DIETARY DETERMINANTS OF HEMOGLOBIN LEVELS AMONG YOUNG ADULTS: EVIDENCE FROM A CROSS-SECTIONAL STUDY

Authors

  • ABUBAKAR Institute of Climate Adaptation and Marine Biotechnology, Universiti Malaysia Terengganu, Kuala Nerus 21030, Malaysia
  • GUL-E-SABA CHAUDHRY Institute of Climate Adaptation and Marine Biotechnology, Universiti Malaysia Terengganu, Kuala Nerus 21030, Malaysia https://orcid.org/0000-0002-4555-8572
  • ZEENIA Institute of Climate Adaptation and Marine Biotechnology, Universiti Malaysia Terengganu, Kuala Nerus 21030, Malaysia.

DOI:

https://doi.org/10.22159/ajpcr.2025v18i9.55768

Keywords:

Anemia,, Body Mass Index,, Hemoglobin,, Iron Deficiency, Nutrition.

Abstract

Objectives: Nutrition plays a crucial role throughout all stages of life, but young adulthood is particularly significant for establishing healthy eating habits that can persist into the future. Globally, iron-deficiency anemia stands as the most prevalent cause of anemia, highlighting the importance of adequate iron intake during this formative period. This study aimed to (i) assess hemoglobin levels in male and female young adults and (ii) examine their association with dietary patterns.

Methods: A cross-sectional study was conducted among adults (n=200). Data collection involved a structured questionnaire assessing dietary patterns, anthropometric measurements, and laboratory evaluation of hemoglobin levels.

Results: A significant difference in the prevalence of overweight, obesity, and anemia was observed between the sexes. Among men, 88.9% were classified as overweight or obese (Class I), with 11.1% having mild anemia. In contrast, 66.7% of women were overweight, and 11.1% had severe anemia. Moreover, only 35% of women had normal hemoglobin levels, compared to 86% of men. The dietary analysis revealed an association between the intake of protein-rich foods – such as legumes, eggs, fish, and other animal sources – and the maintenance of healthy hemoglobin levels. The gender, food adequacy, and food diversity showed positive association through Kendall’s tau-b and Gamma test (0.522, 0.605, 0.437 and 0.849, 0.892, and 0.707, respectively) with p<0.001. Conversely, a significant negative association (−0.423, −0.365, −0.637, and −0.511, respectively) was observed between hemoglobin levels and factors such as body mass index and a family history of iron deficiency anemia across both genders.

Conclusion: These findings underscore the critical need for robust electronic data collection systems within nutrition programs that are sensitive to gender-specific needs, thereby enabling the development of targeted and effective public health strategies to combat anemia and malnutrition in Pakistan.

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References

1. World Health Organization. Nutrition for Health and Development: A Global Agenda for Combating Malnutrition: Progress Report; 2000. p. 86.

2. World Health Organization. Nutrition; 2022. Available from: https:// www.who.int/healthtopics/nutrition [Last accessed on 2025 Apr 18].

3. Farhadi S, Ovchinnikov RS. The relationship between nutrition and infectious diseases: A review. Biomed Biotechnol Res J. 2018 Jul;2(3):168-72. doi: 10.4103/bbrj.bbrj_69_18

4. Sauberlich HE. Implications of nutritional status on human biochemistry, physiology, and health. Clin Biochem. 1984 Apr;17(2):132-42. doi: 10.1016/s0009-9120(84)90344-8

5. Herforth AW, Bai Y, Venkat A, Masters WA. The Healthy Diet Basket is a valid global standard that highlights lack of access to healthy and sustainable diets. Nat Food. 2025 May;27(6):622-31. doi: 10.1038/ s43016-025-01177-0

6. Khairnar N, Pingale P, Amrutkar S. Role of micronutrients in heart diseases. Int J Curr Pharm Res. 2021 Sep;13(5):1-5. doi: 10.22159/ ijcpr.2021v13i5.1880

