Anaemia in India and Its Prevalence and Multifactorial Aetiology: A Narrative Review
Abstract
:1. Introduction
2. Methods
3. Prevalence of Anaemia in India
4. The Association of Dietary Iron Intake and Anaemia: Is It Strong?
5. Iron and Vitamin C: Requirements and Their Dietary Intakes in India
6. Vitamin B12 Requirements and Dietary Intakes in India
7. Health Consequences of Anaemia
8. Can Millet Consumption Help to Reduce Anaemia?
9. Conclusions
Author Contributions
Funding
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Pasricha, S.-R.; Colman, K.; Centeno-Tablante, E.; Garcia-Casal, M.-N.; Peña-Rosas, J.-P. Revisiting WHO haemoglobin thresholds to define anaemia in clinical medicine and public health. Lancet Haematol. 2018, 5, e61. [Google Scholar] [CrossRef]
- Ghosh, S.; Palika, R.; Dasi, T.; Varshney, R.K.; Parasannanavar, D.J.; Gupta, S.S.; Chitikineni, A.; Banjara, S.K.; Pullakhandam, R.; Thomas, T.; et al. Haemoglobin diagnostic cut-offs for anaemia in Indian women of reproductive age. Eur. J. Clin. Nutr. 2023, 77, 966–971. [Google Scholar] [CrossRef]
- WHO. Anaemia Factsheet 2023. Available online: https://www.who.int/news-room/fact-sheets/detail/anaemia (accessed on 25 March 2024).
- Global Health Metrics. Anaemia—Level 1 impairment. Lancet 2019, 393, R2. Available online: https://www.healthdata.org/results/gbd_summaries/2019/anemia-level-1-impairment (accessed on 20 March 2024).
- Daru, J. Sustainable development goals for anaemia: 20 years later, where are we now? Lancet Glob. Health 2022, 10, e587. [Google Scholar] [CrossRef]
- Paul, B.T.; Manz, D.H.; Torti, F.M.; Torti, S.V. Mitochondria and iron: Current questions. Expert Rev. Hematol. 2017, 10, 65–79. [Google Scholar] [CrossRef]
- McCann, S.; Perapoch Amadó, M.; Moore, S.E. The role of iron in brain development: A systematic review. Nutrients 2020, 12, 2001. [Google Scholar] [CrossRef]
- Nair, M.; Choudhury, S.S.; Rani, A.; Solomi, V.C.; Kakoty, S.D.; Medhi, R.; Rao, S.; Mahanta, P.; Zahir, F.; Roy, I.; et al. on behalf of the MaatHRI collaboration. The complex relationship between iron status and anemia in pregnant and postpartum women in India: Analysis of two Indian study cohorts of uncomplicated pregnancies. Am. J. Hematol. 2023, 98, 1721–1731. [Google Scholar] [CrossRef]
- International Institute for Population Sciences (IIPS) and Macro International. National Family Health Survey (NFHS-3), 2005–2006; IIPS: Mumbai, India, 2007. [Google Scholar]
- International Institute for Population Sciences (IIPS) & ICF. National Family Health Survey (NFHS-4) 2015–2016; IIPS: Mumbai, India, 2017. [Google Scholar]
- International Institute for Population Sciences (IIPS) & ICF. National Family Health Survey (NFHS-5), 2019–2021; IIPS: Mumbai, India, 2021. [Google Scholar]
- Sahiledengle, B.; Mwanri, L.; Agho, K.E. Household environment associated with anaemia among children aged 6–59 months in Ethiopia: A multilevel analysis of Ethiopia demographic and health survey (2005–2016). BMC Public Health 2024, 24, 315. [Google Scholar] [CrossRef]
- Singh, S.K.; Lhungdim, H.; Shekhar, C.; Dwivedi, L.K.; Pedgaonkar, S.; James, K.S. Key drivers of reversal of trend in childhood anaemia in India: Evidence from Indian demographic and health surveys, 2016–2021. BMC Public Health 2023, 23, 1574. [Google Scholar] [CrossRef] [PubMed]
- Neufeld, L.M.; Larson, L.M.; Kurpad, A.; Mburu, S.; Martorell, R.; Brown, K.H. Hemoglobin concentration and anemia diagnosis in venous and capillary blood: Biological basis and policy implications. Ann. N. Y. Acad. Sci. 2019, 1450, 172–189. [Google Scholar] [CrossRef] [PubMed]
- Diet and Biomarkers Survey in India (DABS-1). ICMR-National Institute for Nutrition. Available online: https://www.linkedin.com/pulse/absence-anemia-estimation-nfhs-6-understanding-why-vashisht-he-him (accessed on 25 March 2024).
