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Iron and Health

Too little iron Too much iron Iron in the Diet Iron in takes in the UK Iron intake through Life

Getting the right amount of iron in the diet is important for health.

Too little iron:

If the body’s store of iron is low and there is too little iron in the diet to form new red blood cells, the symptoms of iron deficiency anemia will start to develop. Iron deficiency anemia can make people feel tired, irritable and less able to concentrate. In children, it can affect behavior and development. Iron deficiency anemia is probably the most common nutritional deficiency in the world - it is estimated that at least 500 million people are affected. Iron deficiency anemia is much more common in developing countries, as people may be consuming too little food or a limited variety of food.

In the UK it is estimated that 8% of children aged 1.5-4.5 years of age are anemic, and about 4% of adolescent boys and 11% of adolescent girls. Among teenage girls, iron deficiency anemia has been shown to be three times more common in vegetarians than meat eaters (25% versus 9%), and in girls who had tried to lose weight in the last year compared with those who had not (23% versus 7%). Of women aged 16-45 years, 23% have low iron stores and 6% are anemic.

Too much iron:

Iron is stored in the body and large amounts can be toxic. The amount absorbed in the intestine is usually carefully regulated. However, people are usually advised to consult their doctors before taking iron supplements.

IRON IN THE DIET

Many foods contain iron, and eating a wide range of foods can help most people meet their needs for this nutrient. Iron from animal sources (haem iron) is better absorbed than iron from plant sources (non-haem iron). About 15% of iron in diets containing meat or fish is absorbed. Absorption of non-haem iron is affected by various factors in food.

Phytates (in cereals and pulses), fibre, tannins (in tea and coffee) and calcium can bind non-haem iron, which reduces absorption. Vitamin C increases absorption of non-haem iron. This means having food and drinks which contain vitamin C with meals, eg vegetables, salad, orange juice, will increase iron absorption, but tea and coffee with meals will reduce absorption. Absorption of non-haem iron is also increased by meat.

IRON INTAKES IN THE UK

In the UK, the main sources of iron are meat and meat products, cereal products (mostly from iron fortified bread and breakfast cereals) and vegetables.

A large survey of the iron intake of adults in the UK found that, on average, adult men consume 13.7mg/day and women 10.5mg/day from food sources. The reference nutrient intakes (RNI) for adults are 8.7mg/day for men and 14.8mg/day for women. Average iron intakes in the UK have fallen over the last 20 years. The main reasons for this are reduced energy intakes (ie less food is eaten) and lower consumption of meat.

IRON INTAKE THROUGH LIFE

Infants and young children have very high iron requirements. For the first 6 months of life, these requirements are met by stores of iron in the infant’s body together from breast or formula milk. However, by 6 months the stores have been used up and milk alone does not give enough iron for the infant. Solid foods provided after 6 months of age should include rich sources of iron, eg red meat. For vegetarian children, alternative sources of iron should be included in the diet such as green vegetables, pulse and fortified bread and breakfast cereals.

To reduce risk of anaemia, the Department of Health recommends:

not giving cow’s milk (which is low in iron) as the main drink before 12 months of age (bottle fed infants should be given fortified formula)

introducing meat and fish from 6-8 months of age

providing fruit, vegetables and/or vitamin C at every meal to increase iron absorption

not giving tea and coffee which can reduce iron absorption

Iron requirements increase during adolescence because of growth, muscle development and, for girls, the start of menstruation. Consumption of bread and/or breakfast cereals which have been fortified with iron can increase intakes significantly. However, many adolescents do not eat breakfast, so these foods could be encouraged as snacks.

Some girls have very high requirements for iron and may find it difficult to meet their needs from their diet. They may be advised to take iron supplements. Adolescents who start a poorly planned vegetarian diet and young slimmers may be at more risk of iron deficiency.

Some adult women have very high iron requirements because they have large menstrual losses. Around 10% of women aged 19-50 years have requirements greater than the (RNI) reference nutrition intake and may find it difficult to meet their needs from their diet. They may be advised by their doctor to take iron supplements. During pregnancy it is not necessary to have extra iron in the diet because absorption increases and menstruation stops. The fetus is likely to get enough iron even if its mother has low stores. Iron deficiency during pregnancy can increase the risk of the fetus having a low birth weight and developing iron deficiency anaemia after birth.

The main source of iron in the British diet is meat. Vegetarians must therefore include alternative sources of iron in their diets such as green vegetables and pulses. Bread and some breakfast cereals are also fortified with iron and can be a useful source for vegetarians. As iron from plant foods is less well absorbed than iron from animal sources, it is advisable for vegetarians to consume vitamin C with meals, eg fruit juice, fruit and vegetables, as this vitamin can help absorption.

Vegetarians with poorly planned diets may be at risk of iron deficiency. Asian vegetarians, in particular, in the UK may be at greater risk of iron deficiency anaemia because of their higher intake of fibre and other substances which reduce iron absorption.

Taken from the British Nutrition Guide