Efficacy of Moringa Soy Milk as a Food-Based Intervention on Hemoglobin Levels in Anemic Pregnant Women: A Quasi-Experimental Study in Gorontalo, Indonesia

Cholifah; Veni Hadju; Mardiana Ahmad; Suryani As'ad; Jumrah

doi:10.51745/najfnr.9.20.236-248

Efficacy of Moringa Soy Milk as a Food-Based Intervention on Hemoglobin Levels in Anemic Pregnant Women: A Quasi-Experimental Study in Gorontalo, Indonesia

PDF (Full text)

Food Chemistry, Engineering, Processing and Packaging Public Health Nutrition Policy & Economics Functional and Novel Foods

DOI https://doi.org/10.51745/najfnr.9.20.236-248

Issue Vol. 9 No. 20 (2025): July - December, 2025

Submitted 2025-07-25

Accepted 2025-11-04

Published 2025-11-07

This work is licensed under a Creative Commons Attribution 4.0 International License.

Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made.
No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.

Background: Anemia remains a global health challenge, significantly contributing to adverse maternal and obstetric outcomes. Worldwide, its prevalence stands at 37%, rising to 48.9% in Indonesia according to the World Health Organization (WHO) estimates. This study investigates the utilization of Moringa Soy Milk —an innovative, nutrient-dense intervention rich in iron, protein, vitamin C, and antioxidants—as a therapeutic strategy to address this public health issue.

Objective: To evaluate the efficacy of Moringa soymilk supplementation, when administered concurrently with standard iron-folic acid, on improving hemoglobin (Hb) levels in pregnant women diagnosed with anemia.

Methods: This research employed a quasi-experimental design with a pretest-posttest control group design. The sample comprised 66 pregnant women with anemia who were randomly divided into two groups of 33 respondents each. The intervention group received 250 mL of Moringa soymilk consumed once daily in the morning, along with a 60 mg iron-folic acid tablet administered at night, over a 30-day period. The control group received local supplementary food (such as sweet potatoes, bananas, or mung bean porridge), and the identical 60 mg iron-folic acid tablet nightly for 30 days. Hemoglobin levels were measured using a Nihon Kohden Celltac Alpha MEK-6510 hematology analyzer. Data analysis utilized paired t-tests to assess changes within groups and independent t-tests to compare the mean changes between the groups.

Results: Baseline characteristics across the two groups—including age, education, occupation, parity, gestational age, and socioeconomic status —were found to be statistically homogeneous (p > 0.05). Prior to the intervention, the mean Hb level was 9.69 ± 0.69 g/dL in the intervention group and 9.70 ± 0.69 g/dL in the control group. Following the 30-day intervention period, the mean Hb level increased to 10.61 ± 0.38 g/dL in the intervention group and 10.44 ± 0.29 g/dL in the control group. The mean increase in the intervention group was 1.03 g/dL, which was statistically significant (p = 0.001). Similarly, the control group exhibited a mean increase of 0.73 g/dL, which was also statistically significant (p = 0.001). Crucially, the mean difference in the increase of Hb levels between the intervention and control groups was significantly higher in the intervention group (p = 0.047 < 0.05).

Conclusion: The combined intervention of Moringa soymilk and standard iron supplementation yielded a significantly increased in hemoglobin levels and was statistically more effective than the administration of local supplementary food alongside iron supplement tablets. The findings of the present investigation support the integration of Moringa Soy Milk as an efficacious complementary dietary intervention for managing anemia in pregnant women

Keywords

Moringa Soy Milk Hemoglobin Pregnant Women Anemia Food Intervention

Cholifah

Hasanuddin University Makassar Indonesia Midwifery Science, Faculty of Graduate School/Department of Graduate School Hasanuddin University, Makassar City, South Sulawesi 90245
Veni Hadju

Hasanuddin University Makassar Indonesia Nutrition Science, Faculty of Public Health, Hasanuddin University, Makassar City/Department of Nutrition Science, Faculty of Public Health Hasanuddin University, Makassar City, South Sulawesi 90245
Mardiana Ahmad

Hasanuddin University Makassar Indonesia Midwifery Science, Faculty of Graduate School/Department of Graduate School Hasanuddin University, Makassar City, South Sulawesi 90245
Suryani As'ad

Hasanuddin University Makassar Indonesia Department of Clinical Nutrition, Faculty of Medicine, Hasanuddin University/ Department of Clinical Nutrition Hasanuddin University, Makassar City, South Sulawesi 90245
Jumrah

