Welcome to my fourth installment of my 5-installment series on iron and human health. The topic of this fourth installment concerns the best iron foods and whether food fortification (focusing on iron) is a good or bad thing for your health.
If you haven't read the earlier installments of this series, consider the previous blog posts:
The reason I consider the topics of the iron levels in foods, and different types of iron, is because it helps you calculate your daily intake.
Furthermore, the topic of food fortification is included as well - in a separate section - because it's far more important for their daily iron intake than many people realize.
Ready to become an expert on iron? Here we go:
Food is and should be the primary method by which you manage your iron levels. In fact, in a subsequent section I'm going to make the argument that ingesting iron through food is far superior than using supplements.
But let's first consider different types of foods first, and the different types of iron they contain:
Remember I mentioned that iron is absorbed in the gut? A specific type of iron, called "heme iron", is found in animal flesh. Heme iron and is absorbed much more readily than non-heme iron from plant foods:
The quickest way to increase your iron status...
Non-heme form of iron is found in eggs, dairy, and plant foods. About half of the iron in meats--whether sourced from seafood or land animals--is non heme iron as well. In other words, meat from land or sea-based animals contains about 50% heme iron.
About 20-25% of heme iron is absorbed, meaning that if you consume 10 miligrams of iron from meat, you'll end up with a net 2 - 2.5 milligrams of iron in your body.
So let's consider the non-heme variant:
Plant foods contain different types of non-heme iron:
One non-heme type, called "ferric iron" (Fe3+), needs to be converted into ferrous iron (Fe2+) before it can be properly absorbed by the gut. Your stomach acid accomplishes that transformation. "Fe2+" and "Fe3+" denote the chemical structure of these iron types.
There's a third non-heme iron form, called "Carbonyl iron", but that type is mostly found in supplements.
As heme iron absorbs about 3 times as well as non-heme iron, absorption of non-heme iron is about 6-8%. Non-heme absorption levels can be as low as 1% (in the case of eating raw legumes, for example).
Now you know about the absorption of different types of iron, let's look at how much you actually need:
The daily iron requirement - or the "Recommended Daily Allowance (RDA)", categorizes iron the requirement over different age groups:
Additionally, pregnant women need 27 milligrams and lactating women need 11 milligrams. Athletes also have slightly higher requirements, especially when you've just started exercising.
Let's subsequently consider how you can actually reach these daily requirements...
Below I've included a list of the top-100 iron foods:
Iron content is calculated on a 100 gram (3.4 ounce) of product basis.
Foods containing heme iron are listed in bold. Duplicate foods have been excluded. The highest reading in each food category has been included - e.g., if whale meat had a 72 and 63-milligram reading, the 73-milligram data point was included on the list.
Lastly, I gave preference to whole foods in the list above, instead of their processed counterparts. So if sesame paste and sesame seeds were both available, the latter option was preferred.
So here you go:
Conclusion? Organ meats rule the day as you can see, especially from wild animals.
Spices, beans, legumes, nuts, and grains are also good iron sources, except that they don't contain heme iron.
Note that I've not included fortified foods in that earlier list.
Some cereals have an iron content of a whopping 60 milligrams. Babyfood, moreover, can contain up to 50 milligrams of iron.
The amount of iron present in these foods is far lower when they're not fortified. In fact, I'm going to treat the topic of fortification in a later section so that you'll receive the full picture.
Fast food was not included in the list above either, due to some very outcomes such as 30 milligrams of iron in cheese - which is certainly an anomaly.
(Cheese normally contains very little iron, at around 1 milligram per 100 grams of product (3.4 ounces.)
Please keep in mind that some of the iron contents in the list above are overestimated.
Potatoes, placed at position 72, have roughly 3 milligrams of iron according to many scientific sources--instead of 7 milligrams as listed above.
The real iron content of many foods is thus probably lower.
Why include that elaborate top-100 list then? My reason is simple:
You need to understand what the food groups with the highest in iron are to be able to manage your status. If you don't know that pork liver contains lots of heme iron, you'll be loading up on iron-rich foods while you may already have an overload.
And if you don't know what limitations vegetables or grains have, on the contrary, you may end up with a deficiency over time...
Furthermore, realize that the iron content of foods is never set in stone. There's always variation within specific food types.