- Kumari, R.; Bharti, R.K.; Singh, K.; Sinha, A.; Kumar, S.; Saran, A.; Kumar, U. Prevalence of iron deficiency anaemia in adolescent girls in a tertiary care hospital. J. Clin. Diagn. Res. 2017, 11, BC04–BC06. [Google Scholar] [CrossRef] [PubMed]
- Chakrabarty, M.; Singh, A.; Singh, S.; Chowdhury, S. Is the burden of anaemia among Indian adolescent women increasing? Evidence from Indian Demographic and Health Surveys (2015–2021). PLoS Glob. Public Health 2023, 3, e0002117. [Google Scholar] [CrossRef] [PubMed]
- Natekar, P.; Deshmukh, C.; Limaye, D.; Ramanathan, V.; Pawar, A. A micro review of a nutritional public health challenge: Iron deficiency anemia in India. Clin. Epidemiol. Glob. Health 2022, 14, 100992. [Google Scholar] [CrossRef]
- Petry, N.; Olofin, I.; Hurrell, R.F.; Boy, E.; Wirth, J.P.; Moursi, M.; Angel, M.D.; Rohner, F. The proportion of anaemia associated with iron deficiency in low, medium, and high human development index countries: A systematic analysis of national surveys. Nutrients 2016, 8, 693. [Google Scholar] [CrossRef] [PubMed]
- Williams, A.M.; Brown, K.H.; Allen, L.H.; Dary, O.; Moorthy, D.; Suchdev, P.S. Improving anemia assessment in clinical and public health settings. J. Nutr. 2023, 153, S29–S41. [Google Scholar] [CrossRef] [PubMed]
- Jackson, J.; Williams, R.; McEvoy, M.; MacDonald, L.; Patterson, A. Higher consumption of animal flesh foods associated with better iron status among adults in developed countries? A systematic review. Nutrients 2016, 8, 89. [Google Scholar] [CrossRef] [PubMed]
- Pasricha, S.-R.; Black, J.F.P.; Muthayya, S.; Shet, A.; Bhat, V.; Nagaraj, S.; Prashanth, N.S.; Sudarshan, H.; Biggs, B.-A.; Shet, A.S. Determinants of anemia among young children in rural India. Pediatrics 2010, 126, e140–e149. [Google Scholar] [CrossRef] [PubMed]
- Kassebaum, N.J.; Jasrasaria, R.; Naghavi, M.; Wulf, S.K.; Johns, N.; Lazano, R.; Regan, M.; Weatherall, D.; Chou, D.P.; Eisele, T.P.; et al. A systematic analysis of global anemia burden from 1990 to 2010. Blood 2014, 123, 615–624. [Google Scholar] [CrossRef] [PubMed]
- Swaminathan, S.; Ghosh, S.; Varghese, J.S.; Sachdev, H.S.; Kurpad, A.; Thomas, T. Dietary iron intake and anemia are weakly associated, limiting effective iron fortification strategies in India. J. Nutr. 2019, 149, 831–839. [Google Scholar] [CrossRef]
- Household Consumption of Various Goods and Services in India 2011–2012; Report No. 558 (68/1.0/2); National Sample Survey Office, Ministry of Statistics and Programme Implementation, Government of India: Delhi, India, 2012. Available online: https://mospi.gov.in/sites/default/files/publication_reports/Report_no558_rou68_30june14.pdf (accessed on 4 March 2024).
