Iron-rich foods to fight anemia

There are three different types of anemia:

• Iron-deficiency anemia, known as iron deficiency anemia
• Anemia due to vitamin B12 deficiency, known as pernicious anemia
• Anemia due to vitamin B9 deficiency

By promoting anti-anemia foods, this diet reduces the risk of anemia, reduces symptoms and improves the body’s stores of iron, vitamin B9 and vitamin B12.

What are the causes of iron deficiency?

• Insufficient iron intake in the diet (in case of an unbalanced vegetarian diet)
• Low bioavailability
• Reduced absorption due to gastrointestinal disorders (e. g. celiac disease)
• Abundant blood loss (menstruation, childbirth)
• Increased iron requirements (pregnancy, growth, breastfeeding)

What are the causes of vitamin B9 deficiency?

• Lack of folate (vitamin B9) in the diet in cases of malnutrition or chronic alcoholism
• A decrease in vitamin B9 absorption in case of gastrointestinal disease
• An increase in needs (pregnancy, growth, etc.)
• Poor drug interactions
• An increase in long-term blood loss (e. g. hemodialysis)
• Lack of vitamin B12

The recommended folate intake for adults is 400 micrograms per day. However, for pregnant women it is recommended to have a daily intake of 800 micrograms of folates. Three months before conception and until the fourth month of pregnancy, increasing vitamin B9 intake prevents fetal malformations such as poor neural tube closure.

What are the causes of vitamin B12 deficiency?

• Lack of intrinsic factor (IF) in the stomach. FI is a glycoprotein produced in the stomach that transports vitamin B12 to the intestine for absorption. The lack of IF can result from digestive surgery: by pass, gastrectomy, sleeve, etc.
• Lack of vitamin B12 intake for several years due to a strict and unbalanced vegan or vegan diet.
• Deficient absorption due to gastrointestinal disorders (Crohn’s disease, pancreatitis, etc.)
• Abundant blood loss
• Increasing needs
• Taking certain medications or excess alcohol

Our vitamin B12 reserves far exceed our daily losses. Vitamin B12 deficiency is therefore relatively rare and can only occur after years of insufficient intake or malabsorption.

The recommended daily intake of vitamin B12 is 2.4 micrograms for healthy adults.

The right foods to fight anemia

At the nutritional level, some simple recommendations can limit the risk of anemia and increase the body’s iron reserves. The anti-anemia diet consists above all in providing enough iron, vitamin B9 and vitamin B12 through a healthy and balanced diet.

Encourage foods rich in iron, vitamins B9 and B12

To increase your intake of iron and vitamins B9 and B12, it is necessary to make the right choices by choosing foods that are rich in them. Here is a list of the most effective anti-anemia foods.

Offal

Pork liver is the food richest in iron, it contains 18mg of iron per 100g of liver. In second position are the lamb kidneys which contain 12mg of iron per 100g, then the beef liver which contains 7mg of iron per 100g. Offal is also the best source of vitamin B9 and vitamin B12. They are therefore valuable allies in the fight against anaemia.

Red meat, poultry and seafood

Red meat, poultry and seafood products are an excellent source of iron. In addition, by including a source of meat, poultry or seafood with meals, the concomitant increase in non-heme iron increases. Indeed, a factor present in meat, poultry and fish improves the absorption of both forms of iron. For example, by adding ground beef in chili to red beans, the assimilation of non-heme iron from red beans is increased.

It should be noted that vitamin B12 is produced by bacteria that are found almost exclusively in food of animal origin. Eating meat and poultry is therefore recommended to treat anemia. For an idea, a 100g serving of clams or 10 oysters fills 10 to 50 times our need for vitamin B12.

In case of anemia, it is recommended to consume every week:

• 2 portions of poultry
• 2 portions of fish
• 4 portions of meat

Foods high in fibre

Dietary fibre is very interesting for fighting anemia. Their high iron content (up to 10mg per 100g of bran) and vitamin B9 content should be highlighted.

Folates are very present in the husk of cereals (bran and germ). While grain refining deprives us of this vitamin B9 intake, choosing whole wheat-based foods allows us to enjoy it.

In case of anemia, it is recommended to consume every week:

• 14 servings of whole grains (2 per day)
• 7 servings of iron-fortified cereals
• 3 portions of legumes

Foods that are sources of vitamin C

Iron assimilation can be improved by combining iron-rich foods with vitamin C-rich foods. Vitamin C allows the transformation of non-heme iron into a form that is better absorbed by the intestine. 75 mg of vitamin C in a meal increases iron absorption by up to 12%. For example, by accompanying your piece of beef with a raw pepper salad, you improve the absorption of the non-heme iron in the pepper.

For the best sources of vitamin C, check out the Vitamin C nutrient list.

Fruits and Vegetables

Fruits and vegetables are a significant source of non-heme iron and vitamins B9 and B12.

They are also the best source of vitamin C, which facilitates the absorption of iron by the body.
However, folates are partially destroyed by heat. To preserve them, prefer gentle steam cooking and alternate between cooked fruits and vegetables and raw vegetables. The most effective vegetable for controlling anemia is probably spinach.
In case of iron deficiency, it is recommended to consume every week:

• 14 portions of green vegetables
• 21 portions of fruit

Other recommended foods:

• Eggs
• Dairy products
• Pulses
• Soya
• Food yeast
• oilseeds and seeds
• organic potatoes with skin

Here is a table showing the number of weekly servings to consume to reach 18 mg of iron per day (the need of women of childbearing age):

What foods should I avoid for anemia?

