Anemia, A Sickness of the Blood

Children and youthHealthNutrition


Have you felt weak or dizzy lately? Does even a little bit of work make you tired or breathless? These are just a few of the symptoms of a sickness called anemia. But feeling fatigued does not have to be a normal part of your life. You get anemia mainly from not having enough of a nutrient called iron in your diet. You might only need to improve your eating habits to feel healthy again.

Anemia is a worldwide nutrition problem, especially in women. If our bodies do not get iron from the foods we eat, our blood becomes weak and does not do its job of carrying oxygen to different parts of our body. Without a regular supply of oxygen, we may feel shaky, dizzy and easily tired.

Look for other symptoms. If any part of your face is pale, especially the rims of your eyelids, or cheeks, you could be anemic. Pale skinned people may be paler than usual, and may even see the veins in their face through their skin. Check too for pale inner eyelids, tongue, or gums. You may also have swollen hands, face or feet; you may be short of breath and have little or no appetite. Anemic women and children often like to eat earth because it has iron in it. If you have anemia for a long time, and do not treat it, you may develop flat fingernails or nails that curve inward from the sides like a small valley. Children who have anemia may develop mental problems.

People who have malaria sometimes get anemia because they are losing blood. When you lose blood, you may get anemia more easily. Hook worms, ulcers, or heavy bleeding can all lead to anemia. Women suffer from anemia more than men do because women lose blood every month during menstruation. They also lose blood after pregnancy, miscarriage, or abortion. Women must replace the blood they lose and get iron into their bodies.

A healthy diet helps prevent and treat anemia To prevent and treat anemia, start with your diet. Eat foods that have a lot of iron and protein, because these two nutrients work together to make your blood strong. Women, especially pregnant women, should eat as many of these foods as possible.

Your body uses iron from animal foods more easily than from plant foods. You can get both iron and protein from eggs, red meat, liver, chicken, fish, or shellfish. Grain legumes are also good sources of iron. If possible, include at least one serving a day of grain legumes such as chick peas, cowpeas, rice, beans, or lentils. Milk and cheese, especially cottage cheese, have a lot of protein. Many types of nuts and seeds also contain iron and protein, such as peanuts, almonds, caraway, sunflower, pumpkin, or watermelon seeds.

Raw vegetables usually have more nutrients than cooked vegetables, so eat washed, raw vegetables as often as you can. To get a lot of iron, eat the skins of raw carrots and cooked potatoes.

Dark green leafy vegetables have a lot of iron, and are especially good in your diet if you do not eat much meat, fish, or eggs. You can eat the leaves of many plants straight from your garden such as spinach, cabbage, leeks, mint, Swiss chard, and endive. You can also eat leaves from many plants which you may be growing for other purposes. For example, beets, celery, okra, turnips, cauliflower, papaya, hot peppers, taro and sweet potatoes, all have leaves you can eat.

Vitamin C, a nutrient found in many fruits and vegetables, helps your body use iron. So, if you have anemia you should also try to eat foods that have a lot of vitamin C in them. There is Vitamin C in oranges, guavas, kiwi, limes, lemons, mangoes, papaya, melon, green peppers, and tomatoes. Green leafy vegetables also have a lot of vitamin C. So eat foods high in iron at the same time as foods that have a lot of vitamin C.

Avoid drinking tea with food. Studies have shown that if you have tea with meals, your body will not absorb iron very well. Women and children must be especially careful.

And be careful not to cook green leaves for too long. The longer green leaves are cooked, the more vitamins and minerals are lost into the water and steam. Cooking also destroys much of the Vitamin C in foods. One of the best ways to cook green leaves and vegetables without losing many vitamins and minerals is to steam them. Put just enough water to cover the bottom of the pot, put in your vegetables, and boil. Use a lid to prevent the nutrient rich steam from escaping. It helps to cook in iron pots because small amounts of iron from the heated pots will go into the food. You can save the cooking water from vegetables and all edible leaves to use in stews, soups or any other cooking that requires water.

To prevent your children from getting anemia, start them on a healthy diet early. Children need other foods besides breast milk after they reach the age of six months. But very young children may find many fruits, vegetables, and green leaves hard to chew. If you mash or grind foods, children will find them easier to eat. As your children grow, continue to feed them foods rich in iron and protein.

Severe anemia For severe cases of anemia, iron from food will not cure the illness. If you have a swollen face or feet, and a fast heartbeat, your anemia is serious, and you will need to get iron pills. See a health worker, or ask if there is somewhere nearby where you can get iron tablets. Iron tablets cost money and may not always be easy to get so it is better to eat well to prevent anemia in the first place.

Women and anemia Women, especially, need a healthy diet to prevent anemia. In some societies, women cannot eat until all other family members have been fed. Or, they are not allowed to eat certain foods at all or at particular times. The food that remains after others have eaten, or the food women are allowed to eat may not have enough iron and protein to keep them healthy. These kinds of restrictions should be changed so that women can get the foods they need to stay healthy.

