Pumping iron

Iron deficiency is not a new subject, especially among women, but it remains the most common micronutrient deficiency in the world. Many of us will know the symptoms of tiredness and weakness, but low iron levels can also be related to impaired exercise performance and low immune system. This is because iron helps to make red blood cells and to carry oxygen around the body. Adequate iron levels are also important for a healthy immune system and releasing energy from cells.

Who is at risk?

Low iron levels can be due to eating a diet low in iron, poor intestinal absorption, increased needs for growth and exercise, or because of significant blood loss.

  • Women are more likely to be iron deficient as they require 18 milligrams per day compared to only 8 milligrams for men.
  • Athletes are also at high risk of iron deficiency as their high-performing body needs more iron for oxygen delivery and muscle recovery, and they often have restrictive diets.
  • Pregnancy, infancy and adolescence are stages where higher levels of iron are needed for the body to grow rapidly. For example, pregnant women require 1.5 times more iron than usual. For this reason low iron levels can be common in these life stages.
  • People with conditions that may prevent iron absorption such as Coeliac disease, Crohns Disease or Ulcerative Colitis can also be at risk of low iron levels.
  • The World Health Organization found that in people over the age of 75, the rate of iron deficiency anaemia was significantly higher than in other Australians.

Absorbing iron

Because the human body is so clever, our ability to absorb iron gets better as our iron stores become depleted. However, it is true that some sources of iron are better than others. The term ‘bioavailable’ refers to how easily iron can be absorbed from foods. Meat-based sources of iron are the most bioavailable as they have the ‘haem’ form of iron. Foods high in haem iron include red meats, poultry, fish and oysters. Plant-based sources of iron contain ‘non-haem’ iron and this is harder for our bodies to absorb. Good sources include leafy green vegetables, tofu, legumes, eggs, sultanas, dried apricots, fortified breakfast cereal, wholemeal bread, quinoa, and almonds.

Tips to increase iron absorption include:

  • Drinking tea, coffee or wine between meals, rather than at meal times. The tannins in these drinks prevent iron being from being absorbed as well.
  • Eating vitamin C-containing foods such as fruits and vegetables at meals times. This will help your body to break down iron-containing foods for better absorption.
  • Eating your meat and vegetables at the same time, because animal protein boosts iron absorption from plant sources.
  • Cooking vegetables to increase the amount of available non-haem iron.
  • Avoid large amounts of dairy at main meals. High levels of calcium and phosphorus can reduce the absorption of iron from plant foods.

‘Out of the box’ tips for including more iron-containing foods in your daily diet

  • Eggs are a great option for vegetarians, and helpful for cholesterol levels.
  • Kangaroo meat is a source of haem iron which is easily absorbed, very lean, and highly sustainable.
  • Milo is a yummy source of protein and calcium as well as iron! This is a great recovery option after strenuous exercise.
  • Oats are good for heart and bowel health, and an easy breakfast option.
  • Dried apricots are an easy, quick snack option.
  • Mixed beans, chickpeas or tofu are high iron alternatives to meat for vegetarians and vegans.

Healthy high iron ideas

  • Make bircher muesli by soaking oats and dried apricots in juice overnight. Top with yoghurt for breakfast.
  • Avocado and poached eggs on toast topped with baby spinach and lime juice.
  • Falafels made with mixed beans and chickpeas served with mango chutney on a bed of quinoa and spinach.
  • Stir-fried vegetables and kangaroo filet on brown rice.

Do you need an iron supplement?

There are three stages of low iron levels beginning with iron depletion, then iron deficiency and finally iron deficiency anaemia. A simple blood test can identify any stage of low iron levels. Iron deficiency anaemia generally requires an iron supplement, while iron depletion may be treatable with a high-iron diet. In some cases, iron supplementation can interfere with absorption of other nutrients such as zinc, and could have side effects such as nausea and constipation. Supplements can also interfere with other medications you may be taking. For these reasons it is important to have your iron levels checked and always consult with your doctor before starting an iron supplement.

First published in Oxygen magazine.

Written by Jacqui Heward, Accredited Practising Dietitian. Jacqui is a lover of good food and is passionate about health, wellness and all things in moderation. She works with people in rehabilitation and palliative care, and also guides people on lifestyle changes for weight management and preventing chronic diseases.