Dietary intakes and iron status of vegetarian and non-vegetarian children in selected communities in Accra and Cape Coast, Ghana

There is a scarcity of information on dietary intake and iron status of Ghanaian children raised on vegetarian diets. A cross-sectional study design was used to compare the diets and iron status of vegetarian children between the ages of 9 months and 11 years (n= 26) with matched controls, non-vegetarian children (n=26) of similar ages and same sex and living within the same communities in Accra and Cape Coast, Ghana. Dietary information was collected using 24-hr food recall and 12-hr home observation. Haemoglobin, plasma ferritin, C-reactive protein, and Transferrin Receptor (TfR) concentrations were determined on finger prick (haemoglobin) and venous blood samples collected during the study. Based on the 24-hr food recall, vegetarian children's diets were devoid of vitamin B12whereas non-vegetarian children's diets were not (0.0 ± 0.0 mg vs. 1.5 ± 1.8 mg, p<0.001). The dietary intake based on 12-hr home observation showed similar results. However, vegetarians had significantly higher intake of dietary fibre (17.1 ± 11.9 g vs. 8.4 ± 6.2 g, p= 0.002), thiamine (1.1 ± 0.8 mg vs. 0.5 ± 0.3 mg, p= 0.001) and vitamin A (1702 ± 1887 Retinol Equivalent (RE)vs. 671 ± 691 RE, p= 0.010) than non-vegetarian children. Dietary diversity based on nine food groups was similar between groups (5.8 ±1.0score). Plasma ferritin was higher for non-vegetarian children compared to the vegetarians (59.2± 48.2 ng/mL vs. 34.1± 25.8ng/ml, p= 0.012) but there was no group difference in plasma TfR. The prevalence of anaemia was about 25% in both groups. Typical diets of Ghanaian children lack variety and both vegetarian and non- vegetarian diets are insufficient to support adequate iron status. Iron-rich foods such as meat or supplements are needed. There is urgent need for immediate vitamin B12 supplementation for all vegetarian children and a general need for nutrition education to diversify all children's diets.