Low Energy? Don’t Overlook Anemia

Your dietary choices can help fight this common cause of fatigue and weakness.

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Over three million Americans have anemia—low levels of the red blood cells that carry oxygen to the body’s tissues. Although anemia can signal a serious underling condition, for many cases dietary changes can help.

One Condition, Many Causes: Anemia has a variety of causes, including blood loss, cancer, bone marrow diseases, some intestinal diseases, kidney disorders, and inherited conditions (such as sickle cell anemia), so it’s important to get to the root of the problem by seeking proper medical care.

While the causes of anemia vary, the result is typically fatigue, weakness, pallor (most easily seen on the inside of the lower eyelid), and, in more advanced cases, dizziness, rapid heart rate, and shortness of breath. Anemia caused by low levels of vitamin B12 can even cause symptoms of dementia (see below).

Nutrient-Related Anemia: In general, the most common kind of anemia is caused by iron deficiency. Anyone can develop iron-deficiency anemia, but it’s more common in women who are pregnant or menstruating and older adults. People with Crohn’s disease, ulcerative colitis, peptic ulcer, celiac disease, or other conditions that can cause chronic blood loss or malabsorption of iron are also at risk. Supplementation may be necessary to bring iron levels up to normal, but diet can be helpful in preventing and treating this common form of anemia. Iron-rich choices include meat (choose unprocessed, lean cuts), seafood, poultry, beans, lentils, cooked dark leafy greens, and iron-fortified cereals. Vitamin C increases iron absorption, so, when possible, pair iron-containing food choices with foods rich in vitamin C, such as citrus, strawberries, peppers, broccoli, and tomatoes. Fortified breakfast cereal and a glass of orange juice, a spinach salad with tomatoes or strawberries, and stir-fried lean beef with peppers and broccoli are pairing options.

Insufficient dietary intake or inadequate absorption of vitamin B12 can cause pernicious or megaloblastic anemia, which can include symptoms of dementia such as confusion, slowness, irritability, and apathy, and also numbness or tingling in the hands and feet. “Acid in the stomach is important for the absorption of vitamin B12,” says Alice H. Lichtenstein, DSc, a professor at the Friedman School and executive editor of Tufts Health & Nutrition Letter. “As we age, many of us produce less stomach acid. Hence, some older adults and people regularly taking acid suppressing medications absorb less vitamin B12. Any concerns about this should be discussed with your healthcare provider.” Megaloblastic anemia can also be caused by inadequate intake of the B vitamin folate. Since refined wheat, rice, and corn flours are enriched with folic acid (a synthetic form of folate) in the U.S., inadequate intake of this vitamin is now rare.

Make sure your dietary pattern includes foods rich in vitamin B12 (such as meat, fish, eggs, and dairy products). Since B12 is found primarily in animal products, vegans, and to some extent vegetarians, may be at risk for deficiency. Non-animal foods containing vitamin B12 include nutritional yeast, fortified plant-based milk substitutes and cereals, tempeh, algae/seaweed, and mushrooms. Vegans should check with their healthcare provider to determine whether they need B12 supplements to ensure adequate intake.

Although some types of anemia can’t be prevented, most are treatable after an accurate diagnosis. You can help avoid and treat iron- and vitamin-deficiency anemias by consuming a variety of foods in your diet, including unprocessed lean meats, legumes, dark leafy greens, and vitamin-C rich fruits and vegetables.

TAKE CHARGE!

Try these tips to avoid common diet-related forms of anemia:

➧ Listen to symptoms: See a doctor if you have any symptoms, like fatigue or weakness, that could be signs of anemia.

➧ Eat well: Follow a varied diet to ensure adequate nutrient intake to support your body’s red blood cell production.

  • Iron: seafood, poultry, unprocessed lean meats, legumes (beans, lentils), dark leafy greens, and iron-fortified cereals help prevent and treat iron-deficiency anemia
  • Vitamin C: citrus fruits and juices, strawberries, peppers, broccoli, tomatoes, and winter squash are rich in vitamin C, which helps increase iron absorption
  • Vitamin B12: meat, fish, eggs, dairy products, and fortified cereals and plant-based milk substitutes, and nutritional yeast help prevent and treat pernicious and megaloblastic anemia
  • Folate: fruits, dark leafy green vegetables, nuts, beans and enriched grain products (such as refined bread, cereal, pasta and rice) contain folic acid, the synthetic and highly absorbable form of folate, which works with vitamin B12 to mature red blood cells

➧ Follow up: If you are diagnosed with anemia, be sure to ask about the underlying cause and establish a clear treatment plan.

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