7. Harikrishnan S, Sumedha, Anand V. A retrospective study of the prevelance of depression due to low hemoglobin count. Int J Curr Pharm Res. 2022 Mar;14(2):54-6. doi: 10.22159/ijcpr.2022v14i2.1954

8. Rohmatin E, Krisjayanti N, Yuliastuti S, Mintarsih W, Sahlan M. Propolis as an alternative to increase hemoglobin levels in anemic adolescent girls. Int J Appl Pharm. 2022 Sep;14(3):129-31. doi: 10.22159/ijap.2022.v14s3.27

9. Singh P, Prasad S. A review on iron, zinc and calcium biological significance and factors affecting their absorption and bioavailability. J Food Compos Anal. 2023 Oct;123:105529. doi: 10.1016/j. jfca.2023.105529

10. Tremblay A, Gilbert JA. Human obesity: Is insufficient calcium/dairy intake part of the problem? J Am Coll Nutr. 2011;30(Supl 5):449S-53. doi: 10.1080/07315724.2011.10719989

11. Mantadakis E, Chatzimichael E, Zikidou P. Iron deficiency anemia in children residing in high and low-income countries: Risk factors, prevention, diagnosis and therapy. Mediterr J Hematol. Infect Dis. 2020 Jul;12(1):e2020041. doi: 10.4084/MJHID.2020.041

12. Sun J, Wu H, Zhao M, Magnussen CG, Xi B. Prevalence and changes of anemia among young children and women in 47 low-and middle-income countries, 2000-2018. EClinicalMedicine. 2021 Nov;41:101136. doi: 10.1016/j.eclinm.2021.101136

13. Alosaimi AA, Alamri SA, Mohammed M. Dietary knowledge, attitude, and practice regarding prevention of iron deficiency anemia among pregnant women in Riyadh, Saudi Arabia. Int J Adv Nurs Stud. 2020;9(1):29-36. doi: 10.14419/ijans.v9i1.30456

14. Abassi MM, Sassi S, El Ati J, Ben Gharbia H, Delpeuch F, Traissac P. Gender inequalities in diet quality and their socioeconomic patterning in a nutrition transition context in the Middle East and North Africa: A cross-sectional study in Tunisia. Nutr J. 2019 Dec;18:18. doi: 10.1186/s12937-019-0442-6

15. Safiri S, Amiri F, Karamzad N, Sullman MJ, Kolahi AA, Abdollahi M. Burden and trends of dietary iron deficiency in the Middle East and North Africa region, 1990–2021. Front Nutr. 2025 Jan;11:1517478. doi: 10.3389/fnut.2024.1517478

16. Vesselaldo MA, Ramatillah DL. Evaluation of BMI relationship with increased D-Dimer in COVID-19 patients at a Jakarta private hospital. Int J App Pharm. 2022;14(2):49-53. doi: 10.22159/ijap.2022. v14s2.44749

17. Ur Rehman L. Food habits and nutritional crisis in Pakistan: Impact on performance and future health. Khyber J Public Policy. 2023;2(2):23.

18. Rao GH. Obesity is a unique metabolic disease: An update. EC Clin Med Case Rep. 2023;6:1-11.

19. Srivastava T, Negandhi H, Neogi SB, Sharma J, Saxena R. Methods for hemoglobin estimation: A review of’ what works. J Hematol Transfus. 2014 Nov;2(3):1028.

20. Chaudhry GE, Akim AM, Sifzizul TM. Iron deficiency amongst university graduates; Prevalence, diagnosis, and iron consumption. Arch Pharm Pract. 2023 Apr;14(2):44-50. doi: 10.51847/nBiyQpBRag

21. Shahzad S, Islam K, Azhar S, Fiza S, Ahmed W, Murtaza Z. Impact of knowledge, attitude and practice on iron deficiency anaemia status among females of reproductive age group (20-21-year-old) studying in Government Home Economics College Lahore, Pakistan. IABCR. 2017;3(4):31-6. doi: 10.21276/iabcr.2017.3.4.09

