Anemia is a public health problem in developing countries and also in developed countries, caused by several factors. However, its main cause is iron deficiency, which, in most patients who arrive at the office, is due to absorptive issues. The evaluation of food intake and subsequent dietary guidance are important to contribute to treatment and to change dietary practices, thus avoiding the occurrence of iron deficiency. Since this mineral is an important component of a number of proteins, including enzymes and hemoglobin, being directly involved in the transport of oxygen and proper functioning of the immune system, it is important to pay attention to it. Understand how nutritional management should be in the context of anemia.
Causes and Symptoms
Although the most common causes of iron deficiency are gastrointestinal bleeding and menstruation in women, decreased iron in the diet and decreased iron absorption are also culpable causes. In addition, it is commonly observed in many chronic inflammatory conditions, including congestive heart failure, chronic kidney disease, and inflammatory bowel disease. It is noteworthy that tiredness, weakness, low energy, shortness of breath, pale skin and problems with the skin and nails constitute its symptomatology.
Iron Absorption
On a
plant-based diet
only 5% of the ingested iron, which is non-heme, is absorbed. While in a normal diet, 15% of heme iron absorption occurs. Therefore, the nutritionist needs to master strategies that facilitate the absorption of this micronutrient. In addition, it should identify well the factors that harm/compete with it, reflecting impaired absorption.
Thus, among the agents that contribute to an inefficient absorption of iron by the body are caffeine supplementation. Caffeine acts by preventing the fixation of the iron molecule in the intestinal environment In addition, the adhering of restrictive diets that promote energy restriction culminatein in decreased energy availability and inflammatory processes, which, when associated with the practice of intense physical exercise, impair the absorption of this mineral. With the case of physical exercise of endurance and endurance, it is important to emphasize that they physiologically induce an increase in circulating hepcidine levels, enhancing the patient’s susceptibility to inflammatory conditions. At this point, it is worth understanding that the greater the intensity of exercises and damage caused to the muscle, the higher the signaling of inflammatory biomarkers that, as in a cascade of reactions, result in the absorptive involvement of iron.
In addition, iron intake associated with sources of zinc, manganese, calcium, decrease absorption through the mechanism of competition that is resulting from the interaction between these micronutrients.
Clinical practice
In contrast, the nutritionist can use strategies that favor absorption, such as iron intake associated with vitamin C sources, carotenoids, probiotic supplementation based on Lactobacillus, as well as patient awareness about the importance of resoaking for removal of phytote present in some foods rich in iron, such as beans.
Bibliographic references
Reading Suggestion:
The Effect of Vegetarian Diets on Iron Levels in Adults
Watch the video with biomedical doctor Rodrigo Manda on the Science Play platform –
Iron Deficiency
Article: Conduct anemia: Kumar A, Sharma E, Marley A, Samaan MA, Brookes MJ. Iron deficiency anaemia: pathophysiology, assessment, practical management. BMJ Open Gastroenterol. 2022 Jan;9(1):e000759. doi: 10.1136/bmjgast-2021-000759. PMID: 34996762; PMCID: PMC8744124.
