Food Insecurity and Iron Deficiency in a Cohort of Nepali Children
Open Access
- Author:
- Pia, Emily Delaine
- Area of Honors:
- Nutritional Sciences
- Degree:
- Bachelor of Science
- Document Type:
- Thesis
- Thesis Supervisors:
- Laura E Murray-Kolb, Thesis Supervisor
Rebecca L Corwin, Thesis Honors Advisor - Keywords:
- food security
food insecurity
iron deficiency
Nepal - Abstract:
- Background: South Asia has the largest food insecure population on the planet, with 3.7 million food insecure living in Nepal alone (2009 est.). Another major public health concern in South Asia is iron deficiency. While we do not have population-level data on the burden of iron deficiency in Nepal, we do know that anemia affects greater than 40% of this population, and that 50% of anemia is typically attributed to iron deficiency. Objectives: The primary objective of this study was to assess the relationship between food insecurity and iron deficiency in infants living in Bhaktapur, Nepal. We hypothesized that households with greater food insecurity would have children with higher rates of iron deficiency. The secondary objective was to assess the relationship between food insecurity and other relevant indicators of child health including growth, nutrient adequacy, and socioeconomic status. Design: Infants were followed from birth to 24 months of age (n=236) and household food insecurity was assessed using the Household Food Insecurity Access Scale (HFIAS) every six months. Blood samples were analyzed for ferritin (Ft), transferrin receptor (TfR), and hemoglobin (Hb) at 7, 15, and 24 months. Infant dietary intake was assessed monthly using 24-hour food recalls. Results: Only 15% of households reported food insecurity, yet iron deficiency was present in 41-49% of infants at 24 months (as assessed by ferritin and transferrin receptor, respectively). No association was found between household food insecurity (HFIAS>1) and iron deficiency (Ft<12ng/mL and/or TfR>8.3mg/L). There was an association between household food insecurity and level of dietary intake of every essential nutrient (p<0.05) except protein, carbohydrates, and vitamin B12. Conclusions: The prevalence of anemia, iron deficiency, and low nutritional adequacy suggest that food insecurity is a concern in this population, and that HFIAS may not be the ideal surrogate marker for detection. Further research should be done to assess the validity of HFIAS in this context.