Drinking guava juice regularly may be an easy and affordable way to reduce the risk of anemia in women and teenage girls in low- and middle-income countries, according to a new review published in an open access journal. BMJ Nutrition Prevention and Health.
Researchers found that combining guava juice with iron supplements appeared to improve hemoglobin levels more effectively than taking iron supplements alone. The results of this study suggest that tropical fruit juices may be a useful addition to nutritional programs aimed at preventing iron-deficiency anemia in areas where iron-deficiency anemia is prevalent.
Iron deficiency anemia is particularly common in pregnant women and adolescent girls in many developing countries. This condition can cause fatigue, weakness, difficulty concentrating, pregnancy complications, and increased risk of serious illness and death.
Why is guava juice effective?
Guava is naturally rich in vitamin C, which helps your body absorb iron more efficiently from plant-based foods. According to researchers, guavas contain up to four times more vitamin C per 100 grams than oranges.
In addition to vitamin C, guava also contains vitamin A, folic acid, dietary fiber, and small amounts of iron.
Some small studies conducted in Indonesia had already suggested that drinking guava juice could increase hemoglobin levels, but the researchers said that until now the comprehensive evidence had not been considered together in a comprehensive analysis.
17 studies reviewed
To better understand the potential benefits, researchers analyzed studies published in English since 2000. They identified 17 eligible studies, including 15 quasi-experimental studies and 2 randomized controlled trials.
Six studies focused on teenage girls and 11 on pregnant women. Most of the studies investigated guava juice in conjunction with iron supplementation.
Researchers combined data from 12 studies involving 235 women and adolescent girls. Overall, participants experienced an average 1.71 g/dl increase in hemoglobin levels after consuming guava juice.
When researchers looked at each group separately, teenage girls experienced an average increase of 1.52 g/dl, while pregnant women experienced an average increase of 1.84 g/dl.
Guava juice and iron supplements improve performance
Five of the studies directly compared women who took iron supplements alone with women who took iron supplements with guava juice. Each group included 102 participants.
Results showed that the combination approach resulted in an average of 1.29 g/dl higher hemoglobin levels than iron supplements alone.
“An increase of 1-2 g/dl may move an individual from mild or moderate anemia to the non-anemic category, with improved fatigue, cognitive function, and productivity outcomes,” the researchers suggest.
The team noted that there are some important limitations. All studies were conducted in Indonesia and had significant differences in study design, guava type, dosage, intervention duration, and participant characteristics.
The researchers also cautioned that most of the evidence came from quasi-experimental studies rather than more powerful randomized clinical trials. Additionally, the study did not include long-term follow-up, so it is unclear how long the effects last.
Can guava juice be part of public health programs?
Despite its limitations, researchers believe guava juice may be a practical, low-cost nutritional strategy to alleviate mild to moderate anemia.
“Incorporating guava juice into school nutrition programs, antenatal care packages, and community health initiatives may be a viable approach to addressing mild to moderate anemia, in line with the United Nations Decade of Action on Nutrition (2016-2025), which emphasizes dietary diversity and locally sourced nutritious foods,” they note.
They added that guava juice is already widely culturally accepted in many parts of Asia and is relatively inexpensive, so it has the potential to become a sustainable public health tool.
“Guava juice’s nutritional richness, affordability, and cultural acceptance across Asia make it a promising intervention at low cost. Strengthening local supply chains, standardizing formulations, and incorporating such dietary approaches into public health nutrition programs may collectively contribute to more sustainable anemia control,” the researchers added.
Professor Sumantra Ray, co-owner and Chief Scientist and Executive Director of the NNEdPro Global Institute of Food, Nutrition and Health BMJ Nutrition Prevention and Healthstated that the study results support existing knowledge about vitamin C improving iron absorption.
“This study builds on the well-established role of dietary sources rich in vitamin C in increasing iron absorption and improving the effectiveness of iron supplementation,” he commented.
However, he stressed that more rigorous research is needed before guava juice can be recommended as an alternative to traditional anemia treatments.
“However, the quasi-experimental study, high variability in study design, small sample size, and limited follow-up period mean that caution is needed when interpreting the results. Without further rigorous studies to define the optimal therapeutic dose and duration of use, guava juice cannot be recommended as an alternative to conventional treatment for people at risk of iron deficiency anemia,” he added.
