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Recently a client came to me after being diagnosed with anemia. A long time vegetarian she was worried that this meant she’d have to start eating meat again. The truth is you can get enough iron without eating meat — iron deficiency is actually no more common in vegetarians, but it’s all about striking the right balance. But first, it’s important to be sure that your diet is in fact the culprit. There are four main origins of anemia, so it's critical to have your doctor determine the true cause:

Blood loss. This is the most common cause of iron deficiency anemia in the United States. The reason is that blood contains iron within red blood cells. So when you lose blood, you lose iron. Women with heavy periods are at risk of iron deficiency anemia because they lose a lot of blood during menstruation. Slow, chronic blood loss within the body — such as from an ulcer, tumor, colon polyp, or uterine fibroids — can also cause anemia, as can chronic use of aspirin or other pain killers.

An inability to absorb iron. Iron from food is absorbed into your bloodstream in your small intestine. An intestinal disorder can affect your body’s ability to absorb this mineral.

Pregnancy. Without iron supplementation, iron deficiency anemia often occurs in pregnant women because their blood volume increases and their own iron stores go to the baby.

A lack of iron in your diet. If you consume too little iron, over time your body can become iron deficient. If your anemia is indeed nutrition-related, there are several effective ways to boost your intake while maintaining a plant based diet:

• First eat vitamin C rich food with iron rich foods — this can help to boost the absorption of iron from your digestive system into your blood by about six times. Great pairs include:

-Spinach with red bell pepper
-Broccoli with tomatoes
-Bok choy with oranges

• Next, cook in an iron skillet. Acidic foods that have a higher moisture content, such as tomato sauce, absorb the most iron from these pans. One study found that the iron content in 3 oz of spaghetti sauce increased 9 times after being cooked in a cast iron pot.

• Incorporate more beans and grains into your diet. Lentils, quinoa and black beans are all good sources, and 1 cup of soybeans provides 50 percent of what you need daily. Again, pair them with vitamin C to boost absorption. Other good vitamin C sources include strawberries, papaya, kiwi and pineapple.

• Sweeten your meals with a little blackstrap molasses. 1 tbsp provides 20 percent of the daily need for iron. Mix it into natural almond or peanut butter or use it to sweeten baked beans or a banana smoothie.

• Watch your intake of substances that limit iron absorption. Tannins (found in tea and coffee) and calcium interfere, so try to drink tea or coffee, and consume calcium supplements at least a few hours before a meal that is high in iron.

• Be sure not to overdo it. Adult women need 18 mg. of iron per day and men 8 mg. In women, the need increases to 27 mg. in pregnancy and drops to 8 mg. after menopause. Men and post-menopausal women must be careful not to get too much iron, because once you absorb it, essentially the only way to lose it is bleeding, and since these two groups don’t regularly bleed, too much iron could lead to iron overload, a serious condition in which excess iron gets stored in organs such as the liver and heart.

This is why these two groups shouldn’t take a multivitamin with iron unless it has been prescribed by a doctor. 

Cynthia Sass
Cynthia Sass
is a registered dietitian with master's degrees in both nutrition science and public health. Frequently seen on national TV she's a SHAPE contributing editor and nutrition consultant to the New York Rangers and Tampa Bay Rays. Her latest New York Times best seller is Cinch! Conquer Cravings, Drop Pounds and Lose Inches.

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