Why is iron important?

How to Increase Your Iron Absorption and Manage Iron-Deficiency Anemia

If you’ve been diagnosed with iron-deficiency anemia, you may be relieved to learn what’s been causing your symptoms. Iron is an essential mineral that, in addition to helping maintain healthy hair, skin, and nails, aids in the production of hemoglobin, a protein in red blood cells that helps transport oxygen throughout the body. People who are deficient in iron (or who have iron-deficiency anemia) have trouble producing enough healthy red blood cells, which can cause fatigue, shortness of breath, and more.

But don’t start piling your plate full of spinach, Popeye-style, just yet. Here’s what to know about iron-deficiency anemia and how to boost your iron levels.

Treat What’s Causing Your Iron-Deficiency Anemia

Knowing the reason why you’re deficient in iron is an important first step in controlling your condition, says Sioban Keel, MD, a hematologist and an associate professor of hematology at the University of Washington School of Medicine. For example, women who have heavy periods are particularly at risk for the condition, according to the American Society of Hematologists (ASH); some women may need to take an iron supplement or talk to their gynecologist about birth control options that could lessen the bleeding, Dr. Keel says.

Or, says Cristina Sutter, MHSc, RD, from Vancouver, Canada, “if you’re an athlete, and you’re losing extra iron through sweat, or a vegetarian who’s short on , just being aware and remembering to take your supplement and eat a well-balanced diet can make all the difference.”

Eat Smart to Increase Your Iron Absorption

What you eat — and when you eat it — can impact iron absorption. Here are a few ways to work more of this mineral into your diet.

  • Eat meat. The best source of iron is heme iron, which comes from animal-based foods including red meat, poultry, and seafood, according to the National Institutes of Health Office of Dietary Supplements (ODS). While tofu, legumes, and spinach do contain iron, plant-based (or non-heme) iron isn’t as readily absorbed as iron from meat. “Only about 2 to 20 percent of non-heme iron makes its way from your digestive tract into your blood, compared with 15 to 35 percent from animal foods,” says Cynthia Sass, MPH, RD, author of Slim Down Now.
  • Add vitamin C to your diet. “Pairing vitamin C with your meal gives non-heme iron a boost, upping its absorption,” Sass says. In addition to eating more fruits such as oranges, kiwfruiti, and grapefruit, you can get a healthy dose of vitamin C from bell peppers, broccoli, and cauliflower.
  • Cook in a cast-iron skillet. “Using iron cookware transfers some of the iron into your food,” Sass says. “This especially works for acidic foods that have a higher moisture content, such as tomato sauce.” According to a small study done in children, published in December 2013 in the Indian Journal of Pediatrics, cooking a cast-iron pot increased the iron content of the food by about 16 percent.
  • Reschedule your coffee and tea times. Separate coffee and tea (including decaf, though herbal is okay) from iron-rich meals and supplements. “Tannins, which are found in tea and coffee, interfere with absorption, so if you’re trying to build your body’s iron stores, drink tea and coffee at least a few hours before an iron-rich meal,” Sass adds.
  • Space out your iron intake. Your body can absorb more iron when its consumed in several smaller doses rather than one large one, says Sass.

What to Know About Taking Iron Supplements

Because the amount of iron in food is so small compared with the amount that someone with an iron deficiency might need, “it’s unlikely they’d drastically improve their iron levels through diet,” says Sutter. Although foods like liver and shellfish have high amounts of iron — with pork liver coming in at about 15 milligrams (mg) per 3 ounce (oz) serving and 3 oz of oysters containing about 8 mg, according to the U.S. Department of Agriculture and the ODS, respectively — they aren’t commonly available or even recommended for daily consumption, due to high cholesterol levels.

