Dietary factors influencing anemia prevalence across the life span: review

Samriddhi Manral; Pulkit Mathur; Kapil Yadav

doi:10.18203/2394-6040.ijcmph20264242

Authors

Samriddhi Manral Department of Food and Nutrition and Food Technology, Lady Irwin College, University of Delhi, Delhi, India
Pulkit Mathur Department of Food and Nutrition and Food Technology, Lady Irwin College, University of Delhi, Delhi, India
Kapil Yadav Centre for Community Medicine, All India Institute of Medical Sciences (AIIMS), Delhi, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20264242

Keywords:

Anemia, Dietary diversity, Iron deficiency, Nutritional factors, Diet quality, Life cycle

Abstract

Nutritional and dietetic determinants lie at the heart of anemia causation. Life cycle perspective emphasizes the need to tackle anemia at every stage from infancy to old age. This review includes 61 primary studies from PubMed, Google Scholar, and Web of Science. Low dietary diversity, poor meal frequency, food insecurity, reduced consumption of heme iron, fruits, and green leafy vegetables increase anemia risk. Among infants, suboptimal breastfeeding and complementary feeding are key contributors. Pregnant women are significantly impacted by low dietary diversity, worsening anemia risk. The review highlights the importance of life-stage-specific dietary policies and focused interventions in order to tackle anemia.

Author Biographies

Pulkit Mathur, Department of Food and Nutrition and Food Technology, Lady Irwin College, University of Delhi, Delhi, India

Professor

Kapil Yadav, Centre for Community Medicine, All India Institute of Medical Sciences (AIIMS), Delhi, India

Professor

References

World Health Organization. Anaemia. Geneva: World Health Organization; 2023. Available from: https://www.who.int/news-room/fact-sheets/detail/anaemia. Accessed on 3 June 2026.

Chaparro CM, Suchdev PS. Anemia epidemiology, pathophysiology, and etiology in low- and middle-income countries. Ann N Y Acad Sci. 2019;1450:15-31.

Gupta A, Ramakrishnan L, Pandey RM, Sati HC, Khandelwal R, Khenduja P, et al. Risk factors of anemia amongst elderly population living at high-altitude region of India. J Family Med Prim Care. 2020;9:673-82.

Meng L, Liu J, Zhang J, Wang C, Man Q, Li L. Effect of dietary factors on anaemia among rural elderly women in south-west China: a case-control study. Public Health Nutr. 2009;12:1540-7.

Sunardi D, Bardosono S, Basrowi RW, Wasito E, Vandenplas Y. Dietary determinants of anemia in children aged 6-36 months: a cross-sectional study in Indonesia. Nutrients. 2021;13:2397.

Sunardi D, Bardosono S, Basrowi RW, Wasito E, Vandenplas Y. Dietary determinants of anemia in children aged 6–36 months: A cross- crosssectional study in Indonesia. Nutrients. 2021;13(7):2397.

Vitolo MR, Bortolini GA. Iron bioavailability as a protective factor against anemia among children aged 12 to 16 months. J Pediatr (Rio J). 2007;83:33-8.

Fentaw W, Belachew T, Andargie A. Anemia and associated factors among 6 to 59 months age children attending health facilities in Kombolcha town, Northeast Ethiopia: a facility-based cross-sectional study. BMC Pediatr. 2023;23:209.

Kathuria N, Bandyopadhyay P, Srivastava S, Garg PR, Devi KS, Kurian K, et al. Association of minimum dietary diversity with anemia among 6-59 months' children from rural India: an evidence from a cross-sectional study. J Family Med Prim Care. 2023;12:313-9.

Obse N, Mossie A, Gobena T. Magnitude of anemia and associated risk factors among pregnant women attending antenatal care in Shalla Woreda, West Arsi Zone, Oromia Region, Ethiopia. Ethiop J Health Sci. 2013;23:165-73.

Malako BG, Teshome MS, Belachew T. Anemia and associated factors among children aged 6-23 months in Damot Sore District, Wolaita Zone, South Ethiopia. BMC Hematol. 2018;18:14.

Nair MK, Mehta V. Life cycle approach to child development. Indian Pediatr. 2009;46 Suppl:S7-11.

