Elevated 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.
We used baseline data from the FAARM cluster randomized trial (https://clinicaltrials.gov/ct2/show/NCT02505711). Data were collected in early 2015 among 1,133 children 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 were dichotomized.
The children were 51% anemic (mean hemoglobin: 10.8 g/dL) and 46% stunted (mean Z-score: -1.9). Slightly less than half of children (47%) lived in households that reported iron in their drinking water. In a random-effect logistic regression model, perceived iron in groundwater was significantly 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.
These findings provide further evidence of the importance of groundwater iron to iron intake. Child-level results were much stronger than those for women of the same population where iron in drinking water was negatively associated with anemia only among those consuming an iron-poor diet. One explanation could be that young childrens diets were very poor (minimum adequate diet: 23%). These findings demonstrate the utility of asking perceived iron content as a simple, economical method to assess iron in drinking water and should be considered in regions with groundwater iron.