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The anaemia epidemic – is iron deficiency making you tired all the time?


More than a quarter of women are not getting enough iron, putting us at risk of being tired all the time, hair loss, mood swings and full-blown anaemia, say experts. Anna Magee reports 

From the explosion of vegan Instagrammers to the spread of meat-free restaurants across the Capital, eating less meat – or avoiding it altogether – is suddenly cooler-than-cool.  But a group of experts are warning that misleading advice on red meat and one-size-fits-all dietary guidelines are putting millions of British women at risk of nutritional deficiencies – namely iron, the key nutrient found in red meat, a deficiency of which can result on constant tiredness, hair loss and mood swings. Sound familiar?

A staggering 27 per cent of women aged 19 to 64 fail to achieve minimum recommended intakes of iron. Indeed, the latest Diet and Nutrition Survey which assesses the dietary habits of the nation annually has found women are eating an average of just 47 grams of red meat a day, an alarming third less than the Department of Health’s official advice of 70 grams a day.

Why are more women at risk of iron deficiency?

Last year, the government’s Eatwell Guide which provides nutritional advice for Britons from Pubic Health England was updated with advice that everyone should ‘eat less red and processed meat.’ Such umbrella recommendations are dangerous as it’s one-size-fits-all advice for red meat consumption, says public health nutritionist Dr Emma Derbyshire.

Public Health England’s updated Eatwell Guide

‘This implies everybody needs to eat less red and processed meat when in fact, such advice only applies to those who are over-consuming red and processed meats in the first place. Communicating such a message to everyone puts vulnerable groups such as young girls and women who already have low meat intakes at risk of developing anaemia and iron deficiency,’ Dr Derbyshire explains.

Blanket advice to everyone to eat less red meat can be dangerous to those already eating too little, say experts

Iron deficiency anaemia (IDA) is the most common nutritional disorder in the world according to the World Health Organisation. In Britain, the British Medical Journal suggests three per cent of men and eight per cent of women suffer with IDA while a staggering one in ten British women are iron deficient. Moreover. while babies need iron to grow, research suggests that anywhere between 15 and 40 per cent may not be getting the iron they need, and if those are being breast-fed, this could be thanks to the mother’s diet.

Women aged 16 to 49 in Britain are only consuming 47 grams a day of red and processed meat, and the government suggests we should be having around 70 grams each day (or 500 grams a week) to get our iron stores to healthy levels.

But why can’t we just eat more iron-rich greens?  The type of iron found in meat is called heme iron, says Dr Gill Jenkins, an NHS GP practicing in Bristol. ‘This is more easily absorbed than the type of iron you get from pulses and vegetables,’ she says. ‘The classic ‘spinach is good for you’ is all very well but you would have to eat about a wheelbarrow full of spinach to get your iron requirements each week.’

Symptoms of iron deficiency

In her practice, Dr Jenkins sees a growing number of young women cutting out meat, thanks to such blanket messages as that found in the Eatwell guide along with confusing advice from unqualified people on Instagram and Twitter, she says. ‘On one hand, I see iron deficiency and anaemia in pre-menopausal women who have menstrual blood loss and need more iron. But I also see it increasingly in teenage girls who have read articles telling them meat is bad for them and so they just cut it out and that’s when I see the tiredness, the hair loss, the mood swings.’

Hair falling out is a common symptom of iron deificiency, says Dr Jenkins. ‘I will always test for ferritin (iron stores) along with thyroid function and anaemia if someone comes in with thinning hair.’

Feeling tired all the time is a key symptom of iron deficiency

But the most common symptom Dr Jenkins sees in women in her practice is feeling tired all the time. ‘They may think they have chronic fatigue or ME or some other deep-seated issue but when we drill down to it, it’s often because they’re not eating properly and subsequent tests will show their iron levels are compromised because they equate meat with fat or ill health.’

Other symptoms of iron deficiency and anaemia include pale skin, pale upper and lower eyelids, a tingling or crawling feeling in the legs, dizziness, weakness and shortness of breath as well as tongue swelling or soreness.  Watching your iron intake is crucial if you want to have a baby too as infertility can be related to iron deficiency, says Dr Jenkins.

Will eating meat make me fat?

Women often associate meat with fat, says Dr Jenkins. ‘But a good lean piece of meat will satisfy your appetite and suppress hunger much more than eating only carbohydrates or vegetables.’ This is thanks to what’s called the ‘thermogenic’ effect of eating meat on the body. Meat takes longer to digest and therefore burns more calories in doing so while the protein in meat also helps keep people fuller for longer than eating only carbohydrates with vegetables which can often take a shorter time to digest, leaving you hungry again faster.

Are you getting your five-a-week?

How can we ensure we get enough precious iron into our bodies without putting ourselves at risk of weight gain or ill health then? The answer is all about portions, say experts. Together with the Meat Advisory Panel (MAP) which provides nutritional information to the public on meat, Dr Derbyshire suggests we should follow a ‘five-a-week’ message for our meat intake, in the same way as we do our five-a-day for vegetables.

Meat in moderation, as 70 gram portions, five times a week, can keep your iron levels healthy

If you look at the government’s advice to eat 500 grams of red or processed meat a week, an easy way to break this down is to have a 70 gram portion, five times a week,’ Dr Derbyshore suggests. So what does 70 grams of red or processed meat look like? ‘The size of a deck of cards, the palm of your hand or about one and a half sausages,’ she says.

A deck of cards is a great indicator of the right meat portion size

In the case of processed meat, there is mounting evidence that having too much of it can contribute to cancer. However according to Dr Derbyshire, the evidence for processed meat and cancer is associated with preservatives such as nitrates and nitrites. ‘Many British sausages don’t contain these substances and are often only the meat, unprocessed, so talk to your butcher or look on the label for any preservative ingredients such as nitrates or nitrites. The more expensive sausages are less likely to be processed,’ she explains.

How much and what type of meat is best?

Healthista have asked the MAP to provide the following panel to help our readers see the iron, calorie and fat levels of typical pieces of meat. You can that lean beef and venison are great choices for low calorie, high iron and low fat and, as long as you stick to an 70 gram portion five times a week of any of the following low fat choices, you’re probably keeping yourself free of risk of iron deficiency.

More Healthista nutrition:

23 foods high in iron

Why do I bloat? 9 symptoms of gut problems most doctors ignore

Healthy meal ideas – the new online tool for recipe inspiration



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