- Kumar, A.; Gupta, S.; Meena, L.P.; Meher, M.P.; Rai, M.; Kumar, S.; Bharti, A. Study to evaluate the etiology of iron deficiency anemia at a teaching hospital in northeastern part of India. J. Fam. Med. Prim. Care 2020, 9, 3076–3081. [Google Scholar]
- Cotter, J.; Baldaia, C.; Ferreira, M.; Macedo, G.; Pedroto, I. Diagnosis and treatment of iron-deficiency anemia in gastrointestinal bleeding: A systematic review. World J. Gastroenterol. 2020, 26, 7242–7257. [Google Scholar] [CrossRef]
- Sarna, A.; Porwal, A.; Ramesh, S.; Agrawal, P.K.; Acharya, R.; Johnston, R.; Khan, N.; Sachdev, H.P.S.; Madhavan Nair, K.; Ramakrishnan, L. Characterisation of the types of anaemia prevalent among children and adolescents aged 1–19 years in India: A population-based study. Lancet Child. Adolesc. Health 2020, 4, 515–525. [Google Scholar] [CrossRef]
- Sasidharan, P.K. B12 deficiency in India. Arch. Med. Health Sci. 2017, 5, 261–268. [Google Scholar] [CrossRef]
- Singla, R.; Garg, A.; Surana, V.; Aggarwal, S.; Gupta, G.; Singla, S. Vitamin B12 deficiency is endemic in Indian population: A perspective from North India. Indian J. Endocrinol. Metab. 2019, 23, 211–214. [Google Scholar] [CrossRef]
- Singh, A.; Ram, S.; Singh, S.; Tripathi, P. Prevalence and determinants of anaemia among men in rural India: Evidence from a nationally representative survey. PLOS Glob. Public Health 2022, 2, e0001159. [Google Scholar] [CrossRef]
- WIFS. Weekly Iron and Folic Acid Supplementation Programme for Adolescents (10–19 Years of Age); National Health Mission, Ministry of Health and Family Welfare, Government of India: Delhi, India, 2024. Available online: https://nhm.gov.in/index1.php?lang=1&level=3&sublinkid=1024&lid=388 (accessed on 4 March 2024).
- Storz, M.A.; Müller, A.; Niederreiter, L.; Zimmermann-Klemd, A.M.; Suarez-Alvarez, M.; Kowarschik, S.; Strittmatter, M.; Schlachter, E.; Pasluosta, C.; Huber, R.; et al. A cross-sectional study of nutritional status in healthy, young, physically-active German omnivores, vegetarians and vegans reveals adequate vitamin B12 status in supplemented vegans. Ann. Med. 2023, 55, 2269969. [Google Scholar] [CrossRef]
- Nair, K.M.; Iyengar, V. Iron content, bioavailability and factors affecting iron status of Indians. Indian J. Med. Res. 2009, 130, 634–645. [Google Scholar]
- Kajoba, D.; Egesa, W.I.; Muyombya, S.; Ortiz, Y.A.; Nduwimana, M.; Ndeezi, G. Prevalence and factors associated with iron deficiency anaemia among children aged 6–23 months in southwestern Uganda. Int. J. Pediatr. 2024, 2024, 6663774. [Google Scholar] [CrossRef]
- Bose, S.; Banerjee, S.; Chattopadhyay, J.; Manna, M.; Rai, V. Red cell distribution width with clinical significance of B12 deficiency anemia: A Mini Case Report. Am. J. Otolaryngol. Head. Neck Surg. 2021, 4, 1126. [Google Scholar]
