Publication:

A cohort study on change in hemoglobin levels in Indian female tea and coffee drinkers currently on oral iron therapy for iron deficiency anemia

Background Anemia affects 57% of all nonpregnant Indian women between 15-49 years, as per NFHS-5 (2021). Socioeconomic and gender-based dietary inequality contribute to the prevalence of iron-deficiency anemia (IDA). The inhibitory effects of tea and coffee on iron absorption are well documented. Both beverages are commonly consumed in India, as accompaniments or meal substitutes. NFHS-5 doesn’t provide data on the prevalence of IDA in particular.

Methods Hemoglobin levels were collected from patient records for six months, from the beginning of treatment till the end of the study duration. Beverage consumption habits and compliance with oral iron therapy (OIT) were studied. The primary objective was to establish a correlation between excessive beverage consumption and unsatisfactory hemoglobin outcomes at the end of OIT.

Results Of 380 anemic women interviewed, 160 (136 tea; 24 coffee) presented with IDA. Tea consumption was significantly associated with poor improvement in hemoglobin levels (p=0.003). Mean therapy duration was 4.31±1.64 months with hemoglobin improvement of 0.58 g/dL (95% CI: 0.49-0.67, p<0.0001). Compliance with OIT was 79.41%. 38.23% reported adverse effects like constipation, black stool, and nausea with headache (n=2); however, this did not reflect negatively on therapy compliance. Coffee consumption is not prevalent among lower socioeconomic groups in urban Mumbai; hence, no conclusions can be drawn. However, a downward trend between increased coffee intake and improvement in hemoglobin levels was found.

Conclusions Excessive tea consumption might be associated with decreased efficacy of OIT. 35.7% of anemic women interviewed presented with IDA, indicating a dominance of non-nutritional etiologies.