Hasanuddin University Makassar Indonesia Midwifery Science, Faculty of Graduate School/Department of Graduate School Hasanuddin University, Makassar City, South Sulawesi 90245

PDF (Full text)

How to Cite

Efficacy of Moringa Soy Milk as a Food-Based Intervention on Hemoglobin Levels in Anemic Pregnant Women: A Quasi-Experimental Study in Gorontalo, Indonesia. (2025). The North African Journal of Food and Nutrition Research, 9(20), 236-248. https://doi.org/10.51745/najfnr.9.20.236-248

More Citation Formats

Download Citation

Agyenim-Boateng, K. G., Zhang, S., Zhang, S., Khattak, A. N., Shaibu, A., Abdelghany, A. M., Qi, J., Azam, M., Ma, C., Feng, Y., Feng, H., Liu, Y., Li, J., Li, B., & Sun, J. (2022). The nutritional composition of the vegetable soybean (maodou) and its potential in combatting malnutrition. Frontiers in Nutrition, 9, 1034115. https://doi.org/10.3389/fnut.2022.1034115

Ali, S. A., Tikmani, S. S., Saleem, S., Patel, A. B., Hibberd, P. L., Goudar, S. S., Dhaded, S., Derman, R. J., Moore, J. L., McClure, E. M., & Goldenberg, R. L. (2020). Hemoglobin concentration and adverse birth outcomes in pregnant women in South Asia: Findings from the prospective Maternal and Neonatal Health Registry. Reproductive Health, 17 (Suppl 2), 1-13. https://doi.org/10.1186/s12978-020-01006-6

Araujo Costa, E., & de Paula Ayres-Silva, J. (2023). Global profile of anemia during pregnancy versus country income: 19-year estimates (2000-2019). Annals of Hematology,102(8), 2025-2031. https://doi.org/10.1007/s00277-023-05279-2

Aydin, B., Cansu, G. B., & Ozlu, C. (2022). Relationship between glycosylated hemoglobin and vitamin B12 deficiency anemia. Northern Clinics of Istanbul, 9(5), 459–463. https://doi.org/10.14744/nci.2022.76259

Carpenter, R. M., Billah, S. M., Lyons, G. R., Siraj, M. S., Rahman, Q. S., Thorsten, V., McClure, E. M., Haque, R., & Petri, W. A. (2022). U-Shaped Relationship between Maternal Hemoglobin Levels and Low Birth Weight in Rural Bangladesh. American Journal of Tropical Medicine and Hygiene, 106(2), 424-431. https://doi.org/10.4269/ajtmh.21-0268

Dewi, G. K., Istianah, I., & Septiani, S. (2022). Analisis Risiko Anemia Pada Ibu Hamil. Jurnal Ilmiah Kesehatan (JIKA), 4(1), 67–80. https://doi.org/10.36590/jika.v4i1.223

Fondjo, L. A., Addai-Mensah, O., Annani-Akollor, M. E., Quarshie, J. T., Boateng, A. A., Assafuah, S. E., & Owiredu, E. W. (2020). A multicenter study of the prevalence and risk factors for malaria and anemia among pregnant women during their first antenatal visit in Ghana. PLoS ONE, 15 (August 8, 2020), 1-21. https://doi.org/10.1371/journal.pone.0238077

Fondjo, L. A., Tashie, W., Owiredu, W. K. B. A., Adu-Gyamfi, E. A., & Seidu, L. (2021). High prevalence of vitamin D deficiency among normotensive and hypertensive pregnant women in Ghana. BMC Pregnancy and Childbirth,21(1), 1-8. https://doi.org/10.1186/s12884-021-03802-9

Gerb, J., Strauss, W., Derman, R., Short, V., Mendelson, B., Bahrain, H., & Auerbach, M. (2021). Ferumoxytol for the treatment of iron deficiency and iron deficiency anemia during pregnancy. Therapeutic Advances in Hematology,12, 1-8. https://doi.org/10.1177/20406207211018042

Govender, L., & Siwela, M. (2020). The effect of Moringa oleifera leaf powder on the physical quality, nutritional composition and consumer acceptability of white and brown breads. Foods (Basel, Switzerland), 9(12), 1910. https://doi.org/10.3390/foods9121910

Govender, L., & Siwela, M. (2020). Effect of Moringa oleifera (Moringa oleifera) leaf flour on physical quality, nutritional composition, and consumer acceptability of white bread and brown bread. Food, 9 (12). https://doi.org/10.3390/foods9121910

