Iron out your deficiencies

Mridula Wattas 

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Iron-deficiency anaemia in India is rampant among children below the age of three (78.9 per cent) and women (55 per cent); men follow at 249 per cent, according to a National Family Healthy Survey.

Anaemia deficiency happens when there is a decreased number of circulating red blood cells in the body. Symptoms can include extreme fatigue, weakness, dizziness, drowsiness, headaches, chest pains, breathlessness, pale skin and lethargy. The body needs red blood cells to survive. These cells carry haemoglobin, a complex protein that contains iron molecules. These molecules carry oxygen from the lungs to the rest of the body so that various metabolic processes, essential for the body functioning, can take place. 

According to WHO, the normal haemoglobin levels are 12g/dl to 15g/dl for women and 13g/dl to 17g/dl for males. It is vital to create awareness because anaemia can go undetected until it becomes severe. Mild anaemia causes no symptoms.  Anaemia creeps on you silently because its symptom are not visible as most other diseases. Most of the acute symptoms occur only when you have extremely low haemoglobin levels. According to the World Health Organization (WHO), there are two billion people with anaemia in the world and half of the anaemia is due to iron deficiency. 

Types of anaemia 

There are many types of anaemia — thalassemia, aplastic anaemia, sickle cell anaemia and haemolytic anaemia and these cannot be corrected by dietary modifications. However, the most common form of anaemia rampant globally and in India is due to consuming too little iron and Inadequate intake of the vitamins B9 (folate) and B12. But it can be checked with some simple modifications in the diet.

Ill-effects

Anaemia can cause loss of physical productivity in any given population. Maternal anaemia directly leads to maternal mortality, low birth weight babies as well as infant mortality. 

In children, iron deficiency affects physical as well as brain development and increases susceptibility to infections.

 Another group of people who are susceptible to iron deficiency anaemia are people suffering from chronic diseases. Many physicians get so focused on curing a particular chronic disease that they remain either unaware or overlook the anaemia symptoms manifesting in these people. This could be due to their loss of appetite or interference of the medications with normal iron absorption. Whatever maybe the reason it is seen that if we improve the iron and vitamin content of their diet or give them artificial supplementations their quality of life improves dramatically.

Iron deficiency anaemia a major health problem affecting Indian population as it has never been taken seriously. Low awareness, illiteracy, poverty, malnutrition, poor sanitation and imbalanced vegetarian diet have emerged as major factors.

While it has severely impacted the productivity of India’s workforce, it also adversely affects the growth of young children. It also can be life threatening to young mothers. Prevalence of anaemia in chronic diseases in old age leads to poor quality of life and morbidity in elderly. It is imperative to raise levels of public awareness about good nutrition and to include iron-rich foods in daily diet so as to help people make healthier choices. 

— The writer is former head, department of dietetics, PGIMER, Chandigarh  

Dos

Include more foods rich in iron, folic acid and vitamin B12. As vitamin B12 is mostly present in non-vegetarian foods so vegetarians may need to take supplements from time to time.

n Increase the existing iron content of your diet by cooking in cast iron utensils. Whenever you cook any food in an iron vessel some of the iron leaches into the food, increasing its iron content.

n To help increase the absorption of iron in your body, have vitamin C-rich foods like lemon, orange or amla with all meals. Iron is better absorbed in the body in the presence of vitamin C-rich foods. 

n Vitamin A and beta carotene-rich foods like green leafy vegetables, yellow and red fruits and vegetables also enhance the iron absorption.

n When you combine good source of heme iron like chicken and fish with vegetarian foods, it increases the iron absorption from those vegetarian foods. The iron content of the resulting dish is doubled.

n Animal sources of iron are better absorbed in body than plant-based iron sources of food as oxalates found in green leafy vegetables like spinach, kale, beets and in nuts, chocolate, wheat bran,  strawberries and herbs such as oregano, basil and parsley hamper the absorption of iron.

Don’ts

n Avoid drinking tea or wine within one hour of taking food. The tannins in both these drinks can bind iron making it very hard to absorb. Phosphate in fizzy drinks can have the same effect.

n Don’t add too much bran into your flour as excess fibre and phytates present in these leads to reduced iron absorption. Similarly, have soaked and peeled almonds instead of whole almonds as such. This is because the skin of the almonds contain phytates. 

n Don’t eat calcium-based foods with iron-rich foods as calcium also prevent your body from absorbing an adequate amount of iron. Calcium can be found in yogurt, cheese, sardines, canned salmon, tofu, broccoli, almonds, figs, turnip greens and rhubarb.

n Avoid overcooking. 

n Get regular de-worming done to avoid intestinal parasites from absorbing all your dietary iron. 

Iron-rich foods 

n Jaggery, dates, honey and raisins have good amount of iron and can be used as sweeteners instead of empty-calorie white sugar which is harmful for the body.  

n Black sesame seeds, pumpkin seeds and sunflower seeds are rich sources of iron. Add these to your salads and smoothies. 

n Eat more fruits like peaches, apricot, strawberries, pomegranates, tomatoes and prunes. 

n Include more cereals and pulses like quinoa, brown rice, rice flakes, soybean, lentils and black beans in your diet.

n Have more green vegetables like  spinach, celery, mustard greens and broccoli. Eat leafy vegetables in cooked form as the availability of iron increases. 

n Non vegetarian sources include chicken, egg yolk and liver.

Foods rich in folic acid 

Dark leafy greens, beetroot, broccoli, citrus fruits, beans, peas, lentils, lady’s finger, seeds and nuts,  cauliflower, corn, carrots, etc.

Sources of Vitamin B12

Vitamin B12 is naturally found in animal products like fish, meat, poultry, eggs, milk and milk products. It is generally not present in plant foods but fortified breakfast cereals contain vitamin B12. Some nutritional yeast products also contain vitamin B12.