Iron is a crucial mineral at every stage of life, and its demand increases significantly during pregnancy. Although it is present in various foods, the rate of absorption differs widely. Both excessive and insufficient iron intake can cause issues, so it is advisable to check iron levels before starting any supplements.
Why is Having Iron in Your Diet Important?
Iron is a vital mineral that plays a key role in metabolism, cell growth, function, and development. It is a major component of hemoglobin, a protein in red blood cells that transports oxygen from the lungs to muscles and other tissues. Iron is naturally found in many foods, fortified in some, and also available as a supplement.
During pregnancy, iron is crucial for the growth of the placenta and the developing brain of the baby. As blood volume increases by 50% in the second and third trimesters, so does the need for iron. In the US, 18% of pregnant women are iron deficient, and this percentage rises to nearly 30% in the third trimester. Iron deficiency is linked to anemia in both mother and baby, preterm birth, and low birth weight. However, excessive iron can also be detrimental.
How Much Iron do I Need?
The National Academy of Medicine (NAM) recommends the following dietary allowances (RDA) for iron:
- Women above 19 years: 18 mg
- Pregnant women of all ages: 27 mg
- Lactating women above 19 years: 9 mg
NAM notes that due to lower bioavailability of iron in vegan and vegetarian diets, the recommended intakes are 1.8 times higher, resulting in the following adjusted RDAs for vegans:
- Vegan women above 19 years: 32.4 mg
- Vegan pregnant women of all ages: 48.6 mg
- Lactating vegan women above 19 years: 16.2 mg
The iron intake recommended for lactating women is the same as for men because most iron loss occurs through menstruation. It is surprising to assume that women do not menstruate while breastfeeding, as many actually do. Once menstruation resumes after childbirth, regardless of breastfeeding status, iron requirements increase.
The maximum intake level (UL) for everyone above 14 years is 45 mg per day. Excessive iron can hinder the absorption of other essential minerals and is associated with gastrointestinal distress, vomiting, and toxicity.
Interestingly, the risk of toxicity from excessive iron is only associated with animal sources of iron, not plant sources. This is because our bodies can regulate the absorption of nonheme iron and eliminate excess amounts, which is not the case for heme iron. This highlights the remarkable balance our bodies have with plants!
Can I Get Enough Iron From Vegan Food?
Plant-based diets are often higher in iron content than diets containing animal products. However, vegans should be aware that iron absorption from plant-based foods is lower than from animal sources. Nonetheless, adequate levels can be attained from food alone.
Foods with the highest iron content include:
- Legumes: soybeans, lentils, chickpeas
- Leafy greens: spinach, chard, kale
- Seeds: hemp seeds, pumpkin seeds, flax seeds
- Tomato products: sun-dried tomatoes, tomato paste
- Grains: oats, spelt, buckwheat
- Potatoes with skin
Iron occurs naturally in two forms: heme and nonheme iron. Plants contain only nonheme iron, while animals have both types. Fortified foods usually contain the nonheme form. The absorption of nonheme iron is greatly influenced by its solubility and interaction with other nutrients.
To enhance bioavailability, consume iron-rich foods with vitamin C-rich foods like oranges, strawberries, bell peppers, tomatoes, and broccoli. Additionally, soaking, fermenting, and germinating foods like beans and grains increases iron bioavailability.
A perfect vegan meal rich in iron, vitamin C, protein, and fiber is rolled oats made with soymilk, hemp seeds, and raspberries. This simple meal provides nearly 8 mg of iron, 42% of your daily vitamin C, 27 g of protein, and 85% of your daily fiber needs. It is an excellent way to start the day.
Heme or Nonheme Iron: Which Is Better?
At first glance, heme iron from animals seems superior due to its higher bioavailability (15-35% compared to 1-34% for nonheme iron). However, iron absorption from plant foods can be equivalent to that from animal foods when combined with vitamin C or pre-soaked before cooking.
Moreover, researchers have raised concerns about the association between heme iron and strokes, type 2 diabetes, and certain cancers. More information on this can be found in Dr. Michael Greger’s analysis on NutritionFacts.org.
Although heme iron from animals is more bioavailable, nonheme iron from plants is safer.
Do I Need to Take Iron Supplements?
Iron supplementation during pregnancy is likely necessary, considering the increased RDAs for vegans.
Despite plant-based diets being rich in iron, research indicates that vegans tend to have lower serum levels. This is not much different from the general population, as iron deficiency is the most common nutrient deficiency worldwide. Therefore, it is advisable to check iron levels regularly and only supplement if necessary.
If you are pregnant and iron deficient, follow your healthcare provider’s recommendations to increase your levels. Supplementation will likely be advised, and your blood levels will be monitored.
If your iron stores are healthy, there is no need or benefit to supplementing.
Choosing a Vegan Iron Supplement
Most supplements contain the plant-derived nonheme form of iron. Generally, supplements are safe unless they specifically state they contain heme iron (also referred to as iron polypeptides or iron amino-acid chelates).
Some supplements claim to be “gentle on the stomach,” but you may need to try several brands to find one that suits you. Also, your multivitamin or prenatal supplement may already contain iron.
There are many vegan iron supplement options available. My personal favorite is Floradix Iron & Herbs. It is a liquid supplement, making it easy to measure and adjust the dosage. Years ago, when I had a deficiency (before becoming vegan), I tried different tablets, but my iron levels did not significantly increase until I switched to Floradix. I also took this supplement during my pregnancy, in addition to a prenatal supplement containing iron.
Summary
- Vegans may need to supplement with iron during pregnancy, but it is recommended to check levels first.
- Enhance iron bioavailability in plant foods by soaking them or consuming them with vitamin C-rich foods.
- If supplementing, choose a nonheme (plant-derived) form of iron.