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Your blood serves as your body’s transportation system, ensuring nutrients and oxygen are carried to different points in your body, keeping your cells alive and healthy.

Iron deficiency anaemia

Think of your cells as miniature versions of yourself. When you hold your breath, you do not get any oxygen in and might even start to feel lightheaded. The same thing happens when your cells do not get enough oxygen; the key difference being that for your body, instead of holding its breath, there isn’t enough iron to hold onto the oxygen your cells need.

Insufficient amounts of iron would mean your body may struggle to carry the oxygen needed to the cells across your body, a condition known as iron-deficiency anaemia. Common symptoms would include low energy, fatigue or weakness, lightheadedness, and dizziness, even from light activities. This is because not enough oxygen is being carried across your body to sustain the amount of energy your cells need. Picture trying to run while holding your breath; it becomes more difficult the more steps you take.

Iron deficiency anaemia tends to be more common among children and women, as iron needs fluctuate due to growth and menstrual cycles, respectively. During pregnancy, the iron requirements for women increase even more to account for the extra oxygen supply needed by the baby. Iron deficiency tends to be more common in teenage girls as different factors start to play a role, like the onset of menstruation, changes in dietary preferences, whether related to trying to manage their weight, or changes in the food they enjoy

Bioavailability of iron

Getting enough iron in your body relies on two different things: the right amount and the right type. Most often, our dietary factors are what lead to iron deficiency. There are two types of iron:

• Heme iron, which is found in animal proteins like poultry, fish, and red meat, is more readily absorbed into the body from the intestines. Liver (from beef, chicken, or mutton) and bone marrow have higher amounts of iron, making them a good addition to a diet for someone who tends to have an iron deficiency.
• Non-heme iron, found in plants such as legumes, leafy greens, and iron-fortified cereals, unfortunately, tends to have a harder time being absorbed in the body. This, in part, may contribute to iron deficiency while on a vegetarian or vegan diet.

The great thing about nature is that it always tries to find a way to help us get the most out of our food. Vitamin C (commonly found in citrus fruits, berries, potatoes, and red bell peppers) can help improve the absorption of iron. Think of it as an iron’s absorption buddy. It holds non-iron’s hand, making sure it gets absorbed too. Additionally, for non-vegetarians, another absorption buddy for non-heme is heme iron.

Absorption inhibitors

Non-heme iron absorption in the body is quite sensitive and can be reduced or inhibited by high calcium (including supplementation), which competes for absorption. Antioxidants called polyphenols from black tea and coffee, and phytates (from legumes and wholegrains) if consumed in the same meal can affect absorption too.

Breakfast tends to be the most common places where iron absorption may be reduced. Dairy products have the highest concentration of calcium, which can, unfortunately, interfere with the absorption of iron, especially in iron-fortified cereals. Or, if you tend to include black tea or coffee with your breakfast, the caffeine in these beverages may have a similar effect. Having caffeine 30 minutes before or 1.5 - 2 hours after a meal helps increase absorption.

Finding a stable balance

Whenever you are having a vegetarian meal, for example, a leafy salad, try to incorporate some vitamin C, like lemon juice as part of the salad dressing, or red bell peppers to assist with non-heme iron absorption.

Dark roasts of coffee, light green tea, and herbal tea like rooibos tea contain fewer polyphenols, making them a preferred option if you are trying to have a warm beverage with your meal.

Although it's not impossible, a one-meal-a-day diet tends to offer very little iron. So, try to incorporate two balanced meals into your diet to help with iron absorption, or pick heme-iron for your meal, incorporating vitamin C to help with absorbing more iron. Soaking overnight and/or pressure cooking wholegrains and legumes can help reduce the amount of phytates.

When to seek professional help

Managing your iron levels can be challenging, and the dietary recommendations above are a great starting point to help obtain and manage healthy iron levels. If you suspect you could have an iron deficiency, speaking to your doctor or professional nurse, regarding potential blood testing to diagnose anaemia, and a prescription, which may include iron supplementation. Furthermore, a registered dietitian can work with you to help create a personalised nutrition plan to help your body get the iron and other nutrients required for healthy red blood cell formation.