Household Food Insecurity Is Associated with RBC Folate Deficiency and Iron-Deficiency Anaemia Among Non-Pregnant Nepalese Women Aged 15-49 Years

Sanjay Rijal; Naveen Paudyal; Sanjeev Kumar Sahani; Sunita Raut; Kingsley Agho

doi:doi:10.11648/j.jher.20230902.13

| Peer-Reviewed

Household Food Insecurity Is Associated with RBC Folate Deficiency and Iron-Deficiency Anaemia Among Non-Pregnant Nepalese Women Aged 15-49 Years

Sanjay Rijal, Naveen Paudyal, Sanjeev Kumar Sahani, Sunita Raut, Kingsley Agho

Published in Journal of Health and Environmental Research (Volume 9, Issue 2)

Received: 7 May 2023 Accepted: 31 May 2023 Published: 10 June 2023

Views: Downloads:

Download PDF

Share This Article

Twitter
Linked In
Facebook

Abstract

Although food insecurity (a measure of a household’s availability, accessibility, utilisation, and stability of food) and micronutrient deficiencies have remained a serious public health concern in Nepal, research assessing the association between them is least known. Using data from the 2016 Nepal Multiple Indicators Cluster Survey (NMICS), this cross-sectional study that included a sample of 2143 non-pregnant women aged 15-49 years assessed whether there is an association between household (HH) food insecurity with red blood cell (RBC) folate deficiency and iron-deficiency anaemia. Multivariate analysis was conducted to examine the association between HH food insecurity and Iron-deficiency anaemia (IDA) and RBC folate deficiency. Overall, 56% of participants were from food-secure households, whilst 7% were from severely food-insecure households. In adjusted models, living in a severely food insecure household was significantly associated with both IDA [adjusted odds ratio (AOR): 1.63; 95% confidence interval (CI): (1.02, 2.60)] and RBC folate deficiency [AOR: 3.83; 95% CI: (1.03, 14.18)]. Findings from this study revealed that severe household food insecurity was associated with both IDA and RBC folate. Public health policies to ameliorate IDA and RBC folate should provision for spending on food assistance programmes to address household food insecurity in Nepal. Social protection schemes should be expanded for those belonging to severely food insecure HHs who are unable to feed themselves and produce food for subsistence to strengthen their livelihood and ensure access to adequate, nutritious, and diverse food. Further, Food System needs to be strengthened to increase access to and consumption of nutritious, safe, affordable and sustainable diets. Pro-poor and women-focused food security policies need to be developed.

Published in	Journal of Health and Environmental Research (Volume 9, Issue 2)
DOI	10.11648/j.jher.20230902.13
Page(s)	59-66
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2023. Published by Science Publishing Group

Keywords

Food Insecurity, RBC Folate, Iron-Deficiency, Non-Pregnant Women, Nepal, Social Protection

