Evaluation of the relationship between food insecurity and Food patterns, iron deficiency anemia and vitamin D deficiency in women of reproductive age in Tabriz

Abstract

Background and aim: Considering the importance of undesirable effects of nutrient deficiencies in women of reproductive age and the prevalence of food insecurity in these women, the present study assessed the association between household food insecurity (HFI) and anemia, iron deficiency and vitamin D deficiency. Moreover, the dominant dietary patterns and their association with food insecurity in women of reproductive age in Tabriz were assessed. Materials and Methods: In the present cross-sectional study, 266 women of reproductive age were selected using by stratified sampling method. Demographic characteristics were recorded using a questionnaire. Short form of food insecurity questionnaire (6 questions) was used to indicate the food insecurity status. The 80-question FFQ was used to determine the dietary intake and then, factor analysis was used to determine the dietary patterns of the participants. A 5-cc fasting blood sample was obtained for laboratory measurements and then serum vitamin D and ferritin were measured using ELISA and hemoglobin was measured by Photometry method. Data were analyzed by SPSS software (version 23) and Kolmogrov-Smirnov statistical methods was used to determine the normality of the data. To investigate the relationship between food insecurity and the extracted dietary patterns,ordinal regression was used. Logistic regression was used to determine the association between food insecurity and iron deficiency anemia and vitamin D deficiency Results: According to the results of this study, out of 266 women, 32.7% were in the food secure group and 67.3% were in the food insecure group. Three major dietary patterns were identified by using factor analysis method including animal dietary pattern, healthy dietary pattern and Western dietary pattern. There wasn’t significant association between dietary patterns and food insecurity. The results showed that iron deficiency anemia was significantly higher in food insecure group (18.4%) than in food insecure group (6.9%) (p = 0.01). According to the results of logistic regression test, there was a significant association between iron deficiency anemia and food insecurity in the studied women (OR: 3.05 CI:1.22-7.59). This association remained significant after adjusting for age, occupational, educational and marital status, BMI, dietary intake and supplements use. There wasn’t significant association between food insecurity and vitamin D deficiency (OR: 0.82: CI95%: 0.41-1.61). Conclusion In conclusion, the result of our study showed that there was a positive association between HFI and anemia among reproductive age women, however, there was not significant association between HFI and iron deficiency, vitamin D deficiency and dietary pattern. Considering the adverse effect of anemia in this age group, strategies that improve the access of these women to high-quality foods should be implemented to prevent iron deficiency anemia. Moreover, health care providers should carefully monitor the reproductive age women suspected to food insecure.