Different Types of Anemia (Diet-related)

 

 

 

 

 

 

 

Different Types of Anemia (Diet-related)

Iron Deficiency Anemia

Iron Deficiency Anemia is the most common form of anemia, particularly among pregnant women. There are many causes for this type of anemia such as increased iron needs during pregnancy, chronic blood loss and low iron intake from diet.

The recommended iron intake for men and post-menopausal women is 8 milligrams. The recommended intake for pre-menopausal women is 18 mg, and the recommendation increases to 27 mg for pregnant women. If you are a vegetarian, the requirement for iron increases because of the low absorption level of non-heme iron present in vegetable source. According to the Dietary Reference Intake report, it is suggested that iron requirement for vegetarians is two times greater than non-vegetarians.

Folate Deficiency Anemia

Folate, or folic acid, is a type of B vitamin that is important in the formation of healthy blood cells. This type of anemia is common in older adults, heavy drinkers, pregnant women and people suffering from certain medical conditions such as sickle cell anemia.

Folate is found in dark green leafy vegetables, enriched breakfast cereals, beans and lentils.

Vitamin B12 Deficiency Anemia

Vitamin B12 is only found in meat products. Except for vegetarians, most cases of Vitamin B12 Deficiency Anemia are not due to low intake of B12. Instead, it is usually due to the lack of intrinsic factor resulting in poor Vitamin B12 absorption. Found in the stomach, intrinsic factor helps the body absorb Vitamin B12. This type of anemia is usually present in people with gastric bypass surgery or other chronic gastrointestinal diseases such as Crohn's disease. For most cases, Vitamin B12 shots are prescribed.

Despite the fact that different forms of anemia have different causes, they all share similar symptoms. Common signs and symptoms of anemia include:

feeling tired or weak

difficulty in breathing

feeling dizzy

inability to concentrate

Symptoms of Anemia

Fatigue is the most common symptom associated with anemia. Others may include:

·         Pale skin

·         Irregular heartbeat

·         Cold extremities

·         Chest pain

·         Dizziness

·         Confusion or memory loss

·         Constipation or diarrhea

·         Headaches

·         Bleeding gums or a sore, red tongue

·         PICA: Abnormal craving to chew on ice, chalk or crayon

·         Prone to illness

·         Shortness of breath upon the least bit of exertion

 

HEMOGLOBIN, HEMATOCRIT, MCV (mean corpuscular volume), MCH (mean corpuscular hemoglobin), MCHC (mean corpuscular hemoglobin concentration)

·         MCV = Hct X 10/RBC (84-96 fL)

·         Mean corpuscular Hb (MCH) = Hb X 10/RBC (26-36 pg)

·         Mean corpuscular Hb concentration (MCHC) = Hb X 10/Hct (32-36%)

Strictly speaking, anemia is defined as a decrease in total body red cell mass. For practical purposes, however, anemia is typically defined as hemoglobin <12.0 g/dL and direct determination of total body RBC mass is almost never used to establish this diagnosis. Anemias are then classed by MCV and MCHC (MCH is usually not helpful) into one of the following categories:

·               Microcytic/hypochromic anemia (decreased MCV, decreased MCHC)

• Iron deficiency (common)
• Thalassemia (common, except in people of Germanic, Slavonic, Baltic, Native American, Han Chinese, Japanese descent)
• Anemia of chronic disease (uncommonly microcytic)
• Sideroblastic anemia (uncommon; acquired forms more often macrocytic)
• Lead poisoning (uncommon)
• Hemoglobin E trait or disease (common in Thai, Khmer, Burmese,Malay, Vietnamese, and Bengali groups)

·         Macrocytic/normochromic anemia (increased MCV, normal MCHC)

• Folate deficiency (common)
• B12 deficiency (common)
• Myelodysplastic syndromes (not uncommon, especially in older individuals)
• Hypothyroidism (rare)

·         Normochromic/normocytic anemia (normal MCV, normal MCHC) The first step in laboratory workup of this broad class of anemias is a reticulocyte count. Elevated reticulocytes implies a normo-regenerative anemia, while a low or "normal" count implies a hyporegenerative anemia:

