June 3, 2023

It is very important to break down the term “nutritional anemia” to give you in-depth knowledge of the meaning.

WHO defines anemia as a condition in which the number of red blood cells or the hemoglobin concentration within them is lower than normal.

Meaning of Hemoglobin

Hemoglobin, abbreviated Hb or Hgb also spelled as hemoglobin, is the red protein in red blood cells that carries oxygen from the respiratory organs such as the lungs or gills of all vertebrates to various tissues and organs in the body, then transports both carbon dioxide and nitric oxide from the tissues and organs back to the lungs where they are exhaled as waste. Hemoglobin is produced in bone marrow by red blood cells (erythrocytes). Hemoglobinemia is a medical condition in which there is an excess of hemoglobin in the blood plasma while its deficiency is called anemia.

What does nutritional anemia mean?

Nutritional anemia is when the body is not getting enough nutrition rich in iron, folate, and vitamin B12. That is a low dietary iron intake, sub-optimal absorption of iron from the diet, increased loss of iron from loss of blood, low dietary folate intake, or severe hookworm infestation. Simply put, anemia is caused by insufficient or lack of iron, folate, and vitamin B12 in the body.

The expected hemoglobin levels in the body?

AGE                                                              LEVELS(g/100mL)

6 months – 6 years                                           11g/dL

6 years – 14 years                                             12g/dL

Adult males                                                      13g/dL

Adult females                                                   12g/dL

Adult females (pregnant)                                  11g/dL

Common Factors That Cause Nutritional Anemia

Premature infants: Babies born earlier before the normal 37 weeks of pregnancy are completed. As such, they may lack red blood cells (anemia) because they do not have what it takes to make their blood cells. Even full-term babies take about 1-3 months before they can produce very few red blood cells.

 Anemia

Anemia

Children born to anemic mothers: Certain forms of anemia are passed down to the infants through the gene, thereby making the infants anemic from birth and not grow to a healthy weight. The main source of iron for the fetus is from the mother and if the mother becomes anemic, the transfer of iron to the fetus reduces then which places the fetus at risk of iron deficiency. There may be a significant decrease in hemoglobin and iron levels of infants born to deficient mothers. As a result, the infant’s iron reserves become affected.

Young children over six months who are still purely on breast milk: The American Academy of Pediatrics recommends that infants be exclusively breastfed for about 6 months with continued breastfeeding along with introducing appropriate complementary foods for 1 year or longer.

Baby over 6 months
Baby over 6 months

WHO, on the other hand, recommends exclusive breastfeeding up to 6 months of age with continued breastfeeding along with appropriate complementary foods up to 2 years of age or longer. When a child is breastfed purely on breast milk for more than 6 months makes the child not receive enough iron, folate, and vitamin B12 from the mother as much as the child needs for growth and development.

Menstruating and lactating women: Menstruating and lactating mothers are vulnerable to anemia. Studies conducted have shown that anemia is highly prevalent among lactating that during the period of lactation mothers tend to be susceptible to anemia because of maternal iron depletion and blood loss during childbirth.

A study also concluded that although breast milk is not a good source of iron, the concentration and quality of iron are independent of maternal stores. This indicates that Postpartum anemia occurs because the mother was anemic during pregnancy and continues during lactating. While women generally menstruate every month which makes them vulnerable to blood loss. When the blood falls below 8g/dL, the woman may become anemic. This indicates that every woman in her menstruation period is supposed to increase her intake of iron, folate, and vitamin B12 to avoid being anemic.

Parasitic infestation caused by hookworm and tapeworm: Hookworm and tapeworm can cause anemia. Hookworms (Necator americanus and Ancylostoma duodenale) are intestinal worms that live and feed majorly on the blood and vitamins of their human host. As a result, the infected individual may become anemic.

Hookworm
Hookworm

Clinical Symptoms Of Nutritional Anemia

  1. Tiredness and apathy
  2. Palpitations
  3. Shortness of breath on exertion
  4. Lack of concentration
  5. Edema in severe cases

What happens if anemia is left untreated?

It weakens and lowers immunity to infections. Having babies of low birth weight for pregnant women may lead to congestive cardiac failure and death.

What are the causes of nutritional anemia?

1. Lack of sufficient protein in your diet. Because protein is essential for the building up of hemoglobin.

2. Insufficient mineral intake, specifically iron, and a smaller quantity of copper and cobalt are also necessary for the formation of hemoglobin.

3. Insufficient vitamin intake, such as cyanocobalamin (vitamin B12), folic acid, and ascorbic acid (vitamin C).

Types Of Nutritional Anemia

1. Iron deficiency anemia

2. Folic acid deficiency anemia

3. Cyanocobalamin deficiency

Iron Deficiency Anemia

Iron deficiency anemia is anemia caused by low dietary iron, failure of iron absorption from the diet, and increased loss of iron resulting from loss of blood or severe hookworm infestation.

The total body iron (mainly found in the liver, spleen, and bone marrow) is approximately 3g and about 0.5g of iron is stored as ferritin. Premature infants by their blood cell count require supplementary iron. While an adult’s daily iron requirements are approximately 12g, infants >6 months have a high requirement of iron due to their increased body size and blood volume.

What are the sources of iron?

•Green leaves

•Cereals

•Vegetables

•Meat

•Fish

•Fruits

•Organs such as the liver, heart, and kidney

How can you prevent iron deficiency?

1. For pregnant women and women in IDA endemic population, increasing supplementation with iron and folic acid

2. Fortifying your foods with iron

3. Practice and improve your food habits; intake of foods stimulating iron absorption – vitamin C-containing foods

4. Reduce your intake of foods with tannin or phytates that inhibit iron absorption.

5. Eradicating hookworm that causes iron losses

6. Treat malaria

7. Adequate birth spacing

8. Going to a qualified birth attendant who would deal expeditiously with uterine bleeding.

9. Educate yourself by always visiting this blog for health education.

Folic Acid Deficiency Anemia

Folic acid deficiency anemia is anemia caused by low dietary folic acid. Folacin is a generic term used to describe folic acid and its related compounds which exhibit the biological activity of folic acid.

Chronic alcoholism and megaloblastic anemia cause the deficiency of folic acid in the body. Because alcohol impairs the absorption of folacin in the body. The minimum daily folacin requirement is about 50g for every day except for pregnant women if adequate stores are present at the onset of pregnancy, then about 100g of folacin is required daily.

What are the sources of folic acid?

•Dark green leafy vegetables such as spinach

•Organs such as the liver and kidney

•Beans

•Meat

• Flour

•Ripe bananas

•Cabbage and lettuce

How can you prevent folic acid deficiency?

The only way to prevent folate deficiency is to eat more foods rich in folate.

Cyanocobalamin (Vitamin B12) Deficiency Anemia

The term ‘pernicious anemia’ is used to describe anemia due to vitamin B12 deficiency which is necessary for the production of RBCs.

What are the causes of pernicious anemia?

• Inability to utilize vitamin B12 due to inadequate hydrochloric acid in the stomach.

• Due to Sprue. The disease affects the small intestine which leads to the failure of absorption of nutrients including vitamin B12.

Diphyllobothrium latum (a helminth) infestation that extracts vitamin B12 from the food you eat.

• Strict vegetarians who are not getting sufficient vitamin B12 from their diets.

What are the sources of vitamin B12?

• Egg

• Nutritional yeast

• Milk

• Fortified cereals

• Organs such as the liver and kidney

• Sardines

• Clams

• Dairy products

• Yogurt

• Cheese

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