Regular guava juice consumption may prove a readily accessible and affordable addition to help lower the risk of anaemia in women in low- and middle-income countries.

This is according to a systematic review, published in the journal BMJ Nutrition Prevention & Health, which looked at studies that combined guava juice with iron supplementation in managing anaemia.

The analysis of 12 Indonesian studies involving 235 women and teenage girls found an average difference in haemoglobin levels of 1.71g/dl overall, indicating a significant improvement after guava juice consumption.

The average differences among teenage girls was 1.52g/dl, and 1.84g/dl among pregnant women, respectively.

Five of the studies directly compared combined guava juice and iron supplementation against iron supplementation alone.

The former had a higher average difference in haemoglobin of 1.29g/dl, indicating that the combination is more effective than the supplements alone for boosting haemoglobin levels.

This prompted the Pakistani researchers to suggest the inclusion of guava juice in dietary counselling for anaemia prevention in countries with a high occurrence of the condition.

“An increase of 1-2g/dl may shift individuals from mild or moderate anaemia to non-anaemic categories, improving fatigue, cognitive function and productivity outcomes,” they suggest.

Iron deficiency anaemia is very common in teenage girls and pregnant women in low- and middle-income countries, putting them at heightened risk of ill health and death, note the researchers.

In many Asian regions, guava fruit is a rich, affordable source of vitamin C, which boosts uptake of dietary iron from plant sources, they add.

The fruit contains up to four times as much vitamin C per 100g as oranges, and also provides vitamin A, folate, dietary fibre and modest amounts of iron, they point out.