References

[1]	FAO, The state of food insecurity in the world. 2000, Food and Agriculture Organization: Rome.
[2]	Anderson, S. A., Core indicators of nutritional state for difficult-to-sample populations. The Journal of nutrition (USA), 1990.
[3]	FAO, The state of food insecurity in the world: addressing food insecurity in protracted crises. 2010, Food and Agriculture Organisation: Rome.
[4]	Ministry of Health Nepal, et al., Nepal National Micronutrient Status Survey – 2016. 2017, Minisry of Health, Nepal: Kathmandu, Nepal.
[5]	CDC. Folate Microbiologic Assay 2102 [cited 2018 Oct 31]; Available from: https://www.cdc.gov/nchs/data/nhanes/nhanes_11_12/FOLATE_G_met_RBC.pdf.
[6]	DALY, G. and H. Collaborators, Murray CJ, Barber RM, Foreman KJ, Abbasoglu Ozgoren A, Abd-Allah F, et al. Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990-2013: Quantifying the epidemiological transition. Lancet, 2015. 386: p. 2145-91.
[7]	Government of Nepal and World Food Program. Brief on the food security situation in Nepal (mid-November 2016 to mid-March 2017). 2017 [cited 2018 Nov 2]; Available from: https://reliefweb.int/report/nepal/brief-food-security-situation-nepal-mid-november-2016-mid-march-2017.
[8]	Government of Nepal and Ministry of Health and Population (MOHP) [Nepal], National Anaemia Control Strategy. 2007, MOHP: Kathmandu.
[9]	Balcı, Y. I., et al., Prevalence and risk factors of anemia among adolescents in Denizli, Turkey. Iranian journal of pediatrics, 2012. 22 (1): p. 77.
[10]	Alzaheb, R. A. and O. Al-Amer, The Prevalence of Iron Deficiency Anemia and its Associated Risk Factors Among a Sample of Female University Students in Tabuk, Saudi Arabia. Clinical Medicine Insights: Women's Health, 2017. 10: p. 1179562X17745088.
[11]	Alaofè, H., et al., 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 nutrition, 2017. 20 (7): p. 1203-1213.
[12]	Harding, K.. L., et al., Determinants of anemia among women and children in Nepal and Pakistan: An analysis of recent national survey data. Maternal & child nutrition, 2017.
[13]	Filmer, D. and L. H. Pritchett, Estimating Wealth Effects Without Expenditure Data—Or Tears: An Application To Educational Enrollments In States Of India*. Demography, 2001. 38 (1): p. 115-132.
[14]	Fischer, N. C., et al., Household Food Insecurity Is Associated with Anemia in Adult Mexican Women of Reproductive Age–3. The Journal of nutrition, 2014. 144 (12): p. 2066-2072.
[15]	Park, K., et al., Household food insecurity is a risk factor for iron-deficiency anaemia in a multi-ethnic, low-income sample of infants and toddlers. Public health nutrition, 2009. 12 (11): p. 2120-2128.
[16]	Campbell, A., et al., Relationship of household food insecurity to anaemia in children aged 6–59 months among families in rural Indonesia. Annals of tropical paediatrics, 2011. 31 (4): p. 321-330.
[17]	Dixon, L. B., M. A. Winkleby, and K. L. Radimer, Dietary intakes and serum nutrients differ between adults from food-insufficient and food-sufficient families: Third National Health and Nutrition Examination Survey, 1988–1994. The Journal of nutrition, 2001. 131 (4): p. 1232-1246.
[18]	Tarasuk, V. S., Household food insecurity with hunger is associated with women's food intakes, health and household circumstances. The Journal of nutrition, 2001. 131 (10): p. 2670-2676.
[19]	Kaiser, L. L., et al., Food security and nutritional outcomes of preschool-age Mexican-American children. Journal of the American Dietetic Association, 2002. 102 (7): p. 924-929.
[20]	The World Bank, Nepal: Country snapshots. 2014, The World Bank: Kathmandu.
[21]	Bird, J. K., et al., Obesity Is Associated with Increased Red Blood Cell Folate Despite Lower Dietary Intakes and Serum Concentrations–4. The Journal of nutrition, 2014. 145 (1): p. 79-86.
[22]	Mojtabai, R., Body mass index and serum folate in childbearing age women. European journal of epidemiology, 2004. 19 (11): p. 1029-1036.
[23]	Menendez, C., A. Fleming, and P. Alonso, Malaria-related anaemia. Parasitology today, 2000. 16 (11): p. 469-476.
[24]	Mitiku, A., B. Fufa, and B. Tadese, Emperical analysis of the determinants of rural households food security in Southern Ethiopia: The case of Shashemene District. Basic Res J Agric Sci Rev, 2012. 1 (6): p. 132-8.
[25]	Coates, J. C., et al., “He said, she said”: who should speak for households about experiences of food insecurity in Bangladesh? Food Security, 2010. 2 (1): p. 81-95.

