English abstract
Iron deficiency anemia (IDA) is the most common nutritional problem worldwide.
Serum ferritin (<15µg/L), used as an indicator of Iron Deficiency (ID), is associated with
fatigue, impaired cognitive function, decreased productivity, and reproductive health.
According to the Oman National Nutrition Survey (ONNS) 2017, ID affects 24.80 % of
non-pregnant Omani women at childbearing age (15-49 years). Reducing ID during
childbearing age is important because it is associated with negative impacts on the women,
the healthcare system, national economy, and pregnancy outcome. Therefore, the aim of
this study was to investigate the risk factors associated with serum ferritin levels among
non-pregnant Omani women of the ONNS 2017.
A total of 1384 women were included in the study. Ferritin was used as a
continuous dependent variable. The study variables were grouped into three groups of
risk factors. The first group, nutritional variables, included Minimum Dietary Diversity
for Women (MDD-W) to assess dietary patterns, and Body Mass Index (BMI) to assess
chronic nutritional status. The second group, demographic variables, included age, years
of education, marital status, and parity. The third group, socioeconomic variables,
included household family size, employment status and household monthly income. All
variables were extracted from the women and household questionnaires of the ONNS
2017. Multiple linear regression analyses were conducted to assess the association of each
risk factor group with serum ferritin level. Additionally, truncated regression analyses
were conducted to investigate the association between the nutritional factors and ferritin
by intake of iron containing supplements, intake of iron inhibitors, governorate and
household monthly income.
The results showed that 78. 20% of women met the recommended minimum diet
diversity per day (≥ 5). More than 50% of the participants had a BMI ≥25 kg/m2
.
Regression analyses showed that BMI, age, and being married were positively associated
with ferritin levels (P <0.05). while education level was negatively associated with the
ferritin (P = 0.03). However, the minimum diet diversity (≥ 5), parity, employment, and
household family size were not significantly associated with the ferritin level. In truncated
variables, the minimum diet diversity (≥ 5) was positively and significantly associated
with ferritin levels among women with supplement intake (P=0.02) and in those who
reside in households with monthly income of 500-999 OMR (P =0.00). Additionally,
BMI was positively associated with ferritin levels in participants with intake of iron
inhibitors (≥ 1 cup of tea and or coffee per day), in participants with household monthly
income of 200-4999 OMR and within women from six governorates: Dhofor, AlDakhiliyah, Al-Sharqiyah South, Al-Dhahirah, Musandam and Al-Wusta
In conclusion, the consumption of the recommended minimum diet diversity
showed no significant association with ferritin level, either because the majority of women
met the minimum diet diversity (≥ 5) or MDD-W is not an effective indicator of serum
ferritin status. On the other hand, the results of this study show that ferritin levels were
significantly associated with women's BMI, age, years of education and being married.
Therefore, it is recommended to use other dietary pattern indexes to evaluate dietary
patterns in relations to women's micronutrients status to monitor and understand their
interaction.
