Iron is an indispensable nutrient required by every human for oxygen transport, energy production and neurotransmitter synthesis. Despite its criticality, iron deficiency (ID) remains the topmost nutritional deficiency worldwide having affected more than 30% of the world population. The statistics sound alarming but there is truth to it-there are one or two cases of those irrespective of their age (even as young as 10-year-olds to as old as 70-year-olds) suffering from anemia in each of our homes (especially girls). ID and ID anemia (IDA) are a problem present in both developing and developed countries which have an impact on pregnancy outcomes, mortality rates, immunity levels, cognitive functions and physical development in kids. Almost 40% of perinatal maternal deaths are due to anemia, performance of school-going kids becomes greatly hampered due to their cognitive decline experienced due to ID and thyroid functions too are affected. Even in those who suffer from ID alone there is a risk of reduced physical activity, diminished productivity and increased fatigue.
Anemia is also a condition that’s commonly present among the elderly population whose rates keep increasing with increasing age. We are quite aware that the elderly population are becoming more in number, especially in the developed countries where access to medical facilities and all other provisions are easily available. Japan, a country which is known for a longer lifespan is expected to quadruple its elderly population by 2050 and what would be the effect of anemia on them? US reports higher number of anemia cases among elders residing in nursing homes in comparison to those living in the community. Australia too shows that it’s their elderly population who are the greatest victims to anemia-a condition that rapidly increases in proportion after the age of 65.
ID is the result of insufficient absorption or intake of iron to meet the body’s iron requirements. There are several factors affecting the absorption of iron which include the individual’s iron status, iron content and composition of the meal. Dietary iron is of two types namely heme and non-heme. Animals foods such as fish, beef, pork, lamb and poultry are common sources of heme iron whose absorption rate is comparatively higher to the non-heme form whose sources are plant-based foods such as vegetables and grains. So, the diet that you consume plays a critical part in affecting your iron levels in the body.
In Australia, there is a recommendation for adults to consume a maximum of 65 g of lean meat/day from nutritive food sources. Though occurrence of anemia is common with ageing it is not a natural effect of ageing but might be the result of an underlying chronic condition or nutritional deficiency of iron, folate and vitamin B12 (1/3rd of anemia cases in elderly people are due to iron deficiency). Fish and meat are reliable sources of vitamin B12 and iron but the consumption of these foods differ from country to country. For example, the elderly population of Japan consume more fish but less meat and the consumption of these animal sources differ between Asian and Western population too-fish consumption is higher in Japan than in the United States. Meat contributes to about 14% of the daily total iron intake in the United Kingdom. But there are lack of studies linking fish intake with anemia risk. The study below assesses the link between intake of animal foods and the risk of anemia in the Japanese population.
Japanese Long-term Study
A total of 6,469 participants were involved in the study after they were chosen based on different criteria such as abstinence from using iron supplements or fulfilled the age criteria of ≥65 years. Smoking habits were noted down and each of the participants were segregated into one of the 3 groups-past smokers, current smokers and no smokers-based on certain criteria. Exercise habits were taken down and every volunteer belonged to any of these groups-unable to exercise because of illness, unable to exercise because of other reasons and exercising regularly. BMI values were noted and dietary intakes were monitored. 9 nutrients ((carbohydrate/ total fat/ total protein/ animal protein/ plant protein/ iron/ vitamin B-12/ folate/ vitamin C), 7 food groups, 13 food items for fish ((mackerel, sardine/ salmon, trout/ sea bream, flatfish/ tuna, marlin, swordfish/ other raw fish/ shellfish/ squid, octopus/ prawn, shrimp, crab/ salted, semidried, fully dried seafood products/ canned fish products/ tsukudani/ fish paste products/ fish ham and sausage) and 9 food items for meat ((beef/ pork/ ham, sausage/ other animal meat/ chicken/ poultry/ organ meat/ whale meat/ insects, frogs, and turtles) were used in the present study and the daily intake of fish and meat was calculated as the sum of the 13 and 9 food items. Blood samples were collected and anemia was defined as hemoglobin concentrations <13.0 g/dL in males and <12.0 g/dL in females (according to WHO). Results showed that:
Iron Consumption & Anemia Prevention: A Systemic Review
We do recommend dietary modifications to include greater sources of iron (animal foods) and this does seem to be a simple solution but the effect of this on the individual is not extremely clear. The question does arise whether higher consumption of animal flesh paved way for better iron levels in adults in developed countries.
The systematic review included studies based on different criteria, animal flesh was defined as the muscle tissue of an animal carcass (such as red and white meat from chicken/poultry, sheep, pig, cattle, goat, fish, buffalo, kangaroo, camel and deer). Processed meats such as ham, bacon and sausages were also included.
49 studies were included in the review which consisted of 111,846 participants totally. Only 9.6% of the total participants were males, 2 studies were male-only, 29 studies were female-only and the remaining 18 studies consisted of mixed participants. Age of the participants were between 18 and 93 years. Results showed that:
Seven studies showed positive results of which six of them focused on women of childbearing age and they showed that intake of iron had a positive impact on these individuals. One study, Blanton found that moderate consumption of beef resulted in significantly higher serum ferratin (SF) Hb concentration at 16 weeks, the number of women who experienced a SF response during the intervention was not different between beef and non-beef lunch groups. Iron status of women is closely associated to the baseline iron level and women with a lower baseline experience greater improvement due to addition of iron-rich foods. Two studies showed that women who diet for weight loss are at an increased risk of developing poor iron status. So, those women who include meat as a regular part of their weight loss diet have a protective effect on iron status. Exercise too depleted iron stores as sweat and including foods rich in iron help exercising women of childbearing age.
Observational studies show conflicting results. Two studies showed that women consuming greater quantities of red meat and animal flesh had better iron status and reduced risk of iron deficiency but another study, Pynaert et al. showed that there was no link between the two. Few large observational studies included pre- and post-menopausal women who showed benefits reaped due to total flesh intake and iron status. In a large cohort study done on postmenopausal female population increased red meat consumption was reported in women without ID anemia indicating that red meat might be beneficial to lower the risk of ID. A majority of the observational studies reported greater SF and iron status indices in subjects consuming an omnivorous diet compared to a vegetarian diet showing that including foods such as fish and meat does increase greater iron status for adults. Beck et al found that those individuals consuming the highest amount of meat and vegetables had greater SF and Hb and reduced ID risk in comparison to those consuming least meat and vegetables.
Totally, only seven studies showed beneficial effects of consuming animal flesh and iron levels, 38 rated neutral effects and four of them marked negative effects. But overall, there seems to be an optimistic link between consumption of animal flesh and iron status of adults within developed countries.
Meat is an important source of a variety of micronutrients and red meat is a great source of iron (almost 50-60% is in the easily absorbed heme form). Iron is present in the protein heme structure which makes it readily available and in higher amounts (15-25%) in comparison to the plant source (1-7%). Whereas, plants have chelators such as phytic acid that reduce iron absorption.
But we do have studies showing that overconsumption of iron-rich foods or too much of iron content in the body is also not good for health. Animal foods are the go-to foods if you would like to add iron content to your body in a minimal time. Ensure to eat a well-balanced diet consisting of a portion of fish and meat alongside your fruits and vegetables as well.
Fish & Meat Intake & Prevalence of Anemia among the Japanese Elderly: http://apjcn.nhri.org.tw/server/APJCN/28/2/276.pdf
Is Higher Consumption of Animal Flesh Associated with Better Iron Status Among Adults in Developed Countries? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4772052/
The Impact of Lean Red Meat Consumption on Human Health: https://www.tandfonline.com/doi/full/10.1080/19476330902940523
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