 545–557, 2025, doi: 10.2991/978-2-38476-525-6_51. DOI: https://doi.org/10.2991/978-2-38476-525-6_51

M. B. Bellad, A. Patted, and R. J. Derman, “Is it time to alter the standard of care for iron deficiency/iron deficiency anemia in reproductive-age women?,” Biomedicines, vol. 12, no. 2, p. 278, 2024, doi: 10.3390/biomedicines12020278. DOI: https://doi.org/10.3390/biomedicines12020278

B. Kolarš et al., “Iron deficiency and iron deficiency anemia: A comprehensive overview of established and emerging concepts,” Pharmaceuticals, vol. 18, no. 8, p. 1104, 2025, doi: 10.3390/ph18081104. DOI: https://doi.org/10.3390/ph18081104

A. Mizawati, N. Effendi, D. Sulastri, and R. Sastra Purna, “Developing an integrated model for anemia prevention in prospective brides: A qualitative exploration of multisectoral collaboration in bengkulu city of Indonesia,” Clin. Epidemiol. Glob. Heal., vol. 37, p. 102252, Jan. 2026, doi: 10.1016/j.cegh.2025.102252. DOI: https://doi.org/10.1016/j.cegh.2025.102252

N. R. DeTore, O. Balogun, K. W. Choi, and D. J. Holt, “Transdiagnostic prevention in youth mental health, Part II: interventions,” Neuropsychopharmacology, vol. 51, no. 1, pp. 310–322, Jan. 2026. DOI: https://doi.org/10.1038/s41386-025-02234-9

H. Tang et al., “The influence of nutrition literacy, self-care self-efficacy and social support on the dietary practices of breast cancer patients undergoing chemotherapy: A multicentre study,” Eur. J. Oncol. Nurs., vol. 64, p. 102344, Jun. 2023, doi: 10.1016/j.ejon.2023.102344. DOI: https://doi.org/10.1016/j.ejon.2023.102344

A. Mildon, D. Lopez de Romaña, M. E. D. Jefferds, L. M. Rogers, J. M. Golan, and M. Arabi, “Integrating and coordinating programs for the management of anemia across the life course,” Ann. N. Y. Acad. Sci., vol. 1525, no. 1, pp. 160–172, Jul. 2023, doi: 10.1111/nyas.15002. DOI: https://doi.org/10.1111/nyas.15002

B. Thompson, “Combating iron deficiency: food-based approaches.,” in Combating micronutrient deficiencies: food-based approaches, UK: CABI, 2011, pp. 268–288. 10.1079/9781845937140.0268 DOI: https://doi.org/10.1079/9781845937140.0268

S. A. Ashraf, “Food fortification as a sustainable global strategy to mitigate micronutrient deficiencies and improve public health,” Discov. Food, vol. 5, no. 1, p. 201, Jul. 2025, doi: 10.1007/s44187-025-00512-5. DOI: https://doi.org/10.1007/s44187-025-00512-5

R. F. M. Ali and A. M. El-Anany, “From traditional fruit to modern functional food: chemical constituents, bioactive compounds, and therapeutic applications of Sukkari date palm (Phoenix dactylifera): a review,” Front. Nutr., vol. 12, p. 1651121, Sep. 2025, doi: 10.3389/fnut.2025.1651121. DOI: https://doi.org/10.3389/fnut.2025.1651121

X. Pan, M. Köberle, and M. Ghashghaeinia, “Vitamin C-Dependent Uptake of Non-Heme Iron by Enterocytes, Its Impact on Erythropoiesis and Redox Capacity of Human Erythrocytes,” Antioxidants, vol. 13, no. 8, p. 968, Aug. 2024, doi: 10.3390/antiox13080968. DOI: https://doi.org/10.3390/antiox13080968

A. E. Butler et al., “Effect of Date Fruit Consumption on the Glycemic Control of Patients with Type 2 Diabetes: A Randomized Clinical Trial,” Nutrients, vol. 14, no. 17, p. 3491, Aug. 2022, doi: 10.3390/nu14173491. DOI: https://doi.org/10.3390/nu14173491

V. M. T. De Jong et al., “Individual participant data meta‐analysis of intervention studies with time‐to‐event outcomes: A review of the methodology and an applied example,” Res. Synth. Methods, vol. 11, no. 2, pp. 148–168, Mar. 2020, doi: 10.1002/jrsm.1384. DOI: https://doi.org/10.1002/jrsm.1384