- ICMR-NIN. Short Summary Report of Nutrient Requirements for Indians. Recommended Dietary Allowances and Estimated Average Allowances. A Report of the Expert Group-2020, Updated 2024; Indian Council of Medical Research-National Institute of Nutrition: Hyderabad, India, 2020. [Google Scholar]
- ICMR-NIN Expert Group. Nutrient Requirements for Indians, Recommended Dietary Allowances (RDA) and Estimated Average Requirements (EAR); Indian Council of Medical Research-National Institute of Nutrition: Hyderabad, India, 2020. [Google Scholar]
- ICMR. Nutrient Requirements and Recommended Dietary Allowances for Indians; Indian Council of Medical Research: Hyderabad, India, 2010. [Google Scholar]
- Milman, N.T. A review of nutrients and compounds, which promote or inhibit intestinal iron absorption: Making a platform for dietary measures that can reduce iron uptake in patients with genetic haemochromatosis. J. Nutr. Metab. 2020, 2020, 7373498. [Google Scholar] [CrossRef] [PubMed]
- Li, N.; Zhao, G.; Wanling, W.; Zhang, M.; Liu, W.; Chen, Q.; Wang, X. The efficacy and safety of vitamin C for iron supplementation in adult patients with iron deficiency anemia. A randomized clinical trail. JAMA Netw. Open 2020, 3, e2023644. [Google Scholar] [CrossRef]
- NNMB (National Nutrition Monitoring Bureau). Diet and Nutritional Status of Rural Population, Prevalence of Hypertension, and Diabetes among Adults and Infant and Young Child Feeding Practices; NNMB Technical Report No 26; National Institute of Nutrition: Hyderabad, India, 2012. [Google Scholar]
- Rammohan, A.; Awofeso, N.; Robitaille, M.-C. Addressing female iron deficiency anaemia in India: Is vegetarianism the major obstacle? Int. Sch. Res. Not. 2012, 2012, 765476. [Google Scholar] [CrossRef]
- NNMB (National Nutrition Monitoring Bureau). Diet and Nutritional Status of Urban Population of India and Prevalence of Obesity, Diabetes, and Hyperlipidaemia in Urban Men and Women. A Brief NNMB Urban Nutrition Report; NNMB Technical Report No 27; National Institute of Nutrition: Hyderabad, India, 2017. [Google Scholar]
- Krishnaswamy, K.; Madhavan Nair, K. Importance of folate in human nutrition. Br. J. Nutr. 2001, 85 (Suppl. S2), S115–S124. [Google Scholar] [CrossRef]
- Vora, R.M.; Antony, A.C. The unresolved tragedy of neural-tube defects in India: The case for folate- and vitamin-B12-fortified tea for prevention (Editorial). J. Indian Assoc. Pediatr. Surg. 2022, 27, 1–8. [Google Scholar] [CrossRef] [PubMed]
- The WOMAN-2 trial collaborators. Maternal anaemia and the risk of postpartum haemorrhage: A cohort analysis of data from the WOMAN-2 trial. Lancet Glob. Health 2023, 11, e1249–e1259. [Google Scholar] [CrossRef] [PubMed]