Herman-Lara, E., Rodríguez-Miranda, J., Ávila-Manrique, S., Dorado-López, C., Villalva, M., Jaime, L., Santoyo, S., & Martínez-Sánchez, C. E. (2024). In vitro antioxidant, anti-inflammatory activity and bioaccessibility of ethanolic extracts from Mexican Moringa oleifera leaf. Foods (Basel, Switzerland), 13(17), 2709. https://doi.org/10.3390/foods13172709

Igbinosa, I., Berube, C., & Lyell, D. J. (2022). Iron deficiency anemia in pregnancy. Current Opinion in Obstetrics & Gynecology, 34(2), 69–76. https://doi.org/10.1097/GCO.0000000000000772

Jefferds, M. E. D., Mei, Z., Addo, Y., & Hamner, H. C., Perrine, C. G., Flores-Ayala, R., Pfeiffer, C. M., & Sharma, A. J. (2022). Iron deficiency in the United States: Guidelines, Data, and Gap Monitoring Limitations. American Journal of Public Health, 112, S826-S835. https://doi.org/10.2105/AJPH.2022.306998

John, G. E., Okpo, E. A., Akpanke, J., Okoro, C. U., Omang, P. A., & Lennox, J. A. (2023). Microbiological quality and proximate analysis of locally produced soymilk drinks sold in Calabar Metropolis; a public health assessment. African Health Sciences, 23(3), 758–763. https://doi.org/10.4314/ahs.v23i3.87

Kabir, M. A., Rahman, M. M., & Khan, M. N. (2022). Maternal anemia and risk of poor maternal health and birth outcomes in Bangladesh: A nationwide population-based survey. PLoS ONE, 17 (December 12), 1-14. https://doi.org/10.1371/journal.pone.0277654

Kalam, E. M., Mohd Noor, N., Ishak, A., & Mohd Yusoff, S. S. (2024). Moringa oleifera supplementation for anemic pregnant women: A Systematic Review and Meta-analysis. Bangladesh Journal of Medical Science, 23(3), 597–609. https://doi.org/10.3329/bjms.v23i3.75014

Kang, J. H., Dong, Z., & Shin, S. H. (2023). Benefits of Soy in the Era of Precision Medicine: A Review of Clinical Evidence. 33(12), 1552-1562. https://doi.org/10.4014/jmb.2308.08016

Kare, A. P., & Gujo, A. B. (2021). Anemia among pregnant women attending ante natal care clinic in Adare General Hospital, Southern Ethiopia: Prevalence and associated factors. Health Services Insights, 14, 11786329211036303. https://doi.org/10.1177/11786329211036303

Lei, L., Liu, S., Ye, Y., Qiu, X., Huang, D., Pan, D., Chen, J., Qian, Z., McMillin, S. E., Vaughn, M. G., Luo, X., Wu, K., Xiao, S., Li, J., Liu, M., Yang, Y., Lai, M., Dong, G., & Zeng, X. (2021). Association between serum aflatoxin-b1 and anemia in pregnant women: Evidence from the Guangxi Zhuang birth cohort in China. Toxins,13 (11). https://doi.org/10.3390/toxins13110806

Loa, M., Hidayanty, H., Arifuddin, S., Ahmad, M., & Hadju, V. (2021). Moringa (Moringa oleifera) leaf flour biscuits increase erythrocyte index in pregnant women with anemia. In Gaceta Sanitaria (Vol. 35). Elsevier B.V. https://doi.org/10.1016/j.gaceta.2021.10.022

Mahadik, K., Choudhary, P., & Roy, P. K. (2020). Study of thyroid function in pregnancy and feto-maternal outcome: A prospective observational study. BMC Pregnancy and Childbirth,20(1), 1-7. https://doi.org/10.1186/s12884-020-03448-z

Manggul, M. S., Hidayanty, H., Arifuddin, S., Ahmad, M., Hadju, V., & Usman, A. N. (2021). Biscuits containing Moringa (Moringa oleifera) leaf flour can improve anemia in pregnant women. In Gaceta Sanitaria (Vol. 35). Elsevier B.V. https://doi.org/10.1016/j.gaceta.2021.07.013

Matabura, V. V., & Rweyemamu, L. M. P. (2022). Formulation of plant-based food and characterisation of the nutritional composition: A case study on soy-moringa beverage. Journal of Food Science and Technology, 59(10), 3794–3805. https://doi.org/10.1007/s13197-022-05397-1

