The word anemia comes from the two Greek words. A, not, haima, blood; which means anemia is the lack of blood or bloodlessness in the body.
Anemia affected people are found more in most developing countries such as India than developed countries.
Anemia is the deficiency of blood in the body or deficiency of a number of red blood cells in the blood or of the red coloring matter (hemoglobin) of the blood.
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| Sickle cell anemia |
symptoms of anemia:
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| symptoms of anemia |
Causes of malnutrition related anemia:
The causes of malnutrition related anemia are mainly 3 types
Immediate cause:
- Deficiency of nutrients in food-
- lack of iron
- lack of folate
- lack of B complex vitamin
- lack of vitamin C and protein
- presence of some opposed elements in foods-
- phytate
- oxalate
- tea
- tannin of coffee
C) Some physical conditions-
- breathing problem
- looseness
underlying causes:
- low quality and low quantity food
- pollution of environment-
- Water
- Food
- Negligence of health:
- Don’t take any vaccine
- Frequently pregnancy, malaria etc.
Basic causes:
- Lack of awareness about food value
- Lack of getting proper food
- Poverty
- Lack of awareness about health care
Types of malnutrition related anemia-
Macrocytic orthochromic anemia:
Macro means large; less amount of RBC or red blood cells are present in blood but the sizes of these red blood cells are big. In this case less amount of hemoglobin is present in blood but in every RBC, right portion of hemoglobin is present. This type of anemia is occurred due to the lack of vitamin B12 or folic acid. Presence of red blood cells in bone marrow signifies that due to lack of folic acid red blood cells are not fully developed. So it is called orthochromic megaloblastic anemia.
Macrocytic hypochromic anemia:
In this type of anemia red blood cells are big in size but less amount of hemoglobin is present. This type of anemia is occurred due to the lack of iron, folic acid and vitamin B12.
Normocytic hypochromic anemia:
The red blood cells are normal in size but sufficient amount of hemoglobin is not present.
This type of anemia is seen in scurvy and hormonal problem.
Microcytic hypochromic anemia:
Micro means very small; the sizes of red blood cells are short than normal size but a numbers of red blood cells are present in sufficient amount. This is occurred due to the lack of iron.
Apart from these malnutrition related problems, there are other reasons for occurring anemia:
Increase the destruction of red blood cells:
Abnormal broken red blood cells are grown in malaria, syphilis and these broken red blood cells are very quickly destroyed. If destruction of red blood cells increases, bile element also increases and it causes jaundice. Sickle cell, familial hemolytic anemia etc are the example of these types of anemia.
Bleeding:
Due to excess bleeding it can possible to recover the lack of plasma but it is not possible to recover the loss of red blood cells. With red blood cells there is occurred lack of iron which cannot be recovered. The ultimate result is anemia. This type of anemia is called normocytic anemia. By the supplying of iron this type of anemia can be cured.
Production of defective red blood cells:
Defective red blood cells are produced due to the lack of folic acid, vitamin B12, minerals and bile. It is called pernicious anemia. This type of anemia can be cured by eating lots amount of animal protein.
Defect of bone marrow:
Many factors such as poisoning of chemical substances, x- Ray of radioactive, cancer in marrow, kidney disease hamper the production of red blood cells. It is called aplastic anemia.
Life expectancy of red blood cells is 120 days. Bone marrow helps to maintain the number of RBC but if the function of bone marrow is hampered, anemia is occurred.
Iron deficiency anemia :
Nowadays iron deficiency anemia is more prevalent in developing country. Women are more prone to anemia than man. The most difficult is to supply of iron of all nutrients. An adult body contains 2.5 – 4.0 gm iron but iron is most important element to prevent anemia. If you don’t get sufficient amount of iron, the size of red blood cells decreases and the level of hemoglobin also decreases and it is the responsible for anemia and absorption of iron increases.
Anemia which is occurred due to the lack of hemoglobin is called microcytic hypochromic anemia.
Anemia can be mild, moderate or severe depending on the level of hemoglobin.
Causes of iron deficiency anemia:
Lack of iron-
- Rapid growth in childhood
- Increase the size of red blood cells
- Growth of adolescent and menstruation
- Pregnancy – growth of fetus, spreading of blood in last trimester of pregnancy.
- Bleeding during delivery.
Inappropriate absorption of iron –
- Presence of phytate, phosphate, oxalate in food.
- Lack of iron enhancing elements like calcium, protein and vitamin C.
- Many physical conditions like diarrhea, pelegra hamper the absorption of iron.
