Beyond Iron: Dietary, Lifestyle, and Sleep Associated Factors of Anemia in Adults: Evidence from Ranya City, Iraq

Hero Salah Babakr; Renas Mohamed Khdir

doi:10.15218/ejnm.2026.08

Authors

Hero Salah Babakr Department of Nursing, College of Nursing, University of Raparin, Ranya, Sulaymaniyah, Kurdistan Region, Iraq.
Renas Mohamed Khdir Department of Nursing, College of Nursing, University of Raparin, Ranya, Sulaymaniyah, Kurdistan Region, Iraq. https://orcid.org/0000-0001-7881-5021

DOI:

https://doi.org/10.15218/ejnm.2026.08

Keywords:

Anemia, Dietary habit, Lifestyle Characteristics, Sleep associated factors, Adult population

Abstract

Background and Objectives: Anemia, a common blood disorder of low hemoglobin, is a significant global public health issue. While traditionally linked to iron deficiency, recent studies suggest that lifestyle, dietary, and behavioral factors may also play important roles. In Iraq—and specifically Ranya District—there is limited data on how these broader factors contribute to adult anemia. To assess the prevalence of anemia and explore its sociodemographic, dietary, lifestyle, and sleep-associated factors among adults in Ranya District, Iraq.

Methods: A cross-sectional, community-based study was conducted among 384 adults in Ranya City by structured questionnaire administration and laboratory testing of hemoglobin levels. Descriptive statistics and chi-square tests to identify the association between anemia status and explanatory factors.

Results: The overall prevalence of anemia was approximately 24%, with a significantly higher rate among females (31.5%) compared to males (2.9%). Significant associations were found between anemia and gender, occupation, marital status, smoking, dietary patterns, supplement use, meal skipping, and sleep disturbances. Red meat and vegetable intake were not significantly associated. Sleep quality showed a strong relationship with anemia.

Conclusion: Anemia in adults from Ranya City is influenced not only by iron intake but also by modifiable lifestyle and behavioral factors, particularly sleep quality and meal patterns. Public health strategies should expand beyond iron supplementation to address these broader associated factors.

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