For anemia, care should be taken to avoid certain foods that may interfere with the absorption of iron and vitamins B9 and B12. In addition, some eating behaviours can lead to deficiencies in intake. Here are the foods to avoid against anemia.

Tea and coffee

Tea and coffee contain tannins that interfere with the absorption of iron when consumed with meals. It is recommended to take these drinks away from meals: 30 minutes before or 2 hours after. If anemia is found, it is strictly not recommended to include them with meals.

Herbal tea does not contain tannins, so it can completely replace tea during the day.

Strict vegetarian diet misconduct

To ensure an adequate intake of vitamin B12, vegetarians and vegans should consume vegetable milks made from soya or rice, often fortified with B12. Other products are now fortified to meet the needs of people who do not consume animal products for vitamin B12. This is the case for yeast, meat substitutes or specific food supplements.

Phytates, oxalates and calcium

Phytates, oxalates, polyphenols and calcium contained in different foods are known to interfere with iron absorption. However, sources of phytates, polyphenols and calcium are often very interesting (fruits, vegetables and whole grains). It is considered that it is better to focus on what increases iron absorption rather than what decreases it. However, it is suggested that calcium supplements be taken at bedtime if necessary. By avoiding them during meals, iron absorption is significantly increased.

Alcohol

Chronic alcoholism can, like malnutrition, hinder the proper assimilation of vitamins B9, B12 and iron. It is very important to limit your alcohol consumption to 3 glasses per day for men and 2 glasses per day for women.

Drugs that reduce gastric acidity

To be well absorbed, iron needs the hydrochloric acid produced by the stomach. Drugs that reduce gastric acidity can interfere with iron absorption. However, antacids based on aluminum or magnesium hydroxide do not have this effect. They are to be preferred.

Other foods not recommended:

• Industrial foodstuffs
• Refined cereals

Practical daily tips for integrating more anti-anemia foods

Here are some tips on how to include more iron-rich foods in your diet:

• Replace white sugar with natural sugars in your recipes: honey, molasses, agave syrup, etc.
• In cooking, replace butter with vegetable oils: sesame, sunflower or almond
• Vary the sources of animal protein: beef, horse, offal, etc.
• Add spinach shoots to salads, soups and vegetable stir-fries
• Choose organic potatoes and eat the skin
• Finish your meals with a fruit rich in vitamin C: orange, kiwi, strawberry, etc.
• Include lentils in your vegetable soups and salads
• Learn to appreciate the liver
• Replace conventional starchy foods with quinoa and wholemeal products
• As an aperitif or as a starter, think of tomato juice
• Choose muesli-type cereals because they contain fibre, dried fruit and oilseeds
• Add nuts, almonds and pumpkin seeds to your dishes (yoghurts, soups, salads, etc.)

Treating anemia: To go further…..

The different forms of iron

Iron is absorbed in the intestine, more precisely in the duodenum and jejunum. The rate of iron absorption is strongly influenced by two factors: the shape of the iron and the quality of the individual’s iron reserves.

There are two forms of iron:

• Heme iron contained in products of animal origin such as meat, poultry, fish and offal. Its absorption rate is much higher than that of non-heme iron, it is 20 to 30%. Only 10 to 15% of our total iron intake comes from this category.
• Non-haem iron is the only form of iron found in plant foods, dairy products and eggs. Its absorption rate is less than 5% but 85% of our iron intake comes from this category.

Change in iron requirements

The people with the greatest need for iron are women of childbearing age, adolescents and non-breastfed babies. Similarly, people who engage in intense and regular physical activity and patients on dialysis are at increased risk of anemia.

The daily iron requirements for adult women are 16mg, 14mg for adolescents compared to 9mg for men

In children, a high iron intake is essential to avoid anemia. A baby under one year of age has a higher iron requirement than an adult male. Indeed, infants between 7 months and 1 year old need 11mg of iron per day. There is no need to worry if you are breastfeeding, breastmilk contains enough iron. If not, it is important to choose iron-fortified breastmilk substitutes up to 1 year of age.

For more details on the recommended intake, consult our special iron sheet.

Iron-rich foods: The importance of reading labels

On food packaging, labelling includes nutritional information in tabular form. Although it is not mandatory, you can find in this table some information about iron.

The iron content of a food is often indicated as a percentage of the recommended daily intake. For example, if the table shows 30%, it means that a portion of the food in question provides 30% of the amount of iron needed to meet daily needs. This leaves 70% of the recommended iron intake to be found in other foods. On the other hand, this percentage applies to the population on average. For a pregnant woman, for example, this is not appropriate, much more iron will be needed to cover the needs.

To treat anemia: supplementation

In addition to nutritional recommendations, an iron supplement in the form of ferrous sulphate may be recommended for the treatment of iron deficiency anemia. A vitamin C supplement can also be started in parallel, to increase the absorption capacity of iron. Be careful, however, before you supplement with iron, ask your doctor for advice: excessive consumption can be harmful to your health or even fatal in young children.

B9 deficiency anemia can also be treated with a supplement administered as folic acid in addition to dietary hygiene measures.

Finally, in case of anemia due to vitamin B12 deficiency, several possibilities are possible. Only vitamin B12 deficiency due to lack of intake is treatable by diet. In other cases (malabsorption, significant losses, etc.), it is essential to use food supplements or vitamin B12 injections.

Check the list of the best sources of vitamin B12 to know the exact amount of vitamin B12 in foods.

Check the list of the best sources of folate to know the exact amount of vitamin B9 in foods.