Biomedical Research 2016; 27 (1): 165-171 ISSN 0970-938X www.biomedres.info Biomed Res- India 2016 Volume 27 Issue 1 165 Knowledge, attitude and practice of balanced diet and correlation with hypochromic microcytic anemia among adolescent school girls in maros district, South Sulawesi, Indonesia. Sitti Patimah 1 *, Ida Royani 2 , Ansar Mursaha 3 , Abdul Razak Thaha 4 1 Nutrition Department, School of Public Health, Universitas Muslim Indonesia (Campus II), Indonesia 2 Clinical Nutrition Department, School of Medicine, Universitas Muslim Indonesia (Campus II), Indonesia 3 Nutrition Department, Health Polytechnic of Palu, Indonesia 4 Nutrition Department, School of Public Health, Hasanuddin University, Indonesia Introduction In Indonesia, the slogan of “Healthy Four Perfect Five (H4P5)”, launched in 1952 and used as an eating guideline, has deeply rooted in society containing five food groups. In terms of “Healthy 4” includes staple foods source, side dishes, vegetables, and fruits whereas “Perfect 5” was milk [1, 2, 3]. However, this slogan was not appropriate with recent science and nutritional problems in Indonesia, so that the government of Indonesia changed this slogan into “guideline of balanced nutrition”. This guideline has 4 pillars: (1) consume various food, (2) hygiene behavior, (3) physical exercise, and (4) maintaining and monitoring ideal body weight [3]. One of nutritional problems that prevalent among pre- married adolescent girls (15-19 years old) in Indonesia is nutritional anemia. The prevalence of anemia among adolescent girls about 46.6% and it has been considered as a public health nutrition problem [4]. Menstrual abnormalities and inadequate diet are two major cause of anemia among adolescent girls [5]. Anemia can result in development and cognitive function impairment [3, 4], loss of productivity, and increase the susceptibility to infection, that would widely affect the economic burden [6]. Adolescent phase is an important period to establish lifelong behavior including eating behavior [7]. Lancet (2013) in the series of maternal and child nutrition has identified the importance of nutrition of female adolescent for women's health and maternal nutrition [8]. Making adolescence as a key to give effect (general education and health) is a positive thing. It is one of the important steps taken to improve women's health [7]. Waisbord [9] revealed the importance of behavioral studies which applied to child survival programming. Behavior manifested in three forms, namely knowledge, attitudes, and practices [10]. Social determinants become an important point to encourage the occurrence of nutrition and health problems. Therefore, this research is important to assess one of social determinants such balanced diet behavior (knowledge, attitude, and practice balanced diet) in relation to microcytic-hypochromic anemia which is Anemia among adolescent girls is remaining a public health problem in Indonesia. This study was aimed to assess the association of balanced diet behavior and microcytic-hypochromic anemia among adolescent girls. A cross-sectional study has been conducted among 200 adolescent girls in five senior high schools in Maros regency on March to April 2015. Assessment of anemia was performed by Flow Cytometry and SLS-hemoglobin method, data of balanced diet behavior was collected using structured questionnaire. Data was analyzed by using chi- square test with SPSS software for windows. The prevalence of microcytic-hypochromic anemia was 19.5%. There were 41% subjects had low knowledge about balanced diet, more than a half (55.5%) had negative attitude to balanced diet, and 46.5% had a poor practice of balance diet. Knowledge and attitude about balanced diet had no association with microcytic- hypochromic anemia. In contrast, the practices of balanced diet had a significant association with microcytic-hypochromic anemia (p=0.048). It is suggested to conduct an intervention for balanced diet education among adolescent schoolgirls to improve their balanced diet behavior. Abstract Keywords: Balanced nutrition, Behavior, Microcytic-hypochromic anemia, Female adolescent. Accepted December 05, 2015