Anemia : Still a Problem in 21st Century


 

Iron-deficiency anemia is the most widespread nutrient deficiency in the world, affecting an estimated 2 billion people worldwide. Between 40 and 50 % of children under the age of 5 in the developing countries are iron deficient and iron deficiency accounts upto 20% of all maternal deaths. It also impairs immunity and reduces the physical and mental capacities of people of all ages. Women, in general, have smaller stores of iron than men and have increased loss through menstruation, placing them at higher risk for anemia than men.


In short, iron deficiency is a major public health problem world wide with enormous social and economic costs. Rice fortified with iron was created through the introduction of proteins from the kidney beans Phaseolus vulgaris by the same researchers of Swiss Federal Institute of Technology (Lucca et al, 2000). It is reported that the iron content increased two fold in the modified crop, currently under testing stage. Japanese scientists have also succeeded in enriching the rice grain with iron. The International Rice Research Institute (IRRI) has developed rice breeding lines high in iron and zinc using traditional plant breeding techniques. This rice is currently being tested by Novitiates at a convent in the Philippines to see how well the nutrients are absorbed in the human body.



GUIDELINES TO PREVENT & MANAGE ANEMIA


  • EAT FRESH FRUIT OR DRINK JUICE EVERYDAY

The ideal is to have a small glass of juice or a fruit shake before or after every meal, as this will help the absorption of iron by the body. Freshly squeezed fruit and vegetable juices contain large amounts of vitamin C and other natural nutrients, but some carton juices can also have a high vitamin C content: cranberry juice has one of the highest.
If you feel that citrus fruits are a little acid, have another fruit, such as strawberries, after your meal as a dessert.

Keep your vitamin C topped up by including some dark green leafy vegetables with each of your main meals. This could be a soup, a salad, or perhaps steamed broccoli tossed in a light olive oil with freshly chopped root ginger.
 



  • EAT ONE OF THE RICH SOURCES OF IRON TWO OR THREE TIMES A WEEK

If you eat meat this could be either lean red meat, game or offal such as liver, kidney, oxtail.
Remember that the body absorbs 20-40% of the iron available in meat sources, but only 5-20% of the iron from vegetable sources and eggs. If you eat a mixed diet including fruit, vegetables, meat and fish you are thought to absorb approximately 15-20% of the iron in the food.


  • EAT PLENTY OF NON-HAEM SOURCES OF IRON MOST DAYS

This means eggs, green leafy vegetables such as spinach, Savoy cabbage, curly kale, watercress, broccoli, baked beans Soya- beans and other pulses, black treacle, nuts an dried fruits (especially apricots). Vegetarians and vegans, who eat very few or no animal products, should include a rich source of non-haem iron everyday.
It is especially important for vegetarians and vegans to have a glass of freshly squeezed fruit juice with each meal, as you really need the vitamin C to help your body absorb the iron. Some vegetarians may need to take an iron supplement if they cannot get enough iron from the diet.


  • AVOID HAVING EXCESSIVE AMOUNTS OF FOODS AND DRINKS THAT INHIBIT IRON ABSORPTION
     

Coffee, tea and cola-based drinks will prevent the body from absorbing iron effectively because they contain tannins and caffeine. You should keep your tea and coffee intake down to a maximum of two to three cups a day and allow at least one hour between drinking tea or coffee before or after a meal, to give your gut a chance to absorb the iron from the food. Anemic women should make a real effort to cut out the excessive, needless consumption of these drinks; it is far better to make a really good cup of coffee or tea and enjoy it at a suitable time of day.


Remember that chocolate, although it contains iron, also contains substances that prevent efficient iron absorption, so don't over-indulge, even though you may feel as if you need an energy boost; chocolate is not the answer. Choose a zingy piece of fresh citrus fruit or a glass of mango juice instead.

Points to remember when planning an iron rich diet:

  • Consume green leafy vegetables, cereals like wheat, ragi, jowar, bajra, pulses especially sprouted pulses and meat products, which are rich in iron.

  • Do not consume tea and tamarind with iron rich foods as they inhibit the absorption of iron.

  • Consume foods rich in vitamin C such as lime juice, guava, amla, oranges, etc as they enhance the absorption of consumed iron from iron rich foods.

  • Cook foods in iron vessels as this will enhance the iron content in food.

  • Consume jaggery instead of sugar as the iron content in jaggery is higher than in sugar.

  • Increase consumption of iron rich foods during pregnancy, lactation, pre school age and school age, as they are more prone to anemia.

  • Foods fortified with iron can be consumed, as their iron content will be higher compared to non-fortified foods.




  • AVOID EXCESSIVE BRAN

While you are trying to boost your iron and vitamin C intakes, try to keep the amount of cereal fiber such as wholegrain cereals and wholegrain bread low. High-fiber food contain 'salts' (oxalates and phytates) that inhibit the absorption some of the iron.


GENERAL LIFESTYLE TIPS

  • REST
    Try to make sure that you have plenty of rest and don't allow yourself to become psychological run down by putting unrealistic demands on your time. It amazed me to hear women complain of extreme tiredness, which may be partially attributable to anemia, but is just as likely to be the result of being driven to do too much. If your lifestyle normally demands a lot of physical exertion you should try to cut this down, as you will be putting your body under too much physical stress.

  • CUT DOWN ON STRENUOUS EXERCISE
    Although it is good to include some regular gentle cardiovascular exercise such as swimming or dancing to help the body tick over. A word of warning for those of you who are following intensive training programs. When you are anemic you should just concentrate on the gentler exercises, rather than the full training schedule. Remember that the major function of hemoglobin is to carry oxygen around the body, so if you are anemic you may find it difficult to exercise to your usual degree. Your body is below par and therefore needs to be treated with care.

  • IRON SUPPLEMENTS
    If you are unable to eat as much iron as your body requires, either because you do not like the appropriate foods or because your iron status is a little too low to be corrected by diet alone, you may need to take an iron supplement.

    It is generally a good idea to choose a supplement that incorporates some vitamin C with the iron. A supplement that provides a daily 12 mg of iron with 500-1000 mg of vitamin C should be adequate for most women, but if you are unsure about the dose ask your doctor or dietitian.

    Some iron supplements can cause a little indigestion, diarrhea or constipation. Try to avoid taking them on an empty stomach as this can make the problem of indigestion worse.


  • BLOOD TRANSFUSION
    Amongst patients suffering from severe anemia, blood transfusion is the treatment of choice. This method could be adopted when hemoglobin levels have to be restored during short periods such as the third trimester of pregnancy or prior to surgery.

  • ERYTHROPOIETIN THERAPY
    Erythropoietin is a natural hormone which stimulates the production of red blood cells by the bone marrow. Man-made versions of erythropoietin are available. They can be given to people having chemotherapy (a treatment that is used for some types of cancer and leukemia) to raise their level of red blood cells back to normal and reduce feelings of fatigue.
    Anemia is a global problem and unless dealt with effectively may prove to be the most hazardous deficiency. We may end up losing many to this disease unless we start fighting it NOW!!!

Foods rich in Iron

  • Green Leafy Vegetables

  • Broccoli, Spinach, curly kale, spring greens, spring onions

  • Sardines, Fortified breakfast cereals

  • Whole meal bread, Whole Grain Bread

  • Pulses like red lentils, chickpeas, baked beans, kidney beans, Black-eyed peas

  • Cashew nuts, Sunflower seeds

  • Dried fruits like apricots, prunes and figs

  • Baked potatoes.

  • Eggs, Tofu, Brown or Converted Rice

  • Enriched Pasta, Beef, lamb, kidney, dark chicken meat, Lean Red Meats.



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