NUTRITION HOTLINE
By Reed Mangels, PhD, RD
QUESTION: I am 32 weeks pregnant and was told that I am mildly anemic. I try to choose vegan foods high in iron but am not taking an iron supplement. The dietitian told me that it would be better for me to eat red meat than to take an iron supplement because I'd absorb more iron from the meat. Yikes! I've been vegan for years and don't want to eat meat, but I don't want to hurt my baby.
MW, via email
ANSWER: While your dietitian is correct to encourage you to increase your iron intake, it's not necessary to start eating meat.
One form of iron in meat, heme iron, is better absorbed than the form of iron in plant foods, non-heme iron. Supplements contain non-heme iron, but it is easily absorbed since it's not affected by substances like phytate that interfere with iron absorption from plant foods. That's why you may want to discuss the use of a low-dose iron supplement with your healthcare provider.
The absolute amount of iron absorbed is the most important consideration. A 4-ounce portion of broiled steak has 4 milligrams of iron, about 10% - 15% of which are absorbed meaning one would absorb 0.4 - 0.6 milligrams of iron. The same percentage of iron is expected to be absorbed from a 30-milligram iron supplement,1 which would result in 3-4.5 milligrams of iron absorbed. Clearly, the supplement would supply the most iron. So, there's no need to stop being vegan to meet your iron needs. It can be challenging for anyone to meet the high iron needs of pregnancy from diet alone.
You can boost iron absorption from a supplement by being sure to take it along with a vitamin C source like orange slices, by not drinking tea with the supplement, and by avoiding taking it at the same time as you take a calcium supplement.
It is important to get enough iron in pregnancy since iron is needed for the baby's blood, to insure the baby has good amounts of stored iron to meet needs after birth, and for brain development.
You're not alone in your iron deficiency — it's a relatively common issue in pregnancy with about 16% of pregnant women having iron deficiency overall.2 The Centers for Disease Control and Prevention (CDC) recommends taking 30 milligrams per day of supplemental iron.3
REFERENCES
1 Means RT. Iron deficiency and iron deficiency anemia: implications and impact in pregnancy, fetal development, and early childhood parameters. Nutrients. 2020;12(2).
2 Gupta PM, Hamner HC, Suchdev PS, Flores-Ayala R, Mei Z. Iron status of toddlers, nonpregnant females, and pregnant females in the United States. Am J Clin Nutr. 2017 106:1640S-1646S.
3 Recommendations to prevent and control iron deficiency in the United States. Centers for Disease Control and Prevention. MMWR Recomm Rep. 1998;47:1-29.
