Anemia in Adolescence

 

 Anemia is one of the common health problems across the globe, affecting all age groups particularly the pregnant women and young children of which about 50% is  attributed to iron deficiency. In adolescence, anemia have been neglected. It affects the mental and physical development, as well as health maintenance and work performance. It mostly prevalent among adolescent girls because of the additional loss of blood during menstruation and other gender contributing factors. Anemic adolescent girls are more likely to become anemic mothers. During pregnancy, they have an elevated risk of postpartum hemorrhage and giving birth to low-birthweight, premature or stillborn babies who are likely to grow stunted, perpetuating the vicious cycle of malnutrition.

Causes of anemia

Anemia is an indicator of  both poor nutrition and poor health. Iron deficiency in its most severe form results in anemia – IDA.  Iron deficiency anemia is a condition in which anemia occurs due to lack of available iron to support normal red cell production. This may be due to inadequate iron intake, poor iron absorption, increased iron need or chronic blood loss.  Other nutritional deficiencies besides iron, such as vitamin B12, folate and vitamin A can also cause anemia although the magnitude of their contribution is unclear. Infections (such as malaria and intestinal parasitic infection [IPI]), and chronic illness can also result to anemia.

The signs and symptoms of iron deficiency anaemia in adolescents may include:

• Pale skin
• Fatigue or weakness
• Slow cognitive and social development
• Inflammation of the tongue
• Difficulty maintaining body temperature
• Increased likelihood of infections
• Unusual cravings for non-nutritive substances, such as ice, dirt or pure starch

Prevention

• Anemia in adolescence can be prevented through adequate nutrition. Including animal-based protein products provides the body with the heme type of iron. Heme iron is better absorbed by the body.
• Other source of iron are the non-heme iron gotten from plant based foods e.g. green-leafy vegetables. fortified grains, nuts, seeds, legumes, and vegetables.

How to improve iron absorption from food

How food is prepare and which foods eaten together, can affect how much iron the body absorbs. For example, including foods rich in vitamin C such as citrus fruits, tomatoes, berries, to non-heme iron sources such as legumes, nuts, seeds and green leafy vegetables can help absorb more iron if one eats them at the same time as iron-rich foods.

Coffee, tea and red wine (both alcoholic and non-alcoholic), on the other hand, can reduce iron absorption. Calcium-rich foods, calcium supplements and some soybean-based foods can also inhibit iron absorption.

It’s better to have coffee, tea, red wine and dairy foods in between meals.

 

Nutrition in the First 1000 days of Life

Every child has a right to optimal cognitive, emotional and social behavioral development. These parts of the brain continue to develop across lifespan. A great deal of brain’s ultimate structure and capacity is shaped between 0-2 years of life.

 The first 1000 days of life, which includes gestation and the first two years of life, are a vulnerable period in human development when poor nutrition can have short- and long-lasting consequences on human health and function. This a window of opportunity because it is when improvements in nutrition can have the greatest impact in individual’s growth and development. Maternal prenatal nutrition and the child's nutrition in the first 2 years of life (1000 days) are crucial factors in a child’s neurodevelopment and lifelong mental health. Child and adult health risks, including obesity, hypertension, and diabetes, may be programmed by nutritional status during this period. Calories are essential for growth of both fetus and child but are not sufficient for normal brain development. key nutrients that support neurodevelopment include protein; zinc; iron; choline; folate; iodine; vitamins A, D, B₆, and B₁₂; and long-chain polyunsaturated fatty acids. Failure to provide key nutrients during this critical period of brain development may result in lifelong deficits in brain function despite subsequent nutrient repletion.

The best way to meet the nutritional needs of this crucial stage is to:

• diversify your diet 
• take your pre-pregnancy supplements judiciously
• cut down on the use of junks 
• minimize/reduce or avoid pica eating
• exclusively breastfeeding your infant in the first 4-6 months of life
• introduce adequate complementary feeding after the first 6 months while introducing one food item at a time

These  provide the ideal nutrients for optimum growth and development and protection against illness. Not meeting the nutrients is difficult to reverse any deficiency effect after this stage and it has both financial and social implications.

NUTRIENT-DRUG INTERACTIONS

Medications both the prescription and over-the counter can interfere the way body uses nutrients in food. They interact with nutrients in several ways such that, it can increase or decrease appetite, or change the way a nutrient is absorbed, metabolized or even excreted.