According to ASH, even if you’ve identified the of cause of your iron deficiency (and are treating your condition), you may still need to take iron orally or intravenously. Iron supplements are usually taken three times per day, with most people needing to take 150 to 200 mg of elemental iron, according to ASH. To help maximize how your body uses these supplements:

  • Don’t take them at the same time as calcium supplements, if you take both. Calcium may interfere with iron absorption, the ODS says.
  • Take them on an empty stomach or with orange juice to improve absorption, adds Sutter.

Note that most iron supplements have some side effects such as constipation, nausea, and upset stomach. Taking them after dinner and before bed could help offset some of your queasiness.

Boost Your Iron – Before You Donate!

It is important to increase your iron intake in the weeks before you donate. Low hematocrit or low hemoglobin are the most frequent reasons those wanting to donate are disqualified, and both are tested prior to blood donation. Low hematocrit or hemoglobin can be related to a low iron level. The great news is that it is usually temporary!

How to help your body absorb iron:

– Add fruits and vegetables high in Vitamin C. Vitamin C can enhance the iron absorption by as much as 20 times.
– Refrain from tea drinks since tannic acid can interfere with iron absorption.

Recommended daily dietary iron intake:
Females 19 to 50 – 18 mg
Females 50 and over – 8 mg
Males 19 and over – 8 mg

Depending on which location you visit, we will test hematocrit or hemoglobin.

What is hematocrit?

Hematocrit is the percentage of blood volume that is red blood cells. According to the U.S. Food and Drug Administration (FDA), women must have a hematocrit of at least 38% and men a hematocrit of at least 39%. This is to protect donors from becoming anemic by donating blood.

What is hemoglobin?

Hemoglobin is a special protein inside red blood cells that carries oxygen. According to the FDA, to donate blood, men must have a hemoglobin of at least 13 g/dL (grams per deciliter) and women a hemoglobin of at least 12.5 g/dL. This is to protect donors from becoming anemic when they give blood.

Common reasons for low hematocrit or hemoglobin (a possible sign of low iron) are:
– A low-iron diet
– Menstrual blood loss
– A diet low in folate, vitamin B6 or B12

People with chronic illnesses such as arthritis, diabetes, and kidney disease may also have low readings. Some health conditions are not readily apparent but may cause a low hematocrit or hemoglobin and possible low iron levels in your body.

What can I do if my diet seems to be the only reason for my low hematocrit or hemoglobin?

Eating foods rich in vitamin C (citrus fruits, broccoli and tomatoes) helps in iron absorption. Avoid drinking tea while eating high-iron foods. Coffee, milk, fiber and soy protein may also block the absorption of iron. Over-the-counter iron supplements can be taken after consulting with a doctor to determine the exact cause of low hematocrit or hemoglobin.

Following these steps may help raise your percentage just a few points within just a few days.

YOUR COMMITMENT TO BEING A LIFE-SAVING BLOOD DONOR IS IMPORTANT.

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If you’re a blood donor it is especially important that you meet the recommended daily intake of dietary iron. This World Iron Awareness Week (1-7 May), here’s a guide to make sure your diet contains enough iron.

1. SEE RED

Iron is found in a number of foods, including red meat. In general, the redder the meat, the higher the iron content. But not all iron is the same.

2. EAT LEAN RED MEAT REGULARLY

There are two types of iron in food: haem iron, found in meat and fish, and non-haem iron, found mainly in plant foods, such as cereals, vegetables, beans and fruit. We use haem iron far more easily, with about a quarter being used, whereas only about 5% of nonhaem iron is absorbed. For example, eating just 120g of lean beef steak provides the same amount of iron as a massive 1kg of silverbeet. This provides over a third of a woman’s daily iron needs.

3. GET PLENTY OF VITAMIN C

Vitamin C, found in fruit and vegetables, helps the body use non-haem iron. Try to include fruit or vegetables with every meal.

4. EAT RED MEAT AND VEGETABLES TOGETHER

‘Meat and three veg’ is a traditional Kiwi meal and it’s good for you too. Eating meat and vegetables together helps the body use up to four times more of the non-haem iron in the meal. Other examples of iron-rich meal combos include meat and vegetable stir-fry, pasta with vegetables and meat sauce (e.g. spaghetti bolognaise) or a lean beef sandwich.

