Clinical Nutrition

Lesson 7:Anemia

Causes

Anemia is caused by several factors that often occur together. The principal causes are -

• Negative iron balance due to inadequate dietary intake.
  
• Low dietary bioavailability.
  
• Iron loss from the body

During periods of rapid growth as in infancy, early childhood, adolescence and pregnancy, the blood volume expands and extra iron is required to maintain the concentration of blood components like hemoglobin. When the requirements are not met, anemia could occur.

Foods which supply

Heme iron	Non heme iron
Liver	Green leafy vegetables
Mutton	Rice flakes
Fish	Gingelly seeds
Crab	Soybean
Prawns	Bengal gram roasted Dates (dried) Bajra

The quality of iron supplied to the body – heme and non heme iron, the presence of iron absorption inhibitors and promoters – also affect the iron made available to the body.

Iron loss mainly occurs during menstruation, iron transfer to the fetus during pregnancy, blood loss during child birth, helminth infestation and malaria. It can also occur in accidental hemorrhages, and in bleeding ulcers and hemorrhoids.

Inhibitors and Enhancers of iron absorption

Inhibitors	Enhancers
Low gastric acidity	Increased acidity
Phytates and oxalates	Ascorbic acid
Polyphenols Minerals Infection	Presence of meatBody’s need