Best Iron Rich Foods For Pregnant Women

Introduction

When pregnant, many women have low iron levels. Feeling weary, weak, having difficulty focusing, having a poor appetite, getting sick easily, and having a pale hue under your fingernails are all symptoms of low iron. Deficiency in iron can cause a condition called Anemia. 

During pregnancy period, the body's demand for iron increases due to the expansion of blood volume and the need to support the growth and development of the baby.1

Iron deficiency anaemia is a common concern during pregnancy and can pose significant risks to both the expectant mother and the developing fetus. To reduce the risk of iron deficiency anaemia during pregnancy, healthcare providers typically recommend iron supplementation and a diet rich in iron.2

Understanding iron needs during pregnancy

The World Health Organization currently recommends daily iron and folic acid supplementation as part of antenatal care to lower the risk of low birth weight, maternal anaemia, and iron deficiency. The supplement should include 30-60 mg of iron, with a higher dose preferred in countries where anaemia in pregnant women is a severe public health issue (40%), as well as 400 g of folic acid.3

Pregnancy and infancy have a high physiologic requirement for iron, with an estimated 1000-1200 mg of iron required. Two-thirds of this iron is for maternal needs, and the other third is for placental-fetal tissue needs. However, the requirement varies with gestation, with a lower requirement in the first trimester (0.8 mg/day) than before pregnancy and a substantially larger requirement in the third trimester (3.0-7.5 mg/day).4

Factors that may affect the absorption of Iron in  pregnant women are as follows:

  • Pregnancy (second two trimesters)
  • Menorrhagia (blood loss of more than 80 mL per month)
  • Low-meat and ascorbic acid diets
  • Multiple gestations
  • Donating blood more than three times each year
  • Chronic use of aspirin5

Iron rich food sources for pregnant women

Lean red meat

  1. Beef and lamb are good sources of heme iron

Poultry and organ meats

  1. Chicken and turkey as alternatives to red meat
  2. Liver and giblets as concentrated sources of iron

Plant based sources of iron

  • Spinach and other dark leafy greens
  • Legumes and lentils for non-heme iron intake
  • Fortified cereals and whole grains

Seafood

  1. Oysters and clams as iron-rich seafood options

Nuts and seeds

  1. Almonds, pumpkin seeds, and other iron-packed nuts/seeds6

Combining iron rich foods with vitamin C

  • Lemon: Lemon is high in vitamin C and pairs well with iron-rich foods including spinach, quinoa, chia seeds, lentils, oats, spirulina, soybeans, tomato paste, white beans, and kale
  • Spinach and kale: Spinach and kale are both high in Vitamin C and iron, making them perfect all around. To make a savoury dish, combine them with lentils, lemons, quinoa, white beans, or soybeans
  • Strawberries: Strawberries are higher in Vitamin C. They're delicious in any smoothie or on top of a fresh salad for lunch. You could also serve them with porridge or quinoa for breakfast, or make a strawberry and tahini sandwich instead of your standard peanut butter and jelly. Tahini (sesame seed butter) has a lovely nutty flavour and is high in iron
  • Sweet potatoes: Sweet potatoes are higher in Vitamin C. Combine sweet potatoes with lentils, quinoa, and kale (as in these delicious patties), purée in a smoothie with kale or spinach, and top with beans for lunch
  • Vitamin C is also found in oranges, blueberries, raspberries, blackberries, practically all leafy greens, apples, limes, broccoli, papaya, pineapple, goji berries, and kiwi7

Iron supplements during pregnancy 

After about week 12 of pregnancy (the start of the second trimester), when the iron requirements for pregnancy begin to increase, it is recommended to begin iron supplementation at a level of 30 mg/day. During pregnancy, iron supplements can include ferrous sulfate, ferrous gluconate, and ferrous fumarate. Iron supplementation may cause heartburn, nausea, upper abdominal discomfort, constipation, and diarrhoea. These side effects are manageable by:

  • Taking the iron supplement with the food
  • Splitting the dose of iron into two or three
  • Choose the Right Form of Iron
  • Avoid calcium and Antacids
  • Stay hydrated
  • Add Fibre-rich foods5

Meal planning and recipes for iron rich diets

Iron-rich meal plan during pregnancy can be as follows :

  1. Breakfast options can be:
    • Oatmeal with dried fruit and nuts
    • Bran cereal with banana, skim milk, and flaxseeds
    • Toast with nut butter and 100% fruit spread over whole grain bread
    • Scrambled eggs with spinach and tomatoes, with orange slices
  2. Lunch options can be
    • Dark leafy greens, raw vegetables, and grilled chicken with a cup of black bean soup
    • Black beans, salsa, and shredded cheese on a whole grain tortilla; dark leafy green salad
    • On a bed of spinach, quinoa salad with tomatoes, feta cheese, cucumbers, lemon juice, olive oil, and diced chicken breast
    • Hamburger with broccoli and baked sweet potato fries, cooked with lean ground beef on a whole grain bun or wrapped in lettuce
  3. Dinner options can be
    • Grilled pork chop with no-sugar-added applesauce and garlic-and-oil-sautéed spinach and white beans
    • Shrimp stir-fried with rice and vegetables such as broccoli, red peppers, and cauliflower
    • Tomato sauce and whole grain pasta with ground chicken, turkey, or lean beef6

