Anemia

Anemia Lesson - Are you getting enough iron?

By the end of this lesson you will:

•	choose a reason why iron is important
•	target two accessible iron rich food choices
•	choose a dietary practice that will reduce the likelihood of anemia

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Activity 1:

Why do you think iron is important in your diet? List one reason:

• Have you or your child ever felt tired or weak? Have you lost your appetite or feeling short of breath? Does your skin look pale or dry? If you have these symptoms it may be time to consider iron deficiency anemia. This is only one of several types of anemia. The red blood cells contain less hemoglobin and lose their ability to carry oxygen. With anemia, the blood is unable to supply the full oxygen needs of the tissues. Therefore, less oxygen is carried when it is needed. The cells then operate with a lowered energy level.

•	Iron deficiency anemia is usually diagnosed by measuring the blood hemoglobin level. This is why WIC performs a blood test when you are being certified. This test indicates the degree of iron deficiency.

See Below to determine your Hemoglobin value. You can ask the WIC staff what your hemoglobin value was on your last certification.

Maximum Hemoglobin Concentration for Iron-Deficiency Anemia

Sex/Age, Years	Hemoglobin, < g/dL
Males and Females
1 to less than 2	11.0
2 to < 5	11.1
5 to < 8	11.5
8 to < 12	11.9
Males
12 to <15	12.5
15 to < 18	13.3
≥ 18	13.5
Females
12 to < 15	11.8
15 to < 18	12.0
≥ 18	12.0

Source: Adapted From Table 6, Center for Disease Control and Prevention

	Hemoglobin Concentration, <g/dl
Altitude, feet
3,000-3,999	+0.2
4,000-4,999	+0.3
5,000-5,999	+0.5
6,000-6,999	+0.7
7,000-7,999	+1.0
8,000-8,999	+1.3
9,000-9,999	+1.6
10,000-11,000	+2.0
Cigarette smoking
0.5 to <1.0 pack per day	+0.3
1.0 to <2.0 packs per day	+0.5
≥2.0 packs per day	+0.7
All smokers	+0.3

Source: Reproduced from Table 7, Centers for Disease Control and Prevention

Iron deficiency is the most prevalent form of nutrition deficiency anemia in this country. Iron-deficiency anemia has been associated with:

-delayed psychomotor development
-cognitive deficits
-behavioral disturbances in young children

Iron-deficiency anemia has also been associated with:

-impaired growth and development
-depression of the immune system
-fatigue
-decreased resistance to infection
-decreased physical performance
-decreased levels of endurance
-reduced attention span
-deceased school performance
-increased susceptibility to lead poisoning

Iron Facts

•	You need IRON in your diet to help build healthy red blood cells.
•	If you don't have enough iron in your blood, you may:

                -have pale or dry skin
                -feel weak or tired
                -have shortness of breath
                -feel loss of appetite

•	Infants, preschoolers, teenagers, pregnant women need more iron than others due to their increased growth or blood loss.
•	Iron is found in many foods, but in small amounts. Therefore, it is hard for some people to get enough iron from foods to prevent iron deficiency anemia or "tired blood".
•	Iron is needed during infancy for brain growth and development.
•	Scientific studies have shown that iron-fortified infant formula does not cause babies to have constipation or upset stomachs.

Activity 2:

List 2 symptoms of iron deficiency:

1.
2.

How are you currently preventing iron deficiency anemia?

Why do I need iron?

•	You need iron to keep your blood strong. If your blood is low in iron, you have anemia. Anemia can make you or your child:

•	look pale, feel tired and weak, act cranky
•	eat poorly
•	not grow well
•	get sick more easily, get infections and headaches
•	have trouble learning, and do poorly in school or work
•	If you are pregnant, your baby could be born too early or too small

How to prevent Iron Deficiency Anemia:

• Eat a wide variety of foods everyday, including milk products, meat, and alternates, vegetables, fruits, and whole grains.

