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PLACENTUM Jurnal Ilmiah Kesehatan dan Aplikasinya, Vol.
12(1) 2024
PICKY EATING BEHAVIOR ON THE INCIDENT OF STUNTING IN CHILDREN

TODDLERS IN TIRTOMOYO, WONOGIRI
Alfiani Vivi Sutanto1), Lia Ratih Nurhidayah2)

1, 2) Speech Therapy Department, Poltekkes Kemenkes Surakarta 57127, Surakarta,
Indonesia
* Corresponding author
Email: [email protected]
ABSTRACT
Background: The process of development and growth during toddlerhood is determined by
the food consumed every day. Giving the body the appropriate nutrition it needs will produce
good development. However, various obstacles often occur, such as eating disorders in
children. One of the eating disorders in children is the habit of refusing food and being picky
about food, often called picky eating, which will have an impact on their nutritional status.
Thin or poor nutritional status in children under five can put them at risk of stunting. Stunting
is a physical growth disorder characterized by a decrease in growth rate and the impact of a
nutritional imbalance.
Methods: This research is quantitative, with a type of observational analytical research. This
research was conducted from January to October 2023 in Tirtomoyo, Wonogiri, with a
population of 55 children and a sample of 50 children. A questionnaire was developed by
researchers based on the Picky Eating Behavior Rating Scale and Transcultural Nursing
Theory. Whereas the connection between variables is analyzed using the analysis of simple
linear regression through ANOVA and power tables, the influence between variables is
observed through the model summary table on value correlation (R). The license number of
research is 071/277.
Result: There is an influence of the behavior of picky eaters against the incidence of stunting
among toddlers in the Tirtomoyo, Wonogiri, with a level of significance (Sig.) of 0.004 and
a value coefficient determination (R square) of 0.164.
Conclusion: The behavior of picky eaters can influence the incidence of stunting in children.
Keywords: Behavior, Picky Eating, Stunting, Children.
INTRODUCTION to watch a child's development so if any

Children are an investment and the abnormalities occur, they can be detected
foundation of a country's future as early as possible. In the process of life,
generations. Toddlers, or what are usually childhood is the phase where the growth
called babies under 5 years of age, are in and development process occurs, so
the period where growth and development development optimization must be carried
have increased rapidly. This period is out (Muharani, 2020). At this time,
often called the golden age. It's important toddlers also require adequate nutritional
Copyright © 2024, Placentum: Jurnal Ilmiah Kesehatan dan Aplikasinya, ISSN 2303-3746, e ISSN 2620-9969 32
PLACENTUM Jurnal Ilmiah Kesehatan dan Aplikasinya, Vol. 12(1) 2024
intake in greater quantity and quality, growth, characterized by a decrease in

because toddlers in general have sufficient growth rate and the impact of not doing so
physical activity and are still in the on nutritional balance (Apriluana, 2018;
learning process. Pratiwi, 2021). According to UNICEF
Development and growth processes (Prakhasita, 2018), influencing factors
in infancy are determined by the food that stunt an individual include factors
consumed every day. Providing such as poor nutritional intake, infectious
appropriate nutritional intake is necessary diseases, low birth weight (LBW), and
to produce good growth and development. caregiver or parental factors such as
Nutritional balance is obtained from food knowledge and attitudes, resilience food,
intake that meets children's nutritional and parenting patterns. Insufficient
needs, as seen from age and activities nutritional intake can occur due to the
achieving normal body weight (Astuti & child's habit of refusing food and being
Ayuningtyas, 2018). The intake of picky about food (picky eating).
nutrients obtained from food influences According to the United Nations
the growth and development process in International Children's Emergency Fund
toddlers. The food consumed every day by (UNICEF 2013), problem child shortness
humans does not necessarily meet (stunting) is one of the problems of
adequate nutritional requirements, so it is nutrition that occurs in the world,
necessary to consume food in various especially in poor and developing
quantities and types (Almatsier, 2008). countries. There is stunting, which can
Children who consume food with give rise to the risk of pain and death. Data
insufficient nutritional content can cause from the World Health Organization
their immune system to weaken and (WHO) noted that in 2017, 22.2%, or
become susceptible to disease (Waryana, around 150.8 million toddlers in the
2010). world, experienced stunting. More than
Childhood is a phase where various half of the world's stunted toddlers come
food intake problems usually occur, one of from Asia (55%), while more than a third
which is picky eating (Muharani, 2020). (39%) live in Africa. Of the 83.6 million
Saraswati (2012) emphasized that picky stunted toddlers in Asia, the largest
eating is a problem with difficulty eating proportion comes from South Asia
frequently experienced by toddlers. (58.7%), and the largest proportion is
Children who are picky eaters have their slightly in Central Asia (0.9%) (Ilma et al.,
own habits of rejecting food and picky 2019).
food, which will impact their nutritional In Indonesia, the prevalence of
status (Wiliam & Marta, 2017). In general, stunting cases was 30.7 percent in 2013.
toddlers love to pick and choose food The prevalence of stunting remains
(which behaves like picky eating) and will categorized as high and a health problem
experience inadequate intake of food. in society because it is still above 30%
They could potentially experience a lack (Harahap, 2015; Simarmata, 2020).
of nutrition because of variations in food According to the results of the 2015
consumed in limited quantities, as well as Nutritional Status Assessment (PSG),
substance nutrition (Ekstein et al., 2010). 29% of children under five in Indonesia
Based on research conducted by Kusuma are in the short category, and the
et al. (2015), toddlers who picky eat have percentage of nutritional status of toddlers
a thinner nutritional status if compared to (short and very short) in Indonesia in 2013
toddlers who don't picky eat. was 37.2% if compared to 2010 (35.6%)
Thin or poor nutritional status in and 2007 (36.8%). This does not show a
children under five can put them at risk of significant decrease or improvement
stunting. Stunting is a nuisance to physical (Riskesdas, 2015; Simarmata, 2020).
Based on data obtained by during school years, and productivity and

