Understanding What is the Cause of Iron Deficiency in Bangladesh

December 24, 2025 •

4 min read

Affecting about half of all children and over 70% of women, inadequate dietary intake is a significant factor contributing to iron deficiency in Bangladesh. The issue is a complex public health challenge influenced by multiple interlinked factors beyond just diet, including infections and high physiological needs.

Quick Summary

Iron deficiency in Bangladesh is a multifaceted public health issue driven primarily by poor dietary intake, widespread parasitic infections, and increased nutritional demands in vulnerable groups like pregnant women and children. Other contributors include socioeconomic disparities and limited nutritional awareness.

Key Points

Dietary Deficiencies: Inadequate iron intake from diets dominated by polished rice, coupled with consumption of inhibitors like phytates and tea, is a primary cause.
Parasitic Infections: Widespread infections like hookworm and Ascaris lumbricoides lead to chronic blood and nutrient loss, significantly contributing to iron deficiency, especially in children.
Increased Physiological Needs: Pregnant women and growing children have higher iron requirements that are often unmet, making them highly vulnerable to deficiency.
Socioeconomic Factors: Poverty and low household wealth limit access to diverse, nutritious, and iron-rich foods, leading to higher rates of deficiency among the poorest populations.
Lack of Awareness: Limited nutritional knowledge about healthy eating habits and the importance of iron further perpetuates deficiency across various demographics.
Menstrual Blood Loss: Heavy menstrual bleeding is a significant contributor to iron deficiency in women of reproductive age in Bangladesh.
Micronutrient Deficiencies: The problem is compounded by other micronutrient deficiencies, like Vitamin A and Zinc, which can affect iron absorption and overall anemia.

Dietary Factors and Poor Iron Absorption

One of the most significant reasons for iron deficiency in Bangladesh is chronic inadequate dietary intake. The staple diet, often based on polished rice, can lack sufficient bioavailable iron. Furthermore, the diet often includes inhibitors of iron absorption while lacking enhancers.

Low Intake of Iron-Rich Foods

Low Meat Consumption: Many people in Bangladesh, particularly those with low income, consume less red meat, which is a key source of highly absorbable heme iron.
Reliance on Plant-Based Diets: Plant-based sources contain non-heme iron, which is less efficiently absorbed by the body. While legumes and leafy greens are available, poor dietary diversity means their iron content may not be sufficient or well-absorbed.

Iron Absorption Inhibitors

Certain dietary habits common in Bangladesh can significantly hamper iron absorption. Compounds found in everyday foods can bind to iron, making it unavailable for the body.

Phytates: Found in whole grains, lentils, and legumes, phytates can block iron absorption. When these foods form the bulk of the diet, as is common in many households, the effect is pronounced.
Tea and Coffee: The tannins in tea and coffee interfere with iron absorption. The habit of drinking tea with or immediately after meals is a practice that can reduce the iron absorbed from food.

High Prevalence of Parasitic Infections

Parasitic infestations are a major cause of iron deficiency in Bangladesh, especially among children. Worms can cause significant blood loss or interfere with nutrient absorption.

Hookworm: These parasites attach to the intestinal wall and cause chronic blood loss, directly leading to iron deficiency anemia over time. This is a prevalent issue in areas with poor sanitation where contact with contaminated soil is common.
Ascaris lumbricoides: Studies in Dhaka slums have shown a strong association between Ascaris infection and iron deficiency anemia in young children.
Deworming Programs: Health programs from organizations like BRAC include deworming initiatives to combat this parasitic burden, recognizing its impact on iron levels.

Increased Physiological Demands

Certain groups in Bangladesh have higher iron needs that are often not met by their diet, making them particularly susceptible to deficiency.

Pregnancy and Lactation

Increased Blood Volume: During pregnancy, a woman's blood volume expands by up to 50%, necessitating a much higher iron intake to produce enough hemoglobin for both mother and fetus.
Pre-pregnancy Status: Many women in Bangladesh enter pregnancy already anemic due to heavy menstrual blood loss or previous pregnancies, making them even more vulnerable.
High Prevalence: Studies confirm a high prevalence of both anemia and iron deficiency among pregnant women in the country.

