Anemia or low hemoglobin levels

According to the World Health Organization (WHO), there are two billion people with anemia in the world and half of the anemia is due to iron deficiency . In India, anemia is a major public health issue. This deficiency has far-reaching effects on the country’s health as well as economy

  • In adults, low hemoglobin levels result in poor productivity
  • During pregnancy, iron deficiency can lead to maternal mortality, preterm labour, low birth-weight, and infant mortality
  • In children, iron deficiency affects cognitive and motor development and increases susceptibility to infections

The National Family Health Survey (NFHS-3) of 2005-2006, showed that the prevalence of anemia was 70% in children aged 6–59 months, 55% in females aged 15–49 years, and 24% in males aged 15–49 years.

Low iron levels in blood lead to lesser formation of hemoglobin, which in turn results in lower number of red blood cells indicated as anemia. Iron deficiency anemia is the most common type of anemia

The symptoms can be resolved if iron stores are repleted and hemoglobin comes back to normal. There are a several dietary sources of iron but the ones coming from animal source are better absorbed than those from plant. Hence vegetarians are more often at risk of iron deficiency anemia than non vegetarians

Iron is present in two forms. Heme and non-heme iron. Plants and iron-fortified foods contain nonheme iron only, whereas meat, seafood, and poultry contain both heme and nonheme iron. Heme iron is better absorbed by the body than nonheme iron.

The following foods are good sources of heme iron (from animal sources):

  • Chicken liver (like humans, animals also store iron in the liver)
  • Oysters
  • Clams
  • Beef liver
  • Tuna
  • Eggs
  • Shrimp
  • Leg of lamb

The following foods are good sources of nonheme iron (from plants):

  • Dried fruits such as apricots, prunes, and raisins
  • Beans (kidney, lima, Navy)
  • Tofu (soy paneer)
  • Lentils
  • Spinach
  • Peanut butter
  • Brown rice
  • garden cress seeds (halim or aliv) -2 tsp of seeds soaked in water for an hour should be consumed with 1/2 glass of fresh lime water first thing in the morning.

Vitamin C helps to enhance the absorption of nonheme iron from foods. While consuming plant sources of iron such as dals, legumes, etc it is advisable to add some lime juice to them to enhance absorption of iron.

Other ways in which iron absorption can be enhanced are:

  • Avoid taking coffee or tea with meals as they contain certain compounds that hinder iron absorption.
  • Co-ingestion of calcium along with iron leads to poor absorption of either of the two as both these minerals compete for common binding sites on the cell membrane. Whether as food sources or in the form of supplements, it is better to take calcium and iron at different intervals.
  • Ensure sufficient intake of folic acid and vitamin B12 as they are also vital to the functioning of iron.

Usually we tend to neglect low hemoglobin levels, but we can see that it has latent health consequences especially with respect to vigour, stamina and overall productivity. In women, there is a greater risk associated with low hemoglobin levels because there is menstrual blood loss which can lead to iron deficiency. An adolescent girl or women of childbearing age getting pregnant with insufficient iron stores is at risk of maternal or infant mortality.

Despite having a mixed diet, most of us not meeting our daily requirements of iron. Special care must be taken to incorporate green leafy vegetables, Beans and lentils and dried dates in our daily diet. If hemoglobin levels are still low, then one must definitely take a suitable supplement in consultation with the family physician. Anemia.png

Author: drpoojachhawcharia

Dr Pooja Chhawcharia is the Senior Nutritionist at eKincare with over 7 years of experience in Nutrition education, diet counseling and research. She is a Registered Dietician with the Indian Dietetic Association and Certified Diabetes Educator recognized by the International Diabetes federation . She is also interested in ancillary sciences such as Yoga and Naturopathy.

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