NUTRITIONAL HABITS AND SEVERITY OF IRON DEFICIENCY ANAEMIA AMONG GENERAL POPULATION OF SINDH: A POPULATION-BASED STUDY

Abstract

Background: Iron deficiency Anaemia (IDA) is a major public health concern in Sindh, Pakistan, largely driven by inadequate dietary intake of bioavailable iron and socioeconomic disparities. This study assessed the impact of nutritional habits on the severity of IDA among adults in Sindh. Research Objectives The primary objective of this research was to assess the link between nutritional habits specifically, the consumption of iron rich foods and the severity of iron deficiency Anaemia among Sindh's general population. Methods: A cross-sectional population-based study was conducted from January to June 2025, involving 1,000 adults aged 18–60 years from urban and rural districts of Sindh selected via multistage cluster random sampling. Data on sociodemographic factors, dietary intake frequency (meat, eggs, green leafy vegetables, fruits), and tea/coffee consumption timing were collected through validated questionnaires. Haemoglobin levels were determined using automated haematology analyzers. Sample size was calculated assuming a 40% Anaemia prevalence with 95% confidence interval and 5% margin of error. Descriptive statistics, chi-square tests, independent t-tests, and logistic regression analyses were employed to explore associations and predictors of Anaemia severity (p < 0.05 considered significant). Results: The overall Anaemia prevalence was 48.6%, with 21.3% classified as mild, 18.5% moderate, and 8.8% severe Anaemia . Chi-square analysis indicated significantly higher Anaemia in rural populations (55.7%) compared to urban (42.6%) (p=0.001). Independent t-tests showed significantly lower mean haemoglobin levels among participants consuming meat less than twice weekly (11.6 g/dL) versus those with higher intake (13.1 g/dL), and among those consuming tea/coffee with meals (11.4 g/dL) compared to those avoiding it during meals (12.9 g/dL) (p<0.001). Logistic regression identified meat consumption less than twice weekly (OR=2.35, 95% CI: 1.68–3.28), low green leafy vegetable intake (OR=1.58, 95% CI: 1.12–2.23), tea/coffee intake with meals (OR=1.97, 95% CI: 1.35–2.88), rural residence (OR=1.44), and low socioeconomic status (OR=1.68) as significant independent predictors of moderate/severe Anaemia Conclusion: Nutritional habits, specifically low consumption of heme iron-containing foods and intake of iron absorption inhibitors like tea and coffee during meals, alongside socioeconomic factors, significantly contribute to the severity of iron deficiency Anaemia among Sindh adults. Targeted nutritional interventions emphasizing increased animal-source food intake, behavioural modifications around tea/coffee consumption, and socioeconomically sensitive approaches are critical to reducing the Anaemia burden in this population.