Agustina R, Nadiya K, Andini EA, Setianingsih AA, Sadariskar AA, Prafiantini E, et al. Associations of meal patterning, dietary quality and diversity with anemia and overweight-obesity among Indonesian school-going adolescent girls in West Java. PLoS One. 2020;15:e0231519.

Ayogu RNB, Okafor AM, Ene-Obong HN. Iron status of schoolchildren (6-15 years) and associated factors in rural Nigeria. Food Nutr Res. 2015;59:26223.

Ma J, Huang J, Zeng C, Zhong X, Zhang W, Zhang B, et al. Dietary patterns and association with anemia in children aged 9-16 years in Guangzhou, China: a cross-sectional study. Nutrients. 2023;15:4133.

Abriha A, Yesuf ME, Wassie MM. Prevalence and associated factors of anemia among pregnant women of Mekelle town: a cross-sectional study. BMC Res Notes. 2014;7:888.

Gebre A, Mulugeta A. Prevalence of anemia and associated factors among pregnant women in North Western Zone of Tigray, Northern Ethiopia: a cross-sectional study. J Nutr Metab. 2015;2015:165430.

Ghosh P, Dasgupta A, Paul B, Roy S, Biswas A, Yadav A. A cross-sectional study on prevalence and determinants of anemia among women of reproductive age in a rural community of West Bengal. J Family Med Prim Care. 2020;9:5547-53.

Molla A, Egata G, Mesfin F, Arega M, Getacher L. Prevalence of anemia and associated factors among infants and young children aged 6-23 months in Debre Berhan Town, North Shewa, Ethiopia. J Nutr Metab. 2020;2020:2956129.

Zerfu TA, Umeta M, Baye K. Dietary diversity during pregnancy is associated with reduced risk of maternal anemia, preterm delivery, and low birth weight in a prospective cohort study in rural Ethiopia. Am J Clin Nutr. 2016;103:1482-8.

Woldie H, Kebede Y, Tariku A. Factors associated with anemia among children aged 6-23 months attending growth monitoring at Tsitsika Health Center, Wag-Himra Zone, Northeast Ethiopia. J Nutr Metab. 2015;2015:928632.

Jembere M, Kabthymer RH, Deribew A. Determinants of anemia among children aged 6 to 59 months in Dilla Town, Southern Ethiopia: a facility-based case-control study. Glob Pediatr Health. 2020;7:2333794X20974232.

Alemayehu M, Meskele M, Alemayehu B, Yakob B. Prevalence and correlates of anemia among children aged 6-23 months in Wolaita Zone, Southern Ethiopia. PLoS One. 2019;14:e0206268.

Park K, Kersey M, Geppert J, Story M, Cutts D, Himes JH. Household food insecurity is a risk factor for iron-deficiency anaemia in a multi-ethnic, low-income sample of infants and toddlers. Public Health Nutr. 2009;12:2120-8.

Kejo D, Petrucka PM, Martin H, Kimanya ME, Mosha TC. Prevalence and predictors of anemia among children under 5 years of age in Arusha District, Tanzania. Pediatr Health Med Ther. 2018;9:9-15.

Shourove JH, Meem FC, Lima SA, Islam GMR. Prevalence of childhood anemia: potential sociodemographic and dietary factors in Nigeria. PLoS One. 2022;17:e0278952.

Desalegn A, Mossie A, Gedefaw L. Nutritional iron deficiency anemia: magnitude and its predictors among school-age children, Southwest Ethiopia: a community-based cross-sectional study. PLoS One. 2014;9:e114059.

Knijff M, Roshita A, Suryantan J, Izwardy D, Hyun Rah J. Frequent consumption of micronutrient-rich foods is associated with reduced risk of anemia among adolescent girls and boys in Indonesia: a cross-sectional study. SAGE Open Med. 2021;9:20503121211029194.

Engidaw MT, Wassie MM, Teferra AS. Anemia and associated factors among adolescent girls living in AwBarre refugee camp, Somali regional state, Southeast Ethiopia. PLoS One. 2018;13(10):e0205381.

Hassan F, Salim S, Humayun A. Prevalence and determinants of iron deficiency anemia in adolescent girls of low-income communities in Lahore. Ann King Edward Med Univ. 2017;23:399-405.

Engidaw MT, Wassie MM, Teferra AS. Anemia and associated factors among adolescent girls living in Aw-Barre refugee camp, Somali regional state, Southeast Ethiopia. PLoS One. 2018;13:e0205381.

