Recent reviews published in Lancet Hematology by Dr. Ashley Benson and Dr. Jamie Law at Oregon Health and Science University reveal that iron deficiency impacts nearly one in three women, making it the most prevalent nutritional deficiency globally.

This deficiency is crucial for energy production, brain development, and maintaining a robust immune system.

According to the World Health Organization, anemia affects 31% of women of reproductive age, 36% of pregnant women, and 40% of children under 5.

Inflammation can interfere with iron absorption, stemming from acute diseases or chronic conditions such as obesity. With rising global obesity and chronic disease rates, this creates additional challenges in tackling iron deficiency worldwide.

Iron Deficiency

Iron deficiency can lead to anemia, as iron is vital for red blood cell production. Anemia is characterized by low hemoglobin levels, the protein that gives blood its red color and transports oxygen.

The World Health Organization reports that anemia affects 31% of adult women of reproductive age, 36% of pregnant women, and 40% of children under 5 years old. Approximately half of all global anemia cases result from iron deficiency. Common symptoms include pale skin, fatigue, shortness of breath, and irregular heartbeat (known as palpitations).

Iron deficiency poses serious health risks, especially when it causes anemia, including a weakened immune system, complications during pregnancy and childbirth, maternal and infant mortality, and delayed growth and brain development in children.

The repercussions of iron deficiency are particularly severe for women and children, who are the most susceptible.

Menstruating women have a heightened need for iron due to monthly blood loss. Pregnant women require extra iron for the placenta, fetus, and increased blood volume. Children need iron for rapid growth and brain development, making adolescent girls—who are both growing and menstruating—especially vulnerable.

In their study, Benson and Law convened a panel of 26 experts alongside four patient representatives. Their collective recommendations advocate for a more positive and inclusive strategy for managing iron deficiency, particularly for at-risk populations.

The panel stressed the importance of regular screening during pregnancy and early childhood. They emphasized utilizing ferritin, a blood protein indicating liver iron storage, as a reliable marker for diagnosing iron deficiency and determining intervention timing.

If treatment is necessary, oral iron supplements are the first recommendation. They are effective, widely accessible, and cost-effective. For those experiencing side effects like nausea and constipation, the panel suggested taking supplements on alternate days to enhance tolerability. In more severe instances, or if oral iron proves ineffective, intravenous iron may be needed.

Lastly, the panel asserted that iron deficiency should not be viewed as an isolated issue, but rather part of the routine care for mothers and children, including pregnancy tests, child health visits, and nutrition programs.

Iron Advice

While some individuals may need treatments for iron deficiency, many cases can be prevented through daily dietary choices.

Begin by adding more iron-rich foods to your meals, such as pulses, legumes, green leafy vegetables, nuts, and iron-fortified cereals (opt for lower sugar options for kids and adolescents).

For those consuming animal products, limit intake to moderate amounts of lean meat—about 70g (2.5oz) per day, as recommended by the UK Eatwell Guide—which can provide easily absorbable iron.

If you primarily follow a plant-based diet, consider pairing iron-rich foods with vitamin C sources like lemon juice, tomatoes, and strawberries to enhance iron absorption.

Avoid drinking tea or coffee during meals as polyphenols can hinder iron absorption; this applies to taking iron supplements as well. Consuming them with a vitamin C source, such as orange juice, can significantly improve absorption.

If you belong to a higher-risk group—such as menstruating individuals or caregivers of young children—or if you experience excessive fatigue, consult your doctor. A simple blood test can evaluate your iron levels. In children, iron deficiency may also manifest as unusual cravings, such as for ice or non-food items.

Iron deficiency is prevalent but manageable and often preventable. With awareness and mindful choices, maintaining healthy iron levels can be as straightforward as selecting what goes on your plate.

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