Megaloblastic Anemia: Nutritional Considerations

The following steps may reduce the risk of megaloblastic anemia:

• Vitamin B₁₂ supplementation: Individuals following mixed diets generally have adequate vitamin B₁₂ intake. However, many individuals, particularly elderly persons, have less than adequate B₁₂ absorption and may benefit from supplementation. Persons at risk for deficiency include those who have had “stomach stapling” surgery, alcoholics, and individuals who follow unsupplemented vegan diets for many years and their breast–fed infants. In these groups, the risk for vitamin B₁₂ deficiency is easily eliminated with supplementation. Common multiple vitamins, B₁₂ supplements, fortified breakfast cereals, fortified soymilk, and fortified meat analogues contain a reliable source of the vitamin.
• Increased intake of folic acid: Due to fortification of grain products with folic acid, anemia resulting from folic acid deficiency is becoming less common. However, alcoholism often leads to deficiency and may require supplementation. In addition, people with epilepsy who are taking anticonvulsant medications may benefit from folic acid supplementation.
  
  Increased intake of foods rich in folic acid is a wise choice for all. These include beans, legumes, citrus fruits and juices, wheat bran, whole grains, and dark green leafy vegetables.