How to Roast Hen of the Woods Mushrooms
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When Life Hands you Anemia, Make Chili

Submitted by on December 6, 2009 – 10:02 am3 Comments

With about 5mg of iron per serving, this hearty vegetarian chili is far from an anemic entree.

Iron is a problem for lots of people.

While the average American man eats enough of it, most babies, children and pre-menopausal women do not.  And that’s not even including the vegetarianally-inclined.  Iron deficiency is the #1 nutritional deficiency in the world, and remains a problem even in over-nourished America.  Data from population surveys (1999-2000) show that toddlers and females aged 12-49 have the highest rates of iron deficiency in our country, with prevalence of  7% and 9-16%, respectively.

The majority of iron in our bodies exists as part of hemoglobin–the oxygen-transporting complex in red blood cells.  (A much smaller amount is used for other functions, such as DNA synthesis, the synthesis of neurotransmitters, immune function and the metabolism of food to create energy.)  Given these varied roles of iron, it makes sense that (1) people who lose more blood lose more iron, and (2) people who are growing (infants, children, pregnant women) will require more iron to manufacture more red blood cells, new DNA for each new cell in their growing bodies, and to promote brain development.  When someone has an insufficient number of red blood cells due to a lack of dietary iron, the condition is called Iron-Deficiency Anemia (though there are other types of anemia caused by non-iron factors as well).  Symptoms of anemia range from mild (fatigue, always feeling cold, rapid heart rate or palpitations) to severe (all of the above, plus atrophy of taste buds, sore tongue, sores at the corners of the mouth and spoon-shaped fingernails.)  Children with iron-deficiency anemia may experience retardation in cognitive and motor development that may be irreversible, irritability/attention deficit, stunted growth, and increased susceptibility to illness and lead poisoning.  Pregnant women with iron-deficiency anemia are more likely to miscarry and have low-birth weight babies.

Iron absorption and storage is a very tightly regulated process in our bodies; iron is efficiently recycled from old red blood cells that have been decommissioned, and used for the creation of 200 million new red blood cells per day.  On average, we only lose about 1.2mg of iron per day, which is approximately the amount that we absorb from our diets.  When we’re deficient, our body is able to absorb more.  When we’re awash in iron, our body is able to absorb less.  (Although large doses of supplemental iron can overwhelm our body’s natural feedback mechanisms, which is why it’s important to keep your iron supplements out of reach of children–iron overdose is the #1 cause of poisoning among children under 6 years old.)

Don’t let the Daily Values deceive you

Officially, the recommended daily value for iron is 18mg, which is the amount of dietary iron needed by adult women aged 19-50. (Though women who use birth control pills only require about 11mg per day due to an average of 60% less blood lost in their monthly periods.)  Adult men and women over age 50 require significantly less–only 8mg.  Pregnant women require 27mg/day, which is why a prenatal vitamin is recommended; it would be incredibly challenging to meet these needs consistently through diet alone.

More interestingly, infants 7-12 months need 11mg–or almost 40% more than a grown adult male! This is the reason why experts recommend iron-fortified cereals or pureed meat as baby’s first complementary foods after age 6 months; with the amount of iron infants need and the tiny quantities they eat, it’s virtually impossible to meet their needs on breastmilk or formula and foods like applesauce or pureed veggies alone.

But the daily values can be deceiving, as they assume one important fact: that the average American consumes an omnivorous diet. Since iron from animal sources (called “heme iron”) is up to 10x better absorbed–and the presence of meat, poultry or fish in a meal containing vegetarian sources of iron (called “non-heme iron”) helps increase the body’s ability to absorb it– the vegetarians among us actually have significantly increased irons needs as follows:

Vegetarian adult males: 14mg/day

Vegetarian pre-menopausal women: 33mg/day (though less if you’re on the pill)

And for those of you who donate blood with any regularity, know that each pint of blood you donate has over 200mg of iron that you’ll need to replace over time (though NOT all at once… iron toxicity is very serious, and wholly unpleasant).

What foods are the best sources of iron?

Iron absorption ranges by food source, from as low as 2% for spinach and legumes to 20% for steak.  Average bioavailability of iron from a mixed diet is 18%, whereas it’s only 10% from the average vegetarian diet.

Oysters are an iron-rich, sustainable seafood choice.  Slurp 'em if you got 'em.
Oysters are an iron-rich, sustainable seafood choice. Slurp ’em if you got ’em.

