Researchers in Ethiopia compared the health and eating habits of 792 women—half who chew khat (a plant leaf) and half who don’t. They found that women who chew khat are much more likely to be underweight and not get enough important nutrients like protein, calcium, and zinc. Women who chew khat weighed significantly less on average and had worse nutrition overall. This study suggests that khat chewing may be harming women’s health by preventing them from eating enough nutritious food.

The Quick Take

  • What they studied: Does chewing khat (a plant leaf popular in some parts of Africa) affect how much women weigh and what nutrients they eat?
  • Who participated: 792 women aged 15-49 in South Ethiopia—396 who regularly chew khat and 396 who don’t. Researchers measured their weight, height, and asked them what they ate.
  • Key finding: Women who chew khat were nearly 4 times more likely to be underweight (36.6% vs 9.4%). They also ate much less protein, calcium, zinc, and B vitamins than women who don’t chew khat.
  • What it means for you: If you or someone you know chews khat regularly, this research suggests it might be connected to poor nutrition and unhealthy weight loss. This is especially important for women who could become pregnant, since good nutrition is critical for pregnancy health.

The Research Details

Researchers conducted a comparative cross-sectional study, which means they looked at two groups of women at the same point in time and compared them. They didn’t follow people over months or years—they just took a snapshot. One group consisted of women who regularly chew khat, and the other group consisted of women who have never chewed it. Both groups lived in the same area (Halaba Zone in South Ethiopia) so that other factors would be similar.

To measure nutrition, researchers asked each woman what she ate in the previous 24 hours. They also measured each woman’s height and weight using standard equipment. They then used statistical methods to compare the two groups and figure out if differences were real or just due to chance.

This study design is useful because it lets researchers compare two groups living in the same place at the same time. However, it can’t prove that khat chewing causes poor nutrition—it only shows they happen together. The researchers used careful measurement methods (standard scales and height measures) which makes the physical measurements reliable. The 24-hour food recall method is a common way to measure what people eat, though people sometimes forget or misremember foods.

The study included a large number of women (792 total), which makes the results more trustworthy. The researchers used proper statistical methods and measured things carefully. However, because this is a cross-sectional study, we can’t be sure that khat chewing causes the poor nutrition—it’s possible that women with poor nutrition are more likely to chew khat, or that other factors affect both. The study was published in BMJ Open, a reputable medical journal, which suggests it went through quality review.

What the Results Show

The most striking finding was that women who chew khat were much more likely to be underweight. About 37 out of every 100 khat-chewing women were underweight, compared to only about 9 out of every 100 non-chewing women. On average, khat-chewing women weighed about 6.6 kg (14.5 pounds) less than non-chewing women, even though they were the same height.

When researchers looked at what these women ate, they found major differences. Women who chew khat ate significantly less of almost every important nutrient. They got less carbohydrates (the body’s main energy source), less protein (needed for muscles and body repair), and much less of several vitamins and minerals.

Specifically, khat-chewing women were nearly 3 times more likely to not get enough vitamin B12, almost 3 times more likely to lack enough carbohydrates, and more than 3 times more likely to not get enough zinc. They were also significantly more likely to lack calcium, which is crucial for bone health, especially for women who might become pregnant.

The study also found that khat-chewing women had inadequate intake of thiamine and riboflavin (B vitamins that help convert food to energy) and niacin (another B vitamin). These deficiencies could contribute to fatigue and other health problems. The pattern was consistent across almost all nutrients measured—khat chewers simply weren’t eating enough nutritious food.

This study adds to growing evidence that khat chewing is associated with poor health outcomes. Previous research has shown that khat chewing can reduce appetite and affect how the body absorbs nutrients. This study is one of the first to carefully document the nutritional consequences for women of reproductive age in Ethiopia, where khat chewing is common.

This study can show that khat chewing and poor nutrition happen together, but it cannot prove that khat chewing causes poor nutrition. It’s possible that women who are already malnourished are more likely to chew khat, or that poverty (which could lead to both khat chewing and poor nutrition) is the real cause. The study only measured what women ate on one day, which might not represent their typical diet. Also, the study was done in one specific region of Ethiopia, so the results might not apply to other places or different groups of people.

The Bottom Line

If you chew khat regularly, this research suggests you should strongly consider stopping or reducing how much you chew. The evidence is fairly strong that khat chewing is connected to serious weight loss and nutritional deficiencies. If you’re a woman who could become pregnant, this is especially important because good nutrition before and during pregnancy is critical for your baby’s health. If you’re struggling to stop chewing khat, talk to a healthcare provider about support options. Make sure you’re eating enough protein, whole grains, dairy products, and foods rich in zinc and B vitamins.

This research is most important for women of reproductive age (roughly 15-49 years old) who chew khat or are considering starting. It’s also relevant for healthcare workers, public health officials, and families in regions where khat chewing is common. If you don’t chew khat, this research doesn’t directly affect you, but it may be useful information if you’re concerned about someone you know who chews it.

If someone stops chewing khat and improves their diet, they might start gaining weight and feeling more energetic within a few weeks. However, it can take several months to fully restore nutritional stores and reach a healthy weight. The longer someone has been chewing khat and malnourished, the longer recovery may take.

Want to Apply This Research?

  • Track daily weight (same time each morning) and weekly average weight to monitor for unhealthy weight loss. Also track servings of protein-rich foods, calcium sources (dairy, leafy greens), and zinc-rich foods (meat, beans, nuts) to ensure adequate nutrition.
  • Set a specific goal to reduce khat chewing by a certain percentage each week. Use the app to log meals and get alerts when you’re not meeting daily targets for protein, calcium, and zinc. Set reminders to eat regular meals, since khat chewing can suppress appetite.
  • Weekly weight tracking combined with monthly nutritional intake reviews. Users should monitor energy levels, mood, and appetite as khat use decreases. If weight continues to drop or nutritional intake remains poor after reducing khat use, users should consult a healthcare provider.

This research shows a connection between khat chewing and poor nutrition in women, but cannot prove that khat causes malnutrition. If you chew khat and are concerned about your weight or nutrition, please consult with a healthcare provider for personalized advice. This information is not a substitute for medical diagnosis or treatment. Women who are pregnant or planning to become pregnant should especially discuss khat use with their doctor, as poor nutrition during pregnancy can harm fetal development. If you’re struggling with khat dependence, seek help from a healthcare professional or counselor.