• Normoregenerative normocytic anemias (appropriate reticulocyte response)
• Immunohemolytic anemia
• Glucose-6-phosphate dehydrogenase (G6PD) deficiency (common)
• Hemoglobin S or C
• Hereditary spherocytosis
• Microangiopathic hemolytic anemia
• Paroxysmal hemoglobinuria
• Hyporegenerative normocytic anemias (inadequate reticulocyte response)
• Anemia of chronic disease
• Anemia of chronic renal failure
• Aplastic anemia*

 

LAB FINDINGS IN  IRON DEFICIENCY ANEMIA

 

1. Microcytic  hypochromic anemia
2. Low Hb level  (< 11.0 g/dl)
3. Low MCV, MCH, MCHC
4. Low serum ferritin
5. High RWD
6. High iron binding capacity
7. High erythrocyte protoporphyrin

How Is Anemia Treated?

Treatment for anemia depends on the type, cause, and severity of the condition. Treatments may include dietary changes or supplements, medicines, or procedures.

Goals of Treatment

The goal of treatment is to increase the amount of oxygen that your blood can carry. This is done by raising the red blood cell count and/or hemoglobin level. Another goal is to treat the underlying condition or cause of the anemia.

Nutrition for Anemia

One of the simplest ways to improve anemia is through the consumption of foods that are rich in vitamins, minerals, and elements specifically identified as therapeutic for this condition. Because a cardinal symptom of anemia is the existence of weak or insufficient levels of red blood cells in the body (which transport oxygen), therapeutic nutrition focuses on building stronger blood. To achieve that, a dietary intake rich in iron, vitamins B6 and B12, and other specific nutrients is key to improvement.

Low levels of vitamins or iron in the body can cause some types of anemia. These low levels may be due to poor diet or certain diseases or conditions.

To raise your vitamin or iron levels, your doctor may ask you to change your diet or take vitamin or iron supplements. Common vitamin supplements are vitamin B12 and folic acid (folate). Vitamin C is sometimes given to help the body absorb iron.

Iron-deficient Anemia (“iron-poor blood” or “tired blood”)

The World Health Organization has identified iron deficiency as the most common nutritional deficiency in the world, affecting some 30 percent of all people. This seems paradoxical, since iron is one of the most abundant metals on earth and is essential to most life forms. Iron gives blood its characteristic red color.

There are two forms of dietary iron: heme and nonheme. Heme iron is derived from hemoglobin, the blood protein that delivers oxygen to cell tissue. 

Accordingly, heme iron is found in animal foods that contain hemoglobin, such as:

·         Red meats

·         Fish (tuna, bluefin, halibut)

·         Poultry meat (chicken liver contains high amounts)

·         Pork

·         Shellfish such as oysters, clams, crabs and shrimp

Nonheme iron is essentially plant-derived and abundant in:

·         Spinach and other dark green leafy vegetables

·         Peanuts, peanut butter, and almonds

·         Eggs ,Soybeans

·         Peas; lentils; and white, red, and baked beans

·         Dried fruits, such as raisins, apricots, and peaches

·         Prune juice, Raisins and Molasses

·         Beans (pinto, lima, navy, kidney, black) “Iron-enriched” and “iron-fortified” foods, such as breads, cereals, grits, oatmeal, etc

Your body needs iron to make hemoglobin. Your body can more easily absorb iron from meats than from vegetables or other foods. To treat your anemia, your doctor may suggest eating more meat—especially red meat, such as beef or liver—as well as chicken, turkey, pork, fish, and shellfish.

Iron can be given as a mineral supplement. It’s usually combined with multivitamins and other minerals that help your body absorb iron.

Diet & nutrition education (Iron deficiency)

·         eat more fruits and vegetable

·          no coffee or tea with meals

·          programmes should be targeted  to at  risk groups  

·          reduce  phytic content of cereals and legumes by fermentation

·            Avoid foods high in Oxalic acid from your diet. Oxalic acid interferes with                iron absorption. Foods such as almonds, cashews, chocolate and most nuts are high in oxalic acid.

