Iron Content in Groundwater Associated with Anemia among Children 6–37 Months in Rural Bangladesh

Abstract

ObjectivesElevated iron content in groundwater has been cited as a significant dietary iron source. We explored this in order to further understand the etiology of anemia among children in the Food and Agricultural Approaches to Reducing Malnutrition (FAARM) population.MethodsWe used baseline data from the FAARM cluster randomized trial (https://clinicaltrials.gov/ct2/show/NCT02505711) collected in early 2015 among 1,133 children aged 6–37 months in 96 clusters. Levels of drinking water iron were measured by household member self‐report using a 4‐point scale (none, a little, medium, a lot), which was dichotomized into any or none.ResultsHalf of the children (51%) were anemic (mean hemoglobin: 10.8 g/dL) and 46% were stunted (mean Z‐score: −1.9). Only 23% of children ate a minimum adequate diet. Every second child (47%) lived in a household that reported iron in their drinking water. In a random‐effects logistic regression model, perceived iron in groundwater was negatively associated with anemia (aOR: 0.67; 95%CI: 0.50, 0.86) after adjusting for child age, iron‐rich food consumption, and household wealth. Iron‐rich food consumption was not significantly associated with anemia.ConclusionThese findings provide further evidence of the importance of groundwater iron intake. The effect in children was much stronger than in women of the same population where iron in drinking water was negatively associated with anemia only among those consuming an iron‐poor diet. These findings demonstrate the utility of asking perceived groundwater iron content as a simple method to assess iron in drinking water and should be considered in regions with groundwater iron.Support or Funding InformationThis trial is funded by the German Federal Ministry for Education and Research (BMBF) and surveillance by DFID through the Nutrition Embedding Evaluation Programme (NEEP). The intervention is funded jointly by BMBF, and through the following private donations: the Carrefour Foundation, TWFA, and Best‐in‐Brands.