Childhood and Adolescence

Rapid Growth: The rapid growth and development phases of infancy, childhood, and adolescence require increased iron to support the expanding red blood cell mass and general growth.
Gender Disparities: Adolescent girls are at particular risk due to a combination of high growth demands and the onset of menstruation. Studies show a high prevalence of anemia among adolescent girls, linked to poor nutrition and low socioeconomic status.

Socioeconomic and Awareness Factors

Lower socioeconomic status, poverty, and limited health knowledge directly influence iron deficiency rates.

Food Insecurity and Poverty: Households with lower wealth quintiles are more prone to anemia and have less access to diverse, iron-rich foods, especially animal products.
Lack of Awareness: Many studies have found that a significant portion of the population, including educated university students and pregnant women, have a low or moderate understanding of iron deficiency anemia, its causes, and prevention.

Comparison of Major Factors Contributing to Iron Deficiency


Factor	Population Most Affected	Primary Mechanism	Intervention Examples
Dietary Intake	General population, especially low-income households	Insufficient iron consumption, low bioavailability	Dietary diversification, fortification programs
Parasitic Infections	Children, communities with poor sanitation	Chronic blood loss, malabsorption	Deworming initiatives, improved WASH practices
Physiological Needs	Pregnant women, lactating women, adolescents	Increased demand for iron during growth or gestation	Iron-folic acid supplementation, nutritional counseling
Socioeconomic Status	Poorest wealth quintiles, rural populations	Limited access to nutritious foods, poverty	Poverty reduction, targeted nutritional aid
Poor Awareness	All groups, including educated individuals	Limited knowledge of healthy dietary habits and prevention	Community health education campaigns

Other Contributing Factors and the Complex Picture

Some research suggests that while iron deficiency is a key driver of anemia, it may not be the sole cause for all anemic cases in Bangladesh. Other micronutrient deficiencies, such as those of Vitamin A, Vitamin B12, and Zinc, can also contribute to the overall burden of anemia. Furthermore, the bioavailability of iron can be affected by other compounds in the diet, and infections can increase systemic inflammation, impacting iron status. The complex interplay of these factors means that a simple iron supplementation program may not be sufficient for comprehensive prevention and treatment.

For more research on the matter, you can refer to the Cornell eCommons publication on Iron Deficiency in Bangladesh.

Conclusion

The causes of iron deficiency in Bangladesh are multi-layered, extending beyond a simple lack of iron in the diet. While low consumption of iron-rich foods and poor absorption are primary drivers, widespread parasitic infections, the increased physiological demands of pregnancy and growth, and socioeconomic disparities exacerbate the problem. Lack of nutritional awareness across various population groups also remains a significant challenge. Effective strategies to combat this public health issue must be comprehensive, addressing dietary habits, improving sanitation to reduce infections, and ensuring vulnerable populations receive adequate supplementation and education. The interconnected nature of these issues requires a holistic approach to achieve sustainable improvements in iron status and overall health in Bangladesh.

Frequently Asked Questions

The main dietary causes are low intake of iron-rich foods like meat and fish, and poor iron absorption due to inhibitors such as phytates in grains and tannins in tea and coffee, which are common in the local diet.

Pregnant women are susceptible because of the high physiological demand for iron needed to support increased blood volume and fetal development. Many enter pregnancy with pre-existing low iron stores due to factors like heavy menstruation or previous pregnancies.

Parasitic infections, notably hookworms and Ascaris lumbricoides, cause chronic internal blood loss and malabsorption of nutrients in the intestines. This leads to a gradual depletion of the body's iron stores and subsequent deficiency.

Not necessarily. While some areas have high groundwater iron, studies have shown it does not always significantly impact iron deficiency or anemia prevalence. Its bioavailability is a subject of ongoing research, and its protective role is not clear across all regions.

Limited nutritional knowledge is a major barrier to preventing iron deficiency. Studies indicate that many individuals, including educated populations, have only a moderate level of awareness regarding healthy diets, which affects their dietary choices and preventive practices.

Yes, other micronutrient deficiencies, particularly Vitamin A and Zinc, have been shown to exacerbate anemia. The combination of these deficiencies with low iron intake creates a complex nutritional challenge.

Public health initiatives include iron and folic acid supplementation for pregnant women, nutritional education campaigns, and deworming programs in vulnerable communities. However, consistent coverage and adherence remain challenges.