·          Avoid foods that interfere with the iron absorption. Examples of foods to avoid are: beer, dairy products, ice cream, soft drinks, coffee and tea.

·          Take a tablespoonful of blackstrap molasses twice daily.

·          Do not take calcium, vitamin E, zinc, or antacids at the same time as iron supplements. These interferes with the iron absorption.

·         Vitamin C: Include plenty of foods rich in vitamin C when you eat foods that contain iron. The vitamin C will help absorb more of the available iron.

·         Cast-iron cooking: Use cast-iron cookware. Tiny iron particles from the cookware are transferred to food and can provide a significant source of dietary iron.

Vitamin B12

Low levels of vitamin B12 can lead to pernicious anemia. This type of anemia is often treated with vitamin B12 supplements.

Good food sources of vitamin B12 include:

·         Breakfast cereals with added vitamin B12

·         Meats such as beef, liver, poultry, fish, and shellfish

·         Egg and dairy products (such as milk, yogurt, and cheese)

 Folate (folic acid)-deficient Anemia

Folic acid (folate) is a form of vitamin B that’s found in foods. Your body needs folic acid to make and maintain new cells. Folic acid also is very important for pregnant women. It helps them avoid anemia and promotes healthy growth of the fetus.

Good sources of folic acid include:

·         Bread, pasta, and rice with added folic acid

·         Spinach and other dark green leafy vegetables

·         Black-eyed peas and dried beans

·         Beef liver

·         Eggs

·         Bananas, oranges, orange juice, and some other fruits and juices

·         Asparagus, Nuts and Broccoli

·         Black-eyed peas or dried beans

·         Pasta, Flour and Cereal

Vitamin C

Vitamin C helps the body absorb iron. Good sources of vitamin C are vegetables and fruits, especially citrus fruits. Citrus fruits include oranges, grapefruits, tangerines, and similar fruits. Fresh and frozen fruits, vegetables, and juices usually have more vitamin C than canned ones.

dietary recommendations for Megaloblastic Anemia

1. Variety: Choose a healthy variety of foods, especially those rich in B12
2.  and folic acid, such as lean red meat, foods fortified with iron and folic acid, and leafy green vegetables.
3. Do not smoke: Smoking increases vitamin requirements and has a negative effect on your health in general.
4. Supplements: In addition to dietary changes, taking B12 and folic acid supplements may be necessary in some cases. First, talk to your doctor to find out if a supplement is advisable for you.
5. Consumption of a healthy diet including iron-containing foods and those with B-complex vitamins is essential to developing and maintaining a satisfactory blood count.
6. eat foods fortified with B12 and folic.

How Does Nutrition Work to Improve Anemia?

Irrespective of the particular type of anemia or its causative factors, nutritional therapy can improve anemia symptoms. This is because anemia generally manifests in weak or reduced red blood cells, and the above foods are specifically identified as enhancing the production and function of blood cells.

Therapeutic nutrients can only be effective in improving anemia if they are properly absorbed in the body. Heme iron (animal/protein-based) is considered superior for iron-deficient anemia and is readily absorbed by the body. Cooking with iron pots and pans also increases the amount of consumed iron. For vegetarian diets, Vitamin C can enhance the amount of non-heme iron absorbed in meatless meals. Some food compounds may slightly decrease iron absorption, such as oxalic acid in spinach, phosphates in milk products and egg whites, phytates in beans, and possibly tannins in tea.

Are Supplements as Effective as Food in Improving Anemia?

Because many foods are already enhanced with vitamins and minerals, it is best to assess the amounts already consumed from foods and beverages before relying on supplements. Notwithstanding, Vitamin B6, B12, and folate are common supplements used to address dietary needs for anemia.

Iron supplements should be taken only if prescribed by a medical professional. Excessive amounts of iron are stored in organs such as the liver and heart rather than excreted from the body, which may lead to iron toxicity. In persons genetically sensitive to iron, iron overload may lead to hemochromatosis, resulting in liver cirrhosis and heart failure.

 

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