Anaemia in Adolescents(10-19) & Risk of Malnutrition

Anaemia :

Anaemia in Adolescents : Reduced ability of blood to carry oxygen because of a lack of hemoglobin in the red blood cells for a specific age and sex.

How does Anaemia in Adolescents impact the individual?

• Diminished physical growth
• Deficiency in sexual and reproductive development
• Decreased cognitive growth

Types of anaemia :

• Folate or vitamin B12 deficiency anemia
• Iron deficiency anemia
• Dimorphic anemia
• Anemia from various causes
• Anemia from inflammation

The Effects of Adolescent Malnutrition :

Inter-generational cycle of anaemia

• Malnourished girls
• Likely to develop pregnancy complications
• This vicious cycle of iron deficiency anemia persists since an adolescent girl who enters the reproductive age with low iron reserves and becomes pregnant during adolescence or later is more likely to give birth to a low birth weight and preterm baby.
• The baby is also born with low iron reserves, and because of poor infant feeding practices, is more likely to enter adolescence with low iron reserves in the body.

Other negative outcomes of malnutrition

• Worse overall health
• Impairs academic performance
• Low academic achievement
• Reduced productivity and job capacity
• Slowed growth process and sexual maturation rate

Common signs of malnutrition in adolescents include:

• Inadvertent weight loss
• Constant fatigue Not gaining weight that is typical for that age group
• Sunken eyes
• Getting tired more readily than others
• Irritability
• Inadvertent weight gain
• Getting sick frequently and taking longer to recover

Impact of Anaemia on Adolescents :

a. Impact on boys and girls

• Stunted growth
• Weakness and tiredness
• Diminished concentration
• Poor school performance
• Breathlessness

b. Impact on reproductive health of girls

• Irregular menstruation
• A higher chance of miscarriage
• Low birth weight babies
• Premature labor
• Prepartum/postpartum hemorrhage
• Puerperal sepsis
• An increased risk of maternal mortality and morbidity

What are the risk factors and potential causes of a high anemia burden?

Deficiency :

When pregnant, anemic moms

• Inadequate iron stores from birth
• Childhood deficits, and teenage anemia
• Folic acid and B12 deficiency
• Disorders connected to blood that are inherited or acquired

Dietary :

• Improper IYCF, particularly with regard to complementary feeding methods
• Consuming too many “iron inhibitors” (tea, coffee, foods high in calcium) and not enough “iron enhancers” (Vitamin C, etc.)
• 50% of the population consumes less than 50% of the recommended daily allowance for dietary iron
• There is a lack of knowledge about affordable, locally accessible, and nutrient-dense foods;

Iron Loss :

• Because of worm infection by roundworms or hookworms.
• Acute or chronic inflammation or a chronic illness.
• Living in a location where malaria is endemic.
• Poor environmental cleanliness, contaminated drinking water, and inadequate personal hygiene

Maternal Anaemia :

• Iron loss from postpartum hemorrhage
• Increased iron need during pregnancy as a result of tissue, blood development and energy needs
• Adolescent pregnancies
• Teenage pregnancies
• Repeated pregnancies with a gap of less than two years

Haemoglobinopathies :

A class of inherited blood illnesses and diseases known as hemoglobinopathy mostly affects red blood cells.

Consist of two major groups:

• Thalassemias
  • The primary burden of disease is caused by Thalassemia Major (TM) and its severe version, Thalassemia Intermedia (TI), both of which require iron chelation and lifelong blood transfusions for treatment.
• Sickle Cell syndromes
  • Sickle cell disease (SCD), which increases morbidity and mortality in infants and children, needs to be managed throughout one’s life.

Vitamin B₁₂:

A vitamin B₁₂ deficiency adds to the risk of anemia in adolescents and adults in addition to hemoglobinopathies.

Importance :

Vital for a healthy neurological system and the synthesis of red blood cells

Causes of Deficiency :

• Diet deficient in Vitamin B12
• Cause pernicious anemia.
• The most prevalent cause of vitamin B12 deficiency anemia is a shortage of a chemical called intrinsic factor, which can be brought on by the immune system inadvertently.
• Vitamin B12 deficiency can also be induced by a diet low in meat, eggs, and milk.
• Assaults the stomach cells that generate this chemical. We refer to this kind of anemia as pernicious anemia.
• Vitamin B12 cannot be absorbed and is eliminated from the body as waste without intrinsic factor, a protein secreted by the stomach that combines with vitamin B12 in the stomach and transports it through the small intestine to be absorbed in the bloodstream.
• Vitamin B12 is crucial for the synthesis of red blood ceIf left untreated, vitamin B12 deficiency can cause neurological issues like chronic tingling in the hands and feet or trouble balancing.
• Because vitamin B12 is essential for normal brain function, it might cause mental confusion and amnesia.
• If vitamin B12 deficiency is not treated, neurological issues may persist for a long time.
• It is also necessary for a healthy nervous system.

