Micronutrient Status and Dietary Diversity of Women of Reproductive Age in Rural Pakistan

Abstract

Consuming a diverse diet is essential to ensure an adequate intake of micronutrients. The aim of this study was to assess the nutritional status and dietary diversity of women of reproductive age (WRA) living in a marginalized community in rural Pakistan. Forty-seven WRA (35 ± 7 years old) who were not pregnant or lactating at enrollment, were recruited to participate in the study. Twenty-four-hour dietary recall interviews were conducted by the study nutritionist, and the data collected were used to create a minimum dietary diversity for women score (MDD-W) on five occasions during the monsoon and winter seasons (October to February). Nutritional status was assessed using anthropometry and biochemical markers of micronutrient status. Height and weight were used to determine body mass index (BMI), and mid-upper-arm circumference was measured. Plasma zinc, iron, and selenium concentrations were measured using inductively coupled mass spectrometry, and iron status was assessed using serum ferritin and blood hemoglobin concentrations. The mean (±SD) food group diversity score was 4 ± 1 with between 26% and 41% of participants achieving an MDD-W of 5. BMI was 27.2 ± 5.5 kg/m2 with 28% obese, 34% overweight, and 6% underweight. The prevalence of zinc deficiency, based on plasma zinc concentration, was 29.8%; 17% of the participants had low plasma selenium levels; 8.5% were iron deficient; and 2% were suffering from iron deficiency anemia. The findings indicate that the women living in this community consume a diet that has a low diversity, consistent with a diet low in micronutrients, and that zinc deficiency is prevalent. Public health interventions aimed at increasing the dietary diversity of WRA are needed to improve the micronutrient intake, particularly of zinc, in this population.

Nutritional Status of Adolescent Afghan Refugees Living in Peshawar, Pakistan

“…Based on the prevalence rate, anemia and iron deficiency are mild public health issues in this population group. These finding are similar to a recent study conducted in a resource poor community in the same area of Pakistan [ 38 ] but markedly different from the national nutrition survey of Pakistan [ 11 ] and other studies [ 39 ] that report anemia prevalence in >50% of the population. This was an unexpected finding as the routine dietary intake in these population groups include wheat as a staple food which is low in readily bioavailable heme iron [ 38 ].…”

“…These finding are similar to a recent study conducted in a resource poor community in the same area of Pakistan [ 38 ] but markedly different from the national nutrition survey of Pakistan [ 11 ] and other studies [ 39 ] that report anemia prevalence in >50% of the population. This was an unexpected finding as the routine dietary intake in these population groups include wheat as a staple food which is low in readily bioavailable heme iron [ 38 ]. A possible reason to this might be the culinary practices in these population that involve use of iron-based cocking pots and utensils.…”

The global challenge of hidden hunger: perspectives from the field

“…In a study of dietary diversity in a resource-poor setting in Pakistan, we reported that MMD-W was not achieved by most of the participants. This low diet diversity was associated with a high prevalence of zinc deficiency (measured using plasma zinc concentration), however, surprisingly, iron deficiency was not detected using established biomarkers (blood Hb and serum ferritin concentrations) (30) . This may have been due to the intake of iron from non-food sources, such as iron leached from the cooking pots.…”

Biofortified Wheat Increases Dietary Zinc Intake: A Randomised Controlled Efficacy Study of Zincol-2016 in Rural Pakistan

“…The characteristics of the participants, including indicators of socioeconomic status, HH demographics and anthropometric measures of the participating WRA were collected at baseline. These have been reported previously along with dietary diversity data (24). In addition, blood samples were collected at each T to monitor health status throughout the study.…”