{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T03:59:31Z","timestamp":1790222371739,"version":"4.1.0"},"reference-count":56,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Br J Nutr"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Anaemia during pregnancy is a public health concern, yet the relationship between household food insecurity, dietary intake and anaemia among pregnant women remains underexplored. This cross-sectional study investigated these associations in 612 second-trimester pregnant women attending antenatal care in Lilongwe, Malawi. Household food insecurity was assessed using the Household Food Insecurity Access Scale (HFIAS), dietary intake via the Semi-quantitative Food Frequency Questionnaire (SQ-FFQ) and anaemia defined as Hb &lt;10\u00b75 g\/dL. Results showed that 21\u00b724 % were anaemic, and 69\u00b793 % resided in food-insecure households. Severe food insecurity (adjusted OR (a-OR): 2\u00b758, 95 % CI 1\u00b741\u20134\u00b771), insufficient intake of energy (a-OR: 1\u00b773, 95 % CI 1\u00b713, 2\u00b766), Fe (a-OR: 1\u00b798, 95 % CI 1\u00b721, 3\u00b724) and vitamin C (a-OR: 1\u00b771, 95 % CI 1\u00b712, 2\u00b759) were significantly associated with a higher likelihood of anaemia, whereas those with a Minimum Dietary Diversity for Women (MDD-W) had a substantially reduced risk compared with those with low dietary diversity (LDD) (a-OR: 0\u00b719, 95 % CI 0\u00b706, 0\u00b761). Dietary diversity partially mediated the association between household food insecurity and anaemia among pregnant women. Findings underscore the need to promote food security, dietary diversity and nutrient intake through targeted health education and staff training. These strategies could reduce anaemia prevalence and improve maternal health outcomes.<\/jats:p>","DOI":"10.1017\/s0007114526108320","type":"journal-article","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T03:12:22Z","timestamp":1790219542000},"page":"1-11","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Household food insecurity, dietary intake and anaemia among pregnant women in Lilongwe, Malawi: a mixed-methods cross-sectional study with mediation analysis"],"prefix":"10.1017","author":[{"given":"William","family":"Munthali","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00f1zfq44","id-type":"ROR","asserted-by":"publisher"}],"name":"Central South University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8454-8618","authenticated-orcid":false,"given":"Ying","family":"Zhang","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00f1zfq44","id-type":"ROR","asserted-by":"publisher"}],"name":"Central South University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Lin","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00f1zfq44","id-type":"ROR","asserted-by":"publisher"}],"name":"Central South University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lina","family":"Yang","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00f1zfq44","id-type":"ROR","asserted-by":"publisher"}],"name":"Central South University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,9,24]]},"reference":[{"key":"S0007114526108320_ref5","doi-asserted-by":"publisher","DOI":"10.21037\/apm-22-165"},{"key":"S0007114526108320_ref3","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000003557"},{"key":"S0007114526108320_ref6","doi-asserted-by":"publisher","DOI":"10.64628\/AAI.q9yx77x3m"},{"key":"S0007114526108320_ref9","unstructured":"9. Malawi Ministry of Health and Population (MoH) (2023) Government of the Republic of Malawi Health Sector Strategic Plan III-2023\u20132030: reforming for Universal Health Coverage-First Edition. https:\/\/www.health.gov.mw\/download\/hssp-iii\/?wpdmdl=4458&refresh=65374fbcbc9cf1698123708 (accessed October 2023)."