YOUR GUIDE TO IRON ON A PLANT BASED DIET

IRON & IRON DEFICIENCY

So let’s chat about iron deficiency and iron supplements. I love this topic and its something I have wanted to share more about it for some time. As a dietitian, any topic surrounding nutrition and health is really important to me, and there is a lot of mis-information out there so I am really hoping this post will give you guys some valuable information around iron and iron deficiency.

The importance of iron in our bodies.

Iron is an essential mineral, this means we need to consume it to replenish our stores and keep us healthy. Iron is found in animal and plant foods. It is a part of our red blood cells, Haemoglobin, a protein complex contains iron and acts to transport oxygen around our body, from our lungs to our muscles and tissues, exchanging the oxygen and therefore giving us ENERGY!

Iron is also found in Myoglobin, a protein found in the muscle cells. Myoglobin stores oxygen, releasing it to the working muscles when needed, to produce ENERGY! This is why a common symptom of iron deficiency is fatigue and tiredness.

Iron also plays a really important role in our immune system. The bodies defence mechanism to infections and sickness. This is why getting sick often is another symptom of iron deficiency.

It also plays a role in our enzyme reactions, DNA synthesis and new cell turnover, plus many more functions.

Who is at risk of iron deficiency

Iron deficiency is the most common and widespread nutritional disorder in the world! In fact, 1 in 3 Australian women don’t get enough iron through their diet. Women are most at risk since our requirements are double that of men! (18mg vs 9mg) This is because we have a higher iron loss through our monthly menstrual cycle. For pregnant women its even more (27mg) - you are growing a baby in there after all.

Other high risk categories:

babies given cow’s or other milk instead of breastmilk or infant formula
toddlers, particularly if they drink too much cow’s milk
teenage girls
menstruating women, especially those who have heavy periods
women using an IUD (because they generally have heavier periods), pregnant or breastfeeding women
people with poor diets such as alcoholics, ‘fad dieters’ or people with eating disorders
vegetarians or vegans
athletes in training
people with intestinal worms
Aboriginal Australians
regular blood donors
people with conditions that predispose them to bleeding, such as gum disease or stomach ulcers, polyps or cancers of the bowel
people with chronic diseases such as cancer, auto-immune diseases, heart failure or renal (kidney) disease
people taking aspirin as a regular medication
people who have a lower than normal ability to absorb or use iron, such as someone with coeliac disease.

Source: Better Health Channel

Iron Requirements:

Women - 18mg/day

Pregnant women - 27mg/day

Lactating women - 9mg/day

Men & post-menopausal (51+) - 8mg/day

Infants 7-12 months - 11mg/day

Children 1-3 years old - 9mg/day

Children 4–8 years old - 10 mg/day

Children 9–13 years - 8 mg/day

Boys 14–18 years old - 11 mg/day

Girls 14-18 years old - 15mg/day

Symptoms of Iron Deficiency

When we are deficient in iron we may notice signs such as tiredness and fatigue, poor concentration, mood changes, and getting sick more often.

Fatigue & weakness
Tiredness (even with enough sleep)
Poor concentration
Decreased immune system resulting in frequently getting sick
Irritability and mood changes
Shortness of breath
Paleness

ANAEMIA

When iron deficiency is prolonged the condition iron deficiency anaemia occurs. There are actually many different types of anaemias with different causes however iron deficiency is the most common and the one we are covering in this blog post.

Other types include:

Vitamin deficiency anemia. In addition to iron, your body needs folate and vitamin B-12 to produce enough healthy red blood cells. A diet lacking in these and other key nutrients can cause decreased red blood cell production.
Pernicious anaemia. Additionally, some people may consume enough B-12, but their bodies aren't able to process the vitamin. This can lead to vitamin deficiency anemia, also known as pernicious anemia.
Anemia of chronic disease. Certain diseases — such as cancer, HIV/AIDS, rheumatoid arthritis, kidney disease, Crohn's disease and other chronic inflammatory diseases — can interfere with the production of red blood cells.
Aplastic anemia. This rare, life-threatening anemia occurs when your body doesn't produce enough red blood cells. Causes of aplastic anemia include infections, certain medicines, autoimmune diseases and exposure to toxic chemicals.
Anemias associated with bone marrow disease. A variety of diseases, such as leukemia and myelofibrosis, can cause anemia by affecting blood production in your bone marrow. The effects of these types of cancer and cancer-like disorders vary from mild to life-threatening.
Hemolytic anemias. This group of anemias develops when red blood cells are destroyed faster than bone marrow can replace them. Certain blood diseases increase red blood cell destruction. You can inherit a hemolytic anemia, or you can develop it later in life.
Sickle cell anemia. This inherited and sometimes serious condition is an inherited hemolytic anemia. It's caused by a defective form of hemoglobin that forces red blood cells to assume an abnormal crescent (sickle) shape. These irregular blood cells die prematurely, resulting in a chronic shortage of red blood cells.
Other anemias. There are several other forms of anemia, such as thalassemia and malarial anemia.

Source - Better Health Channel

Since inadequate iron intake is the most common cause of anaemia and for the sake of simplicity I’ll only be speaking about this cause.

Heme VS Non-Heme Iron

Heme = from animal sources

Non-heme = from plant sources

So as I mentioned earlier. Us ladies have much higher iron requirements, but to make matters more difficult, only a fraction of the iron found within foods are actually absorbed. Less than 25% of iron in animal foods (heme iron) is absorbed, and even less from plant foods (non-heme iron). I know I have a high amount of vegetarian and vegan readers here so this post is really important for you to read and learn about as we are in the highest risk category.

