Iron deficiency anaemia

Iron deficiency anaemia is the most common type of anaemia which leads to a reduction in number of red blood cells and haemoglobin which is responsible for the exchange of oxygen and carbon dioxide between the blood and tissue cells.

Causes of iron deficiency anaemia

The possible causes of iron deficiency anaemia are

  • Inadequate iron intake as a result of poor diet for example vegetarian diet with insufficient heme iron.
  • Inadequate absorption as a result of diarrhoea, drug reaction and gastritis.
  • Increased iron requirement during childhood, pregnancy and lactation.
  • Increased excretion as a result of blood loss due to injury, haemorrhoids, ulcers or parasites.

Symptoms of iron deficiency anaemia

Anaemia occurs as a result of long term iron deficiency, the symptoms generally represent the malfunction of various body functions. Most common symptoms of iron deficiency anaemia are:

  • Decrease work performance and exercise tolerance.
  • Fatigue
  • Lack of appetite
  • Pica ( persistent eating of substances with little or no nutritive value) for example ice and mud eating.
  • Breathlessness
  • Ulcers on the corner of mouth.

Diagnosis

Iron deficiency can be evaluated by different measurements from your complete blood test.

  • Ferritin level in your blood determines the iron stores.
  • TIBC level below 16 % are considered as inadequate for iron supply to tissues.
  • Haemoglobin level less than 8g/dL can indicate anaemia. However the value of haemoglobin vary widely among individuals.

Treatment

Treatment should primarily focus on determining the exact cause of iron deficiency leading to anaemia. Repletion of iron stores is necessary in order to cure anaemia in the long run.

Supplementation

The main treatment of iron deficiency anaemia is through supplements . Doctors normally prescribe oral administration of inorganic iron in ferrous form such a s ferrous sulphate. However patients on iron supplements are often complaining about the side effects associated with iron supplements as these supplements tend to cause, abdominal discomfort, diarrhoea, constipation, excessive bleeding, heart burn and nausea.

These side effects can be minimised if you take the supplements in an empty stomach or between meals. Iron is best absorbed with vitamin C. Take supplements with a glass of orange juice or lemonade.

Diet

In addition to supplements, attention should be given to the amount of iron consumed.

The rich sources of iron are

  • Liver
  • Kidney
  • Beef
  • Egg yolks
  • Dried fruits
  • Beans
  • Nuts
  • Dark green, leafy vegetables
  • Whole-grains and iron fortified cereals

Iron from animal sources is called heme iron is much better absorbed as compared to non heme iron which is present in eggs, grains, vegetables and fruits.

Factors that inhibits iron absorption

Iron absorption can be inhibited by number of factors. This includes

  • Carbonates, oxalates, phosphates and phytates present in unleavened bread, unrefined cereals and soya beans and fibre in vegetables may inhibits non heme iron.
  • Tea can reduce iron absorption up to 50 %.
  • Calcium found in dairy products also inhibits iron absorption.

Factors that maximise iron absorption

To maximise iron absorption it is important to :

  • include a source of vitamin C in every meal.
  • Avoid drinking too much coffee and tea specially with meals.
  • Improve food choices to increase dietary iron.
  • Include meat, fish or poultry in every meal if possible.

Diet and heart diseases

Heart disease is the major cause of death worldwide. It results from the lack of blood flow to the blood vessels surrounding the heart. The major cause of heart diseases are atherosclerosis and hypertension, both of which are greatly affected by diet. In atherosclerosis fatty material called plaque or atheroma is build up inside the arteries and as a result it narrows them.

Risk factors for coronary heart diseases

There are several risk factors which contribute to develop coronary heart diseases in later life. The primary prevention of coronary heart diseases involves the prevention and management of these risk factors in order to avoid heart problems. These risk factors are as follows

Cholesterol

Cholesterol is the type of fats found in blood. An elevated cholesterol level in blood increases the risk for heart diseases. Cholesterol is transported in the blood through the proteins called lipoproteins. The main lipoproteins are Low density lipoprotein ( LDL) and high density lipoprotein (HDL).

HDL is responsible for carrying cholesterol away from blood to the liver

LDL is responsible for carrying cholesterol to the blood.

A blood cholesterol level below 200 mg/dl and LDL cholesterol up to 100mg/dl is considered desirable. HDL levels should be kept higher in order to prevent heart diseases. The normal reading of HDL is 60 mg/dl or higher. A HDL level less than 40 mg/dl is a risk factor for heart disease.

Hypertension

Hypertension is the major risk factor for heart diseases, stroke and heart failure. It contributes to disease development by causing injury to the blood vessels. Hypertension is defined as a blood pressure above 140/90 mmHg. Hypertension is frequently present with other risk factors including high cholesterol levels and obesity.

Smoking

Nicotine found in cigarettes are responsible for initiation and progression of plaque formation in blood vessels and increases the risk of heart diseases. Clinical studies reveal that smoking is also responsible for the decrease in HDL cholesterol up to 6-8mg/dL.