},{"key":"S0007114526108320_ref16","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph20043178"},{"key":"S0007114526108320_ref19","doi-asserted-by":"publisher","DOI":"10.1093\/acprof:oso\/9780199754038.003.0006"},{"key":"S0007114526108320_ref20","doi-asserted-by":"publisher","DOI":"10.3390\/nu15133012"},{"key":"S0007114526108320_ref32","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0249360"},{"key":"S0007114526108320_ref35","doi-asserted-by":"publisher","DOI":"10.12688\/gatesopenres.13631.4"},{"key":"S0007114526108320_ref36","unstructured":"36. National Statistics Office (NSO). (2024) Malawi Demographic Health Survey 2024. https:\/\/www.nsomalawi.mw\/publications\/demography\/malawi-demographic-health-survey-2024 (accessed March 2025)."},{"key":"S0007114526108320_ref18","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0243721"},{"key":"S0007114526108320_ref47","doi-asserted-by":"publisher","DOI":"10.3390\/nu15173714"},{"key":"S0007114526108320_ref10","doi-asserted-by":"publisher","DOI":"10.1111\/nyas.14092"},{"key":"S0007114526108320_ref51","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnesp.2022.03.016"},{"key":"S0007114526108320_ref2","unstructured":"2. WHO (2023) Anaemia. https:\/\/www.who.int\/health-topics\/anaemia#tab=tab_1 (accessed October 2023)."},{"key":"S0007114526108320_ref56","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.2004.018366"},{"key":"S0007114526108320_ref24","doi-asserted-by":"publisher","DOI":"10.1017\/S0007114521004724"},{"key":"S0007114526108320_ref17","doi-asserted-by":"publisher","DOI":"10.3390\/nu15061383"},{"key":"S0007114526108320_ref54","doi-asserted-by":"publisher","DOI":"10.2147\/OPTH.S287257"},{"key":"S0007114526108320_ref8","unstructured":"8. WHO (2021) Prevalence of anaemia in pregnant women (aged 15\u201349) [updated April 2021]. https:\/\/www.who.int\/data\/gho\/data\/indicators\/indicator-details\/GHO\/prevalence-of-anaemia-in-pregnant-women-%28-%29 (accessed September 2023)."},{"key":"S0007114526108320_ref27","unstructured":"27. Malawi Ministry of Health and Population (MoH) (2017) National Guidelines on Nutrition Care, Support, and Treatment (NCST) for Adolescent and Adults. Lilongwe, Malawi. https:\/\/www.fantaproject.org\/sites\/default\/files\/resources\/Malawi-NCST-Guidelines-Revised-Nov2017.pdf (accessed September 2024)."},{"key":"S0007114526108320_ref34","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-023-05578-6"},{"key":"S0007114526108320_ref4","doi-asserted-by":"publisher","DOI":"10.3390\/nu13051578"},{"key":"S0007114526108320_ref1","unstructured":"1. WHO (2023) WHO calls for accelerated action to reduce anaemia. https:\/\/www.who.int\/news\/item\/12-05-2023-who-calls-for-accelerated-action-to-reduce-anaemia (accessed October 2023)."},{"key":"S0007114526108320_ref40","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph16234778"},{"key":"S0007114526108320_ref45","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0277240"},{"key":"S0007114526108320_ref22","unstructured":"22. FAO (2024) Minimum dietary diversity for women Rome2021 [updated September, 2024]. https:\/\/openknowledge.fao.org\/items\/d432ada6-4706-45a1-b86c-dead45afb616 (accessed September 2024)."},{"key":"S0007114526108320_ref31","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.13181"},{"key":"S0007114526108320_ref48","doi-asserted-by":"publisher","DOI":"10.1186\/s41043-019-0196-y"},{"key":"S0007114526108320_ref49","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0226026"},{"key":"S0007114526108320_ref13","unstructured":"13. Malawi Vulnerability Assessment Committee (MVAC) (2023) Integrated Food Security Phase Classification (IPC)-Malawi Acute Food Insecurity_Jun23_Mar24 Report. https:\/\/mvac.gov.mw\/index.php\/publications\/ipc-communication-brief# (accessed November 2023)."},{"key":"S0007114526108320_ref28","doi-asserted-by":"publisher","DOI":"10.1016\/j.foodpol.2014.04.003"},{"key":"S0007114526108320_ref33","doi-asserted-by":"publisher","DOI":"10.3390\/nu15081805"},{"key":"S0007114526108320_ref7","unstructured":"7. WHO (2014) Global nutrition targets 2025: anaemia policy brief. https:\/\/www.who.int\/publications\/i\/item\/WHO-NMH-NHD-14.4 (accessed October 2023)."