Dietary diversification for prevention of anaemia among women of childbearing age from rural India

Objective: To assess the impact of an intervention modifying dietary habits for the prevention of anaemia in rural India. Design: Intervention study with data on anthropometric (weight, height) measurements, Hb and diet pattern. As per the cut-off for Hb in the government programme, women with Hb <11 g/dl had to be given Fe tablets and formed the supplemented group while those with Hb >11 g/dl formed the non-supplemented group. Settings: Three villages near Pune city, Maharashtra, India. Subjects: Rural non-pregnant women (n 317) of childbearing age (15-35 years). Results: After 1 year of intervention, mean Hb increased (from 10.94 (SD 1.22) g/dl to 11.59 (SD 1.11) g/dl) significantly (P < 0.01) with a consequent reduction in the prevalence of anaemia (from 82.0% to 55.4%) as well as Fe-deficiency anaemia (from 30.3% to 10.8%). Gain in Hb was inversely associated with the initial level of Hb. Significant gain in Hb (0.57 g/dl) was observed among women attending >50% of the meetings or repeating >50% of the recipes at home (0.45 g/dl) in the non-supplemented group and was smaller than that observed in the supplemented group. Consumption of green leafy vegetables more than twice weekly increased substantially from 44.7% to 60.6%, as did consumption of seasonal fruits. Logistic regression showed that women with lower participation in the intervention had three times higher risk (OR = 3.08; 95% CI 1.04, 9.13; P = 0.04) for no gain in Hb compared with those having high participation. Conclusions: Developing action programmes for improving nutritional awareness to enhance the consumption of Fe-rich foods has great potential for preventing anaemia in rural India.