Anemia is defined by World Health Organization (WHO) as low blood hemoglobin concentration, <12 gm/dl, and has been regarded as public health problem in both developed and developing countries. Anemia is the condition manifest by the deficiency of red blood cells or of hemoglobin in the blood.
Hemoglobin is an iron-rich protein that provides red colour to the blood. This red blood cells are responsible for carrying oxygen to tissue and also removing the waste product i.e. carbon dioxide, from the tissues and eliminating it through the kidneys or lungs. The side effect of anaemia is low circulation of oxygen; anemia symptoms usually include muscle weakness, ongoing fatigue or lethargy, dizziness and sometimes mood changes. Severe anemia or unabated anemia can also sometimes cause complications, including damage of heart, brain and other organs. Although it’s rare, anemia that remains untreated can even become deadly. According to National Rural Health Mission (NRHM), Ministry of Health and Family Welfare (MoHFW), Government of India 2013 database, anemia is a severe public health problem in India with a high prevalence of about 74% with hemoglobin <11 gm/dl. It is widely prevalent in all age groups, 58% in pregnant women, 50% among non-pregnant non-lactating women, 56% among adolescent girls, 30% in adolescent boys and around 80% in children under two years of age.
Anemia Risk Factors and Causes
The burden of anemia is a major contributor for low birth weight, lowered resistance to infection, poor cognitive and motor development, weakness, fatigue, difficulty in concentrating and lower productivity. There are three primary reasons which might develop anemia from not having enough red blood cells:
- Enable to producing enough red blood cells.
- Losing too much blood due to injury, menstruation or other circumstances that cause bleeding.
- Body is destroying the red blood cells which have due to changes in immune system.
Children: Causes of nutritional anaemia
• Low iron stores at birth due to anaemia in mother
• Non-exclusive breastfeeding
• Too early introduction of inappropriate complementary food (resulting in diminished breast milk intake, insufficient iron intake, and heightened risk of intestinal infections)
• Late introduction of appropriate (iron-rich) complementary foods
• Insufficient quantity of iron and iron enhancers in diet, and low bioavailability of dietary iron (e.g. non-haem iron)
• Increased iron requirements related to rapid growth and development during infancy and childhood
• Iron loss due to parasite load (e.g. malaria, intestinal worms)
• Poor environmental sanitation, unsafe drinking water and inadequate personal hygiene
Women: Causes of nutritional anaemia
· Insufficient quantity of iron-rich foods and iron enhancers in the diet (foods rich in vitamin C such as citrus fruits) and low bioavailability of dietary iron (e.g., foods containing only non-haem iron)
• Excessive quantity of iron inhibitors in diet, especially during mealtimes (e.g., tea, coffee; calcium-rich foods)
• Iron loss during menstruation
• Poor iron stores from infancy, childhood deficiencies and adolescent anaemia
• Iron loss from post-partum haemorrhage
• Increased iron requirement due to tissue, blood and energy requirements during pregnancy
• Teenage pregnancy
• Repeated pregnancies with less than 2 years’ interval
• Iron loss due to parasite load (e.g., malaria, intestinal worms)
• Poor environmental sanitation and unsafe drinking water
Some Iron rich foods which helps to avoid anemia
1. Cereals: Brown rice is a brilliant choice for meeting the daily iron intake. Switch white rice with brown rice for a healthier food option. Whole grains like barley, quinoa, and oatmeal, are wholesome options when it comes to iron deficiencies. A rich source of iron, these whole grains should be added to the diet to increase the haemoglobin levels. Starches such as rice bran, wheat bran, and oat bran are excellent sources of iron.
2. Vegetables: Leafy greens, especially dark ones, are among the best sources of non-heme iron. They include: spinach, kale, collard greens and Swiss chard. Some leafy greens such as Swiss chard and collard greens also contain folate. A diet low in folate may cause folate-deficiency anemia. Sweet potato is enriched with iron and vitamin B6 and is known to prevent over 100 health conditions, especially those related to brain and heart. Citrus fruits, beans, and whole grains are good sources of folate. Vitamin C helps the stomach to absorb iron. Eating leafy greens with foods that contain vitamin C such as oranges, red peppers, and strawberries, may increase iron absorption. Some greens are good sources of both iron and vitamin C, such as collard greens and Swiss chard. Tomatoes are well known for their high iron content. One cup of tomato provides nearly 30% of daily recommended iron intake. Fenugreek is also called Methi is used as an herb and spice. It is most common ingredient in the day to day life especially in winter. They are rich in vitamins and minerals and also give sufficient iron. Broccoli also contains iron and other essential nutrients, such as magnesium and vitamins A and C which is good for health to prevent from anemia.