Plants that grown in low-iron soil end up containing less iron than when they are grown in soils that contain more iron.
The same principle is also true for animal foods, as their nutrient content is almost always influenced by the food that they ingest.
Next up, let's consider a huge issue that's very much underappreciated today:
Did you know that many food are fortified with iron in many places on this planet? [1; 2] Fortification entails that vitamins or minerals are added to one or more food groups, to ensure that populations ingest enough of those nutrients.
Many countries add iron to the food supply, but few of these countries are located in the developed world.
It's mostly African, South American, and Asian countries that add iron to the food supply - and the US, Canada, Australia, and UK. Most other developed countries do not engage in iron fortification of food.
In the US, wheat and rice are currently fortified with iron.
Fortifying foods is somewhat of a problem though, as it's hard to opt out from such a program if you're strongly relying on foods such as wheat.
Wheat flour mostly contains nutrients because they are
added. In the past, "fortification programs" were called actually
"restoration programs". The previous name correctly
entailed that most nutrients were lost during food processing.
From a historical perspective though, food fortification is not novel:
Even in Greek mythology - the myth of Jason and the Argonauts - iron fillings were added to wine to strengthen warriors.
Large scale food fortification by countries only began far later, in the 1920s, when the iodine mineral was added to salt in the United States. Iodine fortification successfully prevented thyroid problems in millions of people.
After that period, it became mandatory to add vitamin D to milk. Over time, more and more foods were fortified with nutrients, and many nations followed suit.
In some countries folate was added to the food supply because deficiencies in that vitamin cause fetal issues in pregnant women.
The problem with the strategy is that hundreds of thousands of people are exposed to excessive folate even though fetuses are indeed saved. The folate form that governments add to the food supply, however - called "folic acid" - is also poorly tolerated by many.[491; 492; 493; 494; 495]
Excess folate may also cause issues all by itself, such as damage to DNA, colon cancer, genetic mutations, and changes in the immune system. Fetuses exposed to folic acid may also develop new problems that were previously non-existing.
Food fortification is thus not always benign, and can have unintended consequences. - food fortification should thus not be blindly accepted as healthy.
As often, the good does not equal the great.
But let's consider food fortification programs from yet another perspective: countries that have to fortify their food with nutrients automatically concede that the diets of their populations are sub-par.
Insane but true...
Well, if diets supplied all the nutrients populations in these countries needed then no fortification would be necessary.
An example is the mineral "iodine". Iodine is added to the salt in many countries because most people consume too many land-based foods which are generally low in iodine. seafood, especially seaweed, contains very high iodine levels.
If people simply ate the right food, such as some weekly oysters, then adding iodine to food would not be needed.
On the basis of the presence of food fortification programs it can thus be concluded that populations are systematically underfed (or better: malnourished). It's also very probable that fortification programs miss many unidentified food compounds that are very beneficial.
The flipside of my argument is that fortification should not be blindly rejected either.
Fortification with several nutrients, such as vitamin B1, B2, the mineral iodine, have saved millions of lives and and improved billions.
So how about fortification with iron specifically?
Let's find out...
Again, in the US, Canada, Australia, and UK, most wheat-based products are fortified with iron.
Universally fortifying foods with iron is dangerous in the sense that if you've got a genetic hemochromatosis susceptibility , you're now going to be at much greater risk for overload if you consume wheat.[415; 416; 417]
Many other problems associated with iron fortification though.
Adding iron to foods almost certainly increases digestive problems, such as inflammation in the gut and poorer bacterial gut makeups.[421; 422; 423; 424; 425] Your risk for getting infections may also increase from iron food fortification.
Additionally, iron that's added to food is different from most supplemental forms. Iron used in fortification is absorbed only 36% as well as supplemental iron - which may partially explain why some people have stomach issues consuming fortified foods.
There's an interesting overlap, moreover, between foods that many people do not tolerate (such as wheat) today and iron fortification. In fact, gluten intolerance has become more prevalent since the period iron fortifications began.[436; 437]
Iron fortification can create problems if you're not anemic: antioxidant capacity may go down, for example, speeding up aging, due to an increase in the free radicals I mentioned earlier.[430; 431; 432]
Food fortification is important, however, because many people will end up with deficiencies without such programs, even in developed countries such as US.