Cite This Article

Plain Text BibTeX RIS

APA Style

Sanjay Rijal, Naveen Paudyal, Sanjeev Kumar Sahani, Sunita Raut, Kingsley Agho. (2023). Household Food Insecurity Is Associated with RBC Folate Deficiency and Iron-Deficiency Anaemia Among Non-Pregnant Nepalese Women Aged 15-49 Years. Journal of Health and Environmental Research, 9(2), 59-66. https://doi.org/10.11648/j.jher.20230902.13

Copy | Download

ACS Style

Sanjay Rijal; Naveen Paudyal; Sanjeev Kumar Sahani; Sunita Raut; Kingsley Agho. Household Food Insecurity Is Associated with RBC Folate Deficiency and Iron-Deficiency Anaemia Among Non-Pregnant Nepalese Women Aged 15-49 Years. J. Health Environ. Res. 2023, 9(2), 59-66. doi: 10.11648/j.jher.20230902.13

Copy | Download

AMA Style

Sanjay Rijal, Naveen Paudyal, Sanjeev Kumar Sahani, Sunita Raut, Kingsley Agho. Household Food Insecurity Is Associated with RBC Folate Deficiency and Iron-Deficiency Anaemia Among Non-Pregnant Nepalese Women Aged 15-49 Years. J Health Environ Res. 2023;9(2):59-66. doi: 10.11648/j.jher.20230902.13

Copy | Download

@article{10.11648/j.jher.20230902.13,
  author = {Sanjay Rijal and Naveen Paudyal and Sanjeev Kumar Sahani and Sunita Raut and Kingsley Agho},
  title = {Household Food Insecurity Is Associated with RBC Folate Deficiency and Iron-Deficiency Anaemia Among Non-Pregnant Nepalese Women Aged 15-49 Years},
  journal = {Journal of Health and Environmental Research},
  volume = {9},
  number = {2},
  pages = {59-66},
  doi = {10.11648/j.jher.20230902.13},
  url = {https://doi.org/10.11648/j.jher.20230902.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jher.20230902.13},
  abstract = {Although food insecurity (a measure of a household’s availability, accessibility, utilisation, and stability of food) and micronutrient deficiencies have remained a serious public health concern in Nepal, research assessing the association between them is least known. Using data from the 2016 Nepal Multiple Indicators Cluster Survey (NMICS), this cross-sectional study that included a sample of 2143 non-pregnant women aged 15-49 years assessed whether there is an association between household (HH) food insecurity with red blood cell (RBC) folate deficiency and iron-deficiency anaemia. Multivariate analysis was conducted to examine the association between HH food insecurity and Iron-deficiency anaemia (IDA) and RBC folate deficiency. Overall, 56% of participants were from food-secure households, whilst 7% were from severely food-insecure households. In adjusted models, living in a severely food insecure household was significantly associated with both IDA [adjusted odds ratio (AOR): 1.63; 95% confidence interval (CI): (1.02, 2.60)] and RBC folate deficiency [AOR: 3.83; 95% CI: (1.03, 14.18)]. Findings from this study revealed that severe household food insecurity was associated with both IDA and RBC folate. Public health policies to ameliorate IDA and RBC folate should provision for spending on food assistance programmes to address household food insecurity in Nepal. Social protection schemes should be expanded for those belonging to severely food insecure HHs who are unable to feed themselves and produce food for subsistence to strengthen their livelihood and ensure access to adequate, nutritious, and diverse food. Further, Food System needs to be strengthened to increase access to and consumption of nutritious, safe, affordable and sustainable diets. Pro-poor and women-focused food security policies need to be developed.},
 year = {2023}
}

