Ironclad Rules

The best plan to avoid iron deficiency is prevention, but women must get much more aggressive about their iron intakes, since currently most of us average only about half our daily needs. Premenopausal women should consume several iron-rich foods daily, including extra-lean meat, fish, poultry and super mood foods like cooked dried beans and peas, dried apricots, dark green leafy vegetables and whole grains. They also should

  1. Consume a vitamin C-rich food with every meal. Try orange juice, a tossed salad, broccoli or most fruits. Vitamin C dramatically improves the absorption of iron and counteracts some of the inhibitors in foods, such as phytates in whole grains and tannins in tea and coffee.
  2. Emphasize the best iron. There are two types of dietary iron: the iron in meat, called heme iron, and the iron in plants, called nonheme iron. Heme iron is really well absorbed; about 30% of it makes it into the bloodstream, compared to only 2% to 7% of nonheme iron. Consuming small amounts of heme iron in red meat, such as extra-lean beef, with large amounts of nonheme iron, such as chili beans, increases the absorption of nonheme iron. Pork in a vegetable stir-fry and spaghetti with meatballs are other examples.
  3. Cook in a cast iron skillet. The iron leaches out of the pot into the food, raising the iron content several hundred-fold, especially with acid foods, like tomato and spaghetti sauce.
  4. Select iron-fortified foods. Choose foods with extra iron, such as read-to-eat cereals or fortified oatmeal.
  5. Drink tea and coffee between meals. Compounds called tannins in these beverages, whether they are caffeinated or decaffeinated or herb, green or black teas, block iron absorption by up to 80% when drunk with a meal.
  6. Take iron supplements on an empty stomach to improve absorption. The best absorbed forms are the “ferrous” forms, such as ferrous fumarate or ferrous sulfate.

A moderate-dose iron supplement should be considered when food intake falls below 2,500 calories and serum ferritin levels fall below 200 mcg/l. How much? Premenopausal women need 18 milligrams of iron daily, while pregnant women need at least 27 milligrams. (Postmenopausal women and men need as little as 8 to 10 milligrams from food). Women who are vegetarians, who menstruate heavily or who are on the IUD for birth control might need even higher amounts, up to 25 milligrams.

Unless prescribed by a physician, postmenopausal women should not take supplemental iron or should limit intake to no more than 10 milligrams. Severe iron deficiency may require a higher-dose prescription supplement. Supplements are just as effective as food in raising iron levels in the body, but you are best doing both – eating lots of iron-rich foods and taking moderate-dose multi-vitamins that contains iron.

Iron is one of the few nutrients that can easily be assessed by a simple blood test. Feeling “not up to par” might not be all in your head, so don’t take it lying down!

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