Diet and Anemia

What is Anemia

Anemia is a disease that often has nutritional origins, therefore, some changes in the diet could significantly improve the pathological and symptomatological picture of the patients who are affected.

Hemoglobin values

Anemia is a generic alteration of the blood hemoglobin (Hb) values ​​which affects the general state of health of the subject; the cutoffs (or thresholds) for Hb that indicate anemia are:

  • <14 mg/dl nell'uomo
  • <12 mg/dl nella donna
  • < 11 mg/dl nella gravida

The reduction in Hb is directly correlated to the decrease in hematocrit (Hc), which is responsible for the ability to transport oxygen to the tissues; HC cutoffs indicating anemia are:

  • < 40% nell'uomo
  • < 37% nella donna


Anemia differs according to the etiopathological agent responsible for its appearance; the anemic forms that derive from incorrect or insufficient diet are: iron deficiency anemia (from nutritional iron [Fe] deficiency) and pernicious anemia (from nutritional vitamin deficiency: folic acid and / or cobalamin - B12).

Often, food insufficiency is associated with:

  • the reduction of intestinal absorption capacity (intestinal diseases such as celiac disease, neoplasms, surgical resections, steatorrhea, chronic diarrhea, rectum ulcerative colitis, Crohn's disease, etc.)
  • the alteration of the production of gastric intrinsic factor (responsible for the activation of cobalamin [B12] and without which it is not absorbed in the terminal ileum)
  • nutritional insufficiency of viamina C (ascorbic acid - responsible for increasing the iron absorption potential)
  • abuse of anti-inflammatory drugs (such as aspirin)
  • haematuria (urinary excretion of hematocrit usually caused by kidney failure)
  • haemolysis (early and pathological destruction of red blood cells)
  • pathological or physiological bleeding (e.g. menstruation - for this reason the fertile female population is extremely more prone to anemia than others).


Symptoms of anemia are mainly related to asthenia (tiredness and fatigue), difficulty concentrating, headache (headache), dizziness (especially when passing from lying to standing) and fissures in the corners of the mouth (small or large cuts). Obviously, the symptomatic manifestation of anemia can be extremely wide and varied, especially if characterized by a long pathological history.

Diet for anemia

The diet for anemia must satisfactorily comply with subjective nutritional needs, with particular reference to the intake of iron, folic acid and cobalamin, nutrients for which the LARN * suggest the following daily rations:



7mg 50mcg 0,5mcg


7-9mg 100-150mcg 0,7-1,4mcg

Males> 11 years old

12mg 180-200mcg 2mcg

Pre-pubertal females

12mg 180-200mcg 2mcg

Females of childbearing age

18mg 180-200mcg 2mcg

Menopausal females

12mg 180-200mcg 2mcg

Pregnant females

30mg 400mcg 2,2mcg

Feeding females

18mg 350mcg 2,6mcg

* Recommended Nutrient Intake Levels for the population in your country

There are several dietary recommendations for anemia:

  1. first of all, it is advisable to reach the recommended rations above (it is not easy! Especially for pregnant women, nurses and for those who follow diets such as veganism, all categories of subjects to whom specific supplements are often prescribed). To learn more, read the article: foods rich in iron
  2. secondly, it is essential to verify that the iron intake in the diet is covered for about 2/3 by its reduced form, called ferrous iron (Fe ++ or heme iron, which is found mainly in foods of animal origin (meat, fish , eggs) linked to heme (functional group of hemoglobin). On the contrary, ferric iron (Fe +++) deriving from foods of vegetable origin (green radicchio, spinach, rocket etc.) should constitute at most 1/3 of the total iron , as, being in an oxidized form, it is poorly bioavailable to intestinal absorption. To learn more, read the article: intestinal absorption of iron
  3. The diet for anemia must also guarantee the essential vitamin supply of folic acid and cobalamin (essential for the synthesis of cell nucleic acids, therefore also of red blood cells). The most generous dietary sources of folic acid are green leafy vegetables: spinach, broccoli, asparagus, lettuce, etc., while vitamin B12 abounds in products of animal origin: meat, eggs and fish.
  4. The contribution of vitamin C is also of fundamental importance, which chemically reacts together with iron. In the intestinal lumen, ascorbic acid intervenes by preserving the reduced form of ferrous iron and tends to convert (therefore to reduce) the ferric ion into ferrous, enhancing its bioavailability for intestinal absorption. Furthermore, it favors the transfer from plasma transferrin (iron transport protein in the blood) to tissue and increases cellular bioavailability by increasing the stability of the bond itself. The addition of lemon to a red meat steak is therefore ideal for ensuring the absorption and bioavailability of iron in the anemic's diet.
  5. In the diet for anemia it is also advisable not to introduce in the same meal foods that contain high quantities of calcium, phosphorus and iron, as these ions easily compete for intestinal absorption (generally in favor of phosphorus and football). Therefore, when feeding the anemic, it is not recommended to combine meat and cheese or other dairy products within the same meal.
  6. Furthermore, it would be advisable to limit the consumption of foods with a high content of phytates (eg black tea) and oxalates (eg rhubarb); these molecules, due to their chelating function, bind iron, reducing its uptake by enterocytes.

See also: Diet against Athlete's Anemia "

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