dietry aspects of anemia Flashcards
what type of anaemia results from iron deficiency
hypochromic microcytic anameia
what type of anaemia results from folate/B12 deficiency
megaloblastic anaemia
what is the most widespread nutritional problem in the world
iron deficiency
what demographic groups have the highest percentage of Hb below threshold
girls 11-18; adult women; men >65 (generally secondary cause e.g. colon cancer)
how much iron is recycled in the body daily and from where
20-25mg recycled from red cell destruction
4 risk factors for iron deficiency anaemia
H.pylori (use iron for own growth); long-term use of PPIs; blood loss (menstrual, frequent donation); pregnancy
what vitamin increase iron absorption
vitamin C
what are 2 dietary factors that decrease iron absorption and where r they found
phytate (in whole grain cereals); tannins (in fruit, veg, tea)
how much meat is recommended per day
no more than 70g of red/processed meat
4 fucntions of vit B12 (cobalamin)
- development/myelination/function of CNS;
- DNA synthesis (and thus RBC formation);
- co-factor methionine synthase
- L-methylmalonyl-CoA-mutase
why might serum ferratin levels be artificially high
it is an acute phase protein and so does not reflect iron stores when there is infection/inflammation present
how much iron needs to be absorbed per day
1-2mg
what are the 3 main reasons for iron deficency in industrialised countries
- low bioavailability;
- sedentary lifestyle;
- lower micronutrient density
what is the majority of B12 deficiency caused by
impaired absoprtion (pernicious anaemia) due to lack of intrinsic factor
long term use of what kind of drugs can result in B12 deficiency and why
PPIs (and other drugs that affect gastric acid production) -> gastric acid needed to release B12 bound to proteins in food
what can inadequate B12 in children result in
stunted brain growth and intellectual development
where is Vit B12 found in the diet
products of animal origin - meat (esp liver), poultry, fish, dairy, eggs;
fermented foods e.g. sauerkraut (due to bacteria);
fortified cereals
folate vs folic acid
Folate - natural form of vitamin B9 in food
folic acid -synthetic form
what enzyme deconjugates folic acid in the small intestine
glutamate carboxypeptidase II
what increases folate/folic acid requirements
alcohol consumption
what demographics are vulnerable to nutritional anaemias
infants/chidlren (high requirements); vegans; pregnant women; elderly (malabsorption and poor diet); low income; ethnic minorities
4 symptoms of iron deficiency in infants
poor weight gain; frequent infections; developemental delay; behavioural disorders
why might an infant develop iron deficiency at 6 months old
inappropriate weaning
how much does iron absorption increase by in pregnancy
x1.5 in second trimester and x4 in third
what 2 mutations cause increased risk of
neural tube defect in the foetus
Methyl tetrahydrofolate reductase (MTHFR) and methionine synthetase reductase (MTRR) mutations
why is anaemia common in the elderly (8)
- Higher risk of nutritional deficiencies
- Impaired absorption (particularly vitamin B12)
- Dental problems – restricted food choice
- Poor quality meals in institutions
- Lower socio-economic status
- Less mobile – restricted shopping
- Mental problems – dementia, depression
- Lower physical activity requires lower energy intake
management for folate deficiency
5mg folic acid supplement OD; eat folate rich foods e.g broccoli, Brussels sprouts, asparagus, peas, chickpeas, and brown rice
elevate what can be a sign of folate deficicency
homocystein levels (with normal methylmalonyl-coenzyme A)
6 causes of splenomegaly
- haematological malignancy (lymphoma, leukemia, mylofibrosis);
- haematological conditions (chronic haemolytic anaemia);
- infection (EBV, maralia, leishmaniasis);
- liver disease (cirrhosis results in increased portal hypertension);
- sarcoidosis, SLE etc.
- glycogen storage disorders (gaucher’s etc.)
