Thursday, Dec 20 2007

Home News Business Movies Astrology Food Samachar Shopping Sports Videos    More   Veg Recipes | Non Veg Recipes | User Recipes | Expert Recipes | Health & Nutrition | Tips | Post a Query | Post a Recipe | My Bawarchi

How To Prevent Nutritional Anaemia?

By Mumtaz Khalid Ismail

More Links Cause of Anaemia Nutritional anaemia Iron deficiency anaemia Causes of iron deficiency anaemia Dietary iron Nutritional megaloblastic anaemia Sources and recommended daily allowance

Anaemia is a condition where oxygen carrying capacity of the blood is reduced due to reduced haemoglobin concentration in the blood. Normal haemoglobin level is 14.5 to 16.5 gm % and 12 to 14.5 gm % for male and female respectively. Anaemia is diagnosed if haemoglobin level is below 13 gm % in male and below 12 gm % in non-pregnant woman.

1. Inadequate production of red blood cells in bone marrow due to:
   • Lack of raw materials e.g. nutritional anaemia.
   • Depression of bone marrow e.g. chronic infections, drugs, radiation etc.
   • Infiltration of bone marrow in conditions likes malignancy.
2. Excessive destruction of red blood cells due to:
   • Abnormality of haemoglobin like thalassemia,
   • Deficiency of red cell enzymes like Glucose 6 phosphate dehydrogenase deficiency,
   • Abnormality of red cell membrane like hereditary sperocytosis
   • Auto immune haemolytic anaemias
3. Blood loss due to any cause

Nutritional anaemias are group of condition caused by deficiency of nutrients required for the formation of haemoglobin or red blood cells. Nutrients that are essential for formation of normal blood cells are Iron, folic acid, vitamin B12, vitamin B6, vitamin C, vitamin E, protein and copper. Among nutritional anaemias iron deficiency anaemia is the most common anaemia in India. Nutritional megaloblastic anaemia (caused by deficiency of vitamin B12 and folic acid) is the other common nutritional anaemia. These anaemias are due to reduced intake, impaired absorption, increased losses or may be due to the increased demand.

Clinical Features of Anaemia

Pallor, anorexia, pica (eating abnormal things), lethargy, irritability, fatigue, insomnia (lack of sleep), failure to thrive, increased heart rate, difficulty in breathing, mental disturbances, oedema and cardiac failure are the common clinical features. Other symptoms varies depends on the cause of anaemia.

This type of anaemia can occur at any age groups. Recommended daily allowance of iron by Indian council of medical research is 28 mg and 30 mg for adult male and female respectively.

1. Due to reduced intake or absorption of iron:
   • Iron poor diet
   • Malabsorption syndromes
   • Chronic diarrhoea
   • Gastrointestinal surgery
2. Due to increased loss:
   • Gastrointestinal bleeding due to any cause
   • Hook worm infestation
   • Bleeding disorders
   • Excessive menstruation
3. Due to increased demands:
   • Pregnancy
   • Lactation
   • Prematurity and low birth weight
   • Adolescence
   • Chronic illness

Iron in diet comes from two sources. They are haeme and non haem form. Haem iron is present in meat product and non-haem form is plant origin. Other sources of iron in the diet originating from soil, water, dust and cooking of diet in iron pots. Even though breast milk contain less iron content, has better absorption and bioavailability compared to other milks. Good sources of dietary iron are jaggery, green leafy vegetables, dried dates, bajra, pulses, gingelly seeds, meat and fish. Iron absorption is increased if we consume above food items with food containing vitamin C like citrus fruits. The tannin in tea can inhibit iron absorption. So avoid drinking tea with meals.

Prevention

Adequate iron containing food must be consumed including provision for presence of any increased demand. Deworming to be done regularly. Good personal hygiene must be followed. If found necessary iron supplementation to be done in special cases.

Deficiency of vitamin B12 or folate or both are the causes of megaloblastic anaemia. This type of anaemia is the second common nutritional anaemia in Indian population. Deficiency of these nutrients may be due to

• Decreased intake - vitamin B12 deficiency is seen in strict vegetarians since vegetarian food items are very poor source of this vitamin. Over cooking in boiling water reduce folate content in food.
• Impaired absorption - due to disease of gastrointestinal tract and surgical resection of intestine.
• Defective utilisation - due to drugs like few types of cancer drugs and epilepsy drug interfere with metabolism of folic acids.
• Increased demand - infancy, pregnancy, recovery from chronic illness etc.

The main sources of folate are green leafy vegetable, liver and eggs. The daily recommended allowances vary from 400 mcg to 25 mcg per day for pregnant woman to infant. The good dietary sources of vitamin B12 are milk, egg, meat and liver. ICMR recommended daily allowance of vitamin B12 is 0.2 mcg for infant to 1.5 mcg for lactating mother.

Recommended daily allowance of vitamin B12 and folic acid for Indians

Group	Vitamin B12 mcg/day	Folic acid mcg/day
Man	1	100
Woman	1	100
Pregnancy	1	400
Lactation	1.5	150
Infant	0.2	25
Children 1 - 3 years	0.2 - 1	30
4 - 6 years	0.2 - 1	40
7 - 9 years	0.2 - 1	60
10 -12 years	0.2 - 1	70
13 -18 years	0.2 - 1	100

Tell us what you think about this article

---

Health Index Page - Ask Mumtaz - Feedback