3. Meat and poultry: All meat and poultry contain heme iron. Red meat, lamb, and venison are the best sources. Poultry and chicken have lower amounts. Eating meat or poultry with non-heme iron foods, such as leafy greens, can increase iron absorption. Liver is perhaps the most popular organ meat. It’s rich in iron and folate. Some other iron-rich organ meats are heart and kidney. Chicken breast is also a good source of iron.
4. Seafood: Some seafood provides heme iron. Shellfish such as oysters, clams, and shrimp are good sources. Most fish contain iron. Fish high in iron include: sardines, canned in oil, canned or fresh tuna, fresh salmon. Although both fresh and canned salmon are good sources of iron, canned salmon is high in calcium. Calcium binds with iron and reduces its absorption. Foods high in calcium shouldn’t be eaten at the same time as iron-rich foods. Other examples of calcium-rich foods include: raw milk, yogurt, cheese, broccoli and tofu.
5. Fortified foods: Many foods are fortified with iron. The fortified food are fortified orange juice, fortified ready-to-eat cereals, foods made from fortified refined flour such as white bread, fortified pasta, foods made from fortified cornmeal, fortified white rice, etc.
6. Pulses: Pulses are good sources of iron for vegetarians and meat eaters alike. They’re also inexpensive and versatile. Some iron-rich options are: kidney beans, chickpeas, soybeans, black-eyed peas, pinto beans, black beans, peas and lima beans. Boiled lentils contain 3.3 mg of iron per 100 grams which is also a good source of iron. Lentils are also loaded with proteins. Lentils are not limited to tur dal but extend to masur dal, chana dal, moong dal and urad dal.
7. Nuts and seeds: Many types of nuts and seeds are good sources of iron. They taste great on their own or sprinkled on salads or yogurt. When choosing nuts and seeds, choose raw varieties whenever possible. Some nuts and seeds that contain iron are: pumpkin seeds, cashews, pistachios nut, hemp seeds, pine nuts and sunflower seeds. Almonds are also a good source of iron. They’re great as part of a healthy eating plan, but since they’re also high in calcium, they may not increase your iron levels that much. Similarly dry fruits like raisins, apricot, prunes, dried peaches and apricots are also the most nutritious iron friendly dry fruits.
8. Fruits: Apples and strawberries are rich in iron (and multiple other nutrients), which makes them suitable for boosting the hemoglobin levels. Pomegranate is also rich in iron, calcium, protein, carbohydrates, fiber, and several other vitamins and minerals. So it is often recommended for people who have low hemoglobin levels. Water melon is a refreshing and water-based fruit. It helps in increasing the hemoglobin level due to the high levels of iron and vitamin C present in it, which makes the iron absorption process better and faster.
Apart from these there are also some specific foos which contain a good amount of iron i.e.
· Beetroot and Amla: Beetroot contains lots of iron and the Vitamin C from amla helps in its absorption by the body. The juice of red beets and amla strengthens the body's power to regenerate and re-activate the red blood cells and supplies the body with fresh oxygen
· Jaggery: A person can obtain 3% of iron of daily value from 10 grams of jaggery. Combining it with ginger juice facilitates iron absorption.
· Currants: Blackcurrants are also a good way to increase the RBC count. They are known to contain around 1 to 3 milligrams of iron per 100 grams, depending on the type.
· Herbs: Herbs are one of the best options to elevate the hemoglobin levels. Although spices such as thyme, parsley, spearmint, and cumin seeds are rich in iron, the amount that is usually consumed is not significant enough to make much difference. But they do provide an added boost to the daily iron requirement.
· Dark Chocolate: Dark chocolate can help in boost the hemoglobin levels quite easily because every 100 grams of 80% dark chocolate can provide you with 17 milligrams of iron, meeting around 90 % of the daily iron quota.
Points to Remember
Ø Eat iron rich diet along with foods rich in vitamin C.
Ø Tea and coffee contain compounds known as polyphenols, which can bind iron, making it harder for the body to absorb.
Ø Calcium also hinders the absorption of iron so avoid high in calcium foods before or after eating iron rich foods.
Ø Simmering highly acidic foods like tomato puree, in an iron pot can increase the iron content more than ten folds