- Gora, K.; Depan, A.; Yadav, K.; Benwal, D. Causes and management of post-partum hemorrhage at tertiary care center, Rajasthan. India Int. J. Reprod. Contracept. Obstet. Gynecol. 2019, 8, 2425–2428. [Google Scholar] [CrossRef]
- Yager, J.Y.; Hartfield, D.S. Neurologic manifestations of iron deficiency in childhood. Pediatr. Neurol. 2002, 27, 85–92. [Google Scholar] [CrossRef] [PubMed]
- Walter, T. Effect of iron-deficiency anemia on cognitive skills and neuromaturation in infancy and childhood. Food Nutr. Bull. 2003, 24 (Suppl. S2), S104–S110. [Google Scholar] [CrossRef]
- East, P.; Doom, J.R.; Blanco, E.; Burrows, R.; Lozoff, B.; Gahagan, S. Iron deficiency in infancy and neurocognitive and educational outcomes in young adulthood. Dev. Psychol. 2021, 57, 962–975. [Google Scholar] [CrossRef]
- Marcus, H.; Schauer, C.; Zlotkin, S. Effect of Anemia on Work Productivity in Both Labor-and Nonlabor-Intensive Occupations: A Systematic Narrative Synthesis. Food Nutr. Bull. 2021, 42, 289–308. [Google Scholar] [CrossRef]
- Makkar, S.; Minocha, S.; Bhat, K.G.; John, A.T.; Swaminathan, S.; Thomas, T.; Mannar, M.G.V.; Kurpad, A.V. Iron fortification through universal distribution of double-fortified salt can increase wages and be cost-effective. An ex-ante modeling study in India. J. Nutr. 2022, 152, 597–611. [Google Scholar] [CrossRef]
- Soemantri, A.G.; Pollitt, E.; Kim, I. Iron deficiency anemia and educational achievement. Am. J. Clin. Nutr. 1985, 42, 1221–1228. [Google Scholar] [CrossRef]
- Scholz, B.D.; Gross, R.; Schultink, W.; Sastroamidjojo, S. Anaemia is associated with reduced productivity of women workers even in less-physically-strenuous tasks. Br. J. Nutr. 1997, 77, 47–57. [Google Scholar] [CrossRef]
- Allagh, K.P.; Shamanna, B.R.; Murthy, G.V.S.; Ness, A.; Doyle, P.; Neogi, S.B.; Pant, H.B.; Wellcome Trust-PHFI Folic Acid Project Team. Birth prevalence of neural tube defects and orofacial clefts in India: A systematic review and meta-analysis. PLoS ONE 2015, 10, e0118961. [Google Scholar] [CrossRef]
- Morris, J.K.; Addor, M.-C.; Ballardini, E.; Barisic, I.; Barrachina-Bonet, L.; Braz, P.; Cavero-Carbonell, C.; Den Hond, E.; Garne, E.; Gatt, M.; et al. Prevention of neural tube defects in Europe: A public health failure. Front. Pediatr. 2021, 9, 647038. [Google Scholar] [CrossRef]
- Vora, R.M.; Alappattu, M.J.; Zarkar, A.D.; Soni, M.S.; Karmarkar, S.J.; Antony, A.C. Potential for elimination of folate and vitamin B12 deficiency in India using vitamin-fortified tea: A preliminary study. BMJ Nutr. Prev. Health 2021, 4, 293–306. [Google Scholar] [CrossRef]
- Poole, N.; Kane-Potaka, J. The smart food triple bottom line-Starting with diversifying staples. (Including summary of latest smart food studies). Agric. Dev. J. 2020, 41, 21–23. [Google Scholar]
- Lonvah, T.; Ananthan, R.; Bashkarachary, K.; Venkaiah, K. (Eds.) Indian Food Composition Tables 2017; National Institute of Nutrition, Ministry of Health and Family Welfare: Hyderabad, India, 2017. [Google Scholar]
