The Irony of Healthy Eating

Pun fully intended.

You’ll get that later.

Anyhoo, it’s not been the best of summers for this greedy girl, we’ll skip the work woes and financial disasters and jump straight to the peak point of being told I’m ‘significantly’ anaemic- a discovery spurred by having a pretty terrible recovery from a minor surgery. This lead to me being seen by a medical practitioner who didn’t want to immediately diagnose me as overweight/over 40, and a proper look at some recent blood test results.
I’ll rant about the inherently unlevel playing field of women’s healthcare via other mediums, however as iron deficiency anaemia is generally linked to diet I’m going to unpack some of this here.

Anaemia is loosely defined as having a low red blood cell count and/or a low level of haemoglobin in said red blood cells. Haemoglobin is made of iron, and it binds oxygen to carry it through your blood to the tissues of your body. This is a good thing, obviously, so lack of haemoglobin is very much not a good thing for your average human bean. Symptoms can include consistent fatigue, weakness, pale skin, breathlessness, headaches. Sounds lovely, right? Also sounds like a bunch of other disorders or just life in general for some of us. Anaemia affects the immune system too, leaving you open to infections and causing complications with wound healing, which is where my diagnosis came to light. That was a fun week.

So here we are living that anaemic life. As well as a six month (SIX MONTHS!!!!) prescription for iron supplements I was told to ensure I am getting an iron rich diet. Your body doesn’t make any iron, you need to consume it. So, steak, stout and plenty of greens, right? This is not only going to be easy, it’s going to be delicious!!!!
This is where the eeeeeeeeeeeeeeeeeh comes in. Because iron deficiency isn’t just about eating enough iron, it is about ensuring that iron gets out of your stomach and into the rest of you. A light google told me that there are actually a bunch of foods out there that stop you from absorbing the iron in your diet (which seems rude tbh). One immediately jumps to assuming these anti iron culprits will be the usual naughties- saturated fat, processed anything, mars bars and the like.
I’m sorry to say that actually there is a whole bunch of ‘healthy’ food out that that could be sapping your iron levels, in particular some anti-oxidants.
WOAH! Wait just one spinach picking minute- anti oxidants are good for us, right? We know that.
The kicker is that yes, they are good for us but also, they react with iron and make it hard for your body to absorb it at the same time. This goes for polyphenol type anti oxidants which are found in tea, coffee, dark chocolate, berries and broccoli. $&^*ing broccoli!!!! If that wasn’t enough then please also see phytates found in many legumes and wholegrains like oats. Calcium rich food and basically all dairy also contribute to cruddy iron uptake.

So just hang on here, am I telling you not to eat all this stuff? The second kicker comes now- no, I am not telling you that, because you need the legumes and the calcium and all that jazz. I’m telling you that if you are anaemic you need to start seriously juggling your food combinations, and I’m sorry about that.
Much like a single spoon of sugar in your morning cup of tea isn’t going to give you diabetes, a side of broccoli with your steak isn’t going to make you anaemic either. But the ongoing, multiple combinations of iron meddling foods throughout your diet add up, especially if you are plant based. Vegetable based iron is slightly less available to your body to begin with and many touted plant sources of iron (see chickpeas and soya) also contain the meddling compounds like phytates and polyphenols. Insert non-plussed emoji here.

So what’s the answer? Cave man keto? Maybe. Some of us (basically me) don’t have the moral or financial resource to live on steak and eggs for every meal and the more I read about iron absorption from diet, the more contradictions I come across- see the above point about chickpeas.
Thankfully one of the biggest tips is that vitamin C, another anti-oxidant, actually helps to bind dietary iron and get it into your system when consumed alongside iron rich foods. This is why I personally will always maintain that the best side dish to a steak is a tomato salad. If you are on iron supplements and your tummy can handle it, take the supplement an hour before eating and wash it down with orange or tomato juice. Use lemon juice in salad dressings to get the best from those greens. You get the idea.
The next step seems to be trying to avoid eating the blockers at the same time as your iron rich foods. Don’t mix dairy with meat/fish is the easiest one to remember. Watch your tea, coffee and red wine too. I know, I know 😦
But the real GOAT, OG, Boss Level thing to do if you think you have anaemia is to SEE A DOCTOR. Really, now, please. Even if you are able to self diagnose effectively (and you’ll only ever know you were right with a blood test), then fixing the symptom of scares red blood cells isn’t always going to address the underlying problem. Although anaemia is likely to be linked to iron in your diet, it could be due to a number of other sinister underlying conditions. Binging on sardines and ditching the yoghurt are not going to help if you have a bone marrow disorder.

I’m two weeks into my new iron awareness programme and I’m not yet ready to report any great insights or victories- but I’ll be back on this subject at some point. I am particularly tired today and pastier than ever, but gradually creeping my way through the jungles of information available about this reasonably common condition (30% of women aged 15-50). So far my focus is on ditching tea, coffee, and soya (it is in EVERYTHING) completely. I’ve moved on to kids cereal (literal doctors advice) to enjoy the extra goodness from fortification and I take my iron tablets on an empty stomach with a pint of fizzy vitamin c supplement drink. The new go to snack is a couple of dried apricots with some cashew nuts. I already put cavolo nero in everything at this time of year so that’s a little win for now.
For the ferrous curious I’ve listed some decent sources of iron and vitamin c as below, and I would love to hear from anyone in the comments or the inbox to see how you manage anaemia from day to day.

Let’s see how this goes!

Decent Dietary Iron Sources *items may also contain compounds that inhibit absorption
Beef
Offal, especially liver
Poultry
Lamb
Fish- particularly oily fish like sardines and mackerel
Shellfish- particularly oysters and clams
Eggs
White beans
Chickpeas*
Tofu*
Sesame seeds
Pumpkin seeds
Lentils
Skin on potatoes (white or sweet)
Seaweed
Leafy greens- kale, lettuce, bok choi, spinach (better cooked), brussels sprouts, mustard greens, chard, savoy cabbage
Broccoli*
Chanterelle mushrooms

Vitamin C Sources
Citrus fruit- lemon, lime, orange, grapefruit
Tomatoes
Kiwi fruit
Pineapple
Papaya
Parsley
Cabbage
Bell peppers*
Strawberries*
Blackberries*
Blueberries*