Nutrition Related Diseases

ANAEMIA
Types of anaemia
  1. Iron deficiency anaemia (Most common): A Lack of iron inhibits the production of red blood cells. Iron plays an important role in the body as it is a component of haemoglobin that is the carrier of oxygen in our body. A diet deficient in iron over a long time forces the body to deplete iron stores, this then results in iron deficiency anaemia.
  2. Folic acid deficiency: Folic acid is a vitamin that is responsible for generating new body cells (including red blood cells). Folic acid is not stored in significant amounts in the body, and therefore, daily intake of folic acid is needed. Pregnant women should take extra folic acid to help prevent spina bifida in her unborn child. Folic acid is the synthetic form found in tablets, and folate is the form found in our food.
  3. Pernicious anaemia: Vitamin B12 binds with a protein called the intrinsic factor. However, if an autoimmune disease occurs (pernicious anaemia), antibodies forms that prevent this vitamin and protein from binding. Vitamin B12 can then not be absorbed. In this case, Vitamin B12 injections are needed.
Various nutritional deficiencies and absorption issues may be the cause of anaemia.
  1. Inadequate intake due to pain/ poor appetite/ disease/ lack of vitamin C and vitamin B12 intake/ chronic alcoholism
  2. Inadequate absorption e.g. coeliac disease/ Sprue, drug interactions (anti convulsions/ chemotherapy, oral contraceptives)
  3. Inadequate utilisation vitamin C/ vitamin B12 deficiency, alcoholism
  4. Increased blood loss
  5. Increased needs due to disease/ pregnancy/ lactation/ infancy
  6. Increased losses due to liver disease/ kidney dialysis or vitamin B12 deficiency
  7. Poor absorption
  8. High intake of tannins
  9. High intake of dairy products
  10. Poor vitamin B12 / folate/ iron intake
Clinical signs and symptoms of anaemia:
  • Inadequate muscle function
  • Growth abnormalities
  • Poor immunity
  • Fatigue
  • Altered sense of taste
  • Itchiness
  • Sore or abnormally smooth tongue
  • Hair loss
  • Desire to eat non-food items, such as ice, paper or clay (pica)
  • Difficulty swallowing (dysphagia)
  • Painful open sores (ulcers) on the corners of your mouth
  • Spoon-shaped nails
  • Gastritis
  • Cardiac failure
  • Pale skin/ pallor & pale conjunctiva
  • Blue coloured nails and/ brittle nails
  • Fast heartbeat
Dietary management of anaemia
  1. Talk to your dietician on how to increase your Iron, Vitamin B6, B12 and folate intake.
  2. Reduce carbonates, oxalates, phosphates, phytates and tannins as these hinder the absorption of iron and should be limited and preferable not taken WITH food.
    • Tea and coffee can reduce absorption by 50% (Rooibos tea in small amount < 150ml per day in children or 3 less than cups per day in adults).
    • Cocoa can inhibit 90 per cent of iron absorption in the body.
    • Peppermints and herbal tea contain phenolic acid, this also prevents proper iron absorption.
    • Calcium-rich foods, e.g. milk products (cow milk, cheese yoghurt, cream, sour cream, and inkomaas) can prevent your body from absorbing an adequate amount of iron. Milk contains calcium, an essential mineral, but could inhibit the absorption of both non-heme and heme iron. If anaemic do not exceed the recommended calcium intake per day.
  3. Include vitamin C rich foods in combination with iron-rich foods to enhance absorption.
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