There are close to 100 different types of anemia with many causes, including:

" Serious disease such as kidney failure, cancer
" Vitamin or iron deficiencies
" Blood loss due to injury, intestinal disease
" Genetic or acquired defects or disease such as sickle cell
" Side effects of medication

We will discuss iron deficiency anemia, which occurs in vulnerable populations such as infants, children, teens in rapid growth phases, pregnant or lactating women, the elderly, poor or migrating populations. It is the most common and easiest to treat when an underlying disease is absent.

At any given time, approximately 20% of women, 50% of pregnant women, and 3% of men are iron deficient. Iron is obtained naturally from the food we eat and that given up by old and dying red blood cells. It is stored in the marrow of the bones, particularly larger ones. However, there must be a natural absorption mechanism in the body to acquire and use it and there must not be a competing mineral in circulation such as lead.

HOW WOULD YOU KNOW IF YOU MIGHT BE ANEMIC?
You may not recognize symptoms at first. If it is not initiated by bleeding or hemorrhaging, it develops subtly. You may first feel tired often. If so, you should examine your nail beds and mucous membranes of your mouth for paleness. Eventually your face will look pale. If left untreated and causes remain, you eventually will notice:

" Shortness of breath
" Sore tongue
" Brittle nails
" Decreased appetite
" Headaches
" A blue tinge to the whites of your eyes

WHAT CAN BE DONE?
First of all, an assessment of eating habits, nutritional choices, meal regularity and adequacy would be in order. (See assessment tools and recommendations below.)

Physical activity level should be assessed. Without exercise challenge to the cardiovascular and pulmonary systems, oxygen resources cannot build strength.

Assess for a recent episode of blood loss or dark brown or black bowel movements. Individuals over 50 or who take medication for painful arthritis may have intestinal bleeding that can be self-tested with an occult blood kit from the pharmacy.
Your primary care provider can order laboratory blood test such as the following to reveal the cause or severity:

" Low hematocrit and hemoglobin (red blood cell measures)
" Small red blood cells
" Low serum ferritin
" Low serum iron level
" High iron binding capacity (TIBC) in the blood
" Blood in stool (visible or microscopic)

Once the cause and severity has been determined, the diet should be corrected (if that is the root of the problem); iron supplements (ferrous sulfate) may be necessary. When taking iron supplements, the best time is when the stomach is empty, but because of it strength and density, some cannot tolerate without some food-dairy food and antacids interfere with absorption. Vitamin C increases absorption and is essential in the production of hemoglobin. After 2 months of iron therapy the red blood cells should have a normal level of hemoglobin; however, it should be continued for another 6-12 months to replenish the stores in bone marrow.

And physical activity should be planned as a natural and regular event in your life.
While we are discussing iron deficienty anemia in adults, it is important to recognize that anemia in infants and children is a critical concern. Poverty, abuse, and living in a home with poor household conditions place children at risk for iron deficiency anemia. Iron deficiency anemia is seen most commonly in children six months to three years of age. Those at highest risk are low birth weight infants after two months of age, breastfed term infants who receive no iron-fortified foods or supplemental iron after four months of age, and formula fed term infants who are not consuming iron-fortified formula.

SO, ON THE ISSUE OF NUTRITION, WHAT SHOULD AN ANEMIC INDIVIDUAL EAT?
As an introduction, it is important to understand that the framework upon which to build your nutritional program is the new Vegetarian Food Pyramid or the Mediterranean Pyramid, which focuses on a vegetarian diet. The recommendations were made by the nation's experts on nutrition; but they establish the minimum range of food values. Each individual must then consider these factors for further enrichment of the diet:

" Activity level; bicycling, jogging, race walking, swimming, climbing, construction work, etc. will require a certain number of calories and greater quantities of nutrients.
" Replenishment of vitamin and/or mineral stores
" Improvement of the immune system

Nutition experts advise that iron-rich foods include dried fruits like raisins, prunes; meats (liver is the highest source); fish; poultry; eggs (yolk); legumes such as peas and lima beans; green leafy vegetables; nuts; blackstrap molasses; and whole grain bread, particularly with wheat germ. Some manufactured foods are fortified with iron.

Foods high in vitamin C - like citrus fruits, tomatoes and strawberries - help your body absorb iron from food
Some foods block the absorption of iron. These include coffee, tea, egg yolks, milk, fiber and soy protein. Try to avoid these when you're eating food high in iron.

Please proceed to Part 2 . . .