Animal based protein contains actually 40% heme iron and 60% non-heme iron, and plant based iron is 100% non-heme. So while non-heme iron is typically less bioavailable (absorbed) than heme iron, our bodies are intelligent and actually have the ability to iron regulate! Which means we are able to increase the absorption of non-heme (plant) iron when its our only source (such as on a vegan diet). The same goes for iron toxicity, (when we have too much iron in our system) our bodies have the ability to decrease the absorption from non-heme (plant) iron to prevent toxicity. Interestingly, this isn’t the case for heme (animal) iron.

For me personally, I am a 26 year old menstruating women, on a plant based diet, and I had the copper IUD in for 2 years (up until 2019), causing heavy bleeding, plus I travel frequently for work which disrupts my healthy diet, I also work out intensely, around 6 days a week. This puts me in a high risk category for iron deficiency anaemia, and for this reason I have regular blood tests, follow my tips below for getting more iron into my diet AND supplement this with a liquid iron supplement (more on this below).

Iron rich plant foods

You may have read statements like ‘spirulina contains 10x the iron that’s in beef’ but what they didn’t explain was that is per 100g. Who is eating 100g of spirulina in a sitting though right? These kinds of arguments really bother me, because its falsely leading someone to believe that spirulina is a high iron containing food, and while yes per gram it is, realistically when we consume it in normal and realistic quantities such as 1 tsp, it isn’t.

But don’t fear! There are actually many iron rich plant foods :) Here is a list of iron rich plant foods and an infographic with approx amount of iron (remembering you do not absorb all of the iron within plant foods)

Legumes, such as soy beans, tofu and tempeh, beans, lentils and chickpeas
Dark leafy greens such as kale, spinach, collard greens and broccoli
Dried fruits such as raisins, apricots, peaches and pears
Grains such as oats, quinoa, wholegrain pasta and bread
Pumpkin seeds, cashews and almonds ⠀
if you eat these: oysters and mussels are also great sources!⠀

Getting more iron from your plant foods

Here are some tips to ensure you are getting the most from your plant sources of iron!

Vitamin C

To get more iron from your food make sure you pair your iron rich foods with Vitamin C rich foods such as:

citrus fruits – oranges, limes and lemons
berries
kiwifruit
tomatoes
broccoli
sprouts
red, yellow and green capsicum

The great thing is, if you are following a healthy whole food plant based diet, you actually will be consuming an abundance of vitamin C naturally, hence this tip should be easy! Vitamin C is also incredible for our skin since it is key to collagen production! Just make sure you eat raw or only lightly cook these foods as vitamin C can break down from heat.

Coffee, tea and wine

Keep your iron rich foods seperate from your coffee, tea and wine. The tannins can bind to iron and inhibit its absorption. Hence if you are taking a supplement, take it 30 minutes away from your morning coffee/tea.

Calcium rich foods

Well this is sometimes confusing since some iron rich plant foods are also calcium rich plant foods. Calcium binds to the same receptors as iron, hence they compete for absorption. The main thing to remember is if you are taking calcium supplements, take them seperate to your iron supplement and iron rich foods, and definitely don’t chase it down with a glass of cow milk or calcium fortified soy.

Soaking and Cooking

Fibrous grains, legumes and veggies contain phytates. Phytates bind to iron, preventing its absorption. You can reduce their effect by soaking and cooking grains, legumes, and veggies to break down some of the phytates & fibres.

Supplementing your iron

Of course, I love a ‘food first’ approach to nutrition however sometimes this isn’t always enough or viable. We are all different and have unique needs which is why nutrition is definitely not black and white. As I mentioned earlier, I am in a high risk category for iron deficiency since I am a young menstruating woman on a plant based diet who exercises regularly, had a copper IUD for 24 months and travels regularly. I love to eat a fully whole food diet when possible, but often while travelling it is difficult to get all of the nutrition that I require. I also had my copper IUD removed earlier this year as the loss of iron each month was not replenish-able from diet alone. I have regular blood tests (every 3-6 months) to check my B12 and iron studies. While I am not classified as anaemic, and never have been, my iron stores (ferritin) sits at a low level.

I use ‘Floradix Iron + Herbs’ by Flora Health to boost both of my iron & Vitamin B12 levels, which may explain why my B12 has never been abnormal. This liquid iron supplement is an easily absorbed, non-constipating formula. Flora takes great pride in developing high quality, highly bioavailable and well researched nutrition products. They are my go-to company for health related supplements. It also tastes far better than any others I have tried, as it is mixed with juices from grapes and berries, and also contains Vitamin C (ascorbic acid) to assist in absorption. I usually start my day with a swig of Floradix and a full glass of water. The bottle also comes with a handy mini measuring cup so you can ensure you are getting the correct dose. This supplement is widely available through chemists too. For my US & Canadian readers you can get 20% off Flora with the code ELLIE20, click HERE to enter their online store.

I cannot express enough that it is important you have your bloods checked by your GP before taking any supplements since you may cause an iron overload which has harmful consequences.

Iron Overload/Toxicity

Too much iron can cause iron overload or toxicity. Certain conditions may cause someone to become iron overloaded (hemochromatosis). This can cause DNA and their molecule damage and some studies are now linking excess iron intake to cardiovascular disease, Parkinson’s/Alzheimer’s, type 2 diabetes and cancer..

Note:

Iron toxicity (or an overload of iron) is also very harmful, hence it is important to ONLY supplement with iron after having a blood test with your GP.

I hope you guys found this blog post useful. As always, drop a comment if you have any questions and let me know what you would like to see on the blog next.

Elsa xx