Diabetes

Diabetes like hypertension is a disease as well as a risk factor of heart diseases. 80% of patients suffering from diabetes are likely to develop atherosclerosis and heart diseases. Heart diseases in patients with diabetes is attributed to other risk factors such as hypertension, obesity and high cholesterol levels.

Other factors which also contributes in developing heart diseases include

  • Dietary trends
  • Obesity
  • Menopausal status
  • Lack of physical activity
  • Family history of premature congestive heart failure
  • Age

Diet in heart diseases

Clinical trial and experimental studies have shown that numerous dietary factors affects blood lipids levels, atherosclerosis and heart diseases . People who consume more saturated fatty acids are at higher risk of developing heart disease. A proper diet is essential for the prevention of heart diseases and treatment of risk factors responsible for heart disease.

Fats and lipids

Total fat intake is related to obesity which in turns may cause atherosclerosis in longer run. For patients with increased risk of heart diseases it is essential to limit dietary fat to less than 30 percent of total calories in which saturated fat should be less than 7 percent, trans fat less than 1 % and the rest should consist of unsaturated fats mainly polyunsaturated and monounsaturated fats. To achieve these recommendations it is essential to follow some tips:

  • Avoid high fat content of mutton and beef. Use lean cut parts and remove extra fat.
  • Always use skinless poultry
  • High fat fish is rich in omega 3 and omega 6 and is good for heart.
  • Consume low fat dairy products.
  • Avoid margarine as it is rich in trans fatty acids.

Fibre

Soluble fibre found in fruits. vegetables , legumes and isapghol tend to lower the blood cholesterol levels and LDL. Whole grain cereals and legumes are strongly related to decrease risk of heart diseases. The recommended allowance for fibre is 30 grams of which approximately 6-10 grams should be from soluble fibre. This level is easy to attain if one consume 5 or more servings of fruits and vegetables and 6-8 servings of whole grains.

Nuts

Nuts are rich in unsaturated fatty acids and bio active compounds. Studies reveal that a small handful of nuts each day reduces the risk of developing heart diseases by lowering cholesterol and LDL levels in blood.

DASH Diet

DASH diet composed of fruits and vegetables, low fat dairy, chicken ,fish and low in salt tend to lower blood pressure and thus prevent heart diseases.

Dietary guidelines to prevent heart disease

  1. Eat more fruits and vegetables.
  2. Replace refined grains and consume more whole grains.
  3. Limit saturated fats.
  4. Chose low fat protein.
  5. Reduce salt in your diet.
  6. Limit sugar intake.
  7. Reduce portion size.

    by

Aliya Waqas

Effects of high sodium intake

Sodium is an important mineral needed by the body to work properly by controlling blood pressure and blood volume. It is also essential for the proper functioning of nerves and muscles in the body.

Recommended intake

The recommended daily intake of sodium for different age groups is as follows Average sodium intake of a healthy adult should not exceed the maximum recommendation of 2300mg/day. However the average daily intake of sodium in a normal diet is far more than this.

Sources of sodium

The main source of sodium comes from the normal table salt, which is the main ingredient of every savoury. 1 tsp of table salt provide 2300 mg of sodium. Other sources of sodium include

  • Natural sources such as meats , fishes, dairy and eggs.
  • Foods in which salt is added during preparations and processing such as cheese, processed meats, tomatoes, salad dressings bread and cookies.
  • Fast foods and foods prepared at restaurants.
  • Baking soda and baking powder.
  • Monosodium glutamate or Chinese salt

Effects of high sodium intake

Hypertension, stroke and heart diseases

The extra sodium in your body forces kidneys to hold more water to dilute the sodium which in turns increases the volume of blood in bloodstream . It then forces the heart to work more and put a lot of pressure on blood vessels. This extra works and pressure eventually results in stiffening of blood vessels resulting in high blood pressure, stroke and heart diseases.

Osteoporosis

High sodium intake results in increase calcium excretion . An increase loss of calcium via urine results in increased bone remodeling and bone loss which eventually results in weakening of bones and osteoporosis.

Kidneys

Kidneys are responsible to draw the extra fluids from the body through a process called osmosis. This process requires a balance of sodium and potassium to pull water from the bloodstream into the bladder. Eating salt raises sodium in the bloodstream which alters the balance and reduces the ability of kidneys to remove toxic substances out from the body, that in the long run causes damage to the kidneys.

Tips of reducing sodium intake

Almost 75% of the sodium comes from the packaged and processed foods available in the market. Following are some tips to reduce sodium intake .

  • Try to avoid processed meats and packaged foods available in the market. Foods such as sausages, salami and ready made burger patties are rich in salt and should be taken with caution.
  • Choose low salt condiments for example soya sauce, pickles and relishes. Read food label carefully to know the quantity of salt added in them.
  • When using canned food items such as mushrooms, chickpeas and beans, wash them with running water before use.
  • Try to use fresh vegetables as much as possible.
  • Do not use monosodium glutamate (Chinese salt).
  • Do not add salt when boiling rice , pasta or cereals.
  • Use low salt instead of table salt as it contains potassium chloride which helps to lower the blood pressure. However this salt substitute is not advisable for patients with kidney diseases.
  • Do not sprinkle extra salt from the top.