5. KEEP YOUR MEALS TANNIN FREE

The tannin in tea, and to a lesser extent coffee, reduces the amount of iron used from food. Aim to drink tea and coffee between meals rather than with them.

6. BEWARE OF DIETING

Research shows girls and women on low calorie diets often go short on iron. The iron in meat is found in the lean part. Trimming the fat takes away none of the iron, making lean beef and lamb great if you’re watching your weight.

7. EXTRA IRON FOR EXERCISE

Extra iron is vital for everyone involved in sports and exercise. A lack of iron can decrease performance through less oxygen being available where it’s most needed. If you aren’t performing at your best, have your iron levels checked. Have a look at our Food for Sport brochure for more information.

8. DON’T RELY ON SUPPLEMENTS

Iron supplements should only be taken under medical supervision. In the long term, food is the safest and healthiest way to maintain iron levels. Frequent use of iron supplements may reduce the absorption of zinc, copper and calcium, increasing the risk of deficiencies.

9. CHOOSE A VARIETY OF FOODS

Eating a variety of foods is the best way to get enough iron. Choose foods from each of the main food groups to ensure you have enough iron each day: breads and cereals, fruits and vegetables, dairy foods and red meat, fish, chicken, eggs, beans or lentils.

10. BE EXTRA IRON SMART IF YOU’RE AT RISK

There are certain people most at risk of being short of iron:

  • Infants, children and teenagers because they are growing rapidly
  • Pregnant women due to increased blood levels and building baby’s iron stores
  • Girls and women who have periods, due to regular monthly blood loss
  • Athletes and very active people
  • People on restrictive or fad diets

Information courtesy of Beef and Lamb New Zealand

Other resources: Thousands of New Zealanders Don’t Get Enough Iron, Is Your Baby Getting Enough Iron?, and Iron For Toddlers. For a free copy of these resources, please contact: 0800 733 466 I [email protected] I beeflambnz.co.nz

For more information and great iron-rich recipes and meal ideas, visit recipes.co.nz

Health problems, including iron deficiency, may result from an inadequate diet. They may also have a medical basis unrelated to diet. The information above is only general and is not to be taken as a substitute for medical advice in relation to specific symptoms or health concerns.

Everything you need to know about iron

In adults, doses for oral iron supplementation can be as high as 60 to 120 mg of elemental iron per day. These doses typically apply to women who are pregnant and severely iron-deficient. An upset stomach is a common side effect of iron supplementation, so dividing doses throughout the day may help.

Adults with a healthy digestive system have a very low risk of iron overload from dietary sources.

People with a genetic disorder called hemochromatosis are at a high risk of iron overload as they absorb far more iron from food when compared to people without the condition.

This can lead to a buildup of iron in the liver and other organs. It can also cause the creation of free radicals that damage cells and tissues, including the liver, heart, and pancreas, as well increasing the risk of certain cancers.

Frequently taking iron supplements that contain more than 20 mg of elemental iron at a time can cause nausea, vomiting, and stomach pain, especially if the supplement is not taken with food. In severe cases, iron overdoses can lead to organ failure, internal bleeding, coma, seizure, and even death.

It is important to keep iron supplements out of reach of children to reduce the risk of fatal overdose.

According to Poison Control, accidental ingestion of iron supplements was the most common cause of death from an overdose of medication in children less than 6 years old until the 1990s.

Changes in the manufacture and distribution of iron supplements have helped reduce accidental iron overdoses in children, such as replacing sugar coatings on iron tablets with film coatings, using child-proof bottle caps, and individually packaging high doses of iron. Only one death from an iron overdose was reported between 1998 and 2002.

Some studies have suggested that excessive iron intake can increase the risk of liver cancer. Other research shows that high iron levels may increase the risk of type 2 diabetes.

