Anemia in the Turks and Caicos Islands: exploring the dietary link.

OBJECTIVE To conduct the first national dietary survey and examine inter-island differences in and relationships between iron consumption and reports of anemia. DESIGN AND METHODS A total of 144 households, randomly selected from electoral lists for Grand Turk (n=48), Providenciales (n=46), and Middle Caicos (n=50), participated in the survey. Food consumption (via food frequency questionnaire), self-reported health history, and sociodemographic data were collected from female household-heads during home interviews. Data on frequency of consumption and tabulated iron score for each "normal" food portion size were used to calculate each household's iron-intake-score. Chi-squared analyses were used to compare inter-island intake score categories. RESULTS Households were assigned to low (<100), medium (100-160), or high (>160) iron-intake-score categories. The proportion of households with low scores was lower on Grand Turk (<5%) and Providenciales (0%) compared to Middle Caicos (20%), the least developed island. CONCLUSION Suboptimal iron intakes, especially on Middle Caicos, support the prevailing view that anemia in vulnerable groups could be of dietary origin. Findings highlight the need for additional research to determine how various factors (eg, diet, supplement use, physiology, and environment) impact iron status. In the short term, we must identify and treat cases and provide culturally appropriate nutrition education to increase dietary iron intake and promote safe use of multivitamin/mineral supplements. National dependence on imported foods makes this the most viable public health intervention option until the etiology of anemia is fully determined.