Anemia is a condition that occurs when the number of red blood cells and/or the amount of hemoglobin found in the red blood cells is below normal. Anything that causes a deficiency in the formation or production of red blood cells, or that leads to too rapid destruction of red blood cells can lead to anemia. It is sometimes the detectable sign of arthritis, infection, or certain major illnesses including cancer, drug use, hormonal disorders, chronic inflammation in the body, surgery, peptic ulcers, hemorrhoids, diverticular disease, heavy menstrual bleeding, liver damage and dietary deficiencies.

Blood is comprised of two parts; a liquid part (plasma) and cells (white blood cells, red blood cells and platelets).The red cells are the most numerous and as the name implies are responsible for giving blood its colour. Red blood cells exist only to oxygenate the body and have a life span of about 120 days. If a person lacks sufficient iron, the formation of the red blood cells is impaired

Red blood cells and the hemoglobin (a special pigment contained within them) are necessary for the transport and delivery of oxygen from the lungs to the rest of the body. Without a sufficient supply of oxygen, many tissues and organs throughout the body cannot function properly.

Red blood cells are made in the bone marrow (inner part of some bones that make most of the cells in the blood). The hemoglobin molecule is the functional unit of the red blood cells. However, even though the red blood cells are made within the bone marrow, many other factors are involved in their production. For example, iron is a very important component of the haemoglobin molecule; erythropoietin, a special molecule secreted by the kidneys that promotes the formation of red blood cells in the bone marrow.

Preventing anaemia and having the correct number of red blood cells requires cooperation among the kidneys, the bone marrow, and nutrients within the body. If the kidneys or bone marrow are not functioning, or the body is poorly nourished, then normal red blood cell count and function may be difficult to maintain.

Anaemia is actually a sign of a disease process rather than a disease itself. Anemia can be mild, moderate or severe depending on the extent to which the red cell count and/or hemoglobin levels are reduced.

It is usually classified as either chronic or acute. Acute anaemia occurs quickly, for example, in severe bleeding. Chronic anemia may develop slowly over a period of time with long-term illnesses such as diabetes, chronic kidney disease, or cancer. In these situations, the anemia may not be apparent because symptoms are masked by the underlying disease. The presence of anemia in chronic conditions may often go undetected for a period of time and sometimes may only be discovered during tests or examinations for other conditions.

Common causes of anaemia include the following:

Anaemia symptoms can easily be go unrecognized. The fist signs of developing anaemia maybe loss of appetite, constipation, headaches, irritability, and or difficulty in concentration.

Anaemia should always be investigated and cause determined before any treatment can be prescribed. If you are anemic and your diet is ironclad (sufficient in iron) then a simple blood test called Erythrocyte sedimentation rate (ESR) should be done to investigate inflammation in the body.

In nutrition-related anemia, which is the focus of this article, supplements of iron and folic acid may be given, but in addition one must adjust their diet. People with Alpha-thalaceamia should not take iron supplements; this is because their cells are too small to absorb iron and are like to suffer Iron poisoning. All types of anemia must be treated by a qualified health professionals. Diet only may not treat anemia fuly.

Below is an illustrated list of the various foods rich in iron, Vitamin B12 or folic acid.

Foods that are a good source of iron include:

Vitamin C can help your body absorb iron, so it is a good idea to pair iron-rich foods with foods that have a lot of Vitamin C, including citrus fruits and iron-fortified orange juice.

It should also be noted that it is harder for the body to absorb the iron that is found in fruits, vegetables, and grains, than it is for it to absorb iron that is found in animal foods, including red meats, poultry.

Examples of iron rich foods which we can get in our daily diet:

Meat: liver (best source); beef/mutton; chicken; pork/ham; fish; whole egg
Dairy products: milk; cheese; yoghurt; fermented milk (maziwa mala)

*A 90 gram serving of meat or fish is about the size of a deck of cards.

Recommended Dietary Allowance (RDA) for Vitamin B12

Meat: liver (best source), chicken gizzards, kidney, egg yolk
Legumes: beans, peas, soya, nuts
Starches: wheat flour, whole grain bread, sweet potato, potato
Fruits and vegetables: spinach, broccoli, kales, cabbage, brussels sprouts, beetroot

Recommended Dietary Allowance for Folate in Dietary Folate Equivalents (DFE)

If alcohol is contributing to the development of anaemia, then in addition to taking vitamins and maintaining adequate nutrition, alcohol consumption needs to be stopped.

1. First version supplied by Dr Mukuhi Nganga Aug 2009
2. Formatting by Infonet March 2011 3. Review by Dr Alice Ojwang-Ndong January 2012