Foul air and vitamin B12 deficiency main reason for anaemia in India

While anaemia is long known to be caused by iron deficiency, experts on Thursday noted that air pollution and vitamin B12 deficiency have emerged as major culprits behind its increasing prevalence in the country.

Anaemia occurs when there isn’t enough haemoglobin in the body to carry oxygen to the organs and tissues. The condition, which mainly affects women and children, leads to the lower count of red blood cells or the haemoglobin. In severe cases, anaemia can cause poor cognitive and motor development in children.

“Emerging research has suggested that anaemia in India is not solely due to iron deficiency. Two additional factors warrant attention: air pollution and vitamin B12 deficiency,” Dr K Madan Gopal, a public health expert working at the National Health Systems Resource Center, a premier think tank of the Health Ministry, New Delhi, told reporters.

A recent study led by the Indian Council of Medical Research (ICMR), published in the peer-reviewed European Journal of Clinical Nutrition, found that iron deficiency contributes only marginally to its prevalence, with the other two factors playing a much larger role in the widespread occurrence of anaemia in the country.

Gopal explained that exposure to fine particulate matter (PM2.5) can lead to systemic inflammation. This inflammation interferes with the production and survival of red blood cells, exacerbating anaemia.

“Efforts to improve air quality at the community level -- such as local monitoring of pollution sources and public education on pollution mitigation -- can positively impact overall health and, by extension, reduce inflammation-induced anaemia,” the expert said.

“Long-term PM2.5 exposure lowers haemoglobin levels by 2-3 per cent, increasing anaemia risk by 12-15 per cent,” Dr. Sabine Kapasi, advisor, United Nations Covid-19 Task Force, told reporters.

In addition, vitamin B12 is also crucial for properly forming red blood cells. In populations with predominantly vegetarian diets, inadequate vitamin B12 intake is common. “Over 50 per cent of Indians lack vitamin B12 due to poor diets, leading to megaloblastic anaemia -- marked by weakness, dizziness, and cognitive issues,” Kapasi said.

Anaemia remains a significant public health challenge in India. The recent data from the National Family Health Survey (NFHS-5) indicate that approximately 57 per cent of women of reproductive age and 67 per cent of children aged 6-59 months are affected by anaemia.

To fight the condition, the government has rolled out Anemia Mukt Bharat which focuses on supplementing diets with iron and folic acid, fortifying staple foods, and strengthening primary healthcare delivery.

However, Gopal noted that addressing anaemia requires more than top-down approaches.

“At the community level, we must empower local health workers, community leaders, and non-governmental organisations to take ownership of anaemia as a critical health concern. By integrating nutritional education into local outreach programmes, communities can be encouraged to adopt diversified diets and better hygiene practices. Anaemia must become a “felt need” at the grassroots level,” he told IANS.

Alongside iron supplementation, the experts also suggested educating communities on the importance of a balanced diet that includes B12-rich foods or fortified alternatives; and early screening for B12 levels.

They also urged a holistic approach with the fortification of staples like rice and wheat, targeted nutrition awareness, and tackling environmental triggers like air pollution to fight anaemia.

On the other hand, while air pollution is becoming a growing health issue worldwide, a new study focussed on its health and economic costs in the elderly.

The study led by researchers from the University of Tokyo in Japan highlights how fine particulate pollution, or PM2.5 worsens health outcomes, as well as creates significant socioeconomic challenges in regions with ageing populations and limited medical resources.

PM2.5 refers to microscopic particles of pollution small enough to penetrate deep into the lungs and bloodstream, leading to severe respiratory and cardiovascular diseases.

The particles are small enough to evade the body’s natural defences in the nose and throat, making direct prevention difficult. This becomes especially problematic in elderly populations.

“As we age, our immune systems weaken and our bodies are less able to defend against pollutants. Even moderate exposure can exacerbate pre-existing conditions, leading to higher hospitalisation rates and premature mortality,” said lead author Associate Professor Yin Long.

“Our study provides new insights into impacts of PM2.5 in ageing regions, with a particular focus on the mismatch between those impacts and regional medical resource distribution.” The team focuses on Japan -- a country where almost 30 per cent of the population is aged 65 or older. Examining the relationship between PM2.5 exposure, health care disparities, and economic impacts, the team found that elderly people living in rural regions suffer more from PM2.5 pollution.

Indo-Asian News Service