The inspiration behind this article is a woman, whom I met in train last summer when I was traveling back to Mumbai from Bangalore.
It was the first time I was traveling long distance in a train alone! Hence, I had to abide by certain rules laid down by my family members! Amongst many rules, one was ‘Do not talk to strangers!! Well, I said ok and followed all rules (not really! ;)). It was a nice cold afternoon (AC coach!) and I settled in my seat and was ready to read a book The monk…when a lady gasping for her breath, holding a small baggage and a nice Gucci hand bag entered saying ‘9..9..is this seat number 9??’. Some co-passengers helped her to her seat.
She was a lady in her middle age, looked pale and tired. But after few minutes she revived herself and I found her talking with a family which was seated nearby. A little later, they were too busy to listen to her as they had two kids to take care. Soon, she realized she was getting bored and she wanted to keep herself occupied (I guess) and now, she looked at me!! She was the first to talk (remember the rule? I was following it!). I acknowledged her with a smile and continued to read my book. But she kept on talking…the topics ranged from power cuts in Mysore, bad roads and traffic jams in Bangalore, Davangere benne dosa, Dharwad peda, shopping at Lakshmi road,Pune, Mumbai’s chats! Actually, in between the talk, I remember she visited Paris and bought few perfume bottles and purses too!! (But, I was still not talking. I was just listening!) By then, it was 6pm and I could hear vendors selling hot coffee, chai, samosa and many more things which are usually a temptation while traveling. After a cup of chai, the lady continued her talk and I showed minimal response as usual!
Things would go on like this, had she not made the following statement in between her talks. Somewhere, in between her talk, when I was busy checking my face book page after almost ten minutes (seemed like ages to me!), I heard her say ‘I am very conscious about what I eat you see, I include lots of Jaggery in my cooking so that I get enough iron because, I am anemic”.
Now, that’s it! I could not hold myself anymore (sorry…had to break the rule!!) and then….I spoke and spoke and spoke!!
Wondering what made me speak? I had tolerated all her attempts to divert my attention from reading the story of The Monk…. but this time no God could spare her from listening to me ;). It was Jaggery and the link it had with its iron content and the anemic condition that the lady was trying to deal with!!
In practice, jaggery is prepared using iron vessel or kadai. Iron from the vessel/kadai enters into the product (jaggery) during preparation and thus jaggery is considered a good source of iron. But, actually, the iron that is present in jaggery is not bio-available when it is consumed! This simply means that the iron content that is present in jaggery cannot be utilized by the body hence; jaggery is not a source of iron! (The lady was in a shock!!I had to buy her a cup of tomato soup!!)
According to WHO estimates, India is one of the countries in the world that has highest prevalence of anemia. The National Family Health Survey (NFHS-3) conducted in 2005-06, presents the statistics that mark a growth in cases pertaining to anemia. While 56 per cent of adolescent girls are anemic, boys too are falling prey to the disease. Around 30 per cent of adolescent boys are suffering from anemia. Most of the anemic patients, especially women, suffer from mild to severe deficiency of iron. The hemoglobin count in most of the adolescent girls in India is less than the standard 12 g/decilitre, the standard accepted worldwide. NFHS report that shows prevalence of anemia in children in India is as high as 79 per cent. (Though, the data is 7 yrs old, it highlights the need for action. Lots of efforts have been made by Government of India and NGOs along with Balvadis and Anganvadis to tackle this problem. one among that is supplying Iron and folic acid tablets to pregnant women so that anemia can be corrected.)
I found these interesting words told by Dr R S Chatterjee, Sr Consultant of Rockland Hospital, New Delhi in a write up where he says anemia rarely features regular check-up list. “Normally women are not aware of their tendency of being anemic. They don’t have any complaints otherwise. It is only when they come from blood test for some disease, doctors find that they are anemic,” The doctor also makes a point in saying ‘Iron deficiency anemia (IDA) is the most prevalent form in India, but “Lack of consciousness among women aggravates the situation, as now a days, they attach more importance to losing weight.”
The incidence of maternal morbidity and mortality increases when a pregnant woman is anemic. Hence, it is high time that an individual effort is made by Indian woman to become an Iron woman!!
Some of the common symptoms of iron deficiency are breathlessness on exertion, general fatigue and lassitude, giddiness, dimness of vision, headache, insomnia, palpitation, anorexia to mention a few.
Prescription provided by a Doctor for this condition always helps to get back the haemoglobin to normal levels but, in order to maintain the levels, a constant effort through diet is also essential. Recommended dietary allowance for iron (by ICMR-Indian council of Medical Research) is 30mg/day for women and 28 mg/day for Men. This requirement can be met by having a balanced diet on a day to day basis but, during deficiency an extra amount of iron is required compared to normal, which can be achieved by including iron rich food sources in the diet.
Two food sources of iron to the body are- Heme (by Animal source: found in chicken, pork, salmon. beef, shrimp, tuna, turkey etc.) and Non- Heme (by Plant source: found in greens, vegetables, grains, iron-fortified cereals, lentils and beans).
The Heme source of iron is absorbed well in the body however; there are many factors that affect the absorption of non-heme iron. Tannins present in tea, coffee, wine, tamarind etc, excess of fiber containing foods and high intake of calcium interferes with the absorption of iron in the body. But, studies have also shown that many foods increase the absorption of non heme iron. They are ascorbic acid found in tomatoes, oranges, grapefruits, strawberries etc.
Vegetarians can get non-heme sources by including green leafy vegetables like spinach, methi, shepu, amaranth to name a few. Try adding greens while preparing curries, sambar, parata, akki rotis, dosa, and also to dal tadka! An attempt can also be made to include pulses and whole grams along with greens. This will add on to the content of iron as well as protein in a dish.
Before consuming a dish prepared using greens, try to add fresh lemon juice to it. The ascorbic acid present in lemon will increase the absorption of iron from greens in the body. But always remember, if you are including tamarind in cooking then, this tamarind will interfere with the iron absorption. A cup of coffee or tea consumed immediately after a meal also reduces the amount of iron absorbed. So, avoid drinking these beverages immediately after a meal.
If you are on a calcium supplement, then it is wise to have it a little later and not immediately after the meal as it is known to hinder heme iron absorption in the body.
These were some of the ways to aid absorption of iron present in the food. But, this does not mean that jaggery, tamarind etc cannot be consumed. These food items have their own qualities which enhances the sensory attributes of a dish. The fact that it might decrease the absorption of iron in the body when consumed along with an iron rich food makes it essential to be avoided during deficiency state.
By the way, after a cup of tomato soup, the lady was out of shock! The message reached her (as well as everybody reading this article!)….mission accomplished!! By then, it was night and I finished my dinner earlier than usual and went to sleep keeping aside the half read book on The Monk who sold his Ferrari. But trust me I really had a hard time explaining my family members as to why the rule was broken! 😉
P.S: This article was inspired by an Indian Woman and is dedicated to Indian Women!!