Anemia is a deficiency in the size or number of red blood cells or in the amount of hemoglobin they contain. This deficiency limits the exchange of O2 and CO2 between the blood and the tissue cells. Globally, young children, women, and older adults are at the highest risk of developing anemia. Anemia can be classified based on different parameters; one classification depends on whether it is related to nutrition or not, so there are two types: nutritional anemia and non-nutritional anemia. Nutritional anemia refers to anemia that can be directly attributed to nutritional disorders or deficiencies. Examples include iron deficiency anemia and pernicious anemia. It is often discussed in a pediatric context. According to the World Health Organization, a hemoglobin concentration below 110 g/L for children under 5 years of age and pregnant women, and below 130 g/L for men indicates anemia. Hemoglobin is a blood protein that transports oxygen to the cells of the body. Without oxygen, the human body cannot undergo respiration and create Adenosine triphosphate, thereby depriving cells of energy. Nutritional anemia can be caused by a lack of iron, protein, vitamin B12, and other vitamins and minerals that are needed for the formation of hemoglobin. However, iron deficiency anemia is the most common nutritional disorder. Signs of severe anemia include cyanosis, jaundice, and easy bruising. In addition, anemic patients may experience difficulties with memory and concentration, fatigue, lightheadedness, sensitivity to temperature, low energy levels, shortness of breath, and pale skin. Symptoms of severe or rapid-onset anemia are very dangerous as the body is unable to adjust to the lack of hemoglobin potentially resulting in shock and death. Mild and moderate anemia has symptoms that develop slowly over time.
Types of nutritional anemia
Iron deficiency anemia Iron deficiency anemia is the last stage of iron deficiency and it is characterized by the production of small (microcytic) erythrocytes and a diminished level of circulating hemoglobin. It represents the end point of a long period of iron deprivation.
Megaloblastic anemia Megaloblastic anemia reflects DNA disturbance which affects the blood cells (erythrocytes, leukocytes, platelets) and the bone marrow, and it is characterized by large and immature blood cells in the bone marrow (macrocytic anemia), mainly caused by both vitamins B9 (Folic Acid) and B12.
Anemia of protein-energy malnutrition As explained before, hemoglobin is a protein which means that its production requires adequate and enough intake of protein from the diet, but in case of protein-energy malnutrition, hemoglobin will not be produced sufficiently leading to anemia. As a result, there is a reduction in cell mass and thus fewer red blood cells (RBCs) are required to oxygenate the tissue (reduced number of RBCs with a low hemoglobin).
Copper deficiency anemia Copper and its associated proteins are essential for adequate hemoglobin formation, iron utilization by developing erythrocytes, and the optimal function of erythrocyte membranes. Specifically, the copper-containing enzyme ceruloplasmin is required to mobilize iron from the body's storage sites. In a state of copper deficiency, this iron cannot be released, resulting in low serum iron and decreased hemoglobin levels—even when overall iron stores are completely normal.
Sideroblastic anemia Sideroblastic anemia is an inherited defect of heme synthesis enzyme which results in derangement in the final pathway of heme synthesis and buildup of immature Fe- containing RBCs. It is classified as a microcytic and hypochromic type of anemia and it is nutritional because it is Vitamin B6-responsive.
Hemolytic anemia A defect in RBC membranes causes oxidative damage and lysis of the cells. Vitamin E has shown to be protective as it has an antioxidative function.
Symptoms and signs Symptoms of nutritional anemia can include fatigue and lack of energy. However, if symptoms progress, one may experience shortness of breath, rapid pulse, paleness —especially in the hands, eyelids and fingernails—, swelling of ankles, hair loss, lightheadedness, compulsive and atypical cravings, constipation, depression, muscle twitching, numbness, or burning and chest pain. Those who have nutritional anemia often show little to no symptoms. Often, symptoms can go undetected as mild forms of the anemia have only minor symptoms.
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