Peer-reviewed article

Association of dietary diversity with anaemia among children (6 mo-9 y) in Puducherry, South India: A cross-sectional study.

Ramasamy N, Raj R, Dungi VVPR, Ramakrishnan J, Kar R et al. · 1 Aug 2026

Abstract

Background and objectives Limited regional data exist on the relationship between dietary diversity and haemoglobin level in children. We investigated the association between dietary diversity and food variety with anaemia in children between 6 mo to 9 y of age at Puducherry, South India. Methods Utilising a cross-sectional analytical design, 217 mother-child dyads were enrolled using multistage sampling. Data on 24-h dietary recall, anthropometric measurements, and haemoglobin assessment using Hemocue 201 device were recorded. From the 24-h dietary recall, the dietary diversity score was calculated as the number of food groups consumed from nine predefined food groups, while the food variety score represented the total number of individual food items consumed. Associations of dietary diversity with anaemia was reported as a prevalence ratio with 95% confidence interval (CI). Results In our study, 68.7% (n=90) of children aged 6 to 59 mo and 36.1% (n=31) of children aged 5 to 9 y were anaemic. A significant association was observed between lower dietary diversity scores and food variety scores with a higher prevalence of anaemia. Children with a dietary diversity score of less than 4 were 1.32 (95% CI: 1.05 - 1.67) times more likely to be anaemic than those with higher scores. The median food variety score was lower among anaemic children compared to non-anaemic children (median: 6 vs. 7; P= 0.002). We also identified younger age, female sex, rural residence, and lower socioeconomic status as significant predictors of anaemia. Interpretation and conclusions The findings highlight the importance of dietary diversity in the causation of anaemic in children.