Pregnancy can also make a woman feel weak, especially if she does not eat foods with enough iron and protein. A mother must have healthy blood so that the child growing inside her is healthy too. She will lose blood in childbirth, and if she doesn’t get enough time to recover her strength and build up iron in her body, she may get anemia. If a woman allows two or more years between pregnancies, her body has enough time to replace lost iron. A woman who is anemic from having pregnancies too close together can suffer from miscarriage or prolonged bleeding after birth.

Make sure you and your family eat foods with plenty of iron and protein to prevent anemia, the weak blood illness.

Notes If your doctor prescribes iron tablets because you have anemia, get tablets that also have vitamin C and folic acid in them. Take pills with meals or after meals. If you take them on an empty stomach, you may feel sick. Do not feed iron pills directly to children under three years old. You can grind up a piece of a tablet very fine and mix it with their food. You should also be careful not to get too much iron, especially from tablets because getting more than you need can also be harmful to your body.

Both children and adults may get severe anemia if they have hookworms, malaria, chronic diarrhea or dysentery. So prevention of these other diseases is important if you want to prevent anemia. Hookworms are often passed from person to person through infected feces. If a person suffering from hookworms defecates on open ground, the eggs of hookworms mix with the earth. When another person walks barefoot over that same ground, or in any way makes contact with the contaminated dirt, the hookworms can enter the body through the skin. To avoid getting hookworms, wear shoes and use a latrine. If no latrine is available, dig a hole to make a latrine. Be sure to cover the fecal matter with earth afterwards.

Malaria is harder to avoid than hookworms. In many tropical countries, mosquitos carry malaria. If you get bitten by an infected mosquito, you may get malaria. Anemia is one possible symptom of malaria. Malaria, diarrhoea and dysentery must be treated separately before treating the anemia that results from them. Ask a doctor or health worker.

Another type of anemia linked to lack of iron is called megaloblastic anemia. You may get this kind of anemia when you don’t have enough folic acid in your blood. You can die from megaloblastic anemia if you don’t treat it.

Some symptoms are the same as iron deficiency anemia. You may feel tired and weak, get headaches, have a fast heartbeat or experience a shortness of breath. You may also find you have a sore tongue and diarrhea, and you forget things or get easily irritated. You may lose your appetite and lose weight as well.

Again, eat fresh, uncooked, green leafy vegetables and plenty of legumes to avoid folic acid deficiency.

Some children are born with a hereditary type of anemia called Sickle Cell Anemia. A child may seem normal for six months, then signs may begin to appear. Besides eating dirt, and feeling weak, tired or dizzy, you may notice your child often has a fever, cries a lot and has a large belly which is hard at the top. Look for a yellow colour in your child’s eyes and bony bumps on the head by age two. An anemic child may also grow very slowly. If you notice any of these symptoms in your children, bring them to a health worker to get tested for anemia.

Malaria or other infections can bring on a sickle cell crisis. Your child may have a high fever, and severe pain or swelling in the arms, legs, feet and belly. Your child could die. If you see any of these symptoms, take your child to a health centre as soon as possible.

You cannot prevent or treat sickle cell anemia with iron rich foods or iron tablets, but you can prevent a sickle cell attack. Protect your children from malaria and other diseases and infections. Always feed them a healthy diet. Keep children warm with a blanket at night when necessary. If possible, use a foam mattress so that they are not lying directly on cold ground. Take a child with sickle cell anemia for regular monthly visits at a health worker for examination and medicines.


This script was researched and written by Belinda Bruce, a writer in Toronto, Canada. It was reviewed by Hélène Delisle, Department of Nutrition, University of Montreal, Montreal, Canada, and by Dr. Stanley Zlotkin, University of Toronto, Faculty of Medicine, Division of Gastroenterology and Nutrition, Toronto, Canada.

The production of this script was made possible by the generous support of Nancy’s Very Own Foundation, Toronto, Canada.

Information sources

Manual: Anaemia and women’s health (Kit, 14 pages). CHETNA, 2nd Floor, Drive in Cinema Building, Ahmedabad, India 380 054.

“Tea drinking may cause anemia in infants” in LIFE newsletter, Vol. 18, No.6., Dec. 1985/Jan. 1986. League for International Food Education, Washington, DC, USA.

Where There is No Doctor: A Village Health Care Handbook, David Werner, Carol Thuman and Jane Maxwell, 1992. Published in English, French, Spanish and many other languages by the Hesperian Foundation, P.O. Box 1692, Palo Alto, California, 94302, USA.

Caring for Ourselves: A health handbook for Pacific women, Vanessa Griffin, University of South Pacific, 1983. Fiji Times and Herald Limited, Suva, Fiji.

The Complete Canadian Health Guide, June Engel, 1993. Key Porter Books Ltd., Toronto, Canada.

Nutrition for Developing Countries, Felicity Savage King and Ann Burgess, 1992, 2nd edition. Educational Low Priced Books Scheme with Oxford University Press, Walton Street, Oxford, OX2 6DP, Great Britain.