Solopos.com on Wednesday, October 18, suboptimal work capacity (Indonesian
2023, from the Wonogiri Health Service Ministry of Health, 2018).
(Dinkes), the prevalence of stunted or Other similar research regarding
potentially stunted children under five in the incidence of stunting in children under
Wonogiri in the last five months totaled five in Wonogiri Regency more closely
45,155 children. The data was obtained links stunting with maternal nutritional
from the results of weighing children knowledge, attendance at Posyandu,
under five in all sub-districts with details children's eating patterns, and socio-
in July. Of the 42,650 children weighed, economic status. There has been no
4,693 children, or 11%, were in the research on stunting related to picky
stunted category. In August, of the 43,510 eating behavior or children's daily eating
children weighed, 4,615 children, or habits. Therefore, this research was
10.6% of them, were stunted. Finally, in conducted to determine the effect of picky
September, of the 42,308 children eating behavior on the incidence of
weighed, 48.67 children, or 11.5% of stunting in children under five in
them, were stunted. Tirtomoyo, Wonogiri.
Meanwhile, in June 2023, of the
number of babies under two years old who METHOD
had stunted status, there were 1,364 This is a quantitative study with a type of
children. Screening was carried out, and analytic observational study and a cross-
823 children were found to be suspected sectional study design. This study was
of stunting. Then, of these suspects, 684 carried out from January to October 2023
children were successfully examined. in Tirtomoyo Wonogiri, with a population
From the June data collection, 587 of 55 children experiencing stunting,
toddlers were declared stunted. This including toddlers. The retrieval technique
number is spread across various sub- sample used purposive sampling and
districts with the highest number of obtained a sample of 50 children. A
stunting cases. These are the five sub- questionnaire was developed by
districts in Wonogiri with the highest researchers based on the Rating Scale
number of stunting cases: Pracimantoro, Behavior, Picky Eating, and Transcultural
55 children; Tirtomoyo, 55 children; Nursing Theory. The connection between
Kismantoro, 40 children; Giriwoyo, 34 the variables analyzed uses the analysis of
children; and Manyaran, 34 children. simple linear regression through table
Through this data, we know that ANOVA and power influence between
Tirtomoyo is one of the sub-districts with variables observed through a model
the highest number of stunted children in summary table on value correlation (R).
Wonogiri Regency. The license number of research is
If stunting occurs in toddlers and is 071/277.
not addressed early, maybe it will cause a
big impact: an increase in the incidence of RESULTS
pain and death, cognitive development, 1. Description Characteristics Subject
motor and verbal in children that is not Study
optimal, increased health costs, and body This study has been done against 50
posture that is not optimal when adults subjects of research consisting of children
(shorter than in general) increases the risk with stunting and non-stunting conditions
of obesity and other diseases, decreased in Tirtomoyo, Wonogiri..
reproductive health, learning capacity and
performance that is less than optimal
Table 1 Description of Research Subject Characteristics

