To investigate the possible dietary risk factors for anaemia in rural elderly women.

Case–control study conducted in 2005. Cases and matched controls were interviewed in person to elicit information on lifestyle, diet and individual health. Main foods and nutrients were calculated by three 24 h recalls; intake data of tea, edible oils and spices were from an FFQ.

Fourteen villages in two counties of Guangxi Province, south-west China.

Four hundred and twenty anaemic cases and 433 matched controls, aged 50–75 years.

The mean consumption of animal foods for cases (82·4 g/d) was significantly lower than for controls (91·0 g/d), similarly for egg consumption (3·8 g/d for cases and 5·8 g/d for controls; P < 0·05). The absolute value of the Dietary Balance Index, low bound score (DBI_LBS) was significantly higher for cases than for controls (P < 0·05). Intakes of energy, protein, carbohydrate, vitamin A (retinol equivalents, RE), vitamin B1, riboflavin and Ca were significantly lower in cases than in controls (P < 0·05). There was no significant difference in Fe intake between the two groups. High intake of vitamin A (RE) was inversely associated with anaemia (quartile 4 v. quartile 1: OR = 0·6, P for linear trend = 0·02). The absolute value of DBI_LBS was positively related to anaemia (quartile 4 v. quartile 1: OR = 0·4, P for linear trend < 0·0001).

For rural elderly women in south-west China, anaemia had a strong positive association with undernutrition and a negative association with vitamin A intake. Dietary Fe intake was not found to be an independent risk factor for anaemia.