22. Alharbi I, Qashqari HA, Alabdali SF, Binsiddiq ZH, Felimban SA, Bahakeem RF, et al. Awareness of iron deficiency anemia among the adult population in Makkah, Saudi Arabia. IJMDC. 2025 Jan;8(12):3542. doi: 10.24911/IJMDC.51-1733666778

23. Afzal F, Adnan S, Asif J, Zia L, Iftikhar M, Akmal M, et al. Assessment of knowledge and awarness of anemia in district Sialkot, Punjab, Pakistan. Kashf J Multidiscipl Res. 2025 Jan;2(1):138-48. doi: 10.71146/kjmr240

24. Relacion PR, Ordoñez MM, Robles GK, Nañasca DT, Magbuhat SN, Nocedo IC, et al. Awareness and knowledge on iron deficiency anemia and associated factors among college students attending universities in Metro Manila, Philippines. Int J Progress Res Sci Eng. 2021 Aug;2(8):607-19.

25. Aslam M, Azam MB, Latif F, Jaffar M, Haseeb I. An exploratory research to assess total nutritional knowledge of students at the university of lahore, Pakistan. Health Scope. 2023 Jan;12(1):5810-2. doi: 10.5812/jhealthscope-130511

26. Asif M, Aslam M, Altaf S, Atif S, Majid A. Prevalence and sociodemographic factors of overweight and obesity among Pakistani adults. J Obes Metab Syndr. 2020 Mar;29(1):58. doi: 10.7570/ jomes19039

27. Kim KB, Shin YA. Males with obesity and overweight. J Obes Metab Syndr. 2020 Mar;29(1):18-25. doi: 10.7570/jomes20008

28. Krishna A, Manoj TI, Razeena KI. Gender differences in Body Mass Index (BMI) of students of undergraduate education institutions in Kerala [abstract]. ResearchGate; 2020. Available from: https://www. researchgate.net/publication/341071421_Gender_differences_in_ body_mass_index_bmi_of_students_of_under_graduate_education_ institutions_in_kerala [Last ascessed on 2025 Jun 25].

29. Mazumder T, Rutherford S, Rahman SM, Talukder MR. Nutritional status of a young adult population in saline-prone coastal Bangladesh. Front Public Health. 2023 Jun;11:1095223. doi: 10.3389/ fpubh.2023.1095223

30. Mumtaz SU, Iqtadar S, Akther MK, Niaz Z, Komal T, AbaidUllah S. Frequency and psychosocial determinants of gender discrimination regarding food distribution among families: Gender discrimination regarding food distribution among families. Pak Biomed J. 2019 Jun;2(1):29-33. doi: 10.52229/pbmj.v2i1.30

31. Sadia A. Understanding Eating and Drinking Behaviours in Pakistani University Students (Doctoral Dissertation, Queensland University of Technology); 2022. doi: 10.5204/thesis.eprints.237052

32. Institute for Health Metrics and Evaluation. The Lancet: New Study Reveals Global Anemia Cases Remain Persistently High among Women and Children. Anemia Rates Decline for Men [News Release on the Internet]. Seattle (WA): IHME; 2023 Jul 31. Available from: https://www.healthdata.org/news-events/newsroom/news-releases/ lancet-new-study-reveals-global-anemia-cases-remain-persistently [Last ascessed on 2025 Jun 25].

