What to Eat for Anemia? Foods and Meal Plans for Iron Deficiency

Anemia is common, especially among children, women, and older adults, and is caused by decreased hemoglobin, a protein that carries oxygen in the blood. Foods provide dietary iron and other nutrients involved in hemoglobin synthesis, and poor nutrition lacking these essential nutrients causes anemia. Discover how a healthy and balanced diet can help prevent and treat anemia by exploring which foods to eat and avoid.

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What Is Anemia?

Oxygen is essential for a functioning body. Blood carries oxygen to the organs through red blood cells (erythrocytes). In anemia, the number of healthy red blood cells decreases, thus, oxygen in the blood.¹

What Causes Anemia?

Health professionals diagnose anemia when an individual’s blood hemoglobin levels are below the normal range, which occurs due to one or more of the following: blood loss, decreased production, or increased destruction of red blood cells. There could be many causes, such as a diet lacking nutrients involved in hemoglobin synthesis, heavy menstrual bleeding, pregnancy, and chronic diseases.²

Blood Loss

Rapid or chronic blood loss can cause anemia. When bleeding, your body loses red blood cells, decreasing iron in the body, which then causes reduced synthesis of red blood cells.  

Some women experience heavy bleeding because of menstruation, which causes blood loss, contributing to anemia.

A Lack of Iron in Your Diet

There are many types of anemia, the most common of which is iron deficiency anemia. Iron is essential to hemoglobin, a protein that carries oxygen in red blood cells. When iron is deficient, hemoglobin synