Teenagers’ food consumption patterns during the COVID-19 pandemic are very important, to keep the body healthy and avoid infectious diseases such as Covid-19. This study aims to analyze the consumption behavior of balanced nutrition that still needs attention from the students of SMK Kesehatan Binatama so that it can be used to produce health promotion programs for students. This research is a qualitative descriptive study. Secondary data from the results of previous studies. Both closed behavior (such as knowledge, attitudes) and open behavior of students in consuming balanced nutrition, where students' understanding still answered incorrectly, or their attitude negative. It is presented and concluded. The results showed that the knowledge, attitudes, and roles of teachers towards students regarding balanced nutrition during the covid 19 pandemic were mostly good, only in terms of behavior that required attention, namely about the lack of action in terms of 1) maintaining regular weight gain during the covid-19 pandemic for normal weight (54 out of 84); 2) eat fruit at least 2 times a day during the covid-19 pandemic (47 out of 84); 3). reducing consumption of sweet, salty and fatty foods during the covid-19 pandemic (52 out of 84); and 4). do physical activity/sports for at least 30 minutes a day during the covid-19 pandemic (59 out of 84). Then the role of parents is mostly good, the only thing that needs attention is regarding excessive consumption of snacks during the COVID-19 pandemic has not received the attention of parents (43 out of 84).
The Covid-19 pandemic in Indonesia is still a current health issue. Covid-19 pandemic. To break the chain of transmission of Covid-19. The government urges the 3M movement, namely maintaining distance, wearing masks and washing hands. In addition to carrying out the 3M movement, the termination of the transmission of Covid-19 must also be supported by a healthy lifestyle, one of which is by consuming nutritious and healthy food. Nutritional intake that is less than optimal will have an impact on poor health and the risk of being infected with the disease will increase, so maintaining a lifestyle by consuming balanced nutrition is very necessary [1-3].
The pattern of food consumption is the most important behavior and can affect nutritional status. This is because the quantity and quality of food and drink consumed affect the health of individuals and society. To maintain health and avoid various chronic diseases or non-communicable diseases (NCDs) related to nutrition, people's eating patterns need to be improved towards balanced nutritional consumption. Optimal nutrition is essential for the normal growth and physical and intellectual development of infants, children and all age groups. Good nutrition keeps body weight normal or healthy, the body is not susceptible to infectious diseases, increases work efficiency, and avoids chronic diseases and premature death [4].
According to balanced nutrition guidelines, diverse foods refer to foods that contain nutrients needed by the human body [4]. According to [5], balanced nutrition is grouped according to three main functions, namely a source of energy, a source of building blocks and a source of regulated substances. Energy sources come from carbohydrates, fats and proteins, while nutrients come from protein, minerals and water whose function is to form new cells, maintain and replace damaged cells. Regulatory nutrients include protein, minerals, water and vitamins, and their role is to regulate water balance, oxidation, the aging process of cells and regulate the excretion process. According to WHO, adolescence is a transitional age between children and adults in the range between 12 and 24 years. Where this group needs special attention both physiologically and psychologically to maintain the quality of future resources that depend on the quality of today's youth [6]. The condition of adolescents is an important condition that affects the nutritional needs of adolescents, namely rapid growth entering the age of puberty, snacking habits, menstruation and attention to the physical appearance of "Body image" in young women. Thus, the calculation of the nutritional needs of this group must take into account these conditions. Especially for young women, more attention should be paid to their preparation before marriage [4].
Adolescent nutrition knowledge is a person's understanding of the interaction between nutrition, nutrition, and between nutrition and nutritional status and health. If adolescents lack nutritional knowledge, then the adolescent's efforts to maintain a balance between the food consumed and the food needed will decrease and lead to the problem of undernutrition or overnutrition [7-8].
So, having good behavior in consuming nutritious food is very important. according to [9] Behavior is closely related to the choice of food, where behavior is a response or action to the stimuli obtained by a person. Behavior is formed with 3 stages, namely, knowledge, attitudes and actions. Behavior that is followed by knowledge will give positive results compared to behavior that is not followed by knowledge [10]. Based on this description, the researcher aims to analyze the behavior of consuming nutritious food during a pandemic in students of SMK Kesehatan Binatama, Yogyakarta.
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This research is a qualitative descriptive study. The research was conducted at the Binatama Health Vocational School for one month in September 2021 by involving all 84 students of the Binatama Health Vocational School. The data analyzed, namely secondary data from the results of previous studies with the title determination of Nutrition Consumption Behavior of Binatama Health Vocational High School students during the covid-19 pandemic, analyzed behavior: both closed behavior (such as knowledge, attitudes) and open behavior (such as actions) of students in consuming balanced nutrition, where students' understanding still answered incorrectly, or their attitude negative. It is presented and concluded.
Knowledge Analysis of Nutrition Consumption of Binatama Health Vocational High School Students
Based on Table 1, it was found that almost all of the answers were appropriate regarding the knowledge of nutritional consumption of the students of SMK Kesehatan Binatama. contained in the question regarding the first message of food diversity during the Covid-19 pandemic (80.95%), consumption of fruits and vegetables in one day (72.62%), measurement of BMI to determine the nutritional status (84.62%), as well as the impact of being affected by the disease. infectious disease due to lack of energy (76.19%). However, there is 1 incorrect answer regarding signs of fulfilled nutrition in adolescents, which is marked by a fat body (54.76%).
Table 1: Distribution of Respondents’ Knowledge on Nutrition During the COVID-19 Pandemic
KNOWLEDGE | ||||
No | About | - | In accordance 2 | It is not following 1 |
1 | Various kinds of nutrients, namely carbohydrates, proteins, fats, vitamins, water and minerals | 0 | 77 | 7 |
2 | Protein nutrients can be obtained from plants and animals | 0 | 83 | 1 |
3 | Food diversity is the first message in balanced nutrition guidelines during the Covid-19 pandemic | 0 | 68 | 16 |
4 | A fat body is a sign of nutritional fulfillment in adolescents | 0 | 46 | 38 |
5 | Malnutrition during the pandemic can increase the risk of contracting COVID-19 infection | 0 | 75 | 9 |
6 | Consumption of food sources of excessive energy continuously can cause excess body weight | 0 | 77 | 7 |
7 | Lack of fluids in adolescents can cause a decrease in concentration in adolescents during the covid-19 pandemic | 0 | 77 | 7 |
8 | Breakfast will help increase concentration in studying during the covid-19 pandemic | 0 | 83 | 1 |
9 | It is recommended to consume fruits and vegetables regularly to meet fiber needs | 0 | 83 | 1 |
10 | The recommended consumption of fruits and vegetables in a day is 400-600g/person per day | 0 | 61 | 23 |
11 | One way to know nutritional status is by measuring body mass index (BMI). | 0 | 71 | 13 |
12 | The impact of lack of energy nutrition will be at risk for infectious diseases | 0 | 64 | 20 |
Attitude analysis
Based on Table 2, it was found that almost all students had a good attitude indicated by a good attitude in consuming fruit 2 times a day (63.1), exercising at least 30 minutes (60.7%), the risk of getting infectious diseases would increase due to malnutrition (47.6). However, the attitude is less shown in the habit of consuming a variety of foods and the attitude to avoid consuming fast food (13.1%).
Table 2: Analysis of Attitudes towards Nutrition Consumption of Binatama Health Vocational High School Students
ATTITUDE | |||||
No | About | Strongly agree 4 | Agree 3 | Do not agree 2 | Strongly Disagree 1 |
1. | Every day I have to eat a variety of foods during the covid-19 pandemic | 21 | 52 | 11 | 0 |
2. | Consuming vegetables and fruits should be varied so that various sources of vitamins, minerals and fiber are obtained during the covid-19 pandemic | 47 | 33 | 4 | 0 |
3. | Consuming fruit at least 2 times a day during the covid-19 pandemic | 26 | 53 | 5 | 0 |
4. | Consume vegetables at least 3 times a day | 26 | 54 | 4 | 0 |
5. | Breakfast doesn't have to be done every day | 23 | 57 | 4 | 0 |
6. | Drinking 8 glasses of water in one day is important to improve concentration during the covid-19 pandemic | 59 | 25 | 0 | 0 |
7. | Reading nutrition labels on packaged foods I bought during the covid-19 pandemic | 39 | 43 | 2 | 0 |
8. | Every day I diligently exercise at least 30 minutes during the covid-19 pandemic | 26 | 51 | 7 | 0 |
9. | Washing hands before eating will prevent contamination of germs and infection with the Covid-19 virus | 61 | 23 | 0 | 0 |
10. | Monitor body weight regularly to control nutritional status during the COVID-19 pandemic | 32 | 50 | 2 | 0 |
11. | Malnutrition can increase the risk of contracting infectious diseases during the COVID-19 pandemic | 37 | 40 | 7 | 0 |
12. | Avoid fast food to avoid excess nutrition | 26 | 46 | 11 | 1 |
Behavioral Analysis of Nutrition Consumption of Binatama Health Vocational High School Students
Based on Table 3. it is found that the behaviors that are often carried out by Binatama Health Vocational School students are consuming nutritious food 3 times a day (51.2%), reading labels before buying food (59.5) and drinking 8 glasses of water a day (75%).
However, for the behavior of maintaining normal body weight (47.6%), eating fruit 2 times a day (56%), reducing the consumption of sweet, salty, and fatty foods (54.8%), doing physical activity/sports for at least 30 minutes a day (67.9%) mostly rarely done. Then for breakfast on holidays (19%), as well as buying snacks at school (29.8%) have quite a lot for students who have never done this habit during the Covid-19 pandemic.
Table 3: Behavioral Analysis of Nutrition Consumption of Binatama Health Vocational High School Students
BEHAVIOR | |||
About | Often 3 | Seldom 2 | Never 1 |
To maintain a normal weight, I pay attention to weight gain periodically during the covid-19 pandemic | 30 | 50 | 4 |
To meet daily nutrition, I will eat regularly 3 times a day | 43 | 40 | 1 |
I eat fruit at least 2 times a day during the covid-19 pandemic | 37 | 47 | 0 |
I eat vegetables at least 3 times a day during the covid-19 pandemic | 50 | 32 | 2 |
I eat vegetable protein at least 2 times a day during the covid-19 pandemic | 44 | 39 | 1 |
I eat animal protein to avoid lack of blood (anemia) | 48 | 36 | 0 |
I reduce my consumption of sweet, salty, and fatty foods during the covid-19 pandemic | 32 | 46 | 6 |
I will have breakfast every morning before work or school | 50 | 32 | 2 |
I don't have breakfast on holidays | 24 | 44 | 16 |
I drink 8 glasses of water a day during the covid-19 pandemic | 63 | 18 | 3 |
I read the labels on food packaging before buying it during the covid-19 pandemic | 50 | 30 | 4 |
I do physical activity/sports for at least 30 minutes a day during the covid-19 pandemic | 25 | 57 | 2 |
I bought snacks when I was at school | 11 | 48 | 25 |
Analysis of the Role of Parents on Nutrition Consumption of Binatama Health Vocational High School Students
Based on Table 4, it was found that the role of parents showed frequent intensity in reminding to reduce sweet, salty and fatty foods (70.2%), asking to eat high protein foods (67.9%), and reminding the dangers of malnutrition (70.2%). However, the role of parents is large enough to never forbid children from buying excess snacks during the Covid-19 pandemic (43 of 84).
Table 4: Analysis of the Role of Parents on Nutrition Consumption of Binatama Health Vocational School Students The Role of Parents
The Role of Parents | |||
About | Often 3 | Seldom 2 | Never 1 |
Parents provide diverse food during the covid-19 pandemic | 68 | 16 | 0 |
Parents recommend breakfast during the covid-19 pandemic | 78 | 5 | 1 |
My parents reminded me to eat side dishes (fish, eggs, meat, etc.) | 72 | 11 | 1 |
My parents ordered me to read food labels before buying packaged food | 50 | 28 | 6 |
Parents provide vegetables every day during the covid-19 pandemic | 77 | 7 | 0 |
My parents ordered me to always eat vegetables every day | 73 | 10 | 1 |
Parents provide fruit every day during the covid-19 pandemic | 54 | 29 | 1 |
My parents ordered me to eat fruit every day | 55 | 27 | 2 |
My parents told me to drink 8 glasses of water a day | 70 | 12 | 2 |
Parents ordered to wash hands before eating | 78 | 6 | 0 |
Table 4: Continue
My parents reminded me to eat less sweet, salty and fatty foods | 59 | 20 | 5 |
My parents ordered me to eat high-protein foods. | 57 | 24 | 3 |
My parents didn't forbid me from consuming excessive snacks during the covid-19 pandemic | 41 | 29 | 14 |
My parents warned me about the dangers of malnutrition | 59 | 19 | 6 |
My parents warned me about the dangers of overnutrition | 50 | 30 | 4 |
Analysis School Role on the Nutrition Consumption of Binatama Health Vocational School Students
Based on Table 5, it is found that the role of schools, including teachers, is often explained how to provide balanced nutritional food during the Covid-19 pandemic (73.8%), requested that you exercise for at least 30 minutes every day (73.8%). However, they rarely remind students to do health checks (38.1%), provide leaflets about healthy food and balanced nutrition (36.9%).
Table 5: Analysis of School Roles on Nutrition Consumption of Binatama Health Vocational High School Students
School Role | |||
About | Often 3 | Seldom 2 | Never 1 |
Teachers provide education about the benefits of balanced nutrition during the covid-19 pandemic | 76 | 8 | 0 |
The teacher motivates students to eat a variety of foods during the covid-19 pandemic | 74 | 10 | 0 |
The teacher explains the dangers of malnutrition and overnutrition during the covid-19 pandemic | 71 | 13 | 0 |
The teacher reminded the importance of consuming animal protein to avoid anemia (lack of blood) during the covid-19 pandemic | 67
| 16 | 1 |
The teacher explained to us about the nutrients in foods that contain energy during the covid-19 pandemic | 68 | 16 | 0 |
The teacher explained to us about the nutrients in foods that contain protein during the covid-19 pandemic | 69 | 15 | 0 |
Teachers often explain to us the benefits of consuming fruits and vegetables during the covid-19 pandemic | 70 | 14 | 0 |
The teacher explains how to provide balanced nutritional food during the covid-19 pandemic | 62 | 21 | 1 |
The teacher advised us to drink 8 glasses of water per day during the covid-19 pandemic | 77 | 7 | 0 |
The teacher reminds traders to maintain the cleanliness of the snacks sold during the covid-19 pandemic | 67 | 16 | 1 |
The teacher does gymnastics with us once a week during the covid-19 pandemic | 49 | 18 | 17 |
The school conducts student health checks | 48 | 32 | 4 |
Schools provide leaflets about healthy food and balanced nutrition | 50 | 31 | 3 |
The teacher asked me to eat vegetables every day | 63 | 20 | 1 |
Master asked me to eat fruit every day | 62 | 21 | 1 |
The teacher reminds me to wash my hands before eating | 79 | 5 | 0 |
The teacher reminds me to always read labels before buying packaged food | 50 | 24 | 10 |
The teacher asked me to exercise at least 30 minutes every day | 62 | 22 | 0 |
Schools put up posters about balanced nutrition and nutritious food | 66 | 18 | 0 |
This health message regarding the diversity of food is contained in the balanced nutrition guidelines during the Covid-19 pandemic issued by [11] which consists of staple foods, side dishes as well as vegetables and fruit so that the body is protected from viral infections, this is following the statement [7] which states that knowledge about a person's nutrition can be obtained through counseling (education), mass media, electronics, manuals, games and closest relatives/family members.
Then, the knowledge of a fat body is a sign of fulfilled nutrition in adolescents, most of them answered according to as many as 46 people (54.76%), but the fact is that a fat body does not guarantee that adolescent nutrition is fulfilled. A fat body can be said to be someone who is overweight. If at the age of teenagers already have excess weight or obesity, the risk of developing degenerative diseases that interfere with body metabolisms such as type 2 diabetes, heart disease, gallstones and hypertension will be even greater. This is because the risk of fat accumulation will be proportional to the risk of developing these degenerative diseases. In addition, the incidence of obesity in adolescents is a risk factor caused by excessive food consumption patterns. Weight will continue to increase, which is dangerous for young people [12-13].
According to research [14] Knowledge has a significant relationship with the consumption of vegetables and fruit in junior high school students in Gorontalo Regency. Whereas many as 69 children (81.2%) have less knowledge and less consumption of fruits and vegetables. Sufficient knowledge will affect food intake that is good enough to pass the stage of a person's attitude and behavior. In addition, a person's eating attitudes and behavior will affect the food chosen and are related to different nutritional intakes for each individual. Then, the attitude of an individual will appear preceded by knowledge according to good and bad perceptions/views, which will then be embedded in a person until the person behaves following the knowledge he has [13]. In addition to knowledge, attitudes and behavior, the role of parents is very important in fulfilling children's nutrition, in this study the role of parents is enough to never forbid children from buying excess snacks during the Covid-19 pandemic. This is in contrast to other studies where the freer parents let their children control their eating behavior, the better the nutritional status of their children, on the contrary, the tighter the control, the worse the nutritional status of their children. The behavior of using food as a reward and giving pressure is negatively related to the nutritional status of children. Parents who never control their children's emotions through food or never give pressure when their children eat to show that their child's nutritional status is good/normal [15].