Again, that's insane...
That fact alone demonstrates how bad the diets of most people are.
That statement should not be glossed over, as its logical implications are terrifying: without adding vitamins and minerals to the food supply, many people would be deficient in iodine, iron, B vitamins, and many other compounds.
The standard American diet is thus fundamentally nutrient deficient as well.
So let's question the ruling narrative:
Why not fix the diet instead of relying on food fortification when a country's population is deficient in nutrients, especially in developed countries?
The US spends $3.5 trillion dollars on health care per year. US citizens could all afford oysters and liver, if the money was simply spent on it, so that no fortification would be necessary (and its related side effects would disappear as well).
Worldwide, the problem is worse though:
In more than 60 countries, iron, vitamin B1, B2, B3 and B9 all have to be added to wheat flour.
In 20-25 countries, vitamin B6, B12, and zinc are additionally added. Does wheat flour seem like an intrinsically balanced food?
Again, I'm not against food fortification per se, as 300,000 nervous system developmental defects in children are prevented with vitamin B9 fortification on a yearly basis.
In another sense though, that problems is truly tragic, as billions of people on this planet don't have access to basic necessities while others fly around in expensive airplanes polluting the environment.
But let's move back to iron...
Right now in the US, 20 milligrams of iron is added per pound of many plant foods, such as breakfast cereals, grains, flour, and rice.
In the UK, white bread iron fortification is mandatory, while some other food groups such as margarine and cereals are voluntary.
As a consequence of these policies, iron consumption has almost doubled from 1910 in the US.
Adding so much iron to the foodchain can cause problems, because as mentioned in a previous section, minerals such as iron, zinc, manganese, and copper compete for absorption.
When you artificially only add iron to a food such as wheat, the relative risk for getting too little zinc increases exponentially. And yes, zinc problems are indeed very prevalent in the US right now...
So what's the alternative? I'll tell you: creating large scale oyster farming programs, and actually eating the beef liver that's now often discarded (yet another tragedy)
Oysters are the perfect food in nature.
Oysters have an extremely high nutrient density, and contain all the minerals that most people are generally lacking.
These beauty's contain all the nutrients that are commonly used in food fortification programs, such as iodine, zinc, iron, and all B-vitamins. Moreover, oysters also have vitamins and minerals in highly absorbable form.
There's limitless room in lakes and oceans to produce such oysters. In fact, oyster farms don't take up any room, and even filter the water they're located in.
It's possible to build very deep vertical farms with oysters, so that very little space produces lots of high quality food. Oysters also don't need to be fed fish that's low on the food scale, or plants, which are necessary for foods like farmed salmon.
(One counterargument that has emerged against oyster farming is that they emit lots of greenhouse gases such as CO2 and methane, although I'm not fully convinded of that claim.)
Governments could also simply recommend that their citizens consume some beef liver, kidney or spleen or shellfish once in a while.
All problems solved...
It's truly tragic these foods are no longer consumed and are processed into dog food.
And I'm not done yet with my grievance - let's move on to another controversial topic: supplementation...
I hope you're beginning to see the bigger picture here:
Your diet and potentially fortified foods therein have a huge impact on how much iron your body is ingesting on a daily basis.
If you're following a carnivore diet with organ meats, for instance, your heme iron consumption will be through the roof.
If you're a "flexitarian" or "vegetarian", your iron consumption might be much lower in the first place, specifically heme iron.
And, you may think you're eating very little iron because you're relying on wheat and corn or rice a lot. But, in that instance, it's very much appropriate to check the food fortification program in your country.
I've very often come across people who told me that they did very poorly on American wheat but could consume grains in my home country, the Nehterlands, just fine. Of course, multiple reasons can exist for that conclusion, such as GMO wheats, but in general, I find that people tolerate iron-fortified foods much more poorly than natural counterparts.
In this case, the good is the enemy of the perfect. If you want to get your iron levels up, eat some organ meats. And if you want to lower your levels, keep reading, as in the next and last installment I give you 20 different strategies to manage your levels...
This is a post by Bart Wolbers. Bart finished degrees in Physical Therapy (B), Philosophy (BA and MA), Philosophy of Science and Technology (MS - with distinction), and Clinical Health Science (MS), and is currently a health consultant at Alexfergus.com.
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