Understanding Anaemia in India, how it impacts reproductive health and tips to prevent it
Our body contains red blood cells (RBC), which are disc-shaped cells that transport oxygen to the various organs and tissues and a person with a low count of RBC is said to have anaemia. The human body requires a good oxygen supply to perform its functions adequately and when a person suffers from anaemia, they experience symptoms like fatigue and shortness of breath, resulting from poor oxygen delivery to the vital organs and tissues of the body.
In an interview with HT Lifestyle, Alok Khettry, COO India Business at Bharat Serums and Vaccines Limited (BSV), explained, “RBC also contains haemoglobin, an iron-rich protein that binds oxygen to the lungs and allows the cells to transport it throughout the body. To diagnose a person with anaemia, a healthcare professional will measure the amount of haemoglobin they possess in their blood. According to the National Family Health Survey 5 (2019-21), the prevalence of anaemia in India is 25 percent in men (15-49 years) and 57 percent in women (15-49 years).”
What causes anaemia in a person?
Alok Khettry revealed, “Each RBC has a lifespan of 100-120 days
and is produced by the bone marrow. On average, the bone marrow produces two
million RBC each second, while the same amount is removed from circulation. In
this regard, balancing the production and removal of RBC is critical, as any
adverse effect on this process can cause anaemia. This means that in a person
suffering from anaemia, either the production of RBC is too low or the
destruction of RBC is too high.”
He added, “Decreased red blood cell production: Most factors that lead to reduced production of RBC fall in either of the two categories, namely acquired or inherited. Acquired factors that can decrease RBC production include an imbalanced diet that lacks iron, vitamin B12, and folate, which are essential for RBC production, kidney disease, some types of cancer like leukemia and lymphoma, autoimmune diseases, HIV, tuberculosis, hypothyroidism, certain types of medications or treatments, particularly chemotherapy and radiation therapy for cancer and exposure to toxins, such as lead to name a few.”
Pointing out that genetic conditions like Fanconi anaemia, Schwachman-Diamond syndrome and congenital dyskeratosis can also cause anaemia in individuals, Alok Khettry said, “Increased red blood cell destruction: These conditions can also be acquired or inherited. Some acquired factors include blood loss because of accidents or injuries, surgery, heavy menstrual bleeding, childbirth, endometriosis, and gastrointestinal lesions, such as ulcers or those due to IBD or cancer. It can also be caused by hemolysis, which occurs when the RBC breaks down too soon due to various reasons like autoimmune activity, certain infections, medication side effects, and exposure to toxins.”
Additionally, conditions like an enlarged spleen, liver diseases such as hepatitis or cirrhosis and infections like malaria can also cause anaemia. Some inherited causes of increased red blood cell destruction include sickle cell disease, glucose-6-phosphate dehydrogenase (G6PD) deficiency, and thalassemia.
How does anaemia affect reproductive health?
During pregnancy, a woman can be diagnosed with various types of
anaemia, which can cause both short-term and long-term complications to her
reproductive health. According to Alok Khettry, the specific reason behind the
anaemia is generally dependent on the type - Anemia of pregnancy: During
pregnancy, the blood volume increases substantially. This means the iron and
vitamins needed to make this higher RBC also rise. If the pregnant woman
doesn’t consume enough iron-rich food, it will lead to anaemia. This is not
considered abnormal unless the RBC count is too low.
Iron-deficiency anaemia: During pregnancy, the unborn baby uses the RBC of the mother for its growth and development, especially in the last three months of pregnancy. If a pregnant woman has extra red blood cells stored in her bone marrow before she gets pregnant, her body will use these stores during pregnancy. However, if a woman does not have enough iron stores, they can suffer from iron deficiency anaemia during pregnancy. This is the most common type of anaemia in pregnancy. Good nutrition, both before and during pregnancy, is vital to help build up these stores.
Vitamin B-12 deficiency: Vitamin B-12 is another critical mineral for making RBC and haemoglobin. Eating animal-based food like milk, eggs, meats, and poultry helps prevent vitamin B-12 deficiency. Women who eat vegetarian meals are at a higher risk of contracting vitamin B-12 deficiency. During pregnancy, these women may need vitamin B-12 shots to avoid complications.
Folate deficiency: Folate (folic acid) is a B vitamin that works with iron to ensure cell growth. If pregnant women do not consume enough folate during pregnancy, they could get iron deficiency. In addition, folic acid reduces the risk of having a baby with congenital disabilities of the brain and spinal cord, especially if it is consumed in the early periods of pregnancy.
How can anaemia be prevented?
Alok Khettry suggested, “Besides spreading awareness about the
complications and impact of anaemia on the reproductive health of women,
screening tests must be conducted at hospitals and healthcare facilities across
the country. Good nutrition before and during pregnancy can also be vital in
preventing anaemia and building a rich nutritional store in the body. A good,
balanced diet will help women deliver healthy babies and recover faster from
the process of childbirth as well.”
He highlighted, “Some good food sources of iron include meats including beef, pork, lamb, liver, and other organ meats, poultry including chicken, duck, turkey, and liver, especially dark meat, fish including shellfish, sardines, anchovies, clams, mussels, and oysters (all should be well cooked and avoid fish with high mercury content), types of cabbage including broccoli, kale, turnip greens, and collards, legumes like lima beans, green peas, canned baked beans, yeast leavened whole wheat bread and iron-enriched white bread, pasta, and cereals.”
Collaborative Solutions for a Healthier Future
Alok Khettry concluded, “In the collective effort to understand
and address anaemia's impact on reproductive health, collaboration is key.
Healthcare professionals, community leaders, policymakers, and individuals can
work together to foster a culture of open dialogue and proactive health
measures. Through combined efforts, we can script a narrative of resilience,
health, and hope for future generations.
In essence, understanding anaemia in India and its effects on reproductive health requires a collective acknowledgment of its prevalence, breaking cultural barriers, emphasizing nutrition, and advocating for systemic changes. By addressing these facets, we can pave the way for a healthier and more informed tomorrow.”
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