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Raising iron levels

My doctor tells me my iron levels are low. How can I make sure I get enough iron in my diet?

You’re not alone: the average daily iron intake for premenopausal women in Canada is about 12 milligrams, which falls significantly short of the recommended intake of 18 milligrams per day. Lack of iron can leave you feeling tired and weak and increase your likelihood of getting sick because your immune system isn’t functioning at its peak. What you may not realize, however, is that it’s not the total amount of iron you eat each day that’s most important. Rather, it’s the type of foods you’re eating at each meal that most strongly affects your iron levels.

Which iron is best?

Two kinds of iron are found in food: heme iron and non-heme iron. Both are found in meat, poultry, fish and seafood. Heme iron is always well absorbed by the body. Non-heme iron—which makes up 85 to 90 per cent of the iron we eat—is found in enriched and whole grains, beans, nuts and some vegetables and fruit, such as asparagus and dried apricots. It is not well absorbed by the body and is greatly influenced by the combination of food you eat at each meal. Fortunately, you can enhance the absorption of non-heme iron by either including or excluding certain foods.

Boosting iron absorption

Your body can’t absorb non-heme iron well when it is eaten with foods that contain certain compounds, including those called polyphenols. Polyphenols are found in a wide variety of foods, including tea, coffee, red wine, red grape juice, prune juice, apples, cocoa and chocolate.

For example, a cup of tea with a non-heme meal, such as a three-bean salad, reduces iron absorption by 75 to 80 per cent; a cup of coffee reduces absorption by 60 per cent. Drink tea or coffee between meals rather than with meals, or make sure you include a vitamin C-rich food with your meal. Vitamin C releases iron that is bound to compounds such as polyphenols. Good sources include citrus fruit and juices, kiwi, strawberries, red and green peppers, broccoli, kale and brussels sprouts. You can double your non-heme iron absorption when you consume 25 milligrams of vitamin C (about a quarter cup/50 mL of orange juice) at the same meal. The absorption increases by as much as three- to six-fold when you consume 50 milligrams of vitamin C (about a half cup/125 mL of orange juice).

Eating a portion of meat, poultry, fish or seafood at the same meal also enhances non-heme iron absorption. For example, adding ground beef to chili will increase the absorption of iron from beans.

Plan your meals

To make sure that your body gets the iron that it needs, try the following:

• At every meal, include foods that contain iron. Sources of heme iron include meat, poultry, fish and seafood. (Red meat is the best dietary source of iron.) Sources of the less well-absorbed non-heme iron include bread and pasta, beans, nuts and seeds, dried fruit (such as raisins and apricots), dark green leafy vegetables (for example, kale or asparagus) and eggs.
• Enjoy cereal fortified with iron. For example, most instant oatmeal is fortified with iron and most regular oatmeal is not.
• Because it’s a challenge to get enough iron, women of child-bearing age (who lose iron every month) should take a daily multivitamin that contains at least 10 milligrams of iron.

After menopause, daily requirements for iron fall from 18 milligrams down to eight milligrams, and postmenopausal women should consider taking a specially formulated multivitamin that is lower in iron. Although research has been inconclusive, some studies do suggest a link between too much iron and an increased risk of heart disease and cancer.

Liz Pearson is a registered dietitian, professional speaker and co-author of The Ultimate Healthy Eating Plan (That Still Leaves Room for Chocolate) (Whitecap).