Parents who give excessive freedom in choosing food can also cause children to have unhealthy eating behavior so that the child's food intake will be excessive and unbalanced, which in the end the child becomes unhealthy/fat [15]. according to [5] When children reach adolescence, eating habits can be influenced by the environment such as peers, but parents also have an important role in shaping their children's eating habits. Families with high incomes and having poor knowledge will make the family buy any food, both nutritious foods that are high in calories, sugar, fat and fast food [16].
For teenagers, the role of parents is very important in setting a good example in choosing nutritious and healthy foods. However, like teenagers who are still in school, the role of teachers in schools is also another important factor in the nutritional consumption of school children. From the results of this study, there are still many teachers who do not do gymnastics together once a week during the Covid-19 pandemic. This is also due to the Covid-19 pandemic, which requires schools to be online, making it impossible to do gymnastics together once a week. However, this can be overcome by the teacher reminding students to do 30 minutes of exercise once a week.
The role of the teacher in this study was also lacking in reminding students to read labels before buying food and drinks. So that the teacher's role is needed in reminding and providing more education to students the importance of reading labels related to expiration dates, the number of calories and the composition of food or drinks purchased. The teacher's role is still bad in eating behavior will have an impact on student behavior. Where there is no close relationship between students and teachers, so the teacher's role may not necessarily be able to change a student's behavior, especially if the situation is that the teacher's role is still bad [17-18].
Based on the results of this study, the role of health workers in health services is quite rare in recommending reading labels, both nutrition labels and compositions on food packaging before buying them during the Covid-19 pandemic. according to [19] Health workers are at the forefront in providing examples of healthy living behaviors and their behavior will be imitated by the community. Implementing healthy living behavior should be done first by health workers, as professionals in the health sector who are imitated and imitated by the community. In addition to reading nutrition labels and food labels, health workers also rarely provide nutritional counseling to adolescents at school or home and screen students' nutritional status during the Covid-19 pandemic.
Health workers in health care facilities have a role as implementers of health services. In this role, it is expected that the main tasks and functions (tupoksi) of health workers are following the education and skills they have. One of them is nutrition counseling and screening which is done to see students' physical and cognitive growth, one of which is body mass index (BMI). The large percentage of adolescents who experience abnormal nutritional status and an inadequate energy and protein consumption patterns increase the risk of adolescents experiencing anemia and obesity [20-21].
Supported by research [20] where the role of health workers has a relationship in the application of balanced nutrition. The participation of health workers has the opportunity to implement balanced nutrition, which is 4 times greater than that without the role of health workers. Study [21] health workers play a role in implementing the School Health Report program which can improve the nutritional status (BMI/U) of children who previously had a thin BMI then after the program became a normal category BMI, respondents who had a normal BMI category increased in number and respondents who had a fat BMI category before. In other words, the role of health workers in screening and nutritional counseling is very necessary, especially during the Covid-19 pandemic by utilizing technology in providing education to students who carry out schools via online/online [3].
Based on the results and discussion above, it can be concluded the results showed that the knowledge, attitudes and roles of teachers towards students regarding balanced nutrition during the covid 19 pandemic were mostly good, only in terms of behavior that required attention, namely about the lack of action in terms of:
Maintain regular weight gain during the covid-19 pandemic for normal weight
Eat fruit at least 2 times a day during the covid-19 pandemic
Reducing consumption of sweet, salty, and fatty foods during the covid-19 pandemic
Do physical activity/sports for at least 30 minutes a day during the COVID-19 pandemic
Then the role of parents is mostly good, the only thing that needs attention is regarding excessive consumption of snacks during the COVID-19 pandemic has not received the attention of parents (43 out of 84). Suggestions, hopefully, the results of this research can provide information for related parties, namely schools, and parents to provide education for children and students of SMK Kesehatan Binatama Yogyakarta.
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