Ask The Expert is a weekly column on Littlestomaks.com. The idea is to have a reader-submitted question answered by a nutrition expert or a pediatrician. Feel free to submit your question in the comments section below.
This week, Registered Dietitian Nour El-Zibdeh offers tips for getting enough iron from a vegetarian diet without relying on supplements.
|Nour El-Zibdeh, RD
Question: How can I ensure enough iron if my child is on a strict vegetarian diet?
Iron is important for health. It is part of hemoglobin, a protein found in red blood cells, and its main role is to transfer oxygen to body tissues and cells.
Too little iron causes fatigue, decreased immunity, and may impair psychomotor development in infants. Iron deficiency occurs due to three general reasons:
- increased needs of iron (growth),
- decreased absorption (iron in the diet comes from sources that are not easily absorbed, such as plant foods),
- decreased iron intake (low total food intake).
The prevalence of iron deficiency in the United States is low. However, toddlers are at a high risk because they don’t drink or eat iron-fortified formula or cereal anymore, and their intake of iron-containing foods may still be low. Toddlers who are on vegetarian diets, drink more than 24 ounces of milk a day, or suffer from decreased availability of food are at an increased risk.
Type of iron in the diet
There are two types of iron in the diet, heme and non-heme. Heme iron comes from animal sources and is the most easily absorbed. Non-heme iron is the most prevalent in food, found in both animal and plant sources, but its absorption is less efficient and can be influenced by many factors.
When discussing plant sources of iron, two points must be distinguished. First, the amount of iron in plant foods, and second, the amount that is actually absorbed. For example, half cup of soybeans has 4.5 mg of iron, but the fiber and protein in soybeans prevent its absorption. Half cup of tomatoes, on the other hand, has 1 to 2 mg of iron but is easier to absorb. Vitamin C improves the absorption of iron, while phytates (in bran and whole grains), oxalates (in spinach, rhubarb, strawberries, nuts, chocolate, and wheat bran), polyphenols (in coffee and tea), calcium, and fiber prevent its absorption.
Tips for vegetarian toddlers
- Offer a variety of plant foods, especially those high in vitamin C. These include guava, lemon, orange, papaya, tomatoes, beetroot, broccoli, cabbage, cauliflower, pumpkin, and turnips.
- Choose iron-fortified cereals and grains when possible.
- If you are interested in numbers, toddlers one to three years old need 7 mg or iron a day, and toddlers over four years old need 10 mg a day. Since iron in plant foods is not absorbed entirely, aim for more than the recommended amount from plant foods, not supplements. Here are some foods rich in iron.
- Don’t give your toddler more than 24 ounces of milk (cow, goat, or soy) a day. Milk is low in iron and high in calcium (prevents iron absorption), and too much can be filling causing your child to be uninterested in other iron-containing foods. Too much cow’s milk can also irritate the gastrointestinal tract and cause bleeding, which will lead to iron losses.
- Don’t stress about iron deficiency unless your child shows symptoms, which include fatigue and weakness, pale skin, mucous membranes, rapid heartbeat, irritability, decreased appetite, dizziness, or feeling lightheaded.
- Consult with your pediatrician if you suspect deficiency, and don’t give your child iron supplements on your own. The human body doesn’t have a way to get rid of excess iron, so too much can be toxic and cause organ damage.
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