Association between body mass index and hemoglobin levels among university students: a cross-sectional study

Abstract

Introduction: Obesity is a major global health challenge it is estimated that by 2035, approximately 1.77 billion adults will be overweight 1.53 billion will be obese. Anemia has long been recognized in relation to underweight and malnutrition. However, recent studies have found a paradoxical relationship between obesity and iron deficiency which is mediated by chronic inflammation. Objective: This study aimed to determine the association between Body Mass Index (BMI) and Hemoglobin (Hb) levels in university students. Method: An analytical cross-sectional study was carried out at Al-Furat Al-Awsat Technical University in Iraq on 413 students using non-probability purposive sampling. Data were collected using a validated self-administered questionnaire for socio-demographic and lifestyle factors, and anthropometric measurements for calculating BMI, and venous blood analysis for hemoglobin estimation using a hematology analyzer. Data analysis was performed using SPSS version 26 software with Chi-square and One-Way ANOVA tests to find associations at a significance level of p<0.05. Results: The result of 413 students (mean age 20.51 ±1.72 years) showed a high prevalence of anemia (40.7%) and malnutrition, with 17.4% of students being underweight and 32.2% being overweight/obese. There was a statistically significant relationship between BMI and hemoglobin concentration (p<0.001); the prevalence of anemia was significantly higher in both underweight and overweight/obese students than in normally weighted students. In addition, hemoglobin concentration was significantly different according to sex, breakfast and dietary habits, sleep duration and physical activity (p<0.05). Conclusion: The study results revealed a double burden of malnutrition among student anemia posed a serious problem for both underweight and overweight individuals. This condition was closely linked to unhealthy eating habits such as skipping breakfast, high caffeine consumption, and lack of exercise. Therefore, the study recommended integrating anemia screening into all BMI categories and raising nutritional awareness to mitigate the negative health effects of university life