Mbunga, B. K., Mapatano, M. A., Strand, T. A., Gjengedal, E. L. F., Akilimali, P. Z., & Engebretsen, I. M. S. (2021). Prevalence of anemia, iron deficiency anemia, and associated factors among children aged 1-5 years in malaria-endemic rural areas of Popokabaka, Democratic Republic of Congo: A cross-sectional study. Nutrients,13(3), 1-13. https://doi.org/10.3390/nu13031010

Mremi, A., Rwenyagila, D., & Mlay, (2022). Prevalence of postpartum anemia and associated factors among women attending primary health facilities: An institution-based cross-sectional study. PLoS ONE, 17 (February 2), 1-12. https://doi.org/10.1371/journal.pone.0263501

Murti, Y., Arora, S., Akram, W., Bhardwaj, H., Gupta, K., Sachdev, A., Devi, J., Kumar, S., & Kumar, B. (2024). Pharmacology Research - Modern Chinese Medicine Exploring the therapeutic potential of Moringa oleifera Lam. in Traditional Chinese Medicine: A Comprehensive Review. Pharmacology Research - Modern Chinese Medicine, 12 (May), 100473. https://doi.org/10.1016/j.prmcm.2024.100473

Mutiara, E. S., Manalu, L., Klise, R. E., Aginta, S., Aini, F., & Rusmalawaty, R. (2023). Analysis of the Provision of Blood-Addition Tablets to Pregnant Women at the Health Center: A Literature Review Study (Vol. 22). Indonesian Public Health Media. https://doi.org/10.14710/mkmi.22.2.125-135

Norfitri, R., & Rusdiana, R. (2023). FAKTOR RISIKO KEJADIAN ANEMIA PADA IBU HAMIL. Jurnal Ilmu Kesehatan Insan Sehat, 11(1), 25–30. https://doi.org/10.54004/jikis.v11i1.107

Nurhaliza, S., & Husanah, E. (2022). Asuhan kebidanan pada ibu hamil anemia dengan konsumsi susu kedelai di klinik pratama jambu mawar kota pekanbaru tahun 2021. Jurnal Kebidanan Terkini (Current Midwifery Journal), 2(1), 132–137. https://doi.org/10.25311/jkt/vol2.iss1.480

Marshall, N. E., Abrams, B., Barbour, L. A., Catalano, P., Christian, P., Friedman, J. E., Hay, W. W., Jr, Hernandez, T. L., Krebs, N. F., Oken, E., Purnell, J. Q., Roberts, J. M., Soltani, H., Wallace, J., & Thornburg, K. L. (2022). The importance of nutrition in pregnancy and lactation: lifelong consequences. American Journal of Obstetrics and Gynecology, 226(5), 607–632. https://doi.org/10.1016/j.ajog.2021.12.035

Osman, M. O., Nour, T. Y., Bashir, H. M., Roble, A. K., Nur, A. M., & Abdilahi, A. O. (2020). Risk factors for anemia among pregnant women attending antenatal care units in selected jigjiga public health facilities, Somali region, eastern Ethiopia 2019: An unmatched case-control study. Journal of Multidisciplinary Health,13, 769-777. https://doi.org/10.2147/JMDH.S260398

Otto, J. M., Plumb, J. O. M., Clissold, E., Kumar, S. B., Wakeham, D. J., Schmidt, W., Grocott, M. P. W., Richards, T., & Montgomery, H. E. (2017). Hemoglobin concentration, total hemoglobin mass and plasma volume in patients: implications for anemia. Haematologica, 102(9), 1477–1485. https://doi.org/10.3324/haematol.2017.169680

Rohmah, H. N. F. (2023). The effect of soy milk on increasing hemoglobin (Hb) levels in pregnant women. Jurnal Midpro: Karakteristik, Analisis & Model, 15(2), 245–252. https://doi.org/10.30736/md.v15i2.666

Rotella, R., Soriano, J. M., Llopis-González, A., & Morales-Suarez-Varela, M. (2023). The Impact of Moringa oleifera Supplementation on Anemia and other Variables during Pregnancy and Breastfeeding: A Narrative Review. Nutrients, 15(12), 2674. https://doi.org/10.3390/nu15122674

Sales, CH, Rogero, MM, Sarti, FM, and Fisberg, RM (2021). Prevalence and factors associated with iron deficiency and anemia among residents of urban areas of São Paulo, Brazil. Nutrients, 13 (6), 1-18. https://doi.org/10.3390/nu13061888

