Is anaemia in India caused only by iron deficiency?

Iron deficiency accounts for approximately 50–60% of anaemia in India. Other causes: Vitamin B12 deficiency (10–15%); folate deficiency (5–10%); haemoglobin variants such as sickle cell disease (prevalent in tribal populations); and chronic disease anaemia. Each requires specific treatment — B12 supplements will not correct iron deficiency anaemia.

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Disease & Diet

12 min read

July 6, 2026

Iron Deficiency Anaemia Indian Women 2026 | Diet Guide | AaharIQ

NFHS-5: 57% of Indian women are anaemic. Complete guide to iron deficiency anaemia in India — causes, year-by-year data, haem vs non-haem iron foods, Vitamin C synergy, tea-iron antagonism, anaemia in

Anaemia Prevalence in India: NFHS Data Year-by-Year

Population Group	NFHS-3 (2005-06)	NFHS-4 (2015-16)	NFHS-5 (2019-21)	Trend
Women 15–49 years	56.2%	53.0%	57.0%	⚠️ No improvement — slight worsening
Pregnant women	57.9%	50.4%	52.2%	⚠️ Marginal improvement — still critically high
Children 6–59 months	69.5%	58.6%	67.1%	❌ Worsened from NFHS-4 — alarming
Men 15–49 years	24.3%	22.7%	25.0%	⚠️ High in males — often overlooked
Women 15–19 years (adolescents)	56%	54%	59%	❌ Rising in adolescents — critical window
India's anaemia prevalence has not improved in 15 years despite multiple national programmes (ANEMIA MUKT BHARAT, iron supplementation schemes, food fortification). The fundamental reason: iron supplementation without addressing dietary factors that prevent iron absorption is insufficient. Stopping tea with meals and adding a source of Vitamin C to every iron-containing meal would have greater impact than iron supplements alone.
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Iron Content and Bioavailability of Indian Foods

Food	Iron per Serving	Type	Absorption Rate	Practical Value
Chicken liver (100g)	9.9 mg	Haem iron	✅ 20–30%	Highest bioavailable iron food in Indian diet; 2–3mg absorbed per serving
Mutton / goat meat (100g)	2.7 mg	Haem iron	✅ 20–30%	0.5–0.8mg absorbed — significant contribution
Ragi/finger millet (100g)	3.9 mg	Non-haem	⚠️ 5–10%	Best plant iron source in India; also provides calcium; daily ragi adds 0.2–0.4mg absorbed iron
Horsegram (kulthi dal, 100g)	6.7 mg	Non-haem	⚠️ 5–10%	Highest plant iron in Indian legumes; sprouted kulthi has higher bioavailability
Moringa leaves (drumstick, 100g)	0.85mg fresh / 28mg dry powder	Non-haem	⚠️ 5–10%	Moringa powder (1 tablespoon) in dal provides meaningful iron + Vitamin C (enhances own absorption)
Palak / spinach (cooked, 1 cup)	3.7 mg	Non-haem	❌ 2–5% — oxalate reduces absorption	Cook spinach to reduce oxalate; add tomato (Vitamin C) to improve absorption; do not rely on spinach as primary iron source
Lotus seeds / makhana (100g)	1.6 mg	Non-haem	⚠️ 5–10%	Iron-fortified snack option; available in Bihar/Odisha at affordable price
Amaranth (chaulai leaves, 100g)	2.3 mg	Non-haem	⚠️ 5–12%	Underutilised iron-rich leafy vegetable; higher bioavailability than spinach (no oxalate)
Sesame seeds / til (30g)	4.1 mg	Non-haem	⚠️ 5–10%	Til chutney powder (idli podi) is a practical iron-rich condiment for South Indian diets

Iron Absorption Enhancers and Inhibitors

Factor	Effect on Iron Absorption	Practical Action
Vitamin C (ascorbic acid)	✅ Increases non-haem iron absorption by 3–6× — most powerful dietary iron enhancer	Add: lemon squeeze on dal; raw tomato/amla chutney with meals; fresh fruit with iron-rich food
Haem iron (meat)	✅ Enhances absorption of simultaneously consumed non-haem iron	Combine meat/chicken with dal or leafy greens for enhanced total iron absorption
Fermentation (idli, dosa)	✅ Reduces phytate by 40–60%, increasing plant iron bioavailability	Emphasise fermented food preparation; sourdough atta reduces phytate significantly
Tea and coffee	❌ Tannins reduce non-haem iron absorption by 50–80% when consumed with meals	Do NOT drink tea/coffee within 1 hour of iron-rich meals — this single change can significantly improve anaemia
Calcium (dairy, calcium supplements)	❌ Competes with iron for intestinal transporter — reduces absorption by 20–40%	Space calcium-rich dairy at least 2 hours from iron-rich meals; do not take calcium supplements with iron-rich food
Phytates (whole grains, legumes)	❌ Chelate iron — reduce absorption by 50–65%	Soak legumes overnight; sprout grains and legumes; ferment — all reduce phytate 40–70%
Vitamin A	✅ Mobilises iron from storage — improves utilisation	Include beta-carotene-rich foods (orange/yellow vegetables) with iron-rich meals

Frequently Asked Questions

Fastest evidence-based approach: (1) Oral iron supplementation (ferrous bis-glycinate 36mg elemental iron daily — fewer GI side effects and better absorption than ferrous sulfate); (2) Take with Vitamin C (amla juice or orange) on an empty stomach; (3) Avoid tea/coffee for 1 hour before and after iron supplementation.

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