- Lack of the secretion of juice from stomach.
Destruction of blood –
- Sudden bleeding.
- Chronic diseases such as tuberculosis, ulcer, discrepancies of stomach, bone tumor, leukemia.
- Parasite such as presence of hookworm.
Apart from above reasons, through urination, sweat, bile salts and skin iron comes out and there is seen the lack of iron.
Children, adolescents and pregnant women are the main victims of anemia.
During rapid growth of children there is occurred the lack of iron. Breast milk contains no iron, after six months of birth; there is the chance of running out of iron.
Children are suffering from anemia due to the lack of iron and vitamin C and the presence of hookworm.
Adolescents require more iron because loss of iron is occurred during menstruation.
Pregnant mother requires iron more than the normal person for supplying of nutrition to fetus, supplying of iron to fetus and bleeding during delivery. Becoming pregnant again and again causes lack of iron and son it increases the requirement of iron.
Who lives in hillsides, they need more iron because in this type of environment, lack of oxygen is occurred in the air and there is a connection between intake of iron and hemoglobin.
If running out of iron is occurred, it can increase the level of transferrin, and decrease the plasma iron. For this reason pale, small size and small number of red blood cells are built. So it is called hypochromic (pale color) microcytic (small size) anemia.
Symptoms of iron deficiency anemia:
- The function of hemoglobin is to supply of oxygen to blood. If hemoglobin level decreases, supply of oxygen to cells and supply of carbon dioxide to lung is hampered. Less oxygen and more carbon dioxide can cause exhausted and effortless.
- Usual symptoms of iron deficiency are tiredness, jaundice, headache, and pant. If anemia in chronic stage, vision becomes blur, insomnia, anorexia, dyspepsia, ulcer, stomach problem, paraesthesia etc symptoms are observed. It may be happen due to the lack of folic acid.
- Angina and palpitation are occurred due to the lack of oxygen.
- Enhancing cells specially cells of esophagus and mouth are destroyed.
- Papilla of tongue becomes even.
- Nail becomes breakable and concave. Longitudinal veins and small holes on nail are appeared. Nail becomes look like spoon. It is called koilonychia.
- Growth of hair is reduced.
- Pica is seen among pregnant women this means women desire to eat chalk, soil, slate etc.
Prevention:
Anemia can be prevented by the right education, proper diet and proper hygiene.
Diet:
The diet should be rich in protein and iron source specially meat, liver and egg. Besides these all types of pulses, peas, soya chunks, green vegetables, molasses, and dry fruits like dates, whole grains etc are the source of iron. But plant source of iron absorb less iron than the animal source of iron. Milk contains no iron. After birth of baby storage of iron is over within 6 months. So, egg yolk should be given in the food of baby.
Protein and vitamin C rich foods help in absorption of iron .So vitamin C rich foods should be eaten with food. Tea and coffee contains polyphenol which inhibits the absorption of iron. In empty stomach iron tablet should be taken. It helps to absorb iron well.
Supplementation:
To prevent anemia iron and folate tablets should be taken. So under National Anemia Prophylaxis Programme iron and folate tablets are distributed to pregnant women during last trimester and preschool children (1 – 5 year).
Education:
Right education about health awareness helps to cure anemia.
- Parents should be educated about nutrition.
- Children should be given education about iron rich foods.
- Consume vitamin C rich foods such as oranges, guava, amla which are very effective to absorb iron.
- Promote home gardening to increase the availability of iron rich vegetables.
- Cook should be encouraged to use of iron pan, iron ladle, iron spud for cooking to get minimum amount of iron from utensils.
- Use medicine to control hookworm.
- Educate the people to avoid tea and coffee. It inhibits the absorption of iron. So before and after eating food, tea or coffee should be avoided.
- In empty stomach iron tablet should be taken. It helps to absorb iron well.
- Avoid the eating of betel nuts because betel nuts contain oxalate which hampers the absorption of iron.
- Mother should visit different health awareness programme to receive education about nutrition.
Hygiene:
- To treat anemia general hygiene is very important.
- Maintain proper ventilation of bedroom at night because air breathed out is not allowed for accumulating.
- Damp should be avoided.
- Clothing is enough for warmth. Porous clothes provide sufficient warmth. It is the best because these types of clothes allow the skin to work freely and to regulate its own temperature.
- Adequate amount of sleep is required which depends on the severity of cases.
A sample menu of anemic patient:
Meal
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Food stuff
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Amount
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Breakfast
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Mid - morning
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Lunch
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Evening snacks
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Dinner
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