I came across an article published not too long ago in The Sun that had a really scary title:

“HEALTHY EATERS WARNED Women being put at risk of anaemia by following health advice to eat less red meat”

And then right under that, still in big bold letters:

“MILLIONS of women are being put at risk of anaemia as a result of healthy eating advice encouraging them to eat less red meat.”

Taken at face value, I imagine this must be quite scary for a lot of women, who might sit and wonder just how much red meat they’re meant to be eating while other health advice tells them to lower their intake to prevent bowel cancer. Strong scientific evidence exists about consumption of red meat (beef, pork, lamb, goat) and processed meat (cured, smoked, or preserved by chemical additives) to be a risk factor for bowel cancer.

The Scientific Advisory Committee on Nutrition (SACN) published a report in 2010 discussing this issue: whether health advice about reduction in the population meat intake to lower the risk of colorectal cancer would come at the expense of iron. The highlights from the report are (a) reducing meat intake would not decrease iron intakes significantly, (b) these estimates are also likely to be higher than real-life decrease in iron intake because they do not account for substituting red meat with other foods that may contain iron and (c) reducing red meat consumption would have a larger impact on zinc intakes compared to iron. The take-home message from the SACN report is this: reducing the meat intake of the general adult population to 70g per day would have a negligible on iron intakes and the risk of developing IDA.

Keeping that in mind, the recommendation of the UK Department of Health is to limit red meat intake to 70g per day; nothing is mentioned about reducing it to lower than 70g per day or cutting it out of the diet completely. This also does not mean that you must eat 70g of red meat every day; it only means that if your usual diet contains red meat all 7 days of the week, keep your intake at 70g or less per day. Reducing or cutting out red meat only comes at the cost of decreased iron intake if it substituted with iron-poor foods, which, if the public is well-informed about, should typically not be happening. There are plenty other animal-based and plant-based sources to get your daily iron needs besides red meat, I assure you. So the the claims made by the Sun article are inaccurate because the public confusion about ‘following health advice to eat less red meat’ is actually because the public is getting only half of that health advice. When experts recommend eating less meat, they only mean that any amounts in excess of 70g need to be cut out of the diet. And cutting out red meat alone certainly does not mean decreased iron intake if it is substituted with other iron-rich foods.

Sure, people with poor iron intake who aren’t very health-aware or who aren’t mindful of their nutrition are at a bigger risk for iron-deficiency anaemia if they do not eat red meat, but this also applies to all other iron-rich food, whether animal-based or plant-based. So to me, this sounds like a call for better education about the matter rather than a call to eat more red meat!

The Sun article does more harm than good in my opinion. Women have probably been panicking about their iron intakes after reading it, because they now seem to have the impression that it is red meat and red meat alone that can provide them with iron, when this is absolutely not the case. There are certainly many other animal-based and plant-based sources that contain just as much iron as red meat. It is much better to simply provide useful information and health advice to the general population rather than scaring and confusing them further.

Now if you’re feeling a bit nervous about your own iron intake, don’t worry. Keep reading on to get a better idea about iron, iron-deficiency anaemia, and how you can boost your intake.

Why is iron important?

Our red blood cells (RBCs) are the responsible party for transporting oxygen in our entire body with the help of a protein molecule called haemoglobin, which is embedded on the RBC. Iron, which we obtain from our diets, forms an integral part of this molecule and is vital for the oxygen transport and exchange process with other cells in the body. So, to put it simply, insufficient iron intakes for a significant amount of time essentially hinder this exchange process, which as you can imagine, can have some serious consequences.

What is iron deficiency anaemia (IDA)?

 The word ‘anaemia’ refers to a deficiency in the size/number of RBCs in the body or how much haemoglobin they contain. There are several different types of anaemias (which are caused by other nutrient deficiencies such as folate or vitamin B12), but the one we are particularly interested in right now is iron-deficiency anaemia (IDA). This type of anaemia, as the name implies, results because of an iron deficiency and is characterised by smaller-than-average RBCs (microcytic) and lower concentration of haemoglobin (hypochromic). When dietary iron intake is low for a significant period of time, the body iron stores start to run out. At the point when there are symptoms of a deficiency, but the size of RBCs and their haemoglobin content are still normal, a person is classified as iron deficient. Anaemia, the last stage and most serious one, can be diagnosed through lab tests that detect the changes in the RBCs.  

 

Who is most at risk?

If there are no other underlying conditions (such as insufficient iron absorption or defective iron use by the body), IDA is probably because of decreased iron intake or an increased requirement. This is why childbearing-age women (15-49 years), children and adolescents are at an increased risk: because the iron needs for those individuals are higher as the blood volume grows to accommodate different body conditions such as growth for children or teenagers or pregnancy, lactation or menstrual period blood loss for women. For women of childbearing age, the Reference Nutrient Intake for iron 14.8 mg/day.

 What’s the IDA situation for women in the UK?

According to a report published by the World Health Organization in 2011, the UK figures for women are:

  • For non-pregnant women of childbearing age, the prevalence is 14.2%,
  • For pregnant women the prevalence is 23.1%,
  • And for all women of childbearing age the prevalence is 15.2%

What are the symptoms of iron deficiency or IDA?

Symptoms of IDA include general fatigue, poor muscle function, shortness of breath, poor immunity or heart palpitations. Less common symptoms, which may indicate a longer period of IDA, include spoon-shaped nails, smooth and waxy tongue appearance, loss of hair, pale skin, altered taste, stomach ulcers, or ulcers on the sides of the mouth. If you suspect you have IDA, make an appointment with your GP to discuss this; he or she will order some lab tests to determine if you have iron deficiency or IDA.

Can vegetarians or vegans be anaemic?

While it is true that in general, vegetarians and vegans are more prone to be iron deficient than meat-eaters, this is simply because of poor planning of the dietary intake or lower awareness about this issue. In well-planned diets, iron intakes are accurately calculated and appropriate for all age groups including children, teenagers, and childbearing age women and also for pregnancy or lactation conditions.

Which foods contain iron?

Firstly, if you are solely a non-red meat eater, you can eat several other animal foods to get some iron into your system. Great animal sources of iron include poultry meats, fish and other seafood. On the other hand, if you’re a vegetarian, vegan or other form of non-animal meat eater, good sources of iron include tofu, nuts, seeds, beans, peas, pulses, iron-fortified products (e.g. cereal or bread*), dark green leafy vegetables (including kale, spinach and watercress), dried fruits (apricots), edamame, and broccoli. And here’s a little fun fact: although we use spices such as turmeric, dried thyme, curry or ginger in very small amounts in cooking, they are among the highest sources of iron when measured gram for gram.

*Wheat flour (except wholemeal) is fortified in the UK.

 Can different foods affect iron absorption?

Iron from animal-based foods is typically more easily absorbed by our body. If you’re getting your iron from plant-based sources, it is a good idea to add some vitamin C to your meal as it helps make the iron more bio-available for absorption in your stomach. Examples of good sources of vitamin C that can complement your meal include lemon juice, orange juice or lemonade. There are also nutrients that decrease iron absorption such as phytates, polyphenols or calcium. Ideally, you would want to avoid dairy products, tea, coffee, or large amounts of dietary fibre when you’re eating an iron-rich meal to reap as much iron as possible.

What does 70g of red meat look like?

A good real-life approximation of 70g (2.5oz) of red meat would just a little bit smaller in size (but similar in thickness) as a regular deck of cards.