Kaur S, Deshmukh PR, Garg BS. Epidemiological correlates of nutritional anemia in adolescent girls of rural Wardha. Indian J Community Med. 2006;31:255.

Olumakaiye MF. Adolescent girls with low dietary diversity score are predisposed to iron deficiency in southwestern Nigeria. ICAN Infant Child Adolesc Nutr. 2013;5:85-91.

Mishra AS, Lakhera PC, Pandey A. Assessment of nutritional anemia on the basis of dietary pattern estimation among the population of Garhwal Himalayan region. J Family Med Prim Care. 2021;10:669-74.

Little M, Zivot C, Humphries S, Dodd W, Patel K, Dewey C. Burden and determinants of anemia in a rural population in South India: a cross-sectional study. Anemia. 2018;2018:7123976.

Wen Z, Long J, Zhu L, Liu S, Zeng X, Huang D, et al. Associations of dietary, sociodemographic, and anthropometric factors with anemia among the Zhuang ethnic adults: a cross-sectional study in Guangxi Zhuang Autonomous Region, China. BMC Public Health. 2023;23:1934.

Shi Z, Hu X, Yuan B, Pan X, Dai Y, HolmboeOttesen G. Association between dietary patterns and anaemia in adults from Jiangsu Province in Eastern China. Br J Nutr. 2006;96:90612.

Panigrahi A, Sahoo PB. Nutritional anemia and its epidemiological correlates among women of reproductive age in an urban slum of Bhubaneswar, Orissa. Indian J Public Health. 2011;55:317-20.

Khokhar J, Akbar A, Akhtar S, Layla A, Lazarte C, Abbas MA, et al. Prevalence and determinants of anemia among resident female university students from Southern Punjab, Pakistan. Women Health. 2022;62:488-501.

Ali SA, Abbasi Z, Shahid B, Moin G, Hambidge KM, Krebs NF, et al. Prevalence and determinants of anemia among women of reproductive age in Thatta Pakistan: findings from a cross-sectional study. PLoS One. 2020;15:e0239320.

Deriba BS, Bulto GA, Bala ET. Nutritional-related predictors of anemia among pregnant women attending antenatal care in Central Ethiopia: an unmatched case-control study. Biomed Res Int. 2020;2020:8824291.

Kankanamge SU, Ariyarathna S, Perera PPR. Association between dietary patterns and Hb concentration among young adult females. Int J Curr Res. 2017;9:45497-500.

Habib MA, Raynes-Greenow C, Nausheen S. Prevalence and determinants of iron deficiency anemia among non-pregnant women of reproductive age in Pakistan. Asia Pac J Clin Nutr. 2019;27:195-203.

Tulu BD, Atomssa EM, Mengist HM. Determinants of anemia among pregnant women attending antenatal care in Horo Guduru Wollega Zone, West Ethiopia: unmatched case-control study. PLoS One. 2019;14:e0224514.

Delil R, Tamiru D, Zinab B. Dietary diversity and its association with anemia among pregnant women attending public health facilities in South Ethiopia. Ethiop J Health Sci. 2018;28:625-34.

Abay A, Yalew HW, Tariku A, Gebeye E. Determinants of prenatal anemia in Ethiopia. Arch Public Health. 2017;75:51.

Tadesse SE, Seid O, G/Mariam Y, Fekadu A, Wasihun Y, Endris K, et al. Determinants of anemia among pregnant mothers attending antenatal care in Dessie town health facilities, northern central Ethiopia, unmatched case-control study. PLoS One. 2017;12:e0173173.

Baig-Ansari N, Badruddin SH, Karmaliani R, Harris H, Jehan I, Pasha O, et al. Anemia prevalence and risk factors in pregnant women in an urban area of Pakistan. Food Nutr Bull. 2008;29:132-9.

Weldekidan F, Kote M, Girma M, Boti N, Gultie T. Determinants of anemia among pregnant women attending antenatal clinic in public health facilities at Durame Town: unmatched case control study. Anemia. 2018;2018:8938307.

Weldemariam TB. Prevalence and factors associated with anemia among pregnant women attending antenatal care in Shalla Woreda, W/Arsi Zone, Oromia region. Int J Pregnancy Child Birth. 2018;4:155-61.

