Question

Anita is a 60-year-old woman who prides herself on taking charge of her health. Her daily physical activities include walking her dog, playing tennis, or participating in a tai chi class at the senior center. She follows the Dietary Guidelines for Americans, choosing a variety of whole grains; eating at least five servings per day of fruits and vegetables; and keeping her saturated fat and sodium intakes to a minimum. She eats lean sources of protein, choosing poultry, fish, or vegetable sources of protein instead of red meat. She maintains a healthy body weight, has never had high blood pressure or high blood sugar, and does not take medications or supplements. Last week, she went to a blood drive at her church with the intent of donating blood, but she was turned away because her hematocrit (a measure of the percentage of red blood cells in the blood) was slightly below the requirements for donation. Anita was surprised because she has never had a problem donating blood before. The nurse told Anita that her low hematocrit level was indicative of anemia, which has many possible causes. As Anita thought about it, she realized that she had been feeling more tired than usual.

a.Folate deficiency may lead to anemia. What role does folate play in the health of red blood cells?
b.From the description, is it likely that Anita is deficient in folate?
c.Low vitamin B-12 may result in anemia. What role does vitamin B-12 play in the health of red blood cells? Suggest an explanation for why Anita may have low vitamin B-12 status even with adequate dietary intake of vitamin B-12.
d.What dietary changes could Anita make to improve her vitamin B-12 status?

Answer 1

Anita's low hematocrit suggesting anemia could be due to deficiencies in folate or vitamin B-12, essentials for healthy red blood cell production. Her diet adheres to recommendations, so absorption issues may be present. Increasing dietary intake of B-12-rich foods or supplements could help.

Step-by-step explanation:

Anemia is a condition marked by a deficiency of red blood cells (RBCs) or hemoglobin, leading to a lack of oxygen being delivered to body tissues. Among the types of anemia, folate deficiency anemia is concerning because folate plays a crucial role in the synthesis of nucleotides required for DNA replication and repair necessary for the production of healthy RBCs. If Anita is following the Dietary Guidelines for Americans, she would likely be consuming enough folate, unless there is an issue with absorption or an increase in demand.

Deficiency in vitamin B-12 can also lead to anemia, specifically pernicious anemia, which is caused by poor absorption of vitamin B-12 from the diet. Even if Anita's diet includes adequate amounts of vitamin B-12, she may experience absorption issues due to age-related changes in stomach acidity or possible atrophic gastritis. To improve her vitamin B-12 status, Anita might consider increasing her intake of vitamin B-12-rich foods such as fortified cereals, dairy products, eggs, and possibly supplementation under medical supervision.