Guava juice could be key to anaemia reduction in lower-income countries

Regular consumption of guava juice could be an accessible and affordable way to lower the risk of anaemia for women in low- and middle-income countries, according to conclusions drawn from evidence published in BMJ Nutrition Prevention & Health.

Twelve studies from Indonesia involving 235 participants were included in a pooled analysis.

Overall, haemoglobin levels increased by an average of 1.71 grams per decilitre (g/dl) following guava juice consumption.

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Among teenage girls, the average rise was 1.52g/dl, while pregnant women saw a typical increase of 1.84g/dl.

Across five comparison studies involving a total of 204 participants, haemoglobin levels were on average 1.29g/dl higher among those receiving both guava juice and iron supplementation than those receiving supplements alone.

According to the researchers, an increase of 1 to 2g/dl could shift individuals from mild or moderate anaemia to non-anaemic categories, with the result of lower fatigue, enhanced cognitive function and greater productivity.

Iron deficiency anaemia is a common condition among teenage girls and pregnant women in low- and middle-income countries.

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However, guava fruit is a rich, affordable source of nutrition in many Asian countries, containing up to four times as much vitamin C per 100g as oranges, as well as vitamin A, folate, dietary fibre and modest amounts of iron.

The researchers suggest that integrating guava juice into school nutrition programmes, antenatal care packages or community health initiatives could be a feasible approach to address mild-to-moderate anaemia.

They also observe that strengthening local supply chains, standardising formulations and embedding the dietary approach within public health nutrition programmes could all contribute to more sustainable anaemia control.

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Professor Sumantra Ray, chief scientist and executive director at NNEdPro Global Institute for Food, Nutrition and Health, said: 'This study builds on the established role of dietary sources high in vitamin C to enhance iron absorption and improve the effectiveness of iron supplementation.’

However, he added that quasi-experimental research, the wide variation in study design, small sample sizes, and limited length of follow-up mean that caution should be used when interpreting the findings.