Iron (Fe) is an extremely essential nutrient, participating in vital cellular processes and for the normal functioning of many organisms in the body. It is crucial and indispensable for every living cell and plays a major role in transporting oxygen around the body. Red blood cells are one of the many components in the body requiring iron. Red blood cell production, also called 'erythropoiesis' needs sufficient levels of iron for the process to be carried out.

Image: Alnuwaysir, R.I.S. et al. (2021). Iron deficiency in heart failure: mechanisms and pathophysiology

Iron deficiency (ID) is one of the foremost contributors to disease burden around the world, predominantly affecting young children (mainly <5 years), premenopausal women and population groups from low and middle-income countries. World Iron Deficiency Day on the 26th of November provides an opportunity to emphasise the importance and significance of this universal health condition.

Children and iron deficiency

Iron deficiency among children is a widespread and common health issue, ranging in levels of severity from a mild deficiency to anaemia. If iron deficiency is left untreated, a child’s growth and development may be affected; and increases their vulnerability to infections.

A 2022 systematic review investigated children and iron deficiency. The study included 28 research articles, consisting of 27,896 children under 5 years of age. The results of the review found the global prevalence of iron deficiency to be 17.95%, with 4581 children from the cohort presenting with iron deficiency anaemia. Additional data, also from 2022, presented an iron deficiency anaemia incidence in industrialised countries of 20.1% for children aged 0-4 years of age and 5.9% for those aged 5-14 years.

“Iron deficiency is the most prevalent nutritional deficiency worldwide” (WHO)

33% of non-pregnant women | 40% of pregnant women | 42% of children

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Recommended daily iron intake.

Group	Age	mg of iron
Babies (breastfed)	0-6 months	0.2
Babies (formula fed)	0-6 months	Usually iron-fortified due to the iron in formula is less well absorbed.
Infants	7-12 months	11
Children	1-3 years	9
Children	4-8 years	10
Children	9-13 years	8
Boys	14-18 years	11
Girls	14-18 years	15
Women	19-50 years	18
Women	51+ years	8
Pregnant women		27
Breastfeeding women	14-18 years	10
Breastfeeding women	18+ years	9
Men	19+ years	8

Sources of iron

There are two types of iron which can be found in foods – haem and non-haem iron.

Haem iron is the more easily absorbed by the body and can be found in animal tissue – beef, lamb, chicken, fish and kangaroo. Offal (the internal organs of animals) such as liver and kidneys are very good sources as they have high levels iron. Note: pregnant women should not eat too much offal as it contains high levels of vitamin A, which may cause birth defects.

Non-haem iron is not linked to a haem protein and therefore the body has a reduced ability to absorb the iron. Sources include iron-fortified cereals, breads and pasta, wholegrains and legumes. Other plant-based foods include broccoli, raisins, nuts, prunes, seeds and dried beans and peas. Note: if your diet is without any animal tissue, you may need to increase your intake 2-fold to get the same dietary amount recommended.

Examples of haem and non-haem foods

Haem foods	Quantity	Iron (mg)
Kangaroo	150g (cooked)	»6.3
T-bone / rib-eye steak	100g (cooked)	3.6
Lamb shoulder roast	100g (cooked)	2.7
Lamb leg sirloin	100g (roasted)	2.2
Lamb liver	28g (cooked)	2.9
Chicken liver	28g (fried)	2.8
Beef liver	28g (fried)	1.7
Lamb kidney	28g (cooked)	1.6
Chicken breast or thigh	100g (roasted)	1.0
Eggs	50g (poached)	0.88
Salmon	85g (tinned)	0.48
Salmon fillet	170g (cooked)	1.8
Non-haem foods
Spinach	100g (cooked)	3.6
Lentils	100g (cooked)	3.3
Chickpeas	100g (cooked)	2.9
Pumpkin seeds	15g	2.25
Sesame seeds	15g	2.2
Kidney beans	100g (cooked)	2.2
Cashews	28g	1.9
Almonds	28g	1.1
Broccoli	100g (cooked)	2.2
Spinach	30g (raw)	0.81
Brown rice (long grain)	100g (cooked)	0.56
Prunes	40g (3)	0.36

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Anaemia

Anaemia is only one of the many consequences resulting from being iron deficient and occurs when there isn’t enough iron to produce haemoglobin. Haemoglobin is part of red blood cells which carry oxygenated blood through the body.

Over 1.2 billion people worldwide were diagnosed in 2016 with iron deficiency anaemia, and it is among the five highest causes of years lived with disability. Research also found that iron deficiency anaemia is the primary cause of years lived with disability among women across 35 countries.

To read more about iron deficiency anaemia please visit our website - Anaemia Fact Sheet.

Iron deficiency and your heart

Iron deficiency anaemia can cause a fast or abnormal heartbeat, which means the heart has to pump harder to ensure there is enough oxygen in the blood. This may lead to an enlarged heart or heart failure.

Both iron deficiency and iron deficiency anaemia are included among the most commonly detected comorbidities in heart failure. While it is usually common that iron deficiency is linked with anaemia, they do not essentially coexist. Iron deficiency is significantly more prevalent in heart failure than anaemia, with a frequency of approximately 59%. In regard to acute heart failure, the occurrence of iron deficiency was higher in men (79%) compared to women (57%).

USE HEART TO TAKE IRON SERIOUSLY!

Iron deficiency and iron deficiency anaemia are also conditions which can intensify symptoms and impair the diagnosis of heart failure and ischaemic heart disease.

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References

• Iron Deficiency | World Heart Federation (world-heart-federation.org)
• Iron deficiency anemia - Symptoms & causes - Mayo Clinic
• Iron deficiency in children: Prevention tips for parents - Mayo Clinic
• WHO guidance helps detect iron deficiency and protect brain development.
• Iron and iron deficiency - Better Health Channel
• non haem iron - Search (bing.com)
• Nutrition Facts Search Tool (myfooddata.com)
• Kangaroo - Facts and Figures of Australia's Healthiest Meat (thefoodcoach.com.au)
• Red Blood Cell Production - Hematology and Oncology - Merck Manuals Professional Edition
• Alnuwaysir, R.I.S., Hoes, M.F., van Veldhuisen, D.J., van der Meer, P., & Beverborg, N.G. (2021). Iron deficiency in heart failure: mechanisms and pathophysiology. Journal of Clinical Medicine, 11(1), 125. https://doi.org/10.3390/jcm11010125.
• Gedfie, S., Getawa, S., & Melku, M. (2022). Prevalence and associated factors of iron deficiency and iron deficiency anemia among under-5 children: A systematic review and meta-analysis. Global Pediatric Health, 9, 2333794-2333794X221110860. https://doi.org/10.1177/2333794X221110860
• Moscheo, C. et al. (2022). New insights into iron deficiency anemia in children: A practical review. Metabolites, 12(4): 289. doi: 10.3390/metabo12040289.
• Pasricha, S-R., Tye-Din, J., Muckenthaler, M.U., & Swinkels, D.W. (2021). Iron deficiency. The Lancet (British Edition), 397(10270), 233–248. https://doi.org/10.1016/S0140-6736(20)32594-0.