Dietary deficiencies among families of air warriors: Use of iron deficiency anemia as an index

Abstract

Introduction: Anemia is a prevalent health problem in India affecting all age groups. It has shown the highest prevalence among preschool children and occurs more commonly in the lower socioeconomic group. Observationally, it was noticed at an Air Force station that preschool children of air warriors had iron deficiency anemia at levels similar to those seen in lower socioeconomic groups. This prompted us to evaluate dietary practices among families of air warriors as a contributory factor to iron deficiency in these children. Material and Methods: All anemic children diagnosed of iron deficiency in the age group of 6–59 months were included in the study. Data were compiled from the clinical history, dietary habits and laboratory parameters obtained. The dietary habits were analyzed based on parameters defined in the current infant and young child feeding guidelines such as exclusive breastfeeding, minimum meal frequency, minimum dietary diversity, and minimum acceptable diet. Mann–Whitney U-test was used to determine statistical significance of difference between means of two independent groups. Spearman correlation analysis between two independent variables was done and multiple linear regression analysis was performed to identify predictor variables for iron deficiency anemia. Results: About 74.1% of the anemic children fell into age group of 6–23 months (infants and young children). 75% of children of the age group of 6–23 months were started on cow’s milk at the time of weaning. The average amount of cow’s milk consumed in a day was 0.7 L. In this age group, the minimum dietary diversity was observed in 11.1%, minimum acceptable diet in 5.5% and minimum meal frequency in 22.2% of the children. In the same age group, a statistically significant negative correlation was observed between cow’s milk quantity given per day and hemoglobin (ρ = ‒0.77). A significant negative correlation was found between cow’s milk quantity and variables such as age and number of solid meals received in a day (ρ = ‒0.553 and –0.526, respectively). In multiple regression analysis with hemoglobin as the dependent variable, a significant negative association was observed with cow’s milk quantity. Age showed statistically significant positive correlation with hemoglobin (ρ = 0.762) which was also seen on linear regression analysis. Serum ferritin was low in 44.5% while total iron-binding capacity was raised in 100% of the cases. Conclusion: Iron deficiency anemia was disproportionately distributed among infants and young children (age group 6–23 months). Copious consumption of cow’s milk in this age group led to fewer solid feeds per day and lack of dietary diversity which led to an iron deficient state in these children. This probably resulted in manifestation of anemia in this population. The study brings out the need for dietary counseling for air warriors and their families to ensure better health and lower disease burden.