Iron deficiency is scarily common among women, with serious health consequences, ranging from fatigue and anaemia to cognitive impairment – but why are women uniquely afflicted? We’ll be unpacking a number of contributing factors

Shocking research published in the JAMA Network journal has unveiled well over a third of women are iron deficient, highlighting the challenges of reaching the RDI with our ultra-processed diets, combined with the iron-sapping effects of menstruation which affects many. For adult men, the RDI for iron is typically around 8 milligrams per day, while women who menstruate have an RDI of approximately 18 milligrams per day; more than double that amount.  

Why Women Require More Iron

• Menstruation: Women lose blood during their menstrual cycles, leading to a loss of iron. This loss needs to be replenished through dietary sources.
• Pregnancy: Pregnant women require additional iron to support the growth and development of the foetus and placenta.
• Lactation: Breastfeeding mothers need extra iron to account for the transfer of iron to their infants through breast milk.

Despite the increased need for iron in women, several challenges make it difficult to meet these requirements:

• Dietary Choices: Vegetarian and vegan diets can be low in heme iron, the type of iron found in animal products, making it harder for those following these diets to obtain enough iron.
• Absorption Inhibition: Certain dietary components, like calcium and tannins in tea and coffee, can inhibit the absorption of non-heme iron found in plant-based foods
• Blood Loss: Women with heavy menstrual periods may lose more iron than they can replenish through their diet alone.
• Digestive Issues: Some individuals may have conditions that impair their ability to absorb iron efficiently, such as celiac disease or gastrointestinal surgery. 

Consequences of Iron Deficiency

Iron plays an essential role in a range of bodily functions, from providing oxygen to cells to produce energy to supporting proper cognitive function and the development of the central nervous system. It helps in the synthesis of neurotransmitters and plays a role in maintaining healthy brain cells. That’s why failing to meet the RDI for iron can lead to various health consequences, including: 

Fatigue and Weakness: Iron is essential for the production of haemoglobin, which transports oxygen in the blood. Low iron levels can result in fatigue, weakness, and a decreased ability to perform physical activities.

Anaemia: Severe iron deficiency can lead to iron-deficiency anaemia, a condition characterised by insufficient red blood cells to carry oxygen to the body's tissues. Symptoms may include pale skin, brittle nails, and shortness of breath.

Impaired Cognitive Function: Inadequate iron intake can affect cognitive function, memory, and concentration. It may lead to difficulties in daily activities and work performance.

Complications During Pregnancy: Iron deficiency during pregnancy increases the risk of preterm birth, low birth weight, and developmental delays in the child.

Weakened Immune System: Iron deficiency can weaken the immune system, making individuals more susceptible to infections and illnesses. 

How You Can Optimise Iron Absorption

Optimising iron absorption is particularly important for vegans and vegetarians, as plant-based sources of iron (non-heme iron) can be less readily absorbed by the body compared to heme iron from animal sources. Here are some strategies to enhance iron absorption:

Pair Iron-Rich Foods with Vitamin C 

Foods high in vitamin C, like citrus fruits, strawberries, bell peppers, and broccoli, can enhance the absorption of non-heme iron. Consume vitamin C-rich foods with iron-containing meals to increase iron absorption. For example, have a glass of orange juice with your iron-fortified cereal or a side of bell peppers with your spinach salad.

Avoid Iron Antagonists 

Certain compounds can inhibit iron absorption. Phytates, found in whole grains, legumes, and nuts, and polyphenols in tea and coffee are examples of iron antagonists. To mitigate their effects, try soaking, sprouting, or fermenting grains and legumes, and consider reducing your tea and coffee consumption around meal times.

Cook in Cast Iron

Cooking foods in cast iron cookware can increase the iron content of your meals. Acidic foods, like tomatoes or vinegar-based dishes, are particularly effective at leaching iron from cast iron cookware.

Choose Iron-Rich Plant Foods

Select iron-rich plant-based foods, such as lentils, chickpeas, tofu, fortified cereals, pumpkin seeds, and quinoa. These foods provide a good source of non-heme iron for vegetarians and vegans.

Diversify Your Diet

A varied diet can help ensure you get a broad spectrum of nutrients, including iron. Incorporate a range of iron-rich foods, including legumes, leafy greens, seeds, and fortified foods, to increase your chances of obtaining enough iron.

Avoid Consuming Calcium and Iron Together

Yes, calcium is another essential nutrient, but this bone-building mineral can inhibit the absorption of non-heme iron. If you consume dairy alternatives or calcium-fortified foods, try to separate your calcium-rich foods from iron-rich foods. For example, have your calcium-fortified cereal in the morning and a spinach salad for lunch.

Consider Iron Supplements

If you struggle to meet your iron needs through your diet, consult with a healthcare professional or registered dietitian. They can advise you on whether iron supplements are necessary and provide guidance on proper supplementation.

Regularly monitor your iron levels through blood tests, especially if you're following a vegan or vegetarian diet. This will help you assess whether you're getting enough iron and whether you might need to make dietary adjustments or take supplements.

Remember that while enhancing iron absorption is important, it's also crucial to maintain a balanced diet that meets all of your nutritional needs. A well-planned vegetarian or vegan diet can provide adequate iron, especially when you pay attention to iron-rich foods and absorption-enhancing strategies.  

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