Anyone can become at risk of iron deficiency, however, athletes are at a higher risk for iron deficiency, particularly female athletes due to blood loss during the menstrual cycle. As iron is a mineral that transports oxygen around the body for use, athletes have a higher requirement for iron while undertaking aerobic activity. Unfortunately, many aspects of intense exercise and training can make it harder to maintain sufficient iron levels.
Males require about 8mg of iron a day - this is relatively achievable, however, male athletes can still be at risk. Females, who have a regular menstrual cycle require 18mg/day. This is pretty challenging. No celebrations are needed however for a missing period – you may lose less blood, but you increase your risk of many other short and long-term health consequences if you stop having a regular menstrual cycle. If overtraining and/or undereating is the cause of your missed period, you will probably still have issues with low iron as well.
Oh, and if you're vegetarian, the recommendation is to aim for 27mg of iron due to plant-based iron (non-haem) being less bioavailable and harder to absorb!
Eating enough food in general is the number one factor for having adequate iron levels - you need to be eating enough food to get enough iron. It can be very very hard to get 18g of iron a day if you are, consuming say, under 2000 calories - you need an incredibly well-planned diet with large proportions of iron-rich foods and fortified foods. I think the lowest calorie plan I have made that ticked all micronutrient boxes including iron for a female was 1500 calories - and the foods were a bit weird. Outside of not being able to really get enough iron into a low-calorie diet, having inadequate calories and carbs has been shown to increase stress on the body and increase inflammation markers such as the hormone hepcidin, which further inhibits iron absorption. A recent study concluded that ‘three consecutive days of an energy‐deficient diet increased fasting hepcidin levels, and elevated hepcidin levels were further augmented when an energy‐deficient diet was combined with a lower carbohydrate intake’. (PMID: 35785528)
Iron Rich foods to include
Haem Iron
Animal-based foods high in haem Iron that is best absorbed by the body:
Mussels and Oysters are incredibly high in iron
All red meats, such as beef, lamb, kangaroo
Fish and seafood, especially salmon
Poultry, such as chicken and turkey
Non-Haem Iron
Plant foods containing non-haem iron can still provide an adequate amount of iron for the body. Plants can have a lot of iron but it is not as well absorbed. With proper planning, it can still provide an adequate amount of iron for the body. The bioavailability of iron is approximately 14% to 18% from mixed diets that include substantial amounts of meat, seafood, and vitamin C (ascorbic acid, which enhances the bioavailability of nonheme iron) and 5% to 12% from vegetarian diets.
Legumes (such as lentils, beans and chickpeas)
Firm tofu and tempeh
Pumpkin seeds (pepitas) and sunflower seeds
Nuts, especially cashews and almonds
Wholegrain cereals such as oats or muesli, wholemeal bread, brown rice, amaranth, pearl barley and quinoa
Burgen Bread Soy & Linseed bread contains half a milligram more iron per slice than regular whole grain breads and whole grain bread contains more iron than white bread
Vegetables such as kale, broccoli, spinach and green peas
Dried fruits, particularly dried apricots and sun-dried tomatoes
Nutritional yeast
Also, Eggs are suitable on a vegetarian diet and a good source of iron
Fortified Foods
Woolworths Great Start Reduced Sugar Multigrain Cereal
Milo is fortified with iron so choose this in place of hot chocolate or other warm drinks if you are having one; this is true for the plant-based Milo as well
Weetbix
Other Factors for Consideration
Exercise itself also increase levels of the hormone hepcidin, which inhibits the absorption of iron. If you are someone who trains every day and/or multiple times within a day, this can begin to make absorbing enough iron from food very hard, even if you are technically consuming enough.
Tea, coffee, and wine (particularly red) contain tannins that inhibit the absorption of iron.
Vitamin C, as well as other micronutrients such as vitamin A and copper, assist in the absorption of iron from food. Having a well-balanced diet is important.
Practical Meal Examples
Including animal-based iron sources in meals with plant-based based iron sources will increase the absorption of non-haem iron.
Make homemade pizzas for lunch and top with chicken, spinach, sun-dried tomatoes, capsicum and then any other veggies of your choice.
Make sandwiches with Soy & Linseed bread.
Incorporate fish in your diet 2-3 times each week.
Make main dishes and curries with plenty of lentils and wholegrains and season with garlic, pepper and nutritional yeast.
Avoid having tea, coffee or milk as a drink alongside meals, have a glass of freshly squeezed orange juice or have some blackcurrant juice.
Make a trail mix for a snack with dried apricots, pumpkin seeds (pepitas), sunflower seeds, cashews and almonds, and some dark chocolate.
Include red meat once a week, such as beef mince, and bulk up the meal with extra legumes like black beans or kidney beans.
The above information may be quite overwhelming, and there can be even more to it all as well. As a sports dietitian, improving the iron intake of athletes is a high-interest area of mine, so if you are struggling with your iron levels, reach out for assistance. It is always advisable to consult with your doctor and dietitian to assess your blood levels, establish root causes and assess dietary intake prior to beginning any iron supplementation. If supplementation is required, we can then assist with the correct type, dose, and when to take it :)
Subscribe to Live Active, Be Healthy, where each week we explore the importance of healthy lifestyle choices and how to make them a lasting part of your daily routine.
Comments