Wednesday, October 22, 2008

Prenatal Nutrition: Iron

The sources that I read consistently suggest a goal of about 30mg per day of iron for pregnant women. This is a lot of iron for most women, and it can be a challenge to get that much iron through food. Iron is one of the nutritional needs that many pregnant women do not meet through diet, which is why prenatal supplements can be so helpful.

What does iron do?

The Family Nutrition Book, an excellent resource by Dr. William Sears and his wife Martha Sears, an R.N., explains why iron is critical to health:
"Iron is necessary to make hemoglobin, the substance that carries oxygen through your blood to all the cells in your body. Hemoglobin is what makes red blood cells red. With insufficient iron, and therefore not enough hemoglobin, red blood cells become small and pale and don't carry enough oxygen. You may have heard the expression, 'tired blood.' This refers to blood that is low in iron and that can't carry enough oxygen to vital organs and muscles. 'Tired blood' results in a tired body.

Iron is needed not only for blood but also for brains. Neurotransmitters, the neurochemicals that carry messages from one nerve to another, require sufficient iron to function properly. A person with an iron deficiency may have a tired mind as well as a tired body" (Sears 58).

During pregnancy, a woman's blood volume increases by 40%, so additional iron is essential to maintain good health and energy levels. It is also important for the creation of the baby’s red blood cells. In Having a Baby, Naturally, Peggy O'Mara states that the health benefits of "getting enough iron during pregnancy may also reduce the risk of premature delivery and low birth weight" (26).

Elizabeth Somer's book Nutrition for a Healthy Pregnancy explains the additional need for iron during pregnancy in even more detail, "The iron costs of pregnancy are high. More than 246mg of iron is stockpiled in the baby's tissue prior to delivery, and another 134mg is taken up by the placenta, and about 290mg is used to expand the volume of the mother's blood. That equates to about 2.4mg a day during pregnancy just to cover the iron costs of pregnancy. In addition, 1.0mg or more is needed to maintain the mother's normal body processes. Since you absorb only about 10 percent of dietary intake (although iron absorption increases as much as 50 percent during pregnancy in some women), you must consume about 30 to 60mg or more of iron daily to ensure optimal iron status" (84).

What are the symptoms of iron deficiency?

According to The Family Nutrition Book, the following are possible signs of iron-deficiency anemia:
paleness (especially in the face, palms and nail beds)
shortness of breath
difficulty concentrating
increased susceptibility to infections
intolerance of cold temperatures
brittle, thin, spoon-shaped nails (63).

What food sources are good sources of iron?

Beef (4oz): 3.5mg
Ground beef (4oz): 2.5mg
Chicken (4oz): 1.6mg (dark meat) to 1.0mg (white meat)
Turkey (4oz): 2.5 (dark meat) to 1.6 (white meat)
Potato with skin: 2.5mg
Beans (1/2C): 2.0mg
Lentils (4oz): 3.0mg
Barley (4oz): 2.0mg
Sweet Potatoes (4oz): 1.7mg
Pumpkin seeds (1oz): 4.0mg
Cream of Wheat (4oz): 5.0mg
1/2C cooked spinach: 3mg
1C dry roasted mixed nuts: 5.0mg
1 egg: .7mg
Quinoa (grain): 9.0mg
Dried Fruit (1/4C): 2.0mg
Iron-fortified breakfast cereal: check your favorite brands

Peggy O'Mara writes that "You need 27mg of iron in your daily diet. You can get enough of it by consuming:
1/2C of cream of wheat (fortified) or 2 servings of beef, turkey, or clams or 1 cup of lentils and

1 cup of lima or kidney beans or black-eyed peas or 1/2C of prune juice, and

1 wedge of watermelon or 12 dried apricot halves or 1T of blackstrap molasses or 2 eggs, and

1 cup of cooked spinach or 2 cups of cooked kale or 4 oysters and

2 slices of whole wheat bread or 1/2C of tofu or 1 chicken leg" (26).

That equals out to some interesting food combinations, in my opinion, but it gives an idea of some iron-rich food sources and combinations. This is one way I can imagine including these selections in a day:
Breakfast: Cream of wheat cereal and 6 apricot halves
Snack: Wedge of watermelon
Lunch: Sandwich on two slices of whole wheat bread
Snack: Prune juice (?? but then I don't like beans)
Dinner: Omelet of quiche with eggs and spinach

There, that sounds more appetizing.

How can I maximize iron absorption?

