<![CDATA[Anemia remains a major problem among adolescent girls in various regions of Indonesia, with a national incidence of 15.5% and a prevalence of 21.3% in East Java Province. Iron and folic acid supplementation is one of the preventive measures implemented by the government through the distribution of free iron supplement tablets (TTD) to adolescent girls over the past few years. However, this approach is uniform without considering biological variations between individuals. This biological variation can cause differences in absorption, even with adherence to iron supplement consumption and identical doses. This study aims to determine the relationship between adherence to iron supplement tablet (TTD) consumption and the incidence of anemia among adolescent girls in Sukorambi District, considering a nutrigenomic perspective. The research method used was an analytical survey with a cross-sectional approach to 40 adolescent girls. Data on adherence to iron supplements were collected using a questionnaire, anemia status using the Quick Check Hb method, and nutrigenomic analysis based on the literature. Data analysis was performed using the Chi-Square test to determine the relationship between iron supplement compliance and the incidence of anemia. The results showed that iron supplement compliance was not significantly associated (p=0.648) with the incidence of anemia. This indicates that iron supplement adherence is not the sole predictor of iron status. Genetic variation may play a role as an unmeasured confounding factor in this study design. Further nutrigenomic research is needed to integrate genetic factors into evaluating the effectiveness of iron supplementation programs. Keywords: adherence, anemia, iron–folic acid supplementation, nutrigenomics]]>
