Mixed Guava and Local Salak Juice as a Functional Drink for Managing Mild Anemia in Female Adolescents: Evidence from Padangsidimpuan

Abstract

Anemia among female adolescents in Indonesia remains a persistent public health challenge, particularly in semi‑urban settings such as Padangsidimpuan, North Sumatra. While guava (Psidium guajava) is recognized for its high ascorbic acid content that enhances non‑heme iron absorption, local salak (Salacca sumatrana Becc.) is an underutilized iron‑bearing fruit indigenous to the region. Combining these two fruits into a functional beverage may offer a culturally grounded, cost‑effective strategy for managing mild anemia.This study aimed to explore the acceptability, perceived benefits, and contextual factors influencing the adoption of mixed guava–salak juice as a functional drink for mild anemia management among female adolescents in Padangsidimpuan. A qualitative descriptive design was employed. Data were collected through four focus group discussions (FGDs) with anemic female adolescents (n=28), semi‑structured interviews with nutritionists, health workers, and parents (n=12), and sensory‑acceptability panels with hedonic scaling. Thematic analysis was conducted following Braun and Clarke’s six‑stage framework. Five themes emerged: (1) palatability and sensory appeal, (2) perceived health benefits and symptom improvement, (3) cultural congruence and local food identity, (4) barriers to consistent consumption, and (5) integration with existing health programs. The mean hedonic score was 7.4±1.1 on a 9‑point scale, indicating strong acceptability. Participants reported improvements in fatigue and dizziness after four weeks of consumption. Mothers and health workers expressed positive attitudes toward the drink as a home‑based dietary strategy. Mixed guava–salak juice was highly acceptable and seen as a natural, accessible functional drink for mild anemia; incorporating it into community nutrition programs could improve adherence among adolescent girls in salak-growing areas.