More recently, scientists have begun investigating the possible role of excess iron in the development and progression of neurological diseases, such as Alzheimer’s disease, and Parkinson’s disease. Iron may also have a direct damaging role in brain injury that results from bleeding within the brain. Research in mice has shown that high iron states increase the risk of osteoarthritis.

Iron supplements can decrease the availability of several medications, including levodopa, which is used to treat restless leg syndrome and Parkinson’s disease and levothyroxine, which is used to treat a low-functioning thyroid.

Proton pump inhibitors (PPIs) used to treat reflux disease can reduce the amount of iron that can be absorbed by the body from both food and supplements.

Discuss taking an iron supplement with a physician or healthcare practitioner, as some of the signs of iron overload can resemble those of iron deficiency. Excess iron can be dangerous, and iron supplements are not recommended except in cases of diagnosed deficiency, or where a person is at high risk of developing iron deficiency.

It is preferable to achieve optimal iron intake and status through the diet rather than supplements. This can help minimize the risk of iron overdose and ensure a good intake of the other nutrients found alongside iron in foods.

Question:

Why is iron intake an important component of a healthy diet? What can you do to ensure you are getting the daily recommended intake of iron? (150 words).

Macronutrients and Micronutrients:

Some nutrients are required in large amounts each day, for example carbohydrates, proteins and lipids. These are called macronutrients. Other nutrients are required in very tiny amounts, but are still important for health. These are called micronutrients. Some examples of micronutrients are all the vitamins as well as iodine, manganese, zinc, selenium, and iron.

Answer and Explanation:

Iron is an important and critical component of a healthy diet, as it is a key part of every hemoglobin molecule that helps to carry oxygen in our blood. It is also found in the cytochrome molecules that are critical in the process of aerobic respiration in all of our cells.

Most of the iron in a person’s body is found inside their red blood cells, in the hemoglobin. some iron is also stored as a reserve in the liver. A person that gets too small an amount of iron in their diet could end up with iron-deficiency, and this could result in anemia from having too few hemoglobin molecules. This results in the person being very tired and weak. In addition to a diet that is too low in iron, several other factors could contribute to anemia, including blood loss due to menstruation, or internal bleeding, or even pregnancy that demands more iron for the developing fetus.

There are many steps to take to be sure that you get adequate iron in your diet. Most meats are very high in iron. But there is plenty of iron in other foods as well, such as green vegetables (spinach, kale, broccoli), many fruits (apricots, raisins, figs), nuts (walnuts, almonds, peanuts), and iron fortified cereals and bread products.

Foods with vitamin C, such as regular orange juice (no calcium) help iron to be absorbed in the small intestine. There are some foods that interfere with the absorption of iron, though, so they should be eaten at times different than the high-iron foods. Some foods that decrease iron absorption are calcium enriched juices, calcium rich foods, high fiber cereals, and caffeine in colas, teas, and coffee.

Medical Disclaimer: The information on this site is for academic purposes only and is not a substitute for professional medical advice.

An article in this week’s Journal of the American Medical Association (JAMA) focuses on what happens to iron stores in the body after donating blood. As many as one-third of regular blood donors have too little iron in their bloodstreams. According to the article, it can take up to six months to replenish the body’s iron after donating a unit of blood—significantly longer than the recommended 8-week waiting period between deposits at the blood bank.

The article made me wonder about the basics of iron health. How much of this stuff do we need? How do we get it? If you always feel pooped, how likely is “iron poor blood” to blame?

Iron stores

One-quarter of the world’s population is anemic, meaning they don’t get enough iron to produce the red blood cells and oxygen-carrying hemoglobin needed to nourish their myriad cells.

In developed nations like the United States, iron-poor blood is uncommon. Anemia attributable to iron deficiency affects perhaps 1% to 2% of American adults. “Because our country usually has a problem of eating too much, most adults meet the minimum requirements for iron intake,” says nutrition researcher Howard Sesso, an associate professor of epidemiology at Harvard Medical School.