• Include iron rich foods in your diet everyday.

• Try meat, fish, or poultry to get more iron from other foods eaten in the same meal.

• Eat vitamin C-rich foods with meals. This will improve your body's uptake of iron.

• Cook foods in cast iron cookware.

• Reduce the amount of soda, coffee, and tea you drink. These caffeinated beverages can make you take in less iron from the food you eat. If you drink coffee or tea, drink them between meals.

Activity 3:

1. Which blood cells need iron?

White
Red

If you chose red blood cells, you're correct. You need iron in your diet to help build red blood cells.

2. Which vitamin helps the absorption of iron?

Vitamin D
Vitamin A
Vitamin C

Vitamin C has been shown to help increase the amount of iron absorbed in your blood.

Food Sources of Iron

	Meat/Alternates	Vegetable/Fruit	Grain
Good Sources:	liver liverwurst organ meats beef, pork cooked beans cooked oysters tofu		iron fortified cereals WIC cereals

Fair Sources:	chicken eggs nuts sardines seeds shrimp	broccoli greens dried peaches raisins spinach tomato juice watermelon	cereals, whole grain oatmeal, rice tortillas, corn or flour wheat germ

Remember: Your body's uptake of iron from food is improved when you also eat foods containing vitamin C or animal products. Also, using cast iron cookware will increase the amount of iron in your food.

Food Sources of Vitamin C

Good Sources:

asparagus
bell pepper
broccoli
brussell sprouts
cabbage
cantaloupe
salsa

cauliflower
grapefruits
grapefruit juice
green chili (sauce)
orange
orange juice

potato
strawberries
spinach
tomato
tomato juice
turnip

So…choose combinations of foods with the most useable iron, like:
Iron fortified (WIC) cereal and orange juice
Bean and beef taco, topped with tomato and salsa
Chicken enchilada with green chile, steamed broccoli, whole-wheat tortilla, and watermelon for dessert.

Milk products are low in iron:

•

All dairy products like milk, cheese, yogurt and ice cream are very low in iron. They are good foods because they have a lot of calcium for bones and teeth. But drinking too much milk could make your child anemic. The milk fills them up and keeps them from getting enough high iron foods. So, what to do:

•	Start teaching your baby to use a cup at around 6 months. Then stop giving your baby a bottle at around one year. Many children who keep using a bottle after one year drink too much milk, then they are not hungry at mealtime.
•	After their first birthday children should drink only 2 to 3 cups of milk per day (16 to 24 ounces)

Dietary Strategies:

•	Increase consumption of lean meat, fish, and poultry, which contain heme, an effectively absorbed form of iron from hemoglobin and myogloblin. Meat, fish, and poultry also enhance absorption of plant sources of iron (e.g., grains, dried peas and beans, spinach)
•	Increase consumption of vitamin C (e.g., citrus and fortified fruit juices, citrus fruit, strawberries, cantaloupe, green peppers, broccoli, cabbage) taken with meals. This increases the absorption of nonmeat sources of iron.
•	Use highly fortified breakfast cereals.

Activity 4:

1. Which food would help your body absorb the iron in beef?

Milk
Tea
Orange

2. What could happen if your child doesn't have enough iron in their blood?

He could get sick with more colds and infections
He will turn colors.
He will eat more.

3. Which food has the most iron?

Potatoes
Beans
Pickles

4. Which of the following is not associated with iron-deficiency anemia?

Decreased school performance
Impaired growth and development
Impaired vision and eye coordination

5. List 2 changes you will make in your child's diet to prevent iron-deficiency anemia.
1.
2.

Answers: 1. Orange 2. He could get sick with more colds and infections 3. Beans 4. Impaired vision and eye coordination

Which WIC Office do you go to?

AK Regional Hospital
Eagle River
L Street
Providence Hospital

Where are you taking today's lesson?

Back to WIC Lessons
Revised: 06-12-2008