Variable Frequency (n) Percentage (%)
Gender
Man 28 56
Woman 22 44
Child Age
1 to 20 Months 7 14
21 to 30 Months 14 28
31 to 40 Months 15 30
41 to 50 Months 7 14
51 to 60 Months 6 12
61 to 80 Months 1 2
Child's Current Weight
<5kg 1 2
5 to 7 kg 3 6
8 to 9 kg 14 28
10 to 12 kg 26 52
13 to 15 kg 5 10
16 to 17 kg 1 2
Child's Current Height
<51cm 1 2
51 to 60 cm 1 2
61 to 70 cm 2 4
71 to 80 cm 21 42
81 to 90 cm 15 30
91 to 100 cm 9 18
101 to 110 cm 1 2
Splints at Birth
<5kg 3 6
6 to 7 kg 31 62
8 to 9 kg 16 32
Child's Body Length at Birth
<31cm 1 2
31 to 40 cm 5 10
41 to 45 cm 9 18
46 to 50 cm 34 68
51 to 55 cm 1 2
Age Parents (Father)
<26 Years 1 2
26 to 30 years old 13 26
Age Parents (Mother)
<26 Years 3 6
Work Parents (Father)
Private 27 54
Employee 2 4
Laborer 11 22
Teacher 1 2
Trader 1 2
Farmer 5 10
Random 1 2
POLRI 1 2
Unemployment 1 2
Work Parents (Mother)
Private 2 4
Employee 1 2
Laborer 2 4
Farmer 1 2
Housewife _ 44 88
Father's Last Education
Never _ School 1 2
Not completed in primary school 1 2
JUNIOR HIGH SCHOOL 16 32
SENIOR HIGH SCHOOL 28 56
Bachelor 4 8
Mother's Last Education
JUNIOR HIGH SCHOOL 15 30
SENIOR HIGH SCHOOL 29 58
Bachelor 6 12
Parents' Income ( Salary ).
<500,000 11 22
500,000 to 1,000,000 22 44
1,000,000 to 2,500,000 9 18
2,500,000 to 5,000,000 8 16
Mother's Meal Preparing Habits
Bad 1 2
Currently 48 96
Good 1 2
Type of Food Mother Prepares
Not varied 15 30
Variative 35 70
Amount Portion Food
Not enough 1 2
Enough 24 48
Good 25 50
Meal Schedule
Irregular _ 1 2
Enough Regular 21 42
Regular 28 56
Table 5.1 shows that the total mother who has habit quite good at
characteristics subject study dominated by preparing food for children as many as 48
children with type sex man as many as 28 mothers (96%), total mother prepared
people (56%), children with range aged 31 variation food for children as many as 35
to 40 months as many as 15 people (30%), mothers (70%), total mother gave it
children with current weight between 10 amount portion good food for children as
to 12 kg as many as 26 people (52%), many as 25 mothers (50%), and total
children with current height between 71 to mother does it in a way regular timetable
80 cm as many as 21 people (42%), Eat child as many as 28 mothers (56%).
children with birth weight between 6 to 7
kg as many as 31 people (62%), children 2. Analysis Results Univariate
with birth length between 46 to 50 cm as Table 2 shows descriptive statistical test
many as 34 people (68%), father's age results for each variable among them
between 31 to 35 years as many as 14 mean, standard deviation, minimum, and
people (28%), age Mother between 26 to maximum to measure both independent
30 years as many as 20 people (40%), the variables with a scale continuous variable
father's job is as employee private as many behavior picky food (picky eating) shows
as 27 people (54%), work Mother as that the mean and SD values are 0.96 ±
Mother House ladder as many as 44 0.198 with mark lowest 0 (no picky food
people (88%), education The last father (picky eating) and value highest 1 (picky
was high school with 28 people (56 food). Variable incidences of stunting in
people), education final Mother namely children and toddlers show that the mean
high school as many as 29 people (58%), and SD values are 0.92 ± 0.298, with a
income parent between Rp. 500,000 to Rp. mark of lowest 0 (no stunting) and a value
1,000,000 as many as 22 people (44%), of highest 1 (stunting).
Table 2 Description Variable Study

No. Variable N Mean SD Min Max
Behavior Be Picky Food
1. 50 0.96 0.198 0 1
( Picky Eating )
Incidence of Stunting in
2. 50 0.92 0.298 0 1
Children Under Five
Table 3 shows results univariate from the incidence of stunting in children and
study. This shows that the behavior of toddlers is divided into two categories: yes
picky food (picky eating) is shared into 2 and no. Based on the data above, as many
categories: yes and no. According to the as 46 children (92%) experienced stunting
data obtained, up to 48 children (96%) conditions at the age of a toddler.
demonstrated picky eating behavior. The
Table 3 Description of Research Variables Based on Categorical Data

Variable Category N Percentage (%)
Behavior Be Picky Food ( Yes 48 96
Picky Eating ) No 2 4
Incidence of Stunting in Yes 46 92
Children Under Five No 4 8
3. Analysis Results Bivariate regression test results show level

Based on analysis bivariate tested using significance in the ANOVA table (Sig.)
IBM SPSS Statistics 29.0.1.0, the linear 0.004 where p value≤0.05, so can meaning
Ha accepted and there is influence behavior stunting at age toddlers in Tirtomoyo,

picky food (picky eating) to incident Wonogiri.
Table 4 Effect Analysis Results from Behavior Be Picky Food to Stunting

Occurrence in Children Under Five
Variable Number (N) Significance
Behavior Be Picky Food
( Picky Eating ) 0.004
50
Incidence of Stunting in P<0.05
Children Under Five
Source: IBM SPSS Statistics 29.0.1.0
To see big strength influence, based table determination (R square) is 0.164, which
model summary obtained mark contains an understanding that strength of
correlation/relationship (R) is 0.405. From influence is 16.4%.
the number, the obtained coefficient
Table 5 Model Summary

Model R R Square Adjusted R Square Std. Error of the Estimate
1 .405 a ,164 ,147 ,183
a. Predictors: (Constant), Stunting
The test results use a simple linear
DISCUSSION regression test to show level significance
in the ANOVA table (Sig.) 0.004 where p
The aims study is know the value≤0.05, so can be interpreted as Ha
influence of picky eating behavior on the accepted and exists influence behavior
incidence of stunting in children. This picky food (picky eating) to incident
study was carried out in Tirtomoyo, stunting at age toddlers in Tirtomoyo,
Wonogiri. The size sample used is child Wonogiri. To see the strong influence, a
toddlers who experienced or allegedly table model summary is obtained, with a
experienced stunting. Amount mark correlation/relationship (R) of 0.405.
respondents >30 children make this study From the obtained coefficient
not requires a data normality test. The determination (R square) is 0.164, which
variables in this study are nominal in size contains the understanding that influence
with numerical data type. Hypotheses in picky eating behavior against the
this research is the test used to know the incidence of stunting in children amounted
influence between two variables on a scale to 16.4%.
and the researcher uses a simple linear Based on the results of the
regression test. research that has been done, it is known
This study is done on child that the behavior of picky eaters can
toddlers who experience or allegedly influence the incidence of stunting in
experience stunting in the Tirtomoyo, children. This matter follows the opinion
Wonogiri. Based on the 50 respondents of Pebruanti and Rokhaidah (2022) in
studied, 48 children (96%) had the their research entitled "The Relationship
behavior of picky food (picky eating), and between Picky Eating and Incidents of
2 children (4%) did not have the behavior Stunting in Preschool Children at
of picky food (picky eating). Whereas the Kindergarten A Nurul Huda Tumaritis
incidence of stunting in children was Bogor Regency”. This study states that
highest in toddlers, as many as 46 children there is a connection between picky eating
(92%) and as many as 4 children (8%) did and with incidence of stunting in children
not experience stunting incidents. in preschool at Kindergarten A Nurul
Huda Tumaritis Bogor Regency (results from: https://www.solopos.com/

analysis with the chi-square test was regency-wonogiri-canangkan-zero-
obtained p value = 0.023). The study is stunting -pada-2023-bisa-1253868
also in line with research conducted by 2. Adriani, M., & Wirjatmadi, B. (2014).
Nurmalasari, Utami, & Perkasa (2020) Toddler Nutrition and Health The Role
entitled "Picky eaters and stunting in of Micro Zinc in Toddler Growth.
children aged 2 to 5 years in Central Jakarta: Kencana Prenadamedia
Lampung, Indonesia”, where statistical Group.
test results showing that p = 0.000 (<0.05) 3. Almatsier , S. 2014. Basic Principles
which means there is a connection of Nutrition Science. Jakarta:
between picky eating with stunting in Gramedia Pustaka Utama
toddlers in Central Lampung. 4. Astuti, EP, & Ayuningtyas , IF (2018).
Kamumu and Rakay (2023), in a Picky Eater Behavior and Nutritional
study titled “Relationships: Picky Eating Status in Toddler Children. Midwifery
with the Incidence of Stunting in Children Journal: Journal UM Midwifery.
Aged Preschool in Lau, Maros” show that Mataram, 3 (1), 81.
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PLACENTUM Jurnal Ilmiah Kesehatan dan Aplikasinya, Vol.

PICKY EATING BEHAVIOR ON THE INCIDENT OF STUNTING IN CHILDREN

Alfiani Vivi Sutanto1), Lia Ratih Nurhidayah2)

Keywords: Behavior, Picky Eating, Stunting, Children.

INTRODUCTION to watch a child's development so if any

intake in greater quantity and quality, growth, characterized by a decrease in

Based on data obtained by during school years, and productivity and

Table 1 Description of Research Subject Characteristics

Table 2 Description Variable Study

Table 3 Description of Research Variables Based on Categorical Data

3. Analysis Results Bivariate regression test results show level

Ha accepted and there is influence behavior stunting at age toddlers in Tirtomoyo,

Table 4 Effect Analysis Results from Behavior Be Picky Food to Stunting

Table 5 Model Summary

Huda Tumaritis Bogor Regency (results from: https://www.solopos.com/

succeed lower it stunting , this the Nutrition, Volume 3, Number 1, 163-

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