Iron deficiency is the most common deficiency in the United States and worldwide. Approximately 10% of Americans and 30% of the world’s population have iron deficiency anemia. Although anyone can be diagnosed with iron deficiency, certain populations are at a higher risk.
Symptoms of iron deficiency include fatigue (despite adequate sleep), poor temperature regulation, decreased appetite, and pale skin. Side effects as a result of iron deficiency anemia include low attention span, impaired concentration, and low immune response, resulting in opportunistic infections and illness.
1. Women of Childbearing Age:
Females have increased blood losses each month, making them at higher risk for low serum iron levels, particularly if periods are extremely heavy or long in duration.
2. Infants, Children, and Adolescents:
Infants, children, and adolescents are at increased risk for iron deficiency due to rapid growth and expansion of blood volume during these life stages. Infancy is the fastest period of growth, occurring from birth to 1 year of age; during this time, a full-term infant typically triples their birth weight by their first birthday. The American Academy of Pediatrics recommends screening infants for iron deficiency between 9 and 12 months of age, as iron deficiency can lead to growth and developmental delays and a weakened immune system. Infants at the highest risk include those who are breastfed without iron-fortified cereal or other age-appropriate iron-rich foods.
Growth in children continues at a steady rate, and the blood supply increases as well. Children should be monitored to ensure iron needs are adequately met. Like infancy, adolescence represents another period of high growth and expanding blood supply. In addition, females have the onset of their period, which increases their iron needs even more.
Interestingly, the USDA School Lunch and Breakfast Programs are in place to minimize iron deficiency in at-risk populations. Adequate iron intake has been shown to improve attention span, concentration, and learning ability. This is why parents often receive a friendly reminder encouraging breakfast during standardized testing periods, and some schools often offer free breakfast to all students. Check with your school for more information on how to sign up for subsidized breakfast or lunch.
3. Pregnancy:
During pregnancy, women also have another period of rapidly increasing blood supply. Not only does the increase in blood volume affect the iron status of the expectant mother, but it also affects the iron stores of the growing fetus. Babies born with low hemoglobin levels can be less alert and may have trouble breathing after birth. Iron stores are best maintained during pregnancy by choosing a diet rich in iron and vitamin C, in addition to taking prescribed prenatal vitamins.
4. Athletes:
Iron depletion is relatively common among athletes, affecting an estimated 30–50%, particularly female athletes and those participating in endurance sports. Decreased exercise performance can occur even without anemia, as low iron levels may impair muscle function and reduce endurance.
Consuming vitamin C-rich foods in the presence of iron-rich foods (particularly meat sources) will help increase the absorption of the iron. An example of a meal might be to have a steak (a great source of heme iron) with broccoli (an excellent source of Vitamin C).
Calcium and antacids can reduce iron absorption; therefore, they should be taken at opposite times to prevent decreased iron absorption. If iron deficiency persists, iron supplementation should be considered. Taking supplements with animal sources of iron and consuming vitamin C-rich foods, such as citrus fruits and fresh vegetables, will also enhance iron absorption.
If you are in a high-risk group, you should consider asking your health care provider to check your iron status at your annual exam. Iron deficiency is easily prevented and treated and can have a great impact on your health, physical performance, and cognitive ability.
| Iron is found in a variety of foods, including: | Vitamin C is found in a variety of foods, including: |
| Oysters | Oranges |
| Liver | Bell Peppers |
| Lean red meats | Potatoes |
| Iron fortified cereals | Strawberries |
| Peanuts | Pineapple |
| Almonds | Brussel Sprouts |
| Barley | Kiwi |
Article written by Registered Dietitian Leslie Goudarzi, MS, RD, LD, CNSC
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