"Eating food rich in vitamin C along with plant sources of iron helps to unbind phytates and the oxalic acid and increase iron absorption. Vitamin C can double the amount of iron absorbed from a food. Meat, poultry, and fish also enhance the absorption of iron from plant sources . . . Meat can double the amount of iron absorbed from veggies. The best partners for getting the maximum amount of iron out of food are meat and foods high in vitamin C eaten together at the same meal" (Sears 59).

Here are some suggestions of food combinations to maximize iron absorption listed in the Sears book: spaghetti with meat and tomato sauce; meat and potatoes; chicken fajitas with broccoli, sweet peppers and tomatoes; fresh fruit, iron-fortified cereal.

Nutrition for a Healthy Pregnancy offers this helpful information, "Iron intake involves a balance between iron promoters and iron inhibitors, and entails more than just eating iron-rich foods. Here are a few ways to maximize your promoters to guarantee you get the most from your diet:
1. Always consume a vitamin C-rich food with every meal, such as orange juice, a tossed salad, broccoli, more most fruits. Vitamin C improves the absorption of iron and counteracts some of the inhibitors in foods, such as phytates in whole grains and tannins in tea and coffee.

2. Consuming small amount of red meat, such as extra-lean beef, with large amounts of iron-rich plants, such as split pea and ham soup, increases the absorption of the plant iron.

3. Cook in cast-iron skillets. The iron leaches out of the pot into the food, raising the iron content of the meal.

4. Select iron-fortified foods.

5. Drink tea and coffee between meals. Tannins in these beverages (even if they are decaf) reduce iron absorption by up to 80 percent if consumed with food.

6. Take iron supplements on an empty stomach to improve absorption [as long as this doesn't cause nausea!]" (85).

Additional suggestions I can think of:
Potato with skin, chopped broccoli, and a little chopped ham (or bacon)
Beef-barley stew
Mashed sweet potatoes with a little orange juice and honey
Cream of Wheat cereal with chopped almonds and chopped dried fruit
Breakfast cereal and a glass of orange juice
Breakfast cereal, nuts, and dried fruit trail mix
Quinoa hot cereal for breakfast with chopped dried fruits
Qunioa pilaf
Chili with ground beef and tomatoes

It's important to remember that iron from animal ("heme" iron) sources is absorbed much higher amounts than iron from plant sources ("non-heme" iron). Heme iron is absorbed at a rate of 15-35% whereas non-heme iron is absorbed at a rate of only 2-20%. Dr. Sears reminds us that "the percentage of iron listed on the package label is certainly not the amount of iron that gets into your bloodstream. This is especially true of iron-fortified cereals, in which only 4 to 10 percent of the iron listed actually gets absorbed. The amount of iron absorbed from any food depends on the type of iron in the food, the body's need for iron, and the company of other foods eaten at the same meal" (65).

Peggy O'Mara writes recommends concentrating on "dark green leafy vegetables such as spinach and kale. Also eat plenty of whole grains, seaweed, soy products and fortified cereals" if you follow a vegetarian diet (26).

Finally, "The following foods hinder iron absorption: tea and coffee; high fiber foods such as bran; soy proteins; antacid medicines; milk or dairy products consumed with a meal" (Sears 60).

What about iron supplements?

Because adequate iron intake is critical for mother and baby during pregnancy, and because it is higher than what many women are able to consume through food alone, some women find that they need to take an iron supplement. I have heard good things (anecdotally) about Floradix, which is available at many health food stores and on Amazon, where you can check out their reviews, too. Here's what The Motherwear blog had to say about Floradix, Help for the Weary.

O'Mara does caution: "Most prenatal vitamins will provide the amount of iron necessary for expecting women. It is very important, however, to check with your health care provider before taking any additional supplements because too much of it can be toxic. Also keep in mind that some women will experience more constipation with increased iron supplementation" (26).

If anyone has any experience with overcoming anemia or any iron-rich recipes, please leave a comment!

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine

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Anonymous Michelle said...

I did take chlorophyll in the 3rd trimester with Wesley. My iron levels were lower than average but not low enough to risk me out as long as I got it within the normal range (do you remember this? I don't know how much I talked about it at the time). I got to a normal range by taking chlorophyll most days and an occasional iron pill if I felt really fatigued.

October 22, 2008 at 1:18 PM  
Anonymous Supplements said...

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October 23, 2008 at 7:21 AM  
Blogger FertilityHelper said...

To see more information about staying healthy during your pregnancy visit Congratulations to all the preggo mamas out there!!

October 27, 2008 at 12:56 PM  
Anonymous Baby Bedding Set said...

Fluid intake is also an important part of healthy pregnancy nutrition. Women can take in enough fluids by drinking 6 to 8 glasses of water each day, in addition to the fluids in juices and soups.

April 26, 2012 at 2:41 AM  

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