Copy | Download

TY  - JOUR
T1  - Household Food Insecurity Is Associated with RBC Folate Deficiency and Iron-Deficiency Anaemia Among Non-Pregnant Nepalese Women Aged 15-49 Years
AU  - Sanjay Rijal
AU  - Naveen Paudyal
AU  - Sanjeev Kumar Sahani
AU  - Sunita Raut
AU  - Kingsley Agho
Y1  - 2023/06/10
PY  - 2023
N1  - https://doi.org/10.11648/j.jher.20230902.13
DO  - 10.11648/j.jher.20230902.13
T2  - Journal of Health and Environmental Research
JF  - Journal of Health and Environmental Research
JO  - Journal of Health and Environmental Research
SP  - 59
EP  - 66
PB  - Science Publishing Group
SN  - 2472-3592
UR  - https://doi.org/10.11648/j.jher.20230902.13
AB  - Although food insecurity (a measure of a household’s availability, accessibility, utilisation, and stability of food) and micronutrient deficiencies have remained a serious public health concern in Nepal, research assessing the association between them is least known. Using data from the 2016 Nepal Multiple Indicators Cluster Survey (NMICS), this cross-sectional study that included a sample of 2143 non-pregnant women aged 15-49 years assessed whether there is an association between household (HH) food insecurity with red blood cell (RBC) folate deficiency and iron-deficiency anaemia. Multivariate analysis was conducted to examine the association between HH food insecurity and Iron-deficiency anaemia (IDA) and RBC folate deficiency. Overall, 56% of participants were from food-secure households, whilst 7% were from severely food-insecure households. In adjusted models, living in a severely food insecure household was significantly associated with both IDA [adjusted odds ratio (AOR): 1.63; 95% confidence interval (CI): (1.02, 2.60)] and RBC folate deficiency [AOR: 3.83; 95% CI: (1.03, 14.18)]. Findings from this study revealed that severe household food insecurity was associated with both IDA and RBC folate. Public health policies to ameliorate IDA and RBC folate should provision for spending on food assistance programmes to address household food insecurity in Nepal. Social protection schemes should be expanded for those belonging to severely food insecure HHs who are unable to feed themselves and produce food for subsistence to strengthen their livelihood and ensure access to adequate, nutritious, and diverse food. Further, Food System needs to be strengthened to increase access to and consumption of nutritious, safe, affordable and sustainable diets. Pro-poor and women-focused food security policies need to be developed.
VL  - 9
IS  - 2
ER  -

Copy | Download

Author Information

Sanjay Rijal

United Nations Children's Fund (UNICEF), Kathmandu, Nepal
Naveen Paudyal

United Nations Children's Fund (UNICEF), Kathmandu, Nepal
Sanjeev Kumar Sahani

National Nutrition and Food Security Secretariat, National Planning Commission, Kathmandu, Nepal
Sunita Raut

Food and Agriculture Organization, Kathmandu, Nepal
Kingsley Agho

School of Health Sciences, Western Sydney University, New South Wales, Australia

Download PDF

Sections

Plain Text BibTeX RIS

APA Style

Sanjay Rijal, Naveen Paudyal, Sanjeev Kumar Sahani, Sunita Raut, Kingsley Agho. (2023). Household Food Insecurity Is Associated with RBC Folate Deficiency and Iron-Deficiency Anaemia Among Non-Pregnant Nepalese Women Aged 15-49 Years. Journal of Health and Environmental Research, 9(2), 59-66. https://doi.org/10.11648/j.jher.20230902.13

Copy | Download

ACS Style

Sanjay Rijal; Naveen Paudyal; Sanjeev Kumar Sahani; Sunita Raut; Kingsley Agho. Household Food Insecurity Is Associated with RBC Folate Deficiency and Iron-Deficiency Anaemia Among Non-Pregnant Nepalese Women Aged 15-49 Years. J. Health Environ. Res. 2023, 9(2), 59-66. doi: 10.11648/j.jher.20230902.13

Copy | Download

AMA Style

Sanjay Rijal, Naveen Paudyal, Sanjeev Kumar Sahani, Sunita Raut, Kingsley Agho. Household Food Insecurity Is Associated with RBC Folate Deficiency and Iron-Deficiency Anaemia Among Non-Pregnant Nepalese Women Aged 15-49 Years. J Health Environ Res. 2023;9(2):59-66. doi: 10.11648/j.jher.20230902.13