- Anitha, S.; Govindaraj, M.; Kane-Potaka, J. Balanced amino acid and higher micronutrients in millets complements legumes for improved human dietary nutrition. Cereal Chem. 2019, 97, 74–84. [Google Scholar] [CrossRef]
- Sabuz, A.A.; Rana, M.R.; Ahmed, T.; Molla, M.M.; Islam, N.; Khan, H.H.; Chowdhury, G.F.; Zhao, Q.; Shen, Q. Health-promoting potential of millet: A review. Separations 2023, 10, 80. [Google Scholar] [CrossRef]
- Nithiyanantham, S.; Kalaiselvi, P.; Mahomoodally, M.F.; Zengin, G.; Abrirami, A.; Srinivasan, G. Nutritional and functional roles of millets-A review. J. Food Biochem. 2019, 43, e12859. [Google Scholar] [CrossRef]
- Chaurasia, R.K.; Anichari, N. Nutritional and health benefits of millets: A review. Pharma Innov. 2023, 12, 3360–3363. [Google Scholar]
- Ambati, K.; Sucharitha, K.V. Millets-review on nutritional profiles and health benefits. Int. J. Recent. Sci. Res. 2019, 10, 33943–33948. [Google Scholar]
- Anitha, S.; Tsusaka, T.W.; Givens, D.I.; Kane-Potaka, J.; Botha, R.; Sulaiman, N.L.B.; Upadhyay, S.; Vetriventhan, M.; Rajendran, A.; Parasannanavar, D.J.; et al. Does millet consumption contribute to raising blood haemoglobin levels compared to regular refined staples: A systematic review and meta-analysis. Front. Nutr. 2024, 11, 1305394. [Google Scholar] [CrossRef]
- Saikat, D.M.; Victor, A.-S.; Aravazhi, S.; Priyanka, D.; Anitha, S.; Tamilselvi, N.; Divya, N.G.; Harshvardhan, M.; Suchiradipta, B.; Nedumaran, S.; et al. Effectiveness of millet–pulse–groundnut-based formulations in improving the growth of pre-school tribal children in Telangana State, India. Nutrients 2024, 16, 819. [Google Scholar] [CrossRef]
Population | NFHS Report 1 | % Anaemic in Residence | ||
---|---|---|---|---|
Urban | Rural | All | ||
Children 6–59 months | 3: 2005–06 | 63.0 | 71.5 | 69.5 |
4: 2015–16 | 56.0 | 59.5 | 58.6 | |
5: 2019–21 | 64.2 | 68.3 | 67.1 | |
Women 15–48 years not pregnant | 3: 2005–06 | NG 2 | NG | 53.2 |
4: 2015–16 | 51.0 | 54.4 | 53.2 | |
5: 2019–21 | 54.1 | 58.7 | 57.2 | |
Women 15–48 years pregnant | 3: 2005–06 | NG | NG | 58.7 |
4: 2015–16 | 45.8 | 52.2 | 50.4 | |
5: 2019–21 | 45.7 | 54.3 | 52.2 | |
Men 15–49 years | 3: 2005–06 | NG | NG | 24.2 |
4: 2015–16 | 18.5 | 25.3 | 22.7 | |
5: 2019–21 | 20.4 | 27.4 | 25.0 |
Factors 1 | OR 2 for Association with Anaemia (95% CI 3) |
---|---|
Underweight vs. Normal | 1.216 (1.196–1.237) |
Poorest vs. Richest | 1.170 (1.134–1.207) |
Poorer vs. Richest | 1.096 (1.067–1.126) |
Middle income vs. Richest | 1.066 (1.042–1.091) |
Richer vs. Richest | 1.043 (1.023–1.065) |
Household size > 4 vs. 0–4 | 1.032 (1.018–1.046) |
Other drinking water vs. Piped | 1.029 (1.012–1.045) |
Open defecation vs. Toilet | 1.018 (1.000–1.037) |