Consequences of deficiency :

• Can result in neurological issues.
• Can lead to mental disorientation and forgetfulness
• If not treated, neurological issues can become permanent

Appropriate food :

A. person’s BMI is a rough indicator of their weight condition. It is computed by dividing height in meters squared by weight in kilos.

B. A result ranging from 18.5 to 24.9 indicates that the individual’s weight is typical for their height.

• A balanced diet is one that fits the body’s nutritional requirements by including a suitable amount of food from each of the several food categories.
• Between 50 and 60 percent of total calories should come from carbohydrates, ideally complex ones (starches in cereals, millets, pulses, and root vegetables, and glycogen in animal foods); 10 to 15 percent should come from proteins (milk, meat, fish, and eggs; and plant foods like pulses and legumes); and 20 to 30 percent should come from both visible (oils and fats like butter, ghee, and vanaspati) and invisible (fat found in plant and animal foods) fat.

C. Using hemoglobin levels to identify anemia:

Teach the teenager about a balanced diet and good nutrition by using the Healthy Eating Pyramid:

A balanced diet’s relative amounts of each food type are shown by the food pyramid.

• Because the base of the pyramid is broad, meals that are positioned here should be consumed in greater amounts; these are the foods that provide energy.
• Meals high in fats (oils) and sugar are found at the tip of the pyramid.
• These provide energy as well, but only in modest amounts can be included in a regular diet. From an economical and sustainable standpoint
• It is crucial to build a diet on locally sourced foods.

Healthy Eating Practices :

• Slow eating and correct chewing are two examples of healthy eating practices.
• Avoid watching TV or reading while eating.
• Consuming a well-balanced meal that includes the various food groups in sufficient amounts
• Eating in moderation and at the right times
• Drinking enough water (8 to 10 glasses daily)
• Avoiding junk food on a regular basis
• Eating all meals on time and never skipping or overeating

Work with families to promote :

• Present the meal in an eye-catching manner.
• Consider the teen’s preferences as much as you can when preparing meals at home.

Easily accessible in many regions of India, millet ragi is a particularly rich source of calcium. Iron is abundant in gram (chana) and jaggery

• Promote wholesome, locally accessible resources
• Recognize gender-based discrimination
• Educate on preventing anemia
• Encourage families to support their adolescents’ weekly administration of IFA in schools or Anganwadi Centers (AWCs)
• Encourage the use of biannual deworming with albendazole; Avoid collecting water to prevent malaria, filaria, and dengue
• Use footwear and latrines to prevent hookworm infestations;

Encourage good hygiene and a balanced diet:

• Washing fruits and vegetables well before eating them
• Maintaining a clean kitchen Checking the date of manufacturing, expiration date, MRP, etc. when purchasing packaged foods
• Cooking with iron utensils
• Cooking greens in an open container
• Keeping food covered
• Washing hands before eating and after using the restroom

Common iron rich foods

• Mutton
• Seafood
• Chicken
• Lamb
• Eggs
• Chana saag
• Kantewali chulai
• Mustard leaves
• Mint
• Spinach
• Onion stalks
• Nutrition and Anaemia in Adolescents
• Fenugreek leaves (methi)
• Arvi ka saag
• Lentil
• Bengal gram (whole)
• Soybean
• Gingelly seeds (Til)
• Black gram dal (urad dal)
• Red gram dal (arhar)
• Plantain green (unripe kela)
• Watermelon
• Seetaphal

Common Vitamin C rich foods

• Lemon, Oranges, Kiwi
• Peppers
• Amla
• Adding Vitamin C to one’s diet can help in the absorption of iron

Spread Knowledge in the Community on the Causes of Anaemia and Malnutrition :

1. Identify carriers in teenagers by screening before to marriage
2. Address stigma associated with illness, gender bias, and misconceptions about how diseases spread.
3. Give all thalassemia and sickle cell disease patients the best care possible.
4. Provide day care centers at district hospitals for transfusion patients.
5. Maximum alignment with other health initiatives
6. Plan quizzes, instructional seminars, and hand out educational papers.
7. Encourage B12 deficiency screening and raise awareness

Sources of Vitamin B12 rich foods :

• Eggs
• Fish
• Mutton
• Chicken
• Mushrooms
• Milk and dairy products

Key message :

• Nutrition is the process of consuming food while keeping in mind the body’s nutritional requirements.
• Malnutrition is defined as an imbalance, excess, or deficiency of nutrients in the body.
• Malnutrition can increase the risk of illness and even death in children, adolescents, and pregnant and lactating women.
• Micronutrient deficiencies are a major underlying risk factor that contributes to the global burden of disease.
• Adolescence is a time when people transition into a more independent stage of life, which affects how they eat.
• Adolescent girls with limited iron stores who reach reproductive age and falls pregnant later in life or during adolescence is more likely to give birth to a preterm, low-birth-weight child.

Thanks and Regards

N.B. This information is suggestive only.