Anaemia affects about 50 to 70 percent of the Indian population and is a major health challenge in the country. Despite supplements infants, young children, women of child bearing age, pregnant women, in rural as well as urban settings are all affected by iron deficiency. In fact a survey carried out by National institute of Nutrition (NIN) showed the prevalence of a number of micronutrient deficiencies besides that of iron.
Indian Council for Medical Research (ICMR) has worked out the requirements of iron in different groups according to iron loss. They also took into consideration loss of iron in women because of biological reasons, in pregnant women for growth of the foetus, loss through milk in lactating mothers and loss during growth of children. According to data derived from the above conditions it seems that loss of iron is estimated to be approximately 14 g/kg/day. Accordingly the requirement for different age groups has been worked out based on the data of iron loss in various groups and average weight.
- An adult man who weights 60kg therefore requires 0.84mg of iron per day
- For adult women weighing 55kg additional iron is required as they are likely to lose iron during their monthly cycle. Therefore the daily requirement of iron in adult women is likely to be 1.65mg/day
- For pregnant women the requirement of iron is calculated differently. They will not lose iron during monthly cycle but the foetus would require iron for growth and mother would also gain weight. Therefore the requirement has been calculated per trimester of pregnancy.
- Therefore if the weight gained is 10 kg requirement in first trimester would be 130mg, second trimester 320mg and 310 mg in the third trimester of pregnancy
- If the weight gain is 12 kg the requirement in first trimester would be 138mg, 372mg in the second trimester and 351mg in the third trimester of pregnancy.
- Iron requirement for a lactating mother will be calculated according to weight as well as loss of iron in breast milk and so works out to be around 1.27mg/day
- Iron requirement for growth in young children aged 10 to 12 years is calculated on need for iron for expansion of blood volumes and increase in lean body mass besides weight. Keeping these in mind the iron requirement would be 12 μg/kg for boys and 8 μg/kg for girls.
- 10 to 12 year old boys would require 1.05mg/day and girls 1.33mg/day
- 13 to 15 year old boys require 1.60mg/day and girls 1.36mg/day
- 16 t0 17 year old boys would require 1.37mg/day and girls 1.30mg/day
- Requirement during infancy is also dependent on factors like intake from breast milk as iron absorption from breast milk is very high. Also healthy infants are born with an iron store in the blood that lasts from birth to about six months therefore the requirement for iron would be around 0.47mg/day and in a full term infant an intake of 0.23mg/day is enough to maintain haemoglobin levels. After six months iron requirements increases to 0.73mg/day and it is advised to provide iron fortified foods to the baby from 7 to 12 months of age.
- Iron requirement in 1 to 3 year olds is calculated to be around 0.451mg/day as during this age the body hardly has any reserves of iron.
- Iron requirement in 4 to 9 year olds is different as there is an increase in body weight during this time. Therefore 4 to 6 year olds would require 0.633mg/day and 7 to 9 year olds 0.773mg/day
Dietary intake of iron
A survey by National Nutrition Monitoring Bureau (NNMB) has revealed that the intake of iron is inadequate in almost all states in India. It does not even meet the RDA by 50 percent. The deficit is highest in Andhra Pradesh at 72% and lowest in Gujarat at 23 percent. The differences in iron deficiency, region wise are attributed to differences in the consumption of staple foods like rice and millets. To ensure that Indians get their daily requirement of iron it is important to have an accurate measure of
- iron content in food
- bioavailability from Indian diets
The current pattern of vegetarian diets is not sufficient to meet the requirements of iron. To improve iron content non-milk animal foods must be consumed. Where this it is not possible then there must be a high intake of Vitamin C foods as this will help to absorb iron. Indian vegetarian diets have about 7-9mg of iron per 1000 kilocalories. This means the diet must contain at least 20mg per 1000 kilocalories of vitamin C for the iron to be absorbed. From time to time the government gives directions for the fortification of foods with iron so that populations can receive their daily intake of iron.
All data and recommendations are based on literature published by ICMR.
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