The Importance of Iron Rich Foods For Iron Deficiency Anemia prevention & Treatment

Iron Rich Foods To Address Iron Deficiency Anemia -
Iron is a key part of hemoglobin and myoglobin, proteins that carry oxygen in the blood and help deliver it to various parts of our body. In addition, iron is essential for the release of energy in the body and for a healthy immune system.

Iron is obtained from iron rich foods we eat and from the breakdown of red blood cells in our body. When our diet lacks iron, the body uses its stored iron to meet needs. When these reserves get depleted, hemoglobin levels decrease and over time a person develops iron deficiency anemia (IDA).

IRON RICH FOODS - FOOD SOURCES OF IRON
The best sources of iron include iron fortified cereals, chicken and chicken liver, lean red meat, dried beans and legumes, clams, oysters, leafy greens, nuts and whole grains. Iron obtained from animal sources is known as heme iron while iron obtained from plant sources is known as non heme iron. Heme iron is better absorbed than non heme iron in the body.

SOME FOOD SOURCES OF HEME IRON 

Foods	Milligrams or iron per serving
Chicken liver, cooked, 100g	12.8
Clams, mixed species, raw, 85g, 3 oz	11.8
Chicken, broiler or fryer, cooked, 1 cup, approx 145g	10.2
Oyster, breaded and fried, 3oz, 85g	5.9
Beef, tenderloin, roasted, 3oz, 85g	3.0
Beef, eye of round, roasted, 3oz, 85g	2.2
Chicken, leg, meat only, roasted, 3.5oz, 100g	1.3
Chicken breast, roasted, 3 oz, 85g	1.1
Tuna, white, canned in water, 3 oz, 85g	0.8
Source: U.S. Department of Agriculture, Agricultural Research Service. 2003. USDA Nutrient Database for Standard Reference, Release 16. Nutrient Data Laboratory

SOME FOOD SOURCES OF NON-HEME IRON

Foods	Milligrams of iron per serving
Ready-to-eat cereal, 100% iron fortified, ¾ cup	18.0
Oatmeal, instant, fortified, prepared with water, 1 cup	10.0
Soybeans, mature, boiled, 1 cup	8.8
Lentils, boiled, 1 cup	6.6
Beans, kidney, mature, boiled, 1 cup	5.2
Beans, pinto, mature, boiled, 1 cup	3.6
Spinach, boiled, drained, ½ cup	3.2
Black-eyed peas (cowpeas), boiled, 1 cup	1.8
Garbanzo beans, cooked, 1 cup, 164g	1.74
Beet greens, cooked, 1 cup, 144g	2.74
Peas, frozen, cooked, 1cup, 160g	2.43
Rice, white, long grained, cooked, 1 cup, 158g	1.9
Cashew nuts, 1oz (18 nuts)	1.72
Pine nuts, dried (chilgoza or neje) 1oz, 28.35g	1.6
Beets, cooked, 1 cup, 170g	1.34
Plantain, raw, 1 medium, 179g	1.07
Almonds, 1 oz (24nuts)	1.05
Source: U.S. Department of Agriculture, Agricultural Research Service. 2003. USDA Nutrient Database for Standard Reference, Release 16. Nutrient Data Laboratory

ABSORPTION OF IRON
Generally, about 10 to 15% of iron in the diet is absorbed by the body, though individual variations occur. The human body is calibrated to maintain iron levels/stores within normal limits. Thus, absorption increases in individuals who are iron deficient and decreases in normal individuals to prevent iron overload.

Heme iron, found in meat, poultry and fish is much better absorbed by the body than non heme iron found in vegetables, legumes, grains and fruits.  Consequently, vegetarians are at increased risk for developing iron deficiency. Eating heme iron or foods rich in vitamin C in a meal, enhances absorption of non heme iron consumed in the same meal. Vegetarians must be careful to include foods that contain vitamin C such as oranges, orange juice, lemon juice, cantaloupe, strawberries, broccoli, tomatoes and bell peppers in their meals to enhance absorption of iron.

Tea and coffee decrease iron absorption in a meal and should be consumed after a gap of an hour at least.

