Dhiraj Kumar Sah

Iron folic acid distribution program for adolescents What is Anemia ? • It is a decreased ability of RBC to provide adequate oxygen to body tissues. The decreased ability of RBC may be due to: - Decreased number of RBC - Decreased size of RBC - Decreased hemoglobin in RBC (very common) Anemia: Greek for “bloodlessness” Normal and Anemic RBC Anemia Anemia Non-nutritional Nutritional Iron Deficiency Anemia Other nutrient deficiency (Folate, vitamin B12, vitamin A, zinc etc Infections (Malaria, HIV, Parasites) Others (blood disorders, genetic , blood loss due to injuries and menstruation etc) Nutritional anemia, particularly Iron Deficiency Anemia is the most common type affecting health the nutrition of the population Causes of Anemia? • Low level of Iron in Food consumed • Lack of other micronutrients in blood not able to make hemoglobin • Poor absorption • Parasitic Infections • High requirement • Presence of inhibitors in diet How to know Anemia 1. Clinical History 2. Observation 3. Hemoglobin test in blood Sign and Symptoms of Anemia • Pallor of skin and conjunctiva • fatigue, weakness, irritability • shortness of breath • low Blood Pressure • brittle nail • pica (unusual food cravings) • decreased appetite • frontal headache • Low Hematocrit • Low Hemoglobin Hemoglobin in Anemia (mg/l) Population Non-anemia Anemia Children aged 6-59 months 11.0 or higher 10.9 or lower Children aged 5-11 years 11.5 or higher 11.4 or lower Children aged 12-14 years 12.0 or higher 11.9 or lower Non-pregnant women (15 years and above) 12.0 or higher 11.9 or lower Pregnant women 11.0 or higher 10.9 or lower Men (15 years and above) 13.0 or higher 12.9 or lower Severe Amemia Less then 7 Iron Absorption from foods Heme iron is 2-3 times more absorbable than non-heme iron. Influence of Dietary Factors in iron absorption Dietary factor that enhance iron absorption Dietary factor that inhibits iron absorption Meat Phosphate Fish Calcium Poultry Tea ( Tannin) Seafood Coffee Gastric Acid (HCl Secreted in stomach) Colas Vitamin C (Ascorbic Acid) Soy protein Malic Acid High doses of minerals Citric Acid Bran/ fiber – fiber and phytate Polyphenols Oxalate Sources of Iron • Red meat is an excellent dietary source of iron in terms of both amount and bioavailability. Other excellent sources include clams (l;kL), oysters (saltwater clams), tofu and liver. Poultry, fish, pork, lamb and legumes are also good sources. • Whole grain and enriched grain products contain less bioavailable iron than meat. • Dairy products are low in iron. • Vegetarians who consume no animal tissue can maximize iron bioavailability from other sources by consuming Vit. C rich fruits and vegetables with every meal. • Daily intake GLVS and use of diversify food Iron Toxicity • Excess iron intake reduces zinc absorption, causes constipation and other GI effects and may increase risk for heart disease and cancer • Symptoms of iron intoxication include nausea, vomiting, diarrhea, rapid heartbeat, dizziness and confusion. Thank You…..