Iron intake (mg/d) | 0.992 (0.991–0.994) |
Years of education | 0.989 (0.988–0.991) |
Overweight vs. Normal | 0.787 (0.773–0.801) |
Obese vs. Normal | 0.785 (0.762–0.808) |
Anaemia Prevalence (%) | Type of Anaemia (% of Total Anaemia) | |||||
---|---|---|---|---|---|---|
Age Group | Iron Deficiency | Folate or Vitamin B12 | Dimorphic | Inflammation | Other Causes | |
1–4 years | 40.5 | 36.5 | 18.9 | 13.5 | 6.5 | 24.5 |
5–9 years | 23.4 | 15.6 | 24.6 | 10.7 | 5.4 | 43.6 |
Adolescents | 28.4 | 21.3 | 25.6 | 18.2 | 3.4 | 31.4 |
ICMR (2010) [39] | ICMR-NIN (2020) [38] | ||||||
---|---|---|---|---|---|---|---|
Sex/Age | Category | Vitamin B12 (µg/d) | Iron (mg/d) | Vitamin C (mg/d) | Vitamin B12 (µg/d) | Iron (mg/d) | Vitamin C (mg/d) |
Men | 1.0 | 17 | 40 | 2.2 | 19 | 80 | |
Women | NPNL 1 | 1.0 | 21 | 40 | 2.2 | 29 | 65 |
Pregnant | 1.2 | 35 | 60 | 2.45 | 27 | 80 | |
Lactating | 1.5 | 25 | 80 | 3.2 | 23 | 115 | |
Infants | 6–12 month | 0.2 | 5 | 25 | 1.2 | 3(6 2) | 30 |
Children | 1–3 year | 0.2 | 9 | 40 | 1.2 | 8 | 30 |
4–6 year | 0.2–1.0 | 13 | 40 | 1.2–2.2 3 | 11 | 35 | |
7–9 year | 0.2–1.0 | 16 | 40 | 2.2 | 15 | 45 | |
Boys | 10–12 year | 0.2–1.0 | 21 | 40 | 2.2 | 16 | 55 |
Girls | 0.2–1.0 | 27 | 40 | 2.2 | 28 | 50 | |
Boys | 13–15 year | 0.2–1.0 | 32 | 40 | 2.2 | 22 | 70 |
Girls | 0.2–1.0 | 27 | 40 | 2.2 | 30 | 65 | |
Boys | 16–18 year | 0.2–1.0 | 28 | 40 | 2.2 | 26 | 85 |
Girls | 1.0 | 26 | 40 | 2.2 | 32 | 70 |
Millet Type | Iron (mg/100 g) | Millet Type | Iron (mg/100 g) |
---|---|---|---|
Anitha et al. [61] | Sabuz et al. [62] | ||
Pearl D 1 | 8.5 | Pearl | 8.3 |
Pearl P | 4.7 | Foxtail | 2.8 |
Finger VR847 | 2.9 | ||
Finger GPU28 | 2.6 | ||
Nithiyanantham et al. [63] | Chaurasia and Anichari [64] | ||
Pearl | 7.5–16.9 | Pearl | 11.0 |
Finger | 3.9–7.5 | Finger | 3.9 |
Foxtail | 2.8–19.0 | Foxtail | 2.8 |
Proso | 0.8–5.2 | Kodo | 1.7 |
Kodo | 0.5–3.6 | Little | 9.3 |
Little | 9.3–20.0 | Sorghum | 5.4 |
Barnyard | 15.2 | Rice 2 | 1.8 |
Wheat 2 | 3.5 | ||
Ambati and Sucharitha [65] | |||
Pearl | 16.5 | ||
Barnyard | 15.2 | ||
Sorghum | 3.4 | ||
Finger | 3.9 | ||
Kodo | 0.5 | ||
Little | 9.3 | ||
Proso | 0.8 |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Givens, D.I.; Anitha, S.; Giromini, C. Anaemia in India and Its Prevalence and Multifactorial Aetiology: A Narrative Review. Nutrients 2024, 16, 1673. https://doi.org/10.3390/nu16111673
Givens DI, Anitha S, Giromini C. Anaemia in India and Its Prevalence and Multifactorial Aetiology: A Narrative Review. Nutrients. 2024; 16(11):1673. https://doi.org/10.3390/nu16111673
Chicago/Turabian StyleGivens, D. Ian, Seetha Anitha, and Carlotta Giromini. 2024. "Anaemia in India and Its Prevalence and Multifactorial Aetiology: A Narrative Review" Nutrients 16, no. 11: 1673. https://doi.org/10.3390/nu16111673