The best non-vegetarian sources of iron are:

          • Chicken liver (12.8mg in 3.5 oz cooked)
          • Clams (11mg in 1/4 cup canned)
          • Oysters (5.6mg iron in 6 oysters)
          • Shrimp (2.6mg in 3oz)
          • Beef (2.3mg in 3oz)
          • Dark meat turkey (2.3mg in 3oz)
          • Canned light tuna (1.3mg in 3oz)
          • Dark meat chicken (1.1mg in 3 oz)

When it comes to vegetarian sources of iron, it’s tricky to talk about ‘best sources,’ because the absorbability of the iron will vary widely by what you eat the foods with. While tofu is an excellent source of iron on paper, there are compounds in soy protein that have an inhibitory effect on iron absorption.  The same goes for legumes and spinach; the presence of compounds called phytates drastically reduces the absorption of their significant iron content to as little as 2%.  The presence of significant amounts of calcium can also inhibit iron absorption, which is why prenatal vitamins have very little calcium in them and cow’s milk is NOT recommended for children under 12 months old.  In contrast, several dietary factors can enhance the absorbability of non-heme iron; these include: vitamin C, organic acids such as those naturally found in certain fruits and vegetables (citric acid, lactic acid, malic acid), alcohol, and the presence of meat, fish or poultry in the same meal (the mechanism behind this last one is unknown, so the scientific community refers to this mystery phenomenon as “MFP factor”–or meat, poultry, fish factor.  I’m not making this up.)

With these important caveats in mind, here is a list of some of the best vegetarian sources of protein:

  • Fortified breakfast cereals (e.g.,Total, Raisin Bran, Cheerios): content varies, but one serving may contain up to 100% of the 18mg daily value.  Sadly, gluten-free cereals tend not to be fortified.
  • Tofu (6.2mg in 1/2 cup firm)
  • White beans (3.9mg in 1/2 cup)
  • Lentils (3.3mg in 1/2 cup cooked)
  • Blackstrap molasses (3.5mg in 1 TBSP)
  • Cooked spinach (3.2mg in 1/2 cup)
  • Baked potato (2.8mg in 1 medium potato with skin)
  • Kidney beans (2.6mg in 1/2 cup cooked)
  • Amaranth grain (2.6mg in 1/2 cup cooked)
  • Prune juice (2.3mg in 6oz)
  • Cashew nuts (1.7mg in 1 oz)
  • Rolled oats (not fortified) (1.7mg in 1/2 cup dry)

When Life Hands you Anemia, Make Chili

Whether you make it with ground beef (or better yet, turkey) or keep it vegetarian, chili is one of the first foods I recommend to my anemic brothers and sisters looking to increase their dietary iron intake.  (One can only eat so much chicken liver, after all.)  The presence of tomatoes–which contain absorption-enhancing Vitamin C, citric acid and malic acid– help improve the bioavailability of iron in the beans.  If you use ground meat of any kind, you’ll get a two-fold effect on iron content: both from the heme iron content of the meat itself, as well as though the MFP factor’s further enhancement of the vegetarian iron bioavailability.

My go-to- recipe for vegetarian chili is this classic one for False Alarm Vegetable Chili from Martha Stewart.  It will surely go down in history as the unfussiest recipe she has ever featured, as it basically calls for chopping up a bunch of vegetables, dumping them in a pot all at once, and then dumping a bunch of dry and canned ingredients in 5 minutes later.  Voila.  It serves 10, and each serving contains ~4.7mg of iron.

If you prefer some meat in your chili, try this recipe for Colorful Turkey Chili from Whole Foods market.  It serves 4-6, and assuming one serving is ~1/5th of the recipe, each serving would contain ~5mg of iron.

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  • caffettiera says:

    Very interesting post, as usual. My vegan brother-in-law told me that coffee influences negatively iron absorption, do you know if this is true? For him meeting iron needs is indeed a challenge. Also my husband ‘needs’ red meat for iron, even if we don’t really like it. he is prone to low iron levels and that is the main reason we don’t go 100% vegetarian (funny enough, my iron level are always higher despite the fact that I am a woman)…. I also found out that a very good source of iron is octopus, if you like fish and the likes.

  • Tamara says:

    Your vegan brother in law is correct. There’s a compound in coffee called chlorogenic acid that inhibits absorption of vegetarian (non-heme) iron. Also, a compound called myricetin (in wine, tea, berries) will have a similar effect. Note that neither of these compounds will impact iron absorption from meat (heme iron) because heme iron has a different absorption pathway. Good call on the octopus! a 3oz portion has 8mg of iron.

  • Cyran says:

    Hi, My children have been vegetarian for 9 years and I would rather eat vegetarian food myself but am having a lot of trouble with anemia, low iron, so am reluctantly eating some meat (chicken or seafood can’t face anything else). I thought an Indian dish called palek paneer or palek dhal would be a really good idea with all the spinach and we love spicy food. However there are studies showing that the spice Chilli (not turmeric) interfere with the absorption of iron. Do you know if this is true?