Teshome MS, Meskel DH, Wondafrash B. Determinants of anemia among pregnant women attending antenatal care clinic at public health facilities in Kacha Birra District, Southern Ethiopia. J Multidiscip Healthc. 2020;13:1007-15.

Tahir E, Ayotte P, Little M, Bélanger RE, Lucas M, Mergler D, et al. Anemia, iron status, and associated protective and risk factors among children and adolescents aged 3 to 19 years old from four First Nations communities in Quebec. Can J Public Health. 2020;111:682-93.

Hurrell R, Egli I. Iron bioavailability and dietary reference values. Am J Clin Nutr. 2010;91:1461S-7S.

Alaofè H, Burney J, Naylor R, Taren D. Prevalence of anaemia, deficiencies of iron and vitamin A and their determinants in rural women and young children: a cross-sectional study in Kalalé district of northern Benin. Public Health Nutr. 2017;20:1203-13.

Zhang Q, Qin G, Liu Z, Li Z, Li J, Varma DS, et al. Dietary balance index-07 and the risk of anemia in middle aged and elderly people in southwest China: a cross sectional study. Nutrients. 2018;10:162.

Berhe K, Fseha B, Gebremariam G, Teame H, Etsay N, Welu G, et al. Risk factors of anemia among pregnant women attending antenatal care in health facilities of Eastern Zone of Tigray, Ethiopia, case-control study, 2017/18. Pan Afr Med J. 2019;34:121.

Balarajan Y, Ramakrishnan U, Özaltin E, Shankar AH, Subramanian SV. Anaemia in low-income and middle-income countries. Lancet. 2011;378:2123-35.

Alamneh YM, Akalu TY, Shiferaw AA, Atnaf A. Magnitude of anemia and associated factors among children aged 6-59 months at Debre Markos referral hospital, Northwest Ethiopia: a hospital-based cross-sectional study. Ital J Pediatr. 2021;47:172.

Zeleke MB, Shaka MF, Anbesse AT, Tesfaye SH. Anemia and its determinants among male and female adolescents in Southern Ethiopia: a comparative cross-sectional study. Anemia. 2020;2020:3906129.

Shill KB, Karmakar P, Kibria MG, Das A, Rahman MA, Hossain MS, et al. Prevalence of iron-deficiency anaemia among university students in Noakhali region, Bangladesh. J Health Popul Nutr. 2014;32:103-10.

Ayensu J, Annan R, Lutterodt H, Edusei A, Peng LS. Prevalence of anaemia and low intake of dietary nutrients in pregnant women living in rural and urban areas in the Ashanti region of Ghana. PLoS One. 2020;15:e0226026.

Ebuy Y, Alemayehu M, Mitiku M, Goba GK. Determinants of severe anemia among laboring mothers in Mekelle city public hospitals, Tigray region, Ethiopia. PLoS One. 2017;12:e0186724.

Lebso M, Anato A, Loha E. Prevalence of anemia and associated factors among pregnant women in Southern Ethiopia: a community based cross-sectional study. PLoS One. 2017;12:e0188783.

Soh P, Ferguson EL, McKenzie JE, Skeaff S, Parnell W, Gibson RS. Dietary intakes of 6-24-month-old urban South Island New Zealand children in relation to biochemical iron status. Public Health Nutr. 2002;5:339-46.

Aikawa R, Khan NC, Sasaki S, Binns CW. Risk factors for iron-deficiency anaemia among pregnant women living in rural Vietnam. Public Health Nutr. 2006;9:443-8.

Jugha VT, Anchang-Kimbi JK, Anchang JA, Mbeng KA, Kimbi HK. Dietary diversity and its contribution in the etiology of maternal anemia in conflict-hit Mount Cameroon Area: a cross-sectional study. Front Nutr. 2021;7:625178.

Samuel S, Darebo T, Desta DT, Mulugeta A. Socio-economic and dietary diversity characteristics are associated with anemia among pregnant women attending antenatal care services in public health centers of Kembata Tembaro Zone, Southern Ethiopia. Food Sci Nutr. 2020;8:1978-86.

Broderstad AR, Melhus M, Brustad M, Lund E. Iron stores in relation to dietary patterns in a multiethnic population: the SAMINOR study. Public Health Nutr. 2011;14:1039-46.