Iron-deficiency can leave you tired – and worse. Here's how to meet your iron needs, whatever your age. By Lisa Yates.
One in three Australian women don't get enough iron, and between 2-5% suffer from anaemia as a result. Part of the reason is that eating enough iron can be complex, especially if you don't eat much red meat. Here's the low-down of getting the iron you need.
Why do we need iron?
Iron helps your body make red blood cells by binding to a protein called haemoglobin. Haemoglobin is the pigment that makes blood red and carries oxygen from your lungs to the rest of your body. The oxygen is then used to burn carbohydrates and fats, releasing the energy stored inside. Adequate iron not only ensures peak energy levels, but also optimal brain function and a strong immune system.
What happens if we don't get enough iron?
Your body has a number of back-up systems in place that allows it to keep making enough red blood cells. If your diet is lacking in iron, your body will begin to use up its stores. Once they're gone, any iron being transported around the body will be used next, so you may start to feel tired. When this iron runs out and your body can't make enough red blood cells, you have iron deficiency anaemia.
Signs you may be anaemic include
a pale colour
shortness of breath
pins and needles
Over a period of time, this condition can affect the immune system and brain function. Fortunately, your body responds quickly by making iron absorption in the small intestine more efficient, but you need to eat iron-rich foods regularly to treat this condition. If you are a teenage girl, a young woman or a female athlete, you will be more prone to iron deficiency anaemia.
7 reasons you may need more iron
Do you bleed heavily during menstruation? Some women lose more iron than is replaced through diet.
Are you pregnant?
Are you following a fad weight loss diet?
Do you donate blood regularly? The blood bank should test levels to ensure you're not already iron deficient.
Do you have any gastrointestinal conditions, such as coeliac disease, ulcers or haemorrhoids? These may affect the absorption of iron from food or cause blood loss.
Are you a long-distance runner? Runners can squash circulating red blood cells (these are replenished every 120 days) when their foot repeatedly strikes the ground. If you run regularly, wear good shoes and try to run on grass instead.
Do you suffer from frequent infections? A poor immune system may indicate low iron.
If you answered yes to any of these questions, have your GP check your iron levels.
Should I take iron supplements?
Iron supplements are generally used by pregnant women and those with diagnosed iron deficiency anaemia. Choose supplements with iron in a 'ferrous' form rather than a 'ferric' form, as ferrous sulfate is better absorbed. Since iron, calcium and zinc are all absorbed by the same mechanism in your intestine, too much of one can prevent the absorption of others. If you need iron supplements, take them before bed, rather than with meals or other mineral supplements, to ensure you absorb as much as you need without compromising other nutrients.
Is it possible to overdose on iron?
oung children risk iron toxicity if they accidentally eat adult iron supplements. These are often red in colour and may look like lollies, so store them well out of reach. A genetic condition called haemochromatosis affects about one in 300 Australians, who are unable to regulate the amount of iron they absorb from their gut. This causes overloading and iron accumulates in organs, such as the liver, pancreas and heart, causing damage. If left untreated organ failure may occur. Treatment involves having blood taken regularly. Chronic alcoholics with cirrhosis of the liver and anyone who needs regular blood transfusions can accumulate too much iron.
How to get the iron you need at any age
Infants 7-12 months
You need 11 mg/day, based on a mixed diet of animal and plant foods.
Why you need it: Infant iron stores accumulated during pregnancy begin to run out by four to six months of age.
Breast-feed your baby until 12 months of age if possible, as breast milk contains some iron.
When introducing solids, use an iron-fortified rice cereal.
Introduce minced meat to an infant's diet from the age of six months.
You need 1-3 years = 9mg/day 4-8 years = 10mg/day 9-13 years = 8mg/day
Why you need it Growth spurts during these ages increase the requirement for blood and iron.
Use lean mince meat to make meatballs, rissoles and burger patties.
Encourage eating iron-fortified cereals at breakfast, accompanied by a small (120ml) glass of citrus juice. Water the juice down for younger children.
You need Girls 14-18 years = 15mg/day Boys 14-18 years = 11mg/day
Why you need it In girls, menstruation may not be regular and cause more blood loss some months than others. Young women may also experiment with vegetarianism and dieting. Young men require iron for muscle development.
Get teenagers to cook an iron-rich meal for the family.
Mix lentils, legumes and brown rice with colourful steamed vegetables.
You need 19-50 years 18mg/day
Why you need it Menstrual losses for women vary, so a higher intake of iron is required until menopause.
Cook in bulk so homemade convenience meals, rich in iron, can be pulled from the freezer and reheated when working full-time.
Aim to choose meat dishes a few times a week if you eat out regularly.
You need 27mg/day
Why you need it Iron needs increase during the first trimester to support placental growth and in the second and third trimesters for foetal growth and development. Pregnant women have a larger blood volume and absorb iron more efficiently.
Incorporate some lean meat at lunch and at dinner
Use iron supplements as required. To prevent constipation, increase fibre and fluids.
You need 19-50 years 8mg/day
Why you need it Men need adequate iron to help fuel activity, especially if they are physically active at work.
Eat a palm-sized piece of barbecued meat or 2-3 thin slices of roast meat - watch your serving sizes.
Enjoy a small handful of nuts to reduce your risk of heart disease, which also supplies a dose of non-haem iron.
You need Everyone older than 51 years = 8mg/day
Why you need it Once menopause is reached, iron requirements decrease for women. Elderly people living alone often suffer from malnutrition because of poverty, depression and poor dentition.
Drink tea 30 minutes after meals, so tannins don't bind with iron in meals and prevent absorption.
Eat slow-cooked or minced meats if your teeth don't cope well with chewing.
You need Iron absorption from plant foods is low, so vegetarians need 80% more non-haem iron to compensate.
Why you need it Risk of iron deficiency is higher with new or poorly organised vegetarians, and especially vegans.
Eat vitamin C-rich foods with plant foods rich in non-haem iron in the same meal
See a dietitian to help plan your vegetarian meals
Speak to your doctor about supplements
Eating to get the iron you need
The two main forms of iron are haem (found in meats) and non-haem (found in plant foods). Our body is able to absorb haem iron more readily than non-haem iron – 20% absorption compared with 5%. Vitamin C and animal proteins help to release the non-haem iron bound in plant foods, so it's best to eat these with vitamin C-rich fruits and vegetables, or with meat, fish or chicken.
5 iron sources
Red meat contributes more than 50% of our total iron intake, while animal proteins also improve the absorption of non-haem iron. A medium fillet steak provides 13% of the RDI of iron for women of child-bearing age, and 30% of the RDI for men, children and the elderly. Include lean red meat in your diet three to four times a week.
Chicken contains haem iron, with a medium breast providing 11% of RDI for women and 25% for others.
Five oysters can provide 22% of RDI for women and 50% of RDI for others.
Organ meats such as liver and kidney, while no longer fashionable, are rich in haem iron and some people may still enjoy them.
Nuts, legumes, iron-fortified cereals, and wholegrain breads and cereal all contain non-haem iron.