Iron and iron defiency
- Plant foods contain only non-haem iron, which is less available than haem iron from animal sources, additionally plant foods contain a variety of substances known to reduce iron availability.
- Anaemia is a common presentation of coeliac disease and as many as 50% of coeliacs have evidence of anaemia at presentation. Iron deficiency anaemia is the commonest, while folate and B12 deficiency is less common. The more restricted the diet the greater the risk of iron-deficiency anaemia. The iron status of vegetarians with coeliac disease may therefore be questionable and must be monitored regularly.
- The absorption of non-haem iron in plant foods (and eggs) is enhanced by vitamin C and citric acid and inhibited by phytates (found in wheat bran and legumes), oxalates (found in spinach), tannins (found in tea) and other polyphenols (found in coffee and cocoa) in the diet. To ensure a good intake of iron vegans and vegetarians should be encouraged to include legumes, eggs, fortified gluten free products, dried apricots, and green leafy vegetables daily in their diet.
- To maximize the absorption of iron, vitamin C-containing foods should be consumed with meals, while drinking tea, containing tannins, with meals should be discouraged due to the interference with iron absorption.
- Some food preparation techniques such as soaking and sprouting beans, grains, and seeds, can hydrolyse phytate and may improve iron absorption
- Vegans and vegetarians may carry a greater risk of developing iron deficiency anaemia if iron requirements are increased (e.g. during infancy, pregnancy, blood loss). Courtesy of Coeliac UK
