Are you getting enough iron? Jo Lewin explains when you should eat a high-iron diet and which foods may help ensure you get your daily dose.

Spotlight on... high-iron

Iron is an essential nutrient for growth and development and plays a critical role in transferring oxygen around the body. It constitutes a vital part of haemoglobin, the oxygen-carrying component of red blood cells. Haemoglobin is responsible for transporting oxygen from the lungs to the body's tissues and carbon dioxide from the tissues to the lungs. The mineral also plays a part in energy production, muscle function, DNA synthesis and the immune system. We get most of the iron we need from food and our body carefully monitors its levels of iron; absorbing more when demand is high and less when stores are adequate. Iron is stored primarily in the bone marrow and liver.

The Nutrient Reference Intake (NRI) for iron is 14mg per day, with an additional requirement recommended during pregnancy.

Iron deficiency is surprisingly common in the UK and is particularly prevalent among infants under two, teenage girls, pregnant women and the elderly. According to government surveys, the majority of women do not reach their dietary target.

Iron deficiencyPregnancy

Iron deficiency may be due to one or a combination of the following factors:

  • Blood loss. This is the most common cause of iron deficiency in women of childbearing age. It is often due to excessive menstrual bleeding. Other causes of blood loss include bleeding from peptic ulcers, haemorrhoids and donating blood.
  • Increased iron requirement. Periods of growth during childhood and adolescence sharply increases the need for iron. The increased need for iron during pregnancy may not be met through diet alone and so supplementation may be advised to pregnant women as necessary. If you're pregnant and are concerned you may be deficient in iron please consult your doctor.
  • Inadequate dietary intake. This is also a common cause of deficiency. It is good to remember that plant-based sources of iron are a little harder for the body to absorb and that vitamin C will aid in absorption of all forms of iron. Typical infant diets, which are high in milk and cereals, can also be low in iron. Try a cereal fortified with iron to up intake.
  • Diminished iron absorption. This is often due to reduced gastric acid secretion in the stomach; such as atrophic gastritis (common in the elderly), chronic diarrhoea or prolonged use of antacids.

Anaemia

Periods of rapid growth such as adolescence, heavy bleeding, busy lifestyles and lack of iron in your diet will result in your body drawing on its iron reserve. Initially there are no symptoms, but as your iron supply dwindles, so does your body's ability to produce healthy red blood cells. The result is low numbers of red blood cells circulating the blood, a condition called iron-deficiency anaemia. Symptoms of anaemia include weakness, fatigue*, pale complexion, breathlessness, palpitations and an increased susceptibility to infection. Anaemic children have difficulty concentrating and may find it difficult to learn. Doctors can determine levels of body iron stores through a serum ferritin test.

*A note on haemochromatosis…

Haemochromatosis is a specific genetic disorder in which iron builds up over time, leading to excessive levels. If you have a family member with haemochromatosis, you should be screened to determine if you are at risk.

It is hard to diagnose – but one of the symptoms is fatigue. If you are feeling very tired all the time, it is recommended that you go to your GP and have a blood test before embarking on iron supplementation.

Read more about it at the NHS website.

Iron tabletsSupplements and safety

Anaemia requires a careful diagnosis and treatment to correct the underlying cause. Consult a doctor before taking an iron supplement. When prescribed by a doctor, iron is typically taken in a form called ferrous salts – ferrous sulphate, ferrous fumerate or ferrous gluconate. Side effects of iron supplements may include constipation and stomach upsets so be cautious and do not exceed the recommended amount. Keep all supplements containing iron out of reach of children.

Friends and foes

There are two forms of iron in our food. Haem iron is found in animal products and is the most efficiently absorbed form of iron. Non-haem iron is found in plant foods and the body finds it more difficult to absorb by comparison. Vitamin C is a strong promoter of iron absorption, and when vitamin C rich foods are combined with foods rich in iron, absorption of the iron is substantially increased. Watch the amount of tea you consume as a substance called tannin found in tea is thought to inhibit the absorption of iron. Be aware that decaffeinated teas contain just as much tannin as normal tea. Foods high in phytates and oxylates, such as spinach, nuts, chocolate, parsley and rhubarb may also have a negative impact on iron absorption. Dairy products like yogurt, cheese and milk as well as eggs interfere with iron absorption – that's because casein from milk and certain forms of calcium inhibit iron absorption, so make sure you try to eat a varied, balanced diet.

Rich sources of iron
Liver, beef & lamb Soybeans
Clams, mussels & oysters Lentils
Kidney beans Tofu
Leafy green vegetables Blackstrap molasses
Dried figs & apricots Quinoa
Oatmeal, rye Chickpeas
Brewer's yeast Pinto beans

Pregnant women should avoid liver and related products, such as liver pate, as they may contain high levels of vitamin A, which may be harmful to a developing baby.

Recipe suggestions for iron-rich mealsFive-veg lasagne

For the carnivores:

Liver & bacon sauté with potatoes & parsley

Chicken liver & chorizo salad

For fish fans:

Mussels with tomatoes & chilli

Speedy spaghetti with clams

For the vegetarians:

Iron-rich vegetarian collection

Chinese noodles with tofu & hazelnuts

Chickpeas & roasted veg tagine

Don't forget dried fruits are a great source of iron and add sweetness to your stews:

Moroccan lamb with apricots, almonds & mint

Pork with pears, prunes & verjuice

Go crazy for lentils, beans and peas with these tasty light lunches:

Puy lentil salad with soy beans, sugar snap peas & broccoli

Lemony rice & peas

Moroccan harira

Make your own muesli:

Seven-cup muesli


This article was updated on 25th July 2017 by nutritional therapist Kerry Torrens.

A registered Nutritional Therapist, Kerry Torrens is a contributing author to a number of nutritional and cookery publications including BBC Good Food magazine. Kerry is a member of the The Royal Society of Medicine, Complementary and Natural Healthcare Council (CNHC), British Association for Applied Nutrition and Nutritional Therapy (BANT).

Jo Lewin works as a Community Nutritionist and private consultant. She is a Registered Nutritionist (Public Health) registered with the UKVRN. Visit her website at www.nutrijo.co.uk or follow her on Twitter @nutri_jo.

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