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Why its important to get your Iron up – By Evelyn Vo (Nutritionist)

The 2011-12 National Nutrition and Physical Activity Survey (NNPAS) reported that 1 in 8 people aged 2 years and over are not consuming adequate intakes of iron. This post highlights the importance of iron in the diet with a brief overview on the risk of deficiency, and some tips on achieving an adequate intake.

What is iron and why is it important?

Iron is an important mineral, which is a key component in red blood cells responsible for the transportation of oxygen in the blood tissues throughout the body (haemoglobin). It is also involved in immune function, acts as an oxygen reservoir (myoglobin), and is important for children’s cognitive and physical development. Without sufficient iron, haemoglobin levels will be low and anaemia will result.

How are we tracking with iron intakes?

The recent NNPAS data highlighted that inadequate intakes were more prevalent among females, particularly those aged 14-50 years, compared to males aged 14-50 years (refer to the table below). It has been assumed that females aged 14 years and over menstruate. During this process they need more iron to make up for the amount of iron lost during their menstruation (1 mg for every day of bleeding).

Adapted from “Australian Health Survey: Usual Nutrient Intakes, 2011-12

(No 4364.0)” by the Australian Bureau of Statistics, 2015

What is the recommended dietary intake (RDI) of iron for people aged 14-50 years?

The table below details the RDI for iron people aged 14-50 years of age. Females require more iron compared to males within this age range. During pregnancy, the iron requirement increases to 27 mg/day to compensate for the developing foetus drawing iron from the mother in preparation for the first 5-6 months after birth. The important thing about iron is to make sure you do not run low, this is particularly so for females. Prevention is the best strategy!

Adapted from “Iron/ Nutrient Reference Values” by the National Health and Medical Research Council (NHMRC), 2014

What is Iron-Deficiency Anaemia (IDA)?

IDA is the most common form of anaemia, which is a condition where there is a decrease in levels of haemoglobin and a haematocrit (blood test) displays a decreased production of red blood cells and oxygen capacity. IDA usually develops over time if you consistently have inadequate iron levels which is needed to build healthy red blood cells. As a result, the body starts using stored iron. If it does reach to a point where it uses up all the stored iron, your body makes fewer red blood cells, which contains less hemoglobin than what is required for the body.

Presentation of IDA

Symptoms of IDA can lead to:

  • Breathlessness
  • Dizziness
  • Fatigue
  • Looking very pale

Severe symptoms of IDA, in particular with young children, can lead to:

  • Heart problems
  • Decreased resistance to infection
  • Developmental issues with lifelong effects

Factors that can lead to IDA

Factors that can lead to the development of IDA include:

  • Delayed introduction to iron-rich foods during infancy followed by poor dietary habits in preschool:
  • At at 6 months of age, infants need iron from food sources for cognitive and physical development, and increased resistance to infection.
  • Malabsorption:
    • This occurs when your body cannot absorb iron from foods. If you suspect that you have malabsorption issues please contact your GP or local health professional.
  • When haem iron foods are poorly consumed or not consumed at all:
    • Haem iron (from animal sources) is absorbed more efficiently compared to non-heam iron (plant-based sources). If your diet excludes haem iron foods this does not mean you need to start eating meat. Non-haem sources such as: nuts, beans, whole grains such as brown rice and fortified breakfast cereals can still contribute valuable sources of iron in the diet.
  • High levels of blood loss:
    • This is prevalent amongst females aged 14 years and over due to menstruation.
  • Pregnancy:
    • A mother’s requirements increase significantly due to foetal development. Some mothers need to increase their intake of iron-rich foods and others may require iron supplements. It is recommended to consult your GP or local health professional before making any changes to your diet.
  • Professional athletes:
    • Professional athletes, in particular females, are at high risk of iron deficiency due to poor intake of iron-rich foods and iron loss through sweat, gastrointestinal bleeding, and red blood cell damage. This has been reported to become increasingly common for athletes who self-prescribe iron supplements with a self-belief that this will counter the feelings of fatigue due to heavy training However, it is important to remember that iron supplements should come second to iron-rich foods as iron supplements will only be beneficial when there is iron deficiency. There is also a risk of iron overload or haemochromatosis if an excessive amount of iron supplements are consumed. Haemochromatosis is a genetic disorder where the iron salts are deposited in the tissues of the body which can lead to liver damage, diabetes mellitus, bronze discoloration of the skin.

Groups at risk of IDA

  • Infants
  • Preschoolers
  • Adolescents
  • People with malabsorption issues
  • Vegetarians
  • Pregnant women

If you suspect you may be iron deficient please contact your GP or local health professional.

Which foods give you iron?

  • Red meat ~ 2 mg per 100 g
  • Chicken ~ 0.5 mg per 100 g
  • Fish ~ 0.3 mg per 100 g
  • Weetbix ™ ~ 3 mg per 2 biscuits
  • Cooked spinach ~ 3 mg per ½ cup
  • Tofu ~ 2.96 mg per 100 g
  • Cooked brown rice ~ 0.7 mg per 1 cup

Important things to note:

  • Milk is a poor source of iron
    • This has been reported to be prevalent amongst preschoolers who consume high volumes of milk. Milk is a great source of protein, however, this may displace the preschooler’s appetite for solid (iron containing)foods putting them at risk of iron deficiency.
  • Vitamin C plays a role in enhancing iron absorption, particularly of non-haem sources
  • Choose food first before taking iron supplements. It is recommended that if you’re going to take iron supplements you should do so under the supervision of a GP or local health professional.
    • Absorption of iron taken as ferrous sulfate or as an iron chelate is better than that from iron supplements.
    • The absorption of iron improves when you take the supplement on an empty stomach with liquids such as between meals or at bedtime.
    • As previously mentioned Vitamin C enhances the absorption of iron. There is no benefit in taking a Vitamin C tablet over Vitamin C foods because it does not enhance absorption.

Let’s increase our iron intakes through wholesome iron rich foods!

Originally published on The Nutrition Space. Evelyn works at our Heidelberg Practice on Saturdays 8:30-12:30pm. If you would like to make an appointment please visit here.