Sharif, N., Das, B., & Alam, A. (2023). Prevalence of anemia among reproductive women across different social groups in India: A cross-sectional study using nationally representative data. PLoS ONE, 18 (February 2), 1-22. https://doi.org/10.1371/journal.pone.0281015

Storz, M. A., Brommer, M., Lombardo, M., & Rizzo, G. (2023). Soy milk consumption in the United States of America: An NHANES data report. Nutrients, 15(11), 2532. https://doi.org/10.3390/nu15112532

Sulasmi, Khalishah, A. N., Mawarni, B., Hidayati, L., F., N. L. P. I. S., & Dhiya, S. S. (2023). Utilization of Moringa leaves (Moringa oleifera L.) to overcome anemia. In the Journal of Health Packaging (Vol. 2, Issue 1, pp. 18-25). College of Health Sciences Bakti Utama Pati. https://doi.org/10.52299/jpk.v2i1.18

Tan, J., He, G., Qi, Y., Yang, H., Xiong, Y., Liu, C., Wang, W., Zou, K., Lee, A. H., Sun, X., & Liu, X. (2020). Prevalence of anemia and iron deficiency anemia in pregnant women in China (IRON WOMEN): a nationwide cross-sectional study. BMC Pregnancy and Childbirth,20(1), 1-12. https://sci-hub.hkvisa.net/10.1186/s12884-020-03359-z

Tegodan, E., Tura, G., & Kebede, A. (2021). Adherence to iron and folic acid supplements and associated factors among pregnant women attending ANC at Gulele sub-city government health center in Addis Ababa, Ethiopia. Patient Preferences and Adherence,15, 1397-1405. https://doi.org/10.2147/PPA.S301630

Teshome, M. S., Meskel, D. H., & Wondafrash, B. (2020). Determinants of anemia among pregnant women attending antenatal care clinics in public health facilities in Kacha Birra District, Southern Ethiopia. Journal of Multidisciplinary Health, 13, 1007-1015. https://doi.org/10.2147/JMDH.S259882

Triani, Y., Rosyida, Z. M., & Winarni, W. (2023). Pengaruh Pemberian Ekstrak Daun Kelor terhadap Kenaikan Kadar Hemoglobin pada Ibu Hamil dengan Anemia. ASJN (Aisyiyah Surakarta Journal of Nursing), 4(2), 89–95. https://doi.org/10.30787/asjn.v4i2.1401

Valentina, A., Yusran, S., & Meliahsari, R. (2021). Effect Of Chicken Milk Giving On Increasing Hemoglobin (Hb) Conditions In Anemic Pregnant Mothers In The Working Way Of Puskesmas Lepo-Lepo Kendari City 2020. Indonesian Journal of Nutrition and Health, 1 (2). https://doi.org/10.37887/jgki.v1i2.17318

Waterman C., Graham J. L., Arnold, C. D., Stanhope, K. L., and Tong, J. H., Jaja-Chimedza, A., and Havel, P. J. (2020). Isothiocyanate-Rich Moringa Seed Extract Delays the Onset of Diabetes in UC Davis Type-2 Diabetes Mellitus Rats. In Scientific Reports (Vol. 10, Issue 1, pp. 8861). https://doi.org/10.1038/s41598-020-65722-6

Wati, R., & Puspitasari, A. I. (2024). Perbandingan Pemberian Susu Kedelai dan Jagung Manis Terhadap Peningkatan Kadar Hemoglobin pada Ibu Hamil dengan Anemia di TPMB Rinawati. Malahayati Nursing Journal, 6(5), 1939–1947. https://doi.org/10.33024/mnj.v6i5.11260

Zahra, T., Susanto, E., & Kumorowulan, S. (2024). Pengaruh Kombinasi Bubuk Kedelai dan Bunga Rosella (Hibiscus Sabdariffa) Terhadap Perubahan Kadar Hemoglobin Pada Wanita Usia Subur. Health Information: Jurnal Penelitian, 16(1), e1165. https://doi.org/10.36990/hijp.v16i1.1165

More

Efficacy of Moringa Soy Milk as a Food-Based Intervention on Hemoglobin Levels in Anemic Pregnant Women: A Quasi-Experimental Study in Gorontalo, Indonesia

Keywords

How to Cite

Similar Articles

Downloads 83

Views 368

Country (Top 10)

Make a Submission

JournalIssue

Keywords

Browse by Category

Information

Highly Accessed

Published by

Useful Links

Connect

Contact Us