Low haemoglobin is common in India, largely due to iron deficiency and poor absorption
Low haemoglobin often hides in plain sight. The tiredness that does not go away, the breathlessness after a short climb, the pale skin, the headaches that return without warning. In India, iron deficiency remains one of the most common nutritional problems. According to the National Family Health Survey (NFHS-5) by the Government of India, more than half of women of reproductive age are anaemic.
What do experts say?
Haemoglobin is the protein in red blood cells that carries oxygen across the body. When levels drop, every organ feels the strain. As Ms Veena V, Chief Clinical Dietician & HOD - Department of Clinical Nutrition and Dietetics, Aster Whitefield, told TOI Health, “Low haemoglobin is a common health problem which affects many people in India because iron deficiency has become one of the main causes that leads to anaemia. The protein haemoglobin exists in red blood cells to transport oxygen throughout the body and its decreased levels cause people to suffer from fatigue, breathlessness, headaches, dizziness, and poor concentration.”
The good news is that food, when chosen wisely, can play a powerful role in rebuilding iron stores.
Why iron deficiency is so common
Iron deficiency does not happen overnight. It builds slowly. Skipped meals, polished grains instead of whole grains, low intake of leafy greens, and poor absorption all add up.
Ms Veena V points out, “The problem exists because people lack iron in their diets and they also experience difficulties absorbing iron from the foods they consume.”
Iron from plant foods, called non-heme iron, is harder for the body to absorb. That makes food pairing and timing just as important as the food itself.
The Indian Council of Medical Research (ICMR) has repeatedly highlighted iron deficiency as a major public health issue, especially among women and adolescents.
Spinach and Amaranth
Leafy greens are underestimated. Spinach and amaranth contain non-heme iron along with folate and fibre. They also support red blood cell formation.
But here is the catch. Iron from greens absorbs better when paired with vitamin C. A squeeze of lemon over cooked spinach or adding tomatoes to amaranth curry can increase absorption significantly.
This simple kitchen habit can quietly change haemoglobin levels over time.
Lentils and chickpeas
Dal and chole are daily staples in many homes. They also offer iron, plant protein, and slow-release carbohydrates.
Cooking lentils with tomatoes or serving chickpeas with raw onion and lemon improves iron absorption.
“The best food options for iron intake require people to select green leafy vegetables which include spinach and amaranth together with lentils and chickpeas and jaggery and dates and pumpkin seeds and beetroot and iron-rich millets which include ragi,” says Ms Veena V.
Regular intake matters more than occasional heavy portions.
Jaggery and dates
Jaggery, especially darker varieties, retains some iron from processing. Dates offer iron along with fibre and natural sugars.
A small piece of jaggery after lunch or soaked dates in the morning can gently support iron intake. They are not miracle cures, but they can strengthen an already balanced diet.
Moderation is key, especially for people with diabetes.
Pumpkin seeds and ragi
Pumpkin seeds pack iron into a small serving. Roasted and sprinkled over salads or mixed into curd, they add crunch and nutrition.
Ragi, or finger millet, is another iron-rich grain. Ragi dosa, porridge, or rotis can replace refined flour options.
Millets also provide fibre and minerals that support long-term metabolic health.
Beetroot
Beetroot is widely believed to “increase blood.” While it does contain iron and antioxidants, its real strength lies in supporting overall blood flow through nitrates.
Beetroot juice with a squeeze of lemon can complement iron-rich meals, but it should not replace core iron sources like lentils and greens.
Boost absorption
Iron intake is only half the story.
“The process of absorption holds equal significance to the process of intake. The body absorbs non-heme iron which comes from plant sources at a lower rate than it absorbs iron from animal sources. The body absorbs iron better when people consume iron-rich foods together with foods that contain vitamin C, including lemon and oranges and guava and tomatoes.”
Adding lemon to dal. Eating guava with lunch. Including tomatoes in curries. These small habits increase iron uptake in the gut.
At the same time, tea and coffee right after meals reduce iron absorption. Waiting at least one hour can make a difference.
“The body loses its ability to absorb iron when people drink tea or coffee immediately after their meals and when they eat too many processed foods and when their diets lack vitamin C. Long-term dietary imbalance can gradually lead to declining haemoglobin levels.”
Sometimes, the solution lies in timing, not tablets.
When food alone is not enough
Diet plays a major role, but it is not the only factor. Heavy menstrual bleeding, gut disorders, chronic infections, and pregnancy can also lower haemoglobin.
“The treatment of low haemoglobin requires three components which include dietary modifications and health assessments and medical interventions. Mediterranean dietary patterns which include iron-dense foods and their accompanying nutrients serve as an effective method to sustain healthy haemoglobin levels while preventing long-term iron deficiency.”
Blood tests remain essential. Severe anaemia often needs iron supplements prescribed by a doctor. Self-medication can cause side effects or mask underlying conditions.
What matters?
In many Indian homes, anaemia is dismissed as “weakness.” But weakness has a cause. It deserves attention, not neglect.
A plate filled with greens, lentils, seeds, and a squeeze of lemon may look simple. Yet over weeks and months, it can restore energy, clarity, and stamina.
Medical experts consulted
This article includes expert inputs shared with TOI Health by:
Ms Veena V, Chief Clinical Dietician & HOD - Department of Clinical Nutrition and Dietetics, Aster Whitefield.
Inputs were used to highlight why choosing iron-rich foods and proper dietary combinations is a safer way to improve haemoglobin.