K. L. I. Samson, J. A. J. Fischer, and M. L. Roche, “Iron Status, Anemia, and Iron Interventions and Their Associations with Cognitive and Academic Performance in Adolescents: A Systematic Review,” Nutrients, vol. 14, no. 1, p. 224, Jan. 2022, doi: 10.3390/nu14010224. DOI: https://doi.org/10.3390/nu14010224

N. Stabell, M. Averina, and T. Flægstad, “Chronic iron deficiency and anaemia were highly prevalent in a population‐based longitudinal study among adolescent girls,” Acta Paediatr., vol. 110, no. 10, pp. 2842–2849, Oct. 2021, doi: 10.1111/apa.16016. DOI: https://doi.org/10.1111/apa.16016

M. A. Wiafe, J. Ayenu, and D. Eli-Cophie, “A Review of the Risk Factors for Iron Deficiency Anaemia among Adolescents in Developing Countries,” Anemia, vol. 2023, no. 1, pp. 1–11, Jan. 2023, doi: 10.1155/2023/6406286. DOI: https://doi.org/10.1155/2023/6406286

A. Ouamnina, A. Alahyane, I. Elateri, and M. Abderrazik, “Pharmacological insights, traditional applications, and determinants of phytochemical composition in date palm fruit (Phoenix dactylifera L.): A comprehensive review,” J. Food Compos. Anal., vol. 136, p. 106784, 2024, doi: 10.1016/j.jfca.2024.106784. DOI: https://doi.org/10.1016/j.jfca.2024.106784

N. M. Alshwaiyat, A. Ahmad, and H. A. N. Al-Jamal, “Effect of diet-induced weight loss on iron status and its markers among young women with overweight/obesity and iron deficiency anemia: a randomized controlled trial,” Front. Nutr., vol. 10, p. 1155947, May 2023, doi: 10.3389/fnut.2023.1155947. DOI: https://doi.org/10.3389/fnut.2023.1155947

M. H. Alu’datt et al., “Date palm (Phoenix dactylifera) bioactive constituents and their applications as natural multifunctional ingredients in health‐promoting foods and nutraceuticals: A comprehensive review,” Compr. Rev. Food Sci. Food Saf., vol. 24, no. 1, p. e70084, 2025, doi: 10.1111/1541-4337.70084. DOI: https://doi.org/10.1111/1541-4337.70084

R. J. Derman and A. Patted, “Overview of iron deficiency and iron deficiency anemia in women and girls of reproductive age,” Int. J. Gynecol. Obstet., vol. 162, no. S2, pp. 78–82, Aug. 2023, doi: 10.1002/ijgo.14950. DOI: https://doi.org/10.1002/ijgo.14950

A. E.-Y. Chuang, Y.-L. Chen, H.-J. Chiu, H. T. Nguyen, and C.-H. Liu, “Nasal administration of polysaccharides-based nanocarrier combining hemoglobin and diferuloylmethane for managing diabetic kidney disease,” Int. J. Biol. Macromol., vol. 282, p. 136534, 2024, doi: 10.1016/j.ijbiomac.2024.136534. DOI: https://doi.org/10.1016/j.ijbiomac.2024.136534

L. Fontana et al., “Effect of nutrition, sensory education and healthy food exposure interventions on adolescent food habits and attitudes,” Appetite, vol. 218, p. 108388, Mar. 2026, doi: 10.1016/j.appet.2025.108388. DOI: https://doi.org/10.1016/j.appet.2025.108388

R. Paudel et al., “Impact of a Community-based Intervention Program on Nutritional Status of Children Aged Under 5 Years With Undernutrition in Western Rural Nepal,” J. Nutr. Educ. Behav., vol. 57, no. 7, pp. 602–613, Jul. 2025, doi: 10.1016/j.jneb.2025.03.003. DOI: https://doi.org/10.1016/j.jneb.2025.03.003

A. Bechoff, J. de Bruyn, A. Alpha, F. Wieringa, and V. Greffeuille, “Exploring the Complementarity of Fortification and Dietary Diversification to Combat Micronutrient Deficiencies: A Scoping Review,” Curr. Dev. Nutr., vol. 7, no. 2, p. 100033, Feb. 2023, doi: 10.1016/j.cdnut.2023.100033. DOI: https://doi.org/10.1016/j.cdnut.2023.100033

P. Grabowski et al., “Research agenda for holistically assessing agricultural strategies for human micronutrient deficiencies in east and southern Africa,” Agric. Syst., vol. 220, p. 104094, 2024, doi: 10.1016/j.agsy.2024.104094. DOI: https://doi.org/10.1016/j.agsy.2024.104094