Occurrence of Nutritional Deficiencies (Ferritin, Vitamin B12, and D) and Abnormal BMI Among Women of Reproductive Age: Implications for Sustainable Food‐Based Interventions

Diverse dietary transitions across populations have contributed to the simultaneous rise of under- and over-nutrition, especially among women of reproductive age, where such imbalances have direct implications for obstetric, neonatal, and long-term metabolic outcomes. Therefore, this study examines the prevalence and co-occurrence of abnormal body mass index (BMI) and selected micronutrient deficiencies (iron, vitamin B12, and vitamin D) in non-pregnant women of reproductive age (18-40 years). Using a cross-sectional design, non-pregnant women aged 18-40 years were evaluated for anthropometric status, hematological indices, and serum levels of ferritin, vitamin B12, and 25-hydroxyvitamin D. Insulin resistance (IR) was assessed using the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR). Descriptive statistics were used to estimate prevalence, while chi-square tests and multivariate logistic regression models identified associations between age, BMI categories, micronutrient status, and IR. Adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were reported using SPSS version 26. Among the study population, 44.07% exhibited abnormal BMI with concurrent anemia, including overweight with anemia (27.59%), obesity with anemia (10.37%), and underweight with anemia (6.11%). Ferritin deficiency was present in 49.85% of participants, though only 57.22% of these had anemia, indicating subclinical iron depletion. Vitamin B12 and vitamin D deficiencies were found in 34.25% and 67% of women, respectively. IR was observed in 42.82% of subjects. Women aged 33-40 years had a significantly higher likelihood of presenting with abnormal BMI and at least one micronutrient deficiency (OR = 1.54; 95% CI: 1.09-2.12). The clustering of abnormal BMI, micronutrient deficiencies, and IR, especially women of reproductive age, not only calls for age-specific metabolic screening but also dietary diversification, nutrient-rich food promotion, and context-specific fortification to address both visible and hidden forms of malnutrition in reproductive-aged women.