Dietary nutrients can also affect medications by altering their absorption or metabolism. The kind of food eaten can make a medication work faster, slower or even prevent it from working. This may result to different responses leading to loss of therapeutic efficacy or disease control, compromised nutritional status, drug toxicity or even a life-threatening condition.

Types of interactions

· Drug-nutrient (effect on nutritional status)

·        Food-drug interactions (effect of efficacy of drugs)

Some drugs and their nutrients interactions

1.     Contraceptives and folate: oral contraceptives interfere with and impairs the body’s metabolism of folic acid. Inadequate folate status is linked to impaired gene synthesis and insufficient production of Red Blood Cells which in severe cases can lead to fetal Neural Tube Defect. Women who are planning pregnancy shortly after stopping oral contraceptives are at a higher risk of complications as a consequence.

2.     Antibiotics and calcium: dietary calcium binds to antibiotics, reducing the body’s ability to absorb the amount of antibiotic intended. Calcium is found in milk, dark-green leafy vegetables etc.

3.     Antimalarial drugs and vitamin C: taking antimalarial medication with any vitamin C containing supplement or fruits compromise the rates of the parasites clearance. Grape fruit juice, orange juice or any vitamin C concomitant diminishes the efficacy and potency of widely used antimalarial drugs. Vitamin C favours the development of young malaria parasites.

4.     Antibiotics and iron supplements: iron supplements should not be taken with antibiotics or during fever because the body’s defense mechanisms have pulled all the reserves out and will only add strain to the body.

5.     Diuretics and potassium: diuretics (anti-hypertensive drugs) increases the loss of potassium along with fluids. Potassium is important for the proper functioning of the heart and other muscles.

6.     Antidiabetic drugs and vitamin B12: antidiabetic drugs interfere with vitamin B12 absorption and if left untreated, the deficiency can lead to anaemia, dementia, and neurological damage.

 

ATTAINING GOOD NUTRITIONAL STATUS IN SPITE OF THE ECONOMIC CHALLENGES IN NIGERIA

 

It is not news that the cost of living in Nigeria has skyrocketed. The Covid-19 pandemic, inflation, and rising insecurity are among the factors being blamed for that. The fact is, good nutrition may be a huge challenge in some homes at this point. At The Informed Mum, we understand that nutrition plays a vital role in overall health thus we think sharing the following tips would help us attain good nutrition inspite of the cost of food items.

1.       Focus on locally produced foods and buy from local markets. Most Nigerians believe (sometimes rightly) that the quality of foods from the supermarkets is higher than those in the open markets. The poor regulatory conditions in the country make this belief debatable. But one thing we should be able to do at this point is to ditch the foreign foods for local ones. We wouldn’t only be growing our economy; we would also be saving our money. Buy the Nigerian rice, swap Semo for Amala, tuwo or garri. For babies, ditch the packaged baby foods and produce your own cereals-based food like akamu/pap. You can choose to fortify the baby meals with fruits, nuts, and proteins sourced from our locally produced foods. We have some links to explorable baby food options Mango puree, Avocado and egg puree, Sweet potato and spinach puree and many others by clicking Baby meal ideas . “Good quality” doesn’t necessarily mean “imported”. I may actually trust akamu made from the corn I bought in a local market than some of the baby foods bought in supermarkets.

2.       For babies under 6 months of age, exclusive breastfeeding cannot be overemphasized. It is free, cheap and the healthiest option for most babies.

3.       Eat foods in season. Our lack of steady electricity for food storage often means that foods and fruits that are in season are as cheap as dirt, then become as expensive as diamonds when their seasons start to go. One way of feeding fine is to stick to foods that are in season. Season of yams; eat yams. Do the same with beans, fruits and even vegetables. Nigeria is so blessed with arable land that there are foods in season all year round. During the rainy seasons, we get the vegetables like Ugu, spinach and so on, abundant in the Southern parts of Nigeria. When the dry season comes, vegetables from the Northern parts of Nigeria where they practice a lot of irrigation farming start to bloom. There is food for every season, we just need to make our taste buds adapt to our pockets. We would end up both healthy and able to save some money for our other needs