HOW MUCH IRON INTAKE IS RECOMMENDED DAILY?
(The table below lists the recommended dietary allowances for gender, age group and physiological conditions)
Recommended Dietary Allowances for Iron for Infants (7 to 12 months), Children, and Adults

Age	Males(mg/day)	Females(mg/day)	Pregnancy (mg/day)	Lactation (mg/day)
7 to 12 months	11	11	NA	NA
1 to 3 years	7	7	NA	NA
4 to 8 years	10	10	NA	NA
9 to 13 years	8	8	NA	NA
14 to 18 years	11	15	27	10
19 to 50 years	8	18	27	9
51+ years	8	8	NA	NA
Source: Institute of Medicine. Food and Nutrition Board. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium and Zinc. Washington, DC: National Academy Press, 2001.

FACTORS THAT INCREASE THE RISK OF IRON DEFICIENCY ANEMIA INCLUDE:

• Menstruation: In general, pre-menopausal women, due to regular blood loss, have smaller stores of iron and are at higher risk for developing deficiency than men.
• Pregnancy and even the post partum period increase iron needs. Generally iron supplements are recommended during these times, and should be taken in consultation with the doctor
• A vegetarian diet. See above under absorption
• Intestinal parasitic infection: Hookworm infestation depletes iron stores and is a common cause of iron deficiency in the developing countries.  Infection generally occurs due to walking barefoot on contaminated soil or due to accidentally swallowing contaminated soil. 
• Diseases which involve internal bleeding e.g. a bleeding ulcer in the small intestine, colon, or the rectum lower iron reserves. Blood in the stools or unexplained dark stools warrant further investigation and must be checked by a health practitioner 
• Gastrointestinal conditions that make it hard to absorb nutrients from food e.g. prolonged diarrhea, ulcerative colitis increase risk of deficiency
• Kidney failure predisposes individuals to iron deficiency anemia due to lack of erythropoietin, a hormone produced by the kidneys and essential for production of red blood cells.
• Vitamin A deficiency. Vitamin A is essential for mobilizing iron stores and a deficiency of this vitamin will lead to poor hemoglobin levels, even though iron may be present in sufficient amounts in an individual. This condition is common in the developing countries.
• Strenuous physical exercise: Long distance runners, vegetarian athletes and female athletes are at higher risk of developing iron deficiency. In fact they may have up to 30% greater iron needs than regular individuals. Reasons for increased demand could be gastrointestinal blood losses and greater turnover of the red blood cells from running. In females deficiency is compounded by iron loss during menstruation.
• Age:  

1. Infants at birth have iron stores to last about six months. Their iron needs are initially met by breast milk. Infants that are not breastfed should be given an  iron supplement or iron-fortified infant formula. Babies weaned to solid foods should be offered iron-rich foods.
2. In the age group of 1 to 4 years iron needs are high due to rapid growth. Iron intake must be emphasized for children in this age group. Milk is a very poor source of iron. Many children drink large quantities of milk at the expense of other foods and can develop `milk anemia'. Recommended milk intake is two to three cups (approx 500-750ml) per day for toddlers and older children.
3. Adolescents are more prone to low iron levels because of rapid growth rates and erratic eating habits.
4. Older adults are prone to developing iron deficiency as they may not eat enough due to poor dentition, small appetite or underlying disease.

IRON DEFICIENCY ANEMIA
Iron deficiency anemia is the most common nutritional disorder in the world. According to the World Health Organization 30% of the total world's population has iron deficiency anemia. In the developing world the numbers may be a lot higher.

Symptoms of Iron Deficiency Anemia include -

• Fatigue
• Shortness of breath
• Headache
  
• Irritability
  
• Dizziness
  
• Craving for ice or clay
• Weight loss.
  

Iron deficiency anemia complicates the course of some diseases.  Iron deficiency anemia treatment affects the outcome of cancers, some psychiatric diseases and heart disease are adversely affected by anemia. Anemia worsens heart disease symptoms and can precipitate heart failure. Poor memory, poor learning skills and decreased ability to concentrate are often seen school going children and in adults with iron deficiency anemia.

IRON TOXICITY/ POISONING
Too much iron is harmful and can result in a condition called hemochromatosis. Iron overload can even be fatal. That is why though dietary iron intake is safe, iron supplements should be taken only under the advice of a physician. (especially children - ALWAYS KEEP IRON SUPPLEMENTS OUT OF CHILDRENS REACH).

SYMPTOMS OF IRON POISONING:

•  Fatigue
•  Anorexia
•  Dizziness
•  Nausea
•  Vomiting
•  Headache
•  Weight loss
•  Shortness of breath
•  Grayish color to the skin

Contact a doctor IMMEDIATELY if you suspect iron toxicity.

By. Dietitian,
NutritionVista.com