Dietary characteristics associated with hemoglobin and anemia among prospective first-time voluntary blood donors in Accra, Ghana

BACKGROUND: Optimal dietary intake supports adequate hemoglobin (Hb) levels for blood donation. However, little is known about the dietary characteristics of prospective first-time voluntary blood donors (VBDs) in Ghana and their associations with Hb and anemia. We aimed to identify dietary characteristics associated with Hb concentration and anemia status among prospective first-time VBDs in Accra. METHODS: ) screening test. Participants were over-sampled for low Hb. We collected background and dietary data, including number of meals consumed the previous day, foods usually consumed, and average frequency of consumption (AFC) of iron-rich foods and iron-absorption inhibitors (tea/coffee) using a questionnaire. Hb was measured using an automated Hematology Analyzer. We summarized dietary variables descriptively and analyzed associations using bivariate and multivariate statistics. RESULTS: Mean age was 20 years. Most were females (63%) and students (98%). By participant report, 47% consumed ≤ 2 meals the previous day; 17% usually skipped breakfast; and 27% usually skipped lunch. Most reported high (weekly/daily) AFC of meat (78.9%), poultry (91.0%), fish (87.0%), fruits and vegetables (59.2%), legumes (72.6%), and tea/coffee (66.8%). Mean ± SD Hb was 12.4 ± 1.5 g/dL; anemia prevalence was 51.6% reflecting the deliberate oversampling for low Hb. In unadjusted models, reported animal source food (ASF) consumption at breakfast was associated with lower mean Hb (-0.57 g/dL; P = 0.016), while high AFC of poultry (+ 0.72 g/dL; P = 0.046) and legumes (+ 0.50 g/dL; P = 0.029) were associated with higher mean Hb; these associations were attenuated in multivariate models after adjusting for sex, age, and household assets index (HAI). In unadjusted analyses, high reported AFC of poultry was associated with lower odds of anemia (OR: 0.17; 95% CI: 0.05, 0.58; P = 0.005), and high AFC of tea or coffee with higher odds (OR: 1.95; 95% CI: 1.10, 3.44; P = 0.022); both associations remained significant after adjustment for sex, age, HAI, and ethnicity (poultry aOR: 0.16; 95% CI: 0.04, 0.66; tea/coffee aOR: 1.95; 95% CI: 1.05, 3.64). CONCLUSION: High AFC of poultry was the most consistent dietary marker significantly associated with lower odds of anemia, whereas high AFC of tea or coffee was significantly associated with greater odds of anemia. Targeted nutrition interventions that address overall dietary diversity and iron bioavailability could help reduce anemia and improve donor eligibility in Ghana.