Are Vegetarians at Higher Risk for Iron Deficiency?

Dear Timi,
Recently, I have been diagnosed with iron deficiency. My doctor blames it squarely on my eating habits as a vegan and urges me to consider “a more balanced diet” that includes at least some meat, which I don’t want to do. He also suggested that I take iron in form of vitamin supplement pills. What else do you think I should do?

Dear Reader,
Many people who adhere to strictly vegetarian diets risk certain deficiencies in protein and iron, which are abundantly available in animal food products, but less so in plant foods. Since you mention only iron deficiency as a problem in your case, let me focus on this one issue.

Iron is an essential mineral and important component of certain proteins. Most of the iron in the body is found in hemoglobin, which is a protein in the red blood cells responsible for the transport of oxygen throughout the body. A small portion of iron remains stored in the body and can be mobilized in times of acute deficiencies. Women who experience heavy bleeding during their monthly period are prone to significant loss of iron. Adult men and post-menopausal women much less so.

Under normal circumstances, the body maintains naturally a healthy level of iron through a balanced diet. There are two forms of dietary iron, called heme and non-heme. A diet that includes meat, fish and poultry provides sufficient amounts of heme iron. Non-heme iron is present in plant foods, such as vegetables, beans and lentils. Unfortunately for vegetarians, plant-based non-heme iron is not as easily absorbed by the body as meat-based heme iron.

However, if you suffer from iron deficiency due to an exclusively vegetarian diet, you still can make dietary adjustments that do not require meat consumption.

For example, flour, cereals and other grain products that are enriched and fortified with iron can add more non-heme iron. Other rich sources are dark green leafy vegetables, like spinach, collard greens and kale. To enhance non-heme iron absorption, it is important that you add to your meals foods that are rich in Vitamin C (e.g. a spinach salad with a few slices of orange or mixed berries).

On the other hand, a concentrated presence of calcium can inhibit the absorption of non-heme iron. Phytates, which are found in legumes, rice and some grains, can have adversary effects as well, and so can certain proteins from soy.

Discuss your options with your doctor or a clinical dietitian who can monitor your iron level on a regular basis. Prolonged iron deficiency is not harmless. Besides causing you to feel chronically fatigued, it may also compromise your immune system, making you more vulnerable to any number of diseases.

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