Meatless Diets, Iron-Deficiency and the Gender Divide

What’s The Deal with Heme Iron Anyway?
Jennifer Lutz for True Health Initiative
Let’s begin by busting some myths and getting real about some facts. Myth 1: You need meat to beat anemia and iron deficiency. Nobody needs to eat meat to avoid iron deficiency and anemia. However, you do need to eat more plants than meat and be more conscientious of food pairings to meet your iron requirements. Myth 2: Vegans and Vegetarians are NOT at Increased risk of iron deficiency and anemia. Sorry, but unfortunately, science disagrees and biology is gender discriminatory. In the vast majority of studies, female vegans and vegetarians have a higher prevalence of iron deficiency and anemia than both their meat-eating counter parts and male vegans and vegetarians.

Some Fundamental Facts: 

Fact: There are two forms of iron, heme iron (the kind you can only get from animal sources) and non-heme iron, which you can get from a variety of plant sources. The big difference is that heme iron is more readily absorbed by the body, meaning you need to eat a lot more plants than steaks to fulfill the body’s iron needs. The recommended iron intake for vegetarians and vegans is 1.8 times higher than for meat eaters. 

Fact: Plants have a variety of health benefits; eating a lot of them is generally health promoting.  What you eat and when you eat it, can play a part in iron absorption. Some nutrients can increase absorption of non-heme iron, while others can inhibit it. 

How to Eat for Maximal Iron Absorption:  Plants are pretty great. Plant-based diets have been linked to lower incidences of cardiovascular disease, cancer, obesity, and all-cause mortality. However, for those eating only plants, there are a few extra factors to consider re: iron absorption. 

Some nutrients can inhibit non-heme iron absorption. Phyates, oxalates, and polyphenols can all inhibit iron absorption.  All three offer a host of health benefits as well. Phytic acid is found predominantly in beans and grains, nuts and seeds and is a powerful antioxidant.  Dark leafy greens like spinach, kale and Swiss chard are a primary source of oxalic acid.  Your gut health helps determine how well your body can breakdown and absorb oxalates, so remember to keep a healthy and diverse gut biome.  Dark chocolate, red wine, and berries are some of the best sources of polyphenols, which have been connected to improved heart health, brain health, and lowered incidence of type 2 diabetes.

Some nutrients can increase non-heme iron absorption.  Ascorbic acid, otherwise known as vitamin C can significantly increase iron absorption.  More good news: foods high in vitamin C, tend to be super health promoting. Oranges, strawberries, spinach, broccoli, sweet potatoes and tomatoes are all high in vitamin C. Beta-carotene rich foods – yellow to red fruits and vegetables- may decrease the inhibitory effects of tannins and phyates. A colorful plate filled with whole foods, is usually a simply way to balance out your diet.

The Gender Divide: Women-especially those of the menstruating age, are more prone to both iron deficiency and anemia than men. We also have a greater tendency towards calorically restrictive diets, which can can increase the prevalence of deficiencies. In reviews of the current literature, vegan and vegetarian women almost always showed a greater occurrence of iron deficiency and full blow anemia than women with omnivorous diets. While male vegans and vegetarians sometimes showed higher rates of iron deficiency, there was often little difference between them and their ‘steak and potato’ friends. 

The Bottom Line: Vegans and vegetarians may not have the same cardiovascular concerns as their carnivorous counterparts, but they do need to take care to meet their iron requirements, intaking 1.8 times the iron of meat eaters. Vitamin C rich foods can increase iron and are part of a healthy diet. Fruits and vegetables with yellow to red hues may decrease the inhibitory effects of some plants, as well as teas and coffee, high in tannins.  We each have different dietary preferences, needs and beliefs.  There are many ways to eat within the fundamental structure of a healthful diet- be mindful or what you may need a little less of and a little more of, and always remember to enjoy.