Tips for vegetarian and vegan pregnant women

  • Eating correctly throughout pregnancy is essential for both your own and your developing baby's health
  • It is critical to consume a varied and balanced diet when pregnant to ensure adequate nutrition for both your and your baby's development and growth
  • Good sources of iron for vegetarians and vegans include pulses, dark green vegetables, bread and flour, nuts, fortified breakfast cereals (with added iron), and dried fruit such as apricots
  • Milk, cheese, and eggs are excellent vegetarian sources of vitamin B12. Breakfast cereals fortified with vitamin B12, unsweetened soya drinks enhanced with vitamin B12, yeast extract such as Marmite, and nutritional yeast flakes fortified with vitamin B12 are also good options for vegans
  • Although humans acquire vitamin D from the sun, vegetarian food sources include egg yolk, vitamin D-fortified meals such as some breakfast cereals, fat spreads, and nutritional supplements
  • This is due to the fact that non-vegans acquire the majority of their calcium from dairy sources. Dark green leafy vegetables, pulses, fortified unsweetened soya, pea and oat drinks, brown and white bread, calcium-set tofu, sesame seeds, and tahini dried fruit are also good sources of calcium for vegans
  • Cow's milk, dairy products, and eggs are good sources of iodine for vegetarians. Iodine can also be present in plant meals like cereals and grains, although the amount varies depending on the amount of iodine in the soil where the plants are cultivated8

Iron absorption enhancers and inhibitors

Iron absorption enhancers include:

  • Haem iron, present in meat, poultry, fish and seafood
  • Ascorbic acid or vitamin C is present in fruits, juices, potatoes and other tubers and other vegetables such as green leaves, cauliflower and cabbage.
  • Some fermented or germinated food and condiments such as sauerkraut and soy sauce.

Inhibitors of iron absorption include:

  • Phytates present in cereal bran, cereal grain, high-extraction flour, legumes, seeds and nuts
  • Food with high inositol content
  • Iron binding phenolic compounds [Tannins]
  • Calcium from milk and milk products9

Conclusion

Iron plays a crucial role in a healthy pregnancy. It helps in producing haemoglobin, which carries oxygen to the baby and prevents anaemia in both the mother and the developing fetus. 

Iron also supports the growth of the placenta and the baby's brain development. Pregnant women require more iron to accommodate increased blood volume.

Adequate iron intake reduces the risk of complications such as preterm birth and low birth weight. It's essential to include iron-rich foods in the diet and follow medical advice for proper supplementation during pregnancy. 

Embracing a well-balanced diet rich in iron during pregnancy is a wonderful way to nurture both your own health and the development of your baby. By incorporating iron-rich foods like lean meats, poultry, fish, legumes, nuts, seeds, and fortified cereals, you're providing your body with the necessary building blocks for healthy blood production. 

Remember, this nutrient supports your baby's growth, brain development, and overall well-being. Prioritizing iron intake can also help prevent fatigue and complications like anaemia. Your commitment to a nutrient-rich diet is a beautiful gift to yourself and your growing family.

References

  1. Hildebrand D, Walters C, Compton T. Iron is Important During Pregnancy [Internet]. Oklahoma State University. 2022 [cited 2023 Jul 30]. Available from: https://extension.okstate.edu/fact-sheets/iron-is-important-during-pregnancy.html
  2. Pregnancy and birth: Do all pregnant women need to take iron supplements? Institute for Quality and Efficiency in Health Care (IQWiG); 2018.
  3. Antenatal iron supplementation [Internet]. Who.int. [cited 2023 Jul 30]. Available from: https://www.who.int/data/nutrition/nlis/info/antenatal-iron-supplementation
  4. Brannon PM, Taylor CL. Iron supplementation during pregnancy and infancy: Uncertainties and implications for research and policy. Nutrients [Internet]. 2017 [cited 2023 Jul 30];9(12). Available from: http://dx.doi.org/10.3390/nu9121327
  5. Institute of Medicine (US) Committee on Nutritional Status During Pregnancy, Lactation. Iron nutrition during pregnancy. Washington, D.C., DC, USA: National Academies Press; 1990.
  6. Anemia and Pregnancy [Internet]. ucsfhealth.org. UCSF Health; 2019 [cited 2023 Jul 30]. Available from: https://www.ucsfhealth.org/education/anemia-and-pregnancy
  7. McClees H. Vitamin C rich foods you should pair with iron for ultimate absorption [Internet]. One Green Planet. 2022 [cited 2023 Jul 30]. Available from: https://www.onegreenplanet.org/natural-health/vitamin-c-rich-foods-you-should-pair-with-iron-for-ultimate-absorption/
  8. Cornforth T. Iron supplements: Side effects, uses, and more [Internet]. Verywell Health. 2011 [cited 2023 Aug 1]. Available from: https://www.verywellhealth.com/do-iron-supplements-for-anemia-cause-upset-stomach-3522504 
  9. Inhibitors and enhancers of iron absorption [Internet]. Com.ph. [cited 2023 Aug 3]. Available from: https://sangobion.com.ph/inhibitors-and-enhancers-of-iron-absorption
This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Ann Rose Joseph

Doctor of Pharmacy - PharmD , Acharya and BM Reddy college of Pharmacy, Bangalore, Karnataka, India.

Ann Rose is a PharmD intern , showcasing an unwavering passion for healthcare field. With comprehensive knowledge regarding the principles and operational techniques of pharmacy in Healthcare settings.Equipped with a strong background in medication evaluation and clinical management of multiple chronic disease states.

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