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Children 10–18 years

Iron makes us happy- are you getting enough?

Iron is important for happiness because without it our moods change and physical performance deteriorates.

If you have been feeling a bit ‘below par’ lately you could be needing more.

Iron’s main function as part of the haemoglobin in red blood cells is to carry oxygen into the brain and muscle cells, keeping us active and alert. Iron helps us to maintain a healthy immune system and to fight infection.

Symptoms of iron deficiency

As blood reaches every area of our body it is not surprising that a lack of iron affects our health and many body functions. Here are a few typical symptoms of those who are iron deficient:

  • Feeling tired, grumpy and lethargic
  • Tense and apathetic
  • Feeling cold
  • Developmental delays and learning deficits
  • Inability to concentrate and poor memory
  • Failing physical performance
  • Impaired immunity and frequent infections
  • Loss of appetite
  • Broken, flakey nails
  • Hair loss and dry skin

Typical scenarios

These are some examples of falling iron status:

  • John is 17 years old and his mum complains that like many teenagers he never wants to get out of bed in the mornings. But that’s not because he is on the computer all night like some of his friends. He is sleeping for 10-12 hours yet he still wakes up exhausted in the morning.
  • Kerry is 4 years old and often falls asleep at play centre. When she is playing e.g. trying to concentrate on fitting blocks or puzzles together she quickly becomes very frustrated , throwing her toys and bursting into tears
  • Tom is 7 years old and he has difficulty learning. His memory is poor and he has trouble with discrimination and concept learning
  • Pat is 60 years old and is noticing her short-term memory is failing. Pat finds it increasingly hard to remember people’s names, often loses things like money and her car keys and “just feels flat” a lot of the time
  • Katherine is 15 years old and a swimmer who despite increased levels of training is failing to improve her personal best times.

Iron deficiency is more common than you think

In New Zealand, nutrition surveys have found:

  • One in 14 adult women over 15 years
  • A third of teenage girls 15-18 years are iron deficient.
  • Eight out of ten toddlers are not consuming their daily iron requirements
  • Fourteen per cent of children under 2 years are iron deficient

Groups most at risk

Some groups of our population are more at risk than others.

Pregnant women, infants and young children

Iron is necessary during periods of rapid growth and so is essential for infants, children and pregnant women. Iron supplements are no longer given routinely during pregnancy because needs vary and side effects of constipation can occur. Doctors tend to check iron stores at the beginning of pregnancy and again at 28 weeks and only supplement if there is a downward trend in iron status.

Adolescent young women, particularly athletes

Young menstruating girls, particularly if they are weight conscious, vegetarian, gluten intolerant or involved in heavy athletic activities. These factors can combine to deplete stores at a time when academic and physical achievement is crucial.

The elderly

Especially those who live alone, suffer from ill-fitting dentures or a dry mouth which can make it difficult to chew and swallow iron rich foods such as meat.

How much iron do we need?

As you will notice in the following table the daily requirements for iron are high during periods of rapid growth and also for women during their menstruating years.

The recommended intakes of iron according to age group

Age Iron RDA (mgs/day)
0-6mths 0.2
7-12mths 7
1-3yrs 9
4-8yrs 10
9-13yrs 8
Boy 14-18 yrs 11
Girls 14-18yrs 15
Adult men 8
Women 19-50yrs 18
Pregnant Women 27
Adults   >51yrs 8

Good food sources

Iron in food is found in two forms, haem and non-haem iron. Haem iron is derived from the haemoglobin and myoglobin found in animal tissue. While  non-haem iron is mainly found in plant foods such as fruits, vegetables, legumes and cereals.

As the interest in sustainable land use grows, people are looking at ways to reduce their meat intake.Many people also cut back on meat in the belief that it increases body weight, cholesterol and saturated fat intake.

While portion control is always essential to these types of issues, as you will see from the information below, trying to maintain a diet without meat can be quite a challenge so talk to us if you need some practical help.

 

The iron content of basic foods

Haem   sources Amount Iron (mgs)
Lamb kidney 100g 14.7
Mussels 100g 6.9
Lambs fry/liver 100g 10
Beef lean 100g 3
Lamb lean 100g 2.5
Pork lean 100g 2
Chicken lean 100g 1.9
Non-Haem
Chickpeas 1cup 3.1
Fortified
Breakfast cereal 30-40g 3
Rolled oats 1/3 cup 2.1
Baked beans 210g 2
Fortified   bread 1 slice 1
Egg 1 1.1
Peas 1/2 cup 1.2
Silverbeet 1/2 cup 0.2
Spinach 1/2 cup 0.6
Raisins 2 Tbsp 0.2

Ref Foodworks 2015

Iron absorption

Haem iron is well absorbed at around 25-30% for red meat (9-11% for fish and poultry) compared to non-haem iron around 3-5%. So although most of the iron we eat is from non-haem iron rich foods we actually obtain around 80% of our iron from haem iron because it has a higher absorption rate.

Interestingly if a person is low in iron stores they will absorb more iron from all food sources.

Iron absorption can either be enhanced or inhibited depending on the presence of other foods in the diet.

Iron enhancers

  • Vitamin C enhances iron absorption so remember to have fresh fruit or a salad alongside your meat for dinner

Iron inhibitors

  • Tannins in tea and red wine
  • Phytates in whole grains reduces iron absorption.
    So it is wise to keep these foods and fluids separate from the main meal and not to follow-up a main meat meal with a bowl of muesli or other whole grains that can slow iron absorption.Note: the phytate content of some foods e.g. beans can be reduced if these foods are soaked overnight in water which is disgarded before cooking.

Iron supplementation

  • If you are iron deficient your doctor will recommend supplementation for a month or so and it is important to remember to take this medication.
  • In extreme cases iron injections can also be given intramuscularly
  • For babies iron can be administered in a droplet form as directed by your doctor
  • If women are considering starting a family they are advised to check their iron status with their doctor first.
  • Coaches of developing athletes should discuss the iron status of their teams with their sports physician and sports dietitian as low iron levels can greatly impact on team performance

Act Now !

It’s hard to be happy if you are always tired.

If you are unsure about your iron status then talk to your doctor who may arrange a blood test of your iron stores. You can also contact us for a full nutritional assessment of your iron intake and needs.

For more specific information on iron and references read some of Lea’s following articles:

Brain foods

Dietary help for depressed athletes

Vegetarians face extra hurdles

Healthy meals for one

Don’t let eating disorders ruin your performance

Sports nutrition for senior athletes

Diet can offer protection when cold conditions threaten sporting performance 

Eat your way to healthier nails and hair

Children’s growth rate varies

References 

University of Otago and Ministry of Health. (2011). A Focus on Nutrition: Key findings of the 2008/09 New Zealand Adult Nutrition Survey. Wellington: Ministry of Health.

Wall, CR et al. (2008). Ethnic variance in iron status: is it related to dietary intake?Public Health Nutr 12 (9):1413-1421.

Grant, CC et al. (2007). Population prevalence and risk factors for iron deficiency in Auckland, New Zealand.J Paediatr Child Health 43: 532-538.

Iron Awareness week http://www.ironweek.co.nz/Iron

About the author View all

Lea Stening

Lea is one of New Zealand’s leading paediatric dietitians and also specialises in Sports Nutrition. She has specialised in Paediatric Nutrition for 31 years and in 1985 was the first paediatric dietitian to enter private practice in New Zealand. Lea helps families through her private consultations, public lectures, newspaper and magazine articles as well as television and radio interviews. Read more »

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