In the United States, blood loss is the main cause of iron deficiency and anemia. Among women, heavy menstrual periods and childbirth account for this. Among those age 65 and older, the causes of iron deficiency and anemia are likely to be internal bleeding, difficulty absorbing iron and other nutrients, and eating a less varied diet.

The average American man harbors about 3.5 grams (one-eighth of an ounce) of iron in his body. The average woman has about 2.5 grams.

Where do we keep this iron? Roughly 60% of it is held by the oxygen-carrying hemoglobin protein in red blood cells. The next largest storehouse is ferritin, a protein that latches onto iron and sequesters it in the liver, spleen, and bone marrow. When the body needs to draw on its iron account, it comes out of the ferritin bank.

Without enough stored iron, an individual can develop anemia. Symptoms include fatigue, loss of stamina, shortness of breath, weakness, dizziness, and a pale, unhealthy complexion. So precious is iron for your health that the body uses a protein called transferrin like a scrap metal collector to scrounge iron from old red blood cells before they are destroyed.

Keeping the reservoir full

Most of us get the iron we need from food. Proponents of the Paleo or “cave man” diet should be cheered to know that red meat, poultry, and fish contain the most easily absorbed form of dietary iron—called heme iron. This is iron attached to the hemoglobin protein. The body absorbs heme iron more easily than the iron found in plants.

“In the typical American diet, the main sources of iron tend to be animal products,” Sesso says. “Typical meat consumption in the United States is usually more than adequate to meet one’s iron requirements.”

In plant foods, iron is not attached to such a protein. The body doesn’t absorb non-heme iron from fruits, vegetables, beans, and other plant foods as easily as it absorbs heme iron. That means those who eat little or no meat must take in more iron from leafy greens, legumes, whole grains, mushrooms, and other iron-rich plant foods. They also need to get enough vitamin C, which helps the body absorb iron from food.

The USDA recommends that women between the ages of 19 and 50 get 18 mg of iron a day, while women ages 51 and older and men 19 years and beyond need 8 mg a day. Moderate amounts of meat plus fruits and vegetables can provide that amount, helped along by the many foods fortified with iron and other vitamins and minerals, like milk, flour, and breakfast cereals. And half of all Americans get some iron from a daily multivitamin.

One caution about iron: If you don’ think you are getting enough iron, or feel pooped out and assume it’s your “tired blood,” you may be tempted to pop an iron supplement as insurance. But beware. The body does not excrete iron rapidly. That means it can build up over time and, in some people, becomes toxic. The genetic disorder hemochromatosis causes iron to build up in organs, causing heart failure and diabetes.

So don’t just prescribe yourself an iron supplement on a whim; ask your doctor if you need it.

Good sources of iron

Food Portion Iron content (milligrams)
Fortified cold breakfast cereal 3 ounces 30 to 60
Spirulina seaweed 3 ounces 28
Oysters 3 ounces 9
Soybeans, cooked 1 cup 9
Cream of Wheat 1 serving 9
Pumpkin seeds 3 ounces 8
Spinach, boiled and drained 1 cup 7
Lentils, cooked 1 cup 7
Soybeans, cooked 1 cup 5
Kidney beans, cooked 1 cup 4
Beef, ground 4 ounces 3
Turkey, ground 4 ounces 3
Source: USDA National Nutrient Database for Standard Reference

Iron in diet

LOW IRON LEVEL

The human body stores some iron to replace any that is lost. However, low iron level over a long period of time can lead to iron deficiency anemia. Symptoms include lack of energy, shortness of breath, headache, irritability, dizziness, or weight loss. Physical signs of lack of iron are a pale tongue and spoon-shaped nails.

