Megaloblastic Anemia: Nutritional Considerations
The following steps may reduce the risk of megaloblastic
- 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
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.