Authors
Prof (Dr) PK Sasidharan, MD, FICP, FRCP1
1Former Head, Department of Medicine & Division of Haematology, Government Medical College, Kozhikode
Abstract
Nutritional anaemias attributable to iron, B12 and folic acid deficiency in the Indian context is more often due to decreased consumption rather than due to all the other causes put together. In developed countries these deficiencies often are due to physiologically increased need for these micronutrients or pathological situations of malabsorption or increased loss, which are our concern too. Besides B12, iron and folic acid, regular consumption of a complete protein (containing all essential amino acids) is also absolutely essential for haemoglobin syntheses and even that is compromised in Indian scenario. Therefore nutritional anaemias in the Indian subcontinent is not an issue of iron deficiency alone, but it represents the tip of the iceberg of clinical and subclinical malnutrition. There are several myths and wrong ideas on nutrition and balanced diet which need to be changed and people should be empowered to consume proper diet. To make a beginning, we need to work for creating awareness on proper balanced diet and to remove all false beliefs and wrong practices, regarding food items, which are rooted in cultural, religious, regional factors and influence of consumerist forces using good primary education and well trained primary care doctors. Equally important is to empower the people by social, economic, and agricultural reforms, and policy changes, for consuming a balanced diet, for a sustainable solution to nutritional anaemias besides other nutritional deficiencies/disorders. The concept of balanced diet has to be taught in primary schools with school health programs, using the health team in PHCs, coordinated by dedicated primary care doctors. The practical tips and pitfalls of practising healthy eating and lifestyle habits are to be given through the PHCs by the primary care doctors. Besides that policy changes are needed to promote decentralised integrated farming to make available all the components of a balanced diet locally and afresh. The social aspects of malnutrition, including poor management of resources, wrong influences on the people by advertisements and the growing fast food culture all need to be addressed to achieve anaemia free India.
Keywords: Anaemia, Nutrition, Social Health, Health Policy, Primary Care, Family Doctors