33. Khan ZA, Khan T, Bhardwaj A, Aziz SJ, Sharma S. Underweight as a risk factor for nutritional anaemia–A cross-sectional study among undergraduate students of a medical college of haryana. Indian J. Community Med. 2018 Mar;30(1):63-9. doi: 10.47203/IJCH.2018. v30i01.011

34. Gajbhiye V, Lamture Y, Ghidiyal S. Nutritional anaemia among medical students and its correlation with body mass index. J Clin Diagn Res. 2020 Jan;14(1):PC01-2. doi: 10.7860/JCDR/2020/42858.13401

35. Belali TM. Iron deficiency anaemia: Prevalence and associated factors among residents of northern Asir Region, Saudi Arabia. Sci Rep. 2022 Nov;12(1):19170. doi: 10.1038/s41598-022-23969-1

36. Vistro JM, Mughal HS, Siddiqui M. Dietary patterns, food intake frequency, and micronutrient deficiencies in malnourished children: A cross-sectional study in Umerkot, Pakistan: Dietary patterns and malnutrition in Umerkot children. J Women Child Health. 2024 Dec 31;1(4):32-8. doi: 10.62807/jowach.v1i4.2024.32-38

37. Weerasekara PC, Withanachchi CR, Ginigaddara GA, Ploeger A. Understanding dietary diversity, dietary practices and changes in food patterns in marginalised societies in Sri Lanka. Foods. 2020 Nov;9(11):1659. doi: 10.3390/foods9111659

38. Bhatnagar RS, Padilla-Zakour OI. Plant-based dietary practices and socioeconomic factors that influence anemia in India. Nutrients. 2021 Oct;13(10):3538. doi: 10.3390/nu13103538

39. Zimmermann MB, Hurrell RF. Nutritional iron deficiency. Lancet. 2007 Aug; 370(9586):511-20. doi: 10.1016/S0140-6736(07)61235-5

40. Kwofie M. Bridging the Gap of Iron Deficient Foods in Low Resource Setting Communities. Canada: McGill University; 2022.

41. Ilmiyati L, Indarto D, Wasita B. Daily Consumption of fruits and vegetables has different correlations With haemoglobin levels in young women at Karanganyar Regency. In: International Conference on Health and Medical Sciences (AHMS 2020). Atlantis Press; 2021 Jan. p. 117-20. doi: 10.2991/ahsr.k.210127.026

42. Kito A, Imai E. The association with dietary patterns and risk of anemia in Japanese elderly. J Nutr Sci Vitaminol. 2020 Feb;66(1):32-40. doi: 10.3177/jnsv.66.32

43. Firdose K, Firdose N. Dietary Iron. Biochemistry. London: IntechOpen; 2022. doi: 10.5772/intechopen.101265

44. Sharma KK. Improving bioavailability of iron in Indian diets through food-based approaches for the control of iron deficiency anaemia. Food Nutr Agric. 2003(32):51-61.

45. Saini DR, Prakash P, Dadarwal BK, Kumar K. Iron (Fe): Nurturing vitality in humans. Argic Mag. 2023;3(3):708-10.

46. Ashraf F, Nafees Uddin MM, Mustafa MS, Mughal ZU, Atif Aleem S. Prevalence and factors influencing anemia in women of reproductive age visiting a tertiary care hospital (Jinnah Postgraduate Medical Center) in Karachi: A cross-sectional study. Womens Health (Lond). 2024 Jan;20:17455057241227364. doi: 10.1177/17455057241227364

47. Naz S, Aslam M, Sayed A. Prevalence of anemia and its determinants among the rural women of Khyber Pakhtunkhwa-Pakistan. Ann Hum Soc Sci. 2023 Oct;4(4):42-50. doi: 10.35484/ahss.2023(4-IV)04

48. Habib MA, Raynes-Greenow C, Soofi SB, Ali N, Nausheen S, Ahmed I, et al. Prevalence and determinants of iron deficiency anemia among non-pregnant women of reproductive age in Pakistan. Asia Pac J Clin Nutr. 2018 Jan;27(1):195-203.

Published

07-09-2025

How to Cite

ABUBAKAR, et al. “DIETARY DETERMINANTS OF HEMOGLOBIN LEVELS AMONG YOUNG ADULTS: EVIDENCE FROM A CROSS-SECTIONAL STUDY”. Asian Journal of Pharmaceutical and Clinical Research, vol. 18, no. 9, Sept. 2025, pp. 44-50, doi:10.22159/ajpcr.2025v18i9.55768.

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