Consumption Patterns of Tea, Iron and Ascorbate-Rich Foods and Iron Status among Women of Childbearing Age in Nandi County, Kenya
Nyakundi, Patrick Nyamemba
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Twenty-one percent of women of childbearing age (WCA) in Kenya are iron deficient. Iron deficiency poses a variety of adverse effects on cognition, quality of life, behaviour, and emotion, and productivity. Tea consumption within 1-hr before/after meals reduces iron bioavailability. Tea is a commonly consumed beverage in Kenya. Tea has been reported to be taken with meals in Nandi County. However, information on consumption patterns of tea, iron- and ascorbate-rich foods and their influence on iron status among WCA is scarce. The current study investigated consumption patterns of tea, iron- and ascorbate-rich foods on iron status among WCA in Kapsabet Ward, Kenya. The study adopted a cross-sectional analytical design. The Ward was divided into 8 villages and systematic sampling was used to sample a total of 160 respondents proportionately from villages. A researcher-administered, semi-structured-consolidated questionnaire was utilized to gather data on socio-economic and demographic characteristics and tea consumption practices of respondents. Consumption patterns of iron- and ascorbate-rich foods were assessed using a modified 7-day Food Frequency Questionnaire. Venous blood (2ml) was drawn from participants, haemoglobin levels were determined using “Mission® Plus” and serum ferritin (SF) and C-reactive proteins (CRP) analysed using “Elegance Amplified Enzyme-Linked Immunosorbent Assay”. Data were entered into SPSS and demographic and socio-economic characteristics, and consumption of tea, iron- and ascorbate-rich foods data were analysed using descriptive statistics. Logistic regression was conducted to establish the association between tea, iron- and ascorbate-rich foods consumption, socio-economic and demographic characteristics, and iron status. Confounding variables including consumption of food with high phytate levels, milk and milk products, recent major blood losses, iron bioavailability levels, and parasitic infections were controlled for during analysis. Most of the respondents were young (15-24 years) (53.8%), single women (57.5%), with a mean age of 24.7 years, and belonged in households earning < Ksh. 10,000 (38.1%) and budgeted 34.0% of their income for food. Majority of the respondents (90.6%) consumed tea/coffee and mainly (54.5%) taken 2-3 times a day at quantities of 2-4 cups (250 ml) daily (42.1%). They mainly infused tea for >5 minutes, at a moderate tea strength (64.1%), and taken within 1-hr before/after meals. Respondents infrequently consumed meat (61.3%), sardines (61.9%), oranges (54.4%), and fortified breakfast cereals (94.4%) but frequently consumed kale (76.3%) and beans (50.6%). The prevalence of anaemia (Hb <12 g/dl), iron deficiency (SF <15 μg/l or SF 15 - 30 μg/l & CRP >5mg/l) and iron-deficiency anaemia (iron deficient and anaemic) were 86.2%, 36.9% and 32.5% respectively. Two dietary patterns were derived by principal component analysis (PCA). Respondents with high consumption of PCA component_1 foods (sardines, meat, terere, mangoes, oranges, and porridge) (AOR= 4.851, p = 0.021) were 5 times more likely to have normal iron status than those with low consumption. Respondents with a high household budget for food (AOR= 1.237, p = 0.012) were 23.7% more likely to have normal serum ferritin levels than those with a low budget for food. However, respondents were 4 times more likely to be iron depleted with high overall consumption of tea (AOR= 4.065, p = 0.001). Iron status of WCA was positively predicted by high consumption of iron- and ascorbate-rich foods and a higher relative budget for food but inversely predicted by high intake of tea. WCA and other risk groups should limit their tea consumption or take tea more than 1-hr before or after meals for better outcomes in iron status.