},{"key":"S0007114526108320_ref12","unstructured":"12. FAO (2021) The State of Food Security and Nutrition in the World 2021-The world is at a critical juncture. https:\/\/www.fao.org\/state-of-food-security-nutrition\/2021\/en\/ (accessed November 2023)."},{"key":"S0007114526108320_ref11","doi-asserted-by":"publisher","DOI":"10.1186\/s40066-017-0098-4"},{"key":"S0007114526108320_ref14","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980018001775"},{"key":"S0007114526108320_ref15","unstructured":"15. National Statistics Office (NSO) (2019) 2018 Malawi Population and Housing Census Main Report Zomba (Malawi). https:\/\/www.nsomalawi.mw\/images\/stories\/data_on_line\/demography\/census_2018\/2018%20Malawi%20Population%20and%20Housing%20Census%20Main%20Report.pdf (accessed November 2023)."},{"key":"S0007114526108320_ref21","doi-asserted-by":"publisher","DOI":"10.1186\/1475-2891-12-143"},{"key":"S0007114526108320_ref30","unstructured":"30. WHO (2024) Guideline on haemoglobin cutoffs to define anaemia in individuals and populations [updated March 2024]. https:\/\/www.who.int\/publications\/i\/item\/9789240088542 (accessed July 2024)."},{"key":"S0007114526108320_ref38","doi-asserted-by":"publisher","DOI":"10.1017\/S0007114522003208"},{"key":"S0007114526108320_ref39","doi-asserted-by":"publisher","DOI":"10.3945\/jn.114.197095"},{"key":"S0007114526108320_ref41","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980018001775"},{"key":"S0007114526108320_ref25","unstructured":"25. South African Medical Research Council Biostatistics Unit (SAMRCBU) (2020) Malawian Food Composition Table 2019. United States. Agency for International D, editor: Tufts University. Tisch Library; 2020-02-21."},{"key":"S0007114526108320_ref26","year":"2004"},{"key":"S0007114526108320_ref42","doi-asserted-by":"publisher","DOI":"10.3390\/nu7010584"},{"key":"S0007114526108320_ref37","doi-asserted-by":"publisher","DOI":"10.1186\/s13045-021-01202-2"},{"key":"S0007114526108320_ref43","doi-asserted-by":"publisher","DOI":"10.3389\/fnut.2020.00101"},{"key":"S0007114526108320_ref52","doi-asserted-by":"publisher","DOI":"10.1177\/004947550003000210"},{"key":"S0007114526108320_ref53","doi-asserted-by":"publisher","DOI":"10.1186\/s12905-023-02209-2"},{"key":"S0007114526108320_ref55","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-031-60545-1_5"},{"key":"S0007114526108320_ref46","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-021-04117-5"},{"key":"S0007114526108320_ref50","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/nxz009"},{"key":"S0007114526108320_ref44","first-page":"164","article-title":"Review on iron and its importance for human health","volume":"19","author":"Abbaspour","year":"2014","journal-title":"J Res Med Sci"},{"key":"S0007114526108320_ref23","doi-asserted-by":"publisher","DOI":"10.1186\/s40795-023-00715-y"},{"key":"S0007114526108320_ref29","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980018002719"}],"container-title":["British Journal of Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0007114526108320","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T03:12:37Z","timestamp":1790219557000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0007114526108320\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,24]]},"references-count":56,"alternative-id":["S0007114526108320"],"URL":"https:\/\/doi.org\/10.1017\/s0007114526108320","relation":{},"ISSN":["0007-1145","1475-2662"],"issn-type":[{"value":"0007-1145","type":"print"},{"value":"1475-2662","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,24]]},"assertion":[{"value":"\u00a9 The Author(s), 2026. Published by Cambridge University Press on behalf of The Nutrition Society","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}