Copy | Download

@article{10.11648/j.jher.20230902.13,
  author = {Sanjay Rijal and Naveen Paudyal and Sanjeev Kumar Sahani and Sunita Raut and Kingsley Agho},
  title = {Household Food Insecurity Is Associated with RBC Folate Deficiency and Iron-Deficiency Anaemia Among Non-Pregnant Nepalese Women Aged 15-49 Years},
  journal = {Journal of Health and Environmental Research},
  volume = {9},
  number = {2},
  pages = {59-66},
  doi = {10.11648/j.jher.20230902.13},
  url = {https://doi.org/10.11648/j.jher.20230902.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jher.20230902.13},
  abstract = {Although food insecurity (a measure of a household’s availability, accessibility, utilisation, and stability of food) and micronutrient deficiencies have remained a serious public health concern in Nepal, research assessing the association between them is least known. Using data from the 2016 Nepal Multiple Indicators Cluster Survey (NMICS), this cross-sectional study that included a sample of 2143 non-pregnant women aged 15-49 years assessed whether there is an association between household (HH) food insecurity with red blood cell (RBC) folate deficiency and iron-deficiency anaemia. Multivariate analysis was conducted to examine the association between HH food insecurity and Iron-deficiency anaemia (IDA) and RBC folate deficiency. Overall, 56% of participants were from food-secure households, whilst 7% were from severely food-insecure households. In adjusted models, living in a severely food insecure household was significantly associated with both IDA [adjusted odds ratio (AOR): 1.63; 95% confidence interval (CI): (1.02, 2.60)] and RBC folate deficiency [AOR: 3.83; 95% CI: (1.03, 14.18)]. Findings from this study revealed that severe household food insecurity was associated with both IDA and RBC folate. Public health policies to ameliorate IDA and RBC folate should provision for spending on food assistance programmes to address household food insecurity in Nepal. Social protection schemes should be expanded for those belonging to severely food insecure HHs who are unable to feed themselves and produce food for subsistence to strengthen their livelihood and ensure access to adequate, nutritious, and diverse food. Further, Food System needs to be strengthened to increase access to and consumption of nutritious, safe, affordable and sustainable diets. Pro-poor and women-focused food security policies need to be developed.},
 year = {2023}
}

Copy | Download

TY  - JOUR
T1  - Household Food Insecurity Is Associated with RBC Folate Deficiency and Iron-Deficiency Anaemia Among Non-Pregnant Nepalese Women Aged 15-49 Years
AU  - Sanjay Rijal
AU  - Naveen Paudyal
AU  - Sanjeev Kumar Sahani
AU  - Sunita Raut
AU  - Kingsley Agho
Y1  - 2023/06/10
PY  - 2023
N1  - https://doi.org/10.11648/j.jher.20230902.13
DO  - 10.11648/j.jher.20230902.13
T2  - Journal of Health and Environmental Research
JF  - Journal of Health and Environmental Research
JO  - Journal of Health and Environmental Research
SP  - 59
EP  - 66
PB  - Science Publishing Group
SN  - 2472-3592
UR  - https://doi.org/10.11648/j.jher.20230902.13
AB  - Although food insecurity (a measure of a household’s availability, accessibility, utilisation, and stability of food) and micronutrient deficiencies have remained a serious public health concern in Nepal, research assessing the association between them is least known. Using data from the 2016 Nepal Multiple Indicators Cluster Survey (NMICS), this cross-sectional study that included a sample of 2143 non-pregnant women aged 15-49 years assessed whether there is an association between household (HH) food insecurity with red blood cell (RBC) folate deficiency and iron-deficiency anaemia. Multivariate analysis was conducted to examine the association between HH food insecurity and Iron-deficiency anaemia (IDA) and RBC folate deficiency. Overall, 56% of participants were from food-secure households, whilst 7% were from severely food-insecure households. In adjusted models, living in a severely food insecure household was significantly associated with both IDA [adjusted odds ratio (AOR): 1.63; 95% confidence interval (CI): (1.02, 2.60)] and RBC folate deficiency [AOR: 3.83; 95% CI: (1.03, 14.18)]. Findings from this study revealed that severe household food insecurity was associated with both IDA and RBC folate. Public health policies to ameliorate IDA and RBC folate should provision for spending on food assistance programmes to address household food insecurity in Nepal. Social protection schemes should be expanded for those belonging to severely food insecure HHs who are unable to feed themselves and produce food for subsistence to strengthen their livelihood and ensure access to adequate, nutritious, and diverse food. Further, Food System needs to be strengthened to increase access to and consumption of nutritious, safe, affordable and sustainable diets. Pro-poor and women-focused food security policies need to be developed.
VL  - 9
IS  - 2
ER  -

Copy | Download