Getting enough iron and avoiding anaemia (part 1) - Where is iron found?

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Are you getting enough iron?

During pregnancy you need about 14.8mg of iron per day. A recent study carried out among more than 1,200 pregnant women in the Leeds area found that only 20% managed to achieve this. The study included more than 100 vegetarians, and interestingly it was found that these women were slightly more likely than the non-vegetarians to be getting enough iron from their food. The vegetarians were also more likely to take a supplement containing iron. Perhaps this was due to the common belief that vegetarians are more likely to be anaemic. Interestingly, vegans have been found to have higher iron intakes than lacto-ovo-vegetarians, because dairy products are low in iron.

The only indicator you really have of whether you are getting enough iron is the result of your blood tests, and whether you have a low haemoglobin (Hb) and Mean Cell Volume (MCV). However, mild iron deficiency can affect health even if you’re not officially anaemic. Also, these tests aren’t usually done until the end of the first trimester, and it is important to have a good iron intake from as early as possible in pregnancy. The table overleaf will help you estimate whether you’re getting enough iron and see how you can boost your intake. It really is worth trying to get the iron you need from food rather than supplements, as iron supplements are often poorly absorbed and can cause other problems such as constipation, as well as reducing absorption of other minerals.

While vegetarians are no more likely than meat-eaters to have anaemia, several studies have shown they have lower iron stores. During pregnancy most women have their serum ferritin levels measured, which is an indicator of iron stores. If your ferritin level is found to be low, you may not even be told about it, or you may be prescribed iron supplements. It depends on how important individual care providers think this is. Having low iron stores isn’t a problem in itself, but it means you’re more likely to develop anaemia. Look at your antenatal notes and if you find your ferritin level is low then you should be particularly vigilant, and ensure you get plenty of iron in your diet (serum ferritin below 12µg/L is generally considered low but this varies between hospitals).

Where is iron found?

Iron is found in a wide variety of foods and comes in two different forms. Haem iron is present in meat and fish, and is absorbed by the body more easily than non-haem iron, which comes from plant sources. This is sometimes used as an argument to show that diets including meat are superior. However, generally no more than about 10% of the average meat-eater’s iron comes in the form of haem iron; the remaining 90% is non-haem iron. In the Leeds study mentioned earlier, it was found that only 5% of the pregnant women’s iron intake came from meat and fish. That said, vegetarians do need to think about including good sources of iron in their diet every day.

Food Iron (mg) per 100g Iron per portion
Breakfast cereals    
Muesli 5.8 2.9mg per 50g
Porridge oats 4.1 2.0mg per 50g
Wheats, e.g. Shredded Wheat 4.2 1.8mg per two bisks
Wheat bisks, e.g. Weetabix* 11.9 4.5mg per two bisks
Special K and similar* 11.6–22.0 4.6–9.0mg per 40g
Bran flakes* 11.6–14.0 4.5–5.6mg per 40g
Cornflakes* 8.0–14.0 3.2–5.6mg per 40g
Instant hot oats* 11.9 4.8mg per 40g
Starchy foods    
White bread 1.7 1.2mg per two slices
Wholemeal bread 2.4 1.8mg per two slices
White pasta (cooked) 0.5 1.1mg per 220g
Wholemeal pasta (cooked) 1.1 2.4mg per 220g
White rice (cooked) 0.2 0.4mg per 100g
Brown rice (cooked) 0.5 1.0mg per 200g
Potatoes 0.4 0.8mg per 200g
Pulses and vegetables    
Lentils (cooked) 3.5 2.8mg per 2 tablespoons
Chickpeas (cooked) 2.1 1.4mg per 2 tablespoons
Kidney beans (cooked) 2.5 1.7mg per 2 tablespoons
Baked beans 1.4 2.8mg per half-tin (200g)
Spinach (cooked) 1.6 1.3mg per 80g
Broccoli (cooked) 1.0 0.8mg per 80g
Peas (cooked) 1.6 1.3mg per 80g
Other foods    
Eggs 1.9 1.2mg per egg
Houmous 1.9 1.0mg per 2 tablespoons
Tahini 10.6 2.0mg per heaped teaspoon
Dried apricots 4.1 1mg per five fruits
Raisins 3.8 1.1mg per tablespoon

*These cereals are usually fortified; unfortified varieties contain less iron.

Another way of increasing the amount of iron in your diet is by cooking in cast iron cookware. This isn’t very common in the UK, but balti curries are traditionally cooked in iron woks and even supermarket-bought vegetable baltis have been found to have a much higher iron content than other vegetable curries. The iron accumulated during cooking also seems to be quite well absorbed, so you might want to think about investing in a cast-iron cooking pot.

Guinness and spinach for iron power?

Guinness and other stouts were once thought to be good for pregnancy because they contained lots of iron and would ‘build you up’. However, Guinness contains approximately 0.01mg of iron per 100ml, or 0.3mg per half-pint. A typical bowl of breakfast cereal contains about 10 times as much (3.0–7.0mg per bowl). Stout also contains alcohol, of course, which isn’t good for pregnancy or breastfeeding.

You might also be advised to eat spinach for extra iron. If this is what Popeye was relying on, he was mistaken. Although spinach does contain iron, it also has high levels of oxalic acid, which binds tightly to the iron, so it can’t be absorbed. This means the iron in spinach is likely to pass straight through the body.

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