When you hear the word “malnutrition,” you might picture not eating enough food or even starvation. But malnutrition can also be about nutrition gaps, where your body isn’t getting the nutrients it needs to function well.
If you’ve been feeling unusually tired, lightheaded or short of breath, your body may be low on important nutrients. This can cause nutritional anemia, which is a treatable condition that affects millions of people.
What does “nutritional anemia” mean?
Anemia happens when you don’t have enough healthy red blood cells to carry oxygen throughout your body.
Nutritional anemia is when you have anemia because you aren’t getting enough vitamins and minerals. “It may occur due to poor diet, blood loss or nutrient absorption issues,” said Gina Keenan, a registered dietitian with Banner Health.
The most common nutrients involved are:
- Iron: Iron deficiency anemia occurs when you don’t have enough iron to make hemoglobin. It’s usually due to poor diet or blood loss.
- Vitamin B12 or folate: Called megaloblastic anemia, these deficiencies make your body produce unusually large red blood cells and can lead to neurological symptoms. It’s caused by poor diet or absorption issues.
Nutritional anemia is different from genetic forms of anemia or anemia caused by chronic disease.
How malnutrition can lead to anemia
Malnutrition can mean you are not absorbing or getting enough of certain nutrients. Several factors can lead to nutritional anemia:
- Not eating enough nutrient-rich foods: A diet low in iron or vitamins can lead to deficiencies. This may happen if you eat a restrictive diet, have limited food access or eat a lot of junk foods.
- Not getting enough protein or calories: Low levels of protein or calories can cause inflammation that makes it harder to absorb nutrients.
- Trouble absorbing nutrients: Some digestive conditions or surgeries can interfere with how your body absorbs nutrients. In these cases, even if you are eating well, your body may not be getting what it needs.
- Increased nutrient needs: Your body needs more nutrients during certain life stages and/or with some health conditions. If your intake doesn’t match your needs, you can develop deficiencies. Needs may be higher because of:
- Growth during childhood and adolescence
- Pregnancy
- Aging
- Chronic illness
Signs your body may be low on key nutrients
Nutritional anemia can develop slowly and the signs aren’t the same for everyone. Many symptoms are mild at first and easy to overlook. These symptoms can overlap with stress, lack of sleep or busy schedules, which is why anemia is sometimes missed.
Common signs include:
- Fatigue or weakness
- Trouble doing everyday tasks
- Loss of appetite
- Dizziness
- Frequent headaches
- Pale skin
- Sore tongue
- Numbness or tingling in hands or feet
- Feeling unusually cold
- Shortness of breath with routine activity
- Trouble concentrating
- Irritability
- Brittle nails
- Pica (craving non-food items like dirt or ice)
- Ear pounding, in iron deficiency anemia
- Anxiety or depression, if you are deficient in vitamin B12
Who is most at risk for nutritional anemia?
Certain groups are more likely to develop nutrient deficiencies.
- Older adults: As you age, you may have less appetite and you may not absorb nutrients like vitamin B12 well.
- Women with heavy periods: Blood loss during menstruation increases iron needs.
- Women who are pregnant or breastfeeding: You need more iron and folate for pregnancy and milk production.
- Infants and young children, as well as teens during growth spurts: Rapid growth raises demand for nutrients, especially iron.
- People with digestive conditions: Conditions affecting the stomach or intestines, like Crohn’s disease and Celiac disease, can make it harder to absorb nutrients.
- People who have had bariatric surgery: Weight-loss surgery changes how you absorb nutrients.
- People with limited diets or food insecurity: Limited access to a variety of foods can increase the risk of nutrient gaps. Vegetarians and vegans may be at risk.
- People with certain diseases: Kidney disease and cancer increase your risk.
Why nutritional anemia is often missed
Nutritional anemia does not always cause dramatic symptoms. If you feel fatigued, you may assume it’s due to stress, aging or poor sleep. You may be eating enough calories and not realizing you’re not getting enough nutrient-rich foods.
Because symptoms develop gradually, you may not seek care until you feel worse. Routine checkups and simple blood tests can help spot anemia early. “If nutritional anemia is not treated, it may lead to other health issues such as pregnancy complications or heart problems,” Keenan said.
How providers check for nutritional anemia
Health care providers typically will conduct a physical exam and ask you about your family history. They will order blood tests to evaluate red blood cells and check for nutrient deficiencies.
If they spot anemia, you may need more testing to figure out what’s causing it. Treatment depends on whether the problem is related to diet, absorption or another condition.
Follow-up testing can make sure your treatment is working and nutrient levels are improving.
What can you do to prevent nutritional anemia?
Balanced, nutrient-rich eating patterns can help. Keenan recommends that you:
- Consume iron-rich foods from lean meats, poultry and fish.
- Pair plant-based sources of iron, like beans, lentils, tofu and dark leafy grains, with foods high in Vitamin C, like oranges, strawberries and tomatoes.
- If possible, cook in a cast iron skillet to increase the iron content of foods.
- Avoid drinking tea or coffee with meals, since they contain substances that keep you from absorbing iron.
- Choose fortified cereals, breads and pasta to increase iron, folic acid and vitamin B12.
- Eat lean meats and low-fat dairy for more vitamin B12.
Your health care provider may recommend supplements. You should only take them under medical guidance.
Managing underlying conditions that affect nutrient absorption is also important. Regular checkups are helpful, especially if you’re in a higher-risk group.
When to talk to a health care provider
Consider speaking with a provider if you have:
- Fatigue that lasts more than a few weeks
- Weakness that affects your daily life
- Ongoing dizziness or shortness of breath
- Known risk factors for anemia
- Concerns about your diet or nutrient intake
Simple treatments can often help with nutritional anemia and make a difference in how you feel.
The bottom line
Malnutrition is not always about eating too little. Sometimes, like with nutritional anemia, it is about missing key nutrients you need.
If you have symptoms or concerns about your nutrition, reach out to a Banner Health provider for help understanding what your body needs and how to support it.
