Getting Iron on a plant based diet

One of the biggest concerns with cutting or even decreasing meat and dairy from the diet is getting enough Iron. Here is some great information gleamed from Dr. Michelle McMacken (who you can follow on Instagram @veg_md) with some added information

It is a misconception that getting enough iron on a plant based diet is not possible. Plant foods are abundant in this vital mineral. For an example 100 grams of cashew nuts have almost twice the amount of iron as 100 grams of cooked beef. Once you change your eating habits then Iron on a plant based diet doesn't have to be difficult. 

Understanding Iron

Iron is an essential mineral found mainly in our red blood cells. It's main role is to transport O2 to all the tissues in the body. We also need iron for energy, metabolism, neurological development, and hormone synthesis. The heme iron found in blood and muscle is more readily absorbed than non-heme iron found in plants but this isn't necessarily a good thing. It results in us tending to store Iron even though our bodies don't need it. Higher iron stores correlate with inflammatory conditions like type 2 diabetes, certain types of cancer, heart disease and premature mortality. In a recent study (R. Sinha et al, Meat Intake and Mortality, Arch Intern Med. 2009, March 23: 169 (6):562-571) of almost half a million adults heme iron was strongly linked to death from nine different causes. This may be because heme iron is a pro-oxidant molecule that can form carcinogens (contributing to the development of atherosclerosis by oxidizing cholesterol with free radicals. The risk has been quantified as a 27% increase in coronary heart disease risk for every 1 milligram of heme iron consumed daily). and create DNA damage, oxidative stress and inflammation. The human body cannot get rid of excess iron and due to haem iron's high bioavailability and the fact it can bypass the body's finely tuned and evolved iron regulatory system it is more likely to lead to high iron stores. 

In contrast, when we get iron from plants in the form of non-heme iron (examples below) our bodies are better able to regulate absorption - if our iron stores are low, we absorb more and if too high we don't take on as much. People eating plant based diets can adapt over time to absorb more iron. Non-heme iron has not been tied to chronic diseases and it has the added benefits of phytonutrients found in plants.

Iron Inhibitors

Iron is abundant in many plant foods. Phytates* in some plant foods can decrease absorption but this can be overcome by cooking, soaking plant foods and pairing these foods with Vitamin C or citrus. It has been shown that 50mg of Vitamin C (found in 3/4 cup of broccoli, brussel sprouts, cauliflower, bell peppers, papaya or strawberries) raises iron absorption 4-6 times! Our family loves a red lentil and tomato based sauce dish. 1 cup of tomatoes has 25mg of Vitamin C -  To maximise iron absorption avoid drinking coffee and tea with meals as these inhibit absorption as do calcium supplements, and dairy. Try to have these an hour either side of meals (tea and coffee that is - I would avoid dairy altogether : please check out my thoughts on dairy with my blog post  https://everfit.co.nz/blog/everfit/dairy-for-life )

*Phytates are powerful antioxidants and may reduce risk for certain chronic diseases and some cancers so don't look to avoid them 

Vegans and vegetarians are no more likely to have iron deficiency anemia compared to omnivores. In fact vegans consume as much or more. Moderate to severe iron-deficiency anemia may require iron supplements with the help of a health professional. Eating meat is not the best answer. If you do have iron-deficiency anemia the first step is finding out why. The cause is almost never a well planned plant based diet. More common reasons are menstrual blood loss, gastrointestinal bleeding, low vitamin D, peri menopause, or another health issue. Before considering iron supplementation get checked by a physician and understand the cause - supplementation without needing it can result in iron overload, which can present with symptoms mimicking anemia. 

Whole grains generally contain more iron than refined grains. They also have several other nutrients and plant compounds beneficial to health. Nuts and seeds are good sources of non-heme iron as well as an array of other vitamins, minerals, fiber, healthy fats, and other awesome plant compounds. Beans, peas, and lentils are rich in iron and contain good amounts of protein, fiber, vitamins, minerals plus other compounds that will reduce your risk of various diseases. 

A lack of Iron should not be a barrier stopping you switching to plant based diet and reducing (or eliminating) meat, eggs, and dairy. Note the mg of Iron will vary - I have taken the average many different sources.

- Lentils (6.6mg per cup cooked or 37% of RDI)

-Tofu (2.9mg per 100grms or 17% of RDI)

- Beans (especially soy - 8.8mg per cup or 49% of RDI)

- Leafy greens (spinach, kale, beet greens 2.5-6.4mg per cup cooked or 14-35% of RDI)

- Broccoli (1mg per cooked cup or 6% of RDI)

- Oats (3.4mg per cooked cup or 19% of RDI)

- Olives (3.3mg per 100grams or 18% of RDI)

- Quinoa (2.8mg per cup cooked or 16% of RDI) 

- Seeds (Pumpkin, sesame, hemp and flaxseeds contain 1.2-4.2mg per 2 Tablespoons or 7-23% of RDI)

-Cashews (2.5mg per 50g or 15% of RDI)

-Cacao powder (6mg per 20g or 36% of RDI)

-Dark Chocolate (3.3mg per 28 grams)

Even though vegans and vegetarians tend to eat more iron than meat eaters they tend to have lower iron store values. There is some research suggesting that plant based eaters should have 1.8 X the recommended values BUT this advice is based on a study that had the vegetarian group eating a high iron inhibitory diet and limited Vitamin C to promote uptake.  The recommended daily intake of Iron (NZ Nutrition Foundation site) varies depending on age and stage. For example the recommended Iron intake for a women aged between 19-50 years is 18mg/day, a pregnant women up to 27mg/day. Children between 1-13 years should have between 8-10mg/day and infants under 1 year 11mg/day. The average man requires 8mg/day.  If you are an endurance runner then you will need more than these recommendations as there is a loss of iron during sweating. 

For women on an oral contraceptive (premenopausal) this protects from iron deficiency. If you have a diagnosis of anemia and you are on an OC pill it could be linked to the OC-induced inflammation side effect. If this is the case it might be beneficial to change the formulation of the OC. For women naturally cycling take the iron with Vitamin C in the morning before training. As discussed earlier avoid dairy, coffee, tea, zinc, antacids within 2 hrs of taking the iron as compounds within these will bind with the iron and interfere with absorption. Look at supplementing in the low hormone phase every 2nd day (around day 3-16) due to the changing hepcidin levels throughout the menstrual cycle. Hepcidin is the hormone that controls absorption of iron from food. More hepcidin equals less iron absorption. It is high post exercise, and with chronic stress - another reason to have good methods to deal with accumulation of stress. 

Making whole plant foods the main part of your diet will provide your body with a diverse array of micronutients, phytonutrients, and fibre that will meet your nutritional and health needs

Feel free to view this informative video by Dr. Michael Greger on the safety of Heme vs Non heme iron. https://www.nutritionfacts.org/video/the-safety-of-heme-vs-non-heme-iron/ 

Brad Dixon is a sports physio, coach, and wellness evangelist based at EVERFIT Physio & Coaching. His passion is promoting enhancing daily habits that nudge people towards potential and save the planet. His book ‘Holistic Human’ is available here - https://everfit.co.nz/Store/Category/Book . The power is in our daily habits! Connect with Brad at www.everfit.co.nz, Facebook, Strava, Instagram (@everfitcoach), and YOU TUBE https://youtube.com/c/EverFITcoach