Those at risk for low iron level includes:

  • Women who are menstruating, especially if they have heavy periods
  • Women who are pregnant or who have just had a baby
  • Long-distance runners
  • People with any type of bleeding in the intestines (for example, a bleeding ulcer)
  • People who frequently donate blood
  • People with gastrointestinal conditions that make it hard to absorb nutrients from food

Babies and young children are at risk for low iron level if they do not get the right foods. Babies moving to solid foods should eat iron-rich foods. Infants are born with enough iron to last about six months. An infant’s extra iron needs are met by breast milk. Infants that are not breastfed should be given an iron supplement or iron-fortified infant formula.

Children between age 1 and 4 grow fast. This uses up iron in the body. Children of this age should be given iron-fortified foods or an iron supplement.

Milk is a very poor source of iron. Children who drink large quantities of milk and avoid other foods may develop “milk anemia.” Recommended milk intake is 2 to 3 cups (480 to 720 milliliters) per day for toddlers.

TOO MUCH IRON

The genetic disorder called hemochromatosis affects the body’s ability to control how much iron is absorbed. This leads to too much iron in the body. Treatment consists of a low-iron diet, no iron supplements, and phlebotomy (blood removal) on a regular basis.

It is unlikely that a person would take too much iron. However, children can sometimes develop iron poisoning by swallowing too many iron supplements. Symptoms of iron poisoning include:

  • Fatigue
  • Anorexia
  • Dizziness
  • Nausea
  • Vomiting
  • Headache
  • Weight loss
  • Shortness of breath
  • Grayish color to the skin

Increasing Iron in Your Diet

What is iron?

Iron is a mineral that combines with protein to form hemoglobin, the red substance in blood that carries oxygen to the body’s cells. Iron helps prevent nutritional anemia and increase resistance to infection.

The U.S. Revised Recommended Daily Allowances (USDA) for iron:

Children

  • 7-12 months: 11 mg/day
  • 1-3 years: 7 mg/day
  • 4-8 years: 10 mg/day
  • 9-13 years: 8 mg/day

Men

  • 14-18 years: 11 mg/day
  • 19+ years: 8 mg/day

Women

  • 14-18 years: 15 mg/day
  • 19-50 years: 18 mg/day
  • 51+ years: 8 mg/day
  • Pregnant: 27 mg/day
  • Lactating:
  • 18 years: 10 mg/day
  • 19-50 years: 9 mg/day

Which foods contain iron?

There are two forms of iron found in foods: heme and nonheme. Iron from heme food sources is better absorbed into the body than nonheme sources. Heme iron is found in animal foods that contain hemoglobin. Heme food sources of iron include red meats, poultry, and fish.

Plant foods contain the nonheme iron, which is not as well absorbed. Most sources of dietary iron are in the nonheme form. Good food sources of nonheme iron include fortified cereals, beans, lentils, tofu, spinach, dried fruits (apricots, prunes, raisins), prune juice, enriched breads, broccoli, and nuts.

What is the role of Vitamin C?

To increase absorption of iron in foods of plant origin, include vitamin C-rich foods such as:

  • citrus fruits and juices
  • broccoli, Brussels sprouts, cabbage
  • tomatoes and peppers
  • baked potatoes
  • melon, berries and kiwi

If you take medication and eat grapefruit or drink grapefruit juice, check with your pharmacist about possible food-drug interactions.

Should I take an iron supplement?

Your doctor or registered dietitian may recommend an iron supplement. A commonly reported side effect when taking iron supplements is constipation. Increasing fiber in the diet (whole grain breads, cereals, fruits, and vegetables), increasing your fluid intake, and moderately increasing exercise will all help to relieve constipation. Do not take iron and calcium supplements together. Men usually do not need an iron supplement.

Sample High-Iron Menu

Breakfast

  • ¾ cup iron-fortified cream of wheat
    • Iron (mg): 9.0
  • 4 oz. orange juice
    • Iron (mg): 1.0
  • 8 oz. skim milk
    • Iron (mg): 0.1

Lunch

Dinner

Total Iron: 25.6

Iron Content of Selected Foods

*Choose the leanest cuts of meats, such as tenderloin, sirloin, beef round, and reduced fat ground meat.

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