Dietary Diversity, Iron Status, and Anaemia Among Adivasi Women: Insights from the Chiguru Cohort in Chamarajanagar District, Southern Karnataka.

Abstract

Anaemia remains a significant public health concern, particularly among marginalized populations such as tribal communities. This study examines the complex relationships between dietary diversity, iron status biomarkers, and anaemia prevalence among Adivasi women in southern Karnataka, India. A cross-sectional analysis using data from the Chiguru Adivasi cohort in Chamarajanagar District, Karnataka, India. The study included 479 women. PNC women aged 18 and above, and other women in the family aged 18-65 years, primarily from the Soliga tribe. The authors assessed Household Dietary Diversity Score (HDDS)-a measure of food variety-and measured hemoglobin (Hb), soluble transferrin receptor (sTfR) levels, and ferritin, along with sociodemographic data. The HDDS did not directly predict Hb levels but was negatively associated with sTfR (β = -2.975, p = 0.045). After adjusting for confounders, sTfR was a significant predictor of anaemia (OR = 1.68, 95% CI: 1.40-2.01, p < 0.01). Geographic variations in dietary diversity among the Soliga community, assessed through stratified analysis of Household Dietary Diversity Scores (HDDS) across taluks and proximity to forested areas, were found to be influenced by forest access, seasonal availability of wild foods, and local agricultural practices. This study highlights the role of dietary diversity and iron biomarkers in understanding anaemia among Adivasi women. While household dietary diversity was not directly associated with hemoglobin, it showed a significant inverse relationship with soluble transferrin receptor (sTfR) levels, indicating improved tissue-level iron status with more diverse diets. Elevated sTfR levels were strong predictors of anaemia, reinforcing their utility as sensitive biomarkers for early iron deficiency. These findings emphasize the need for culturally relevant, cost-effective interventions that promote locally available iron-rich foods and strengthen community-led nutrition programs to enhance both dietary quality and iron status. Integrating these biomarker-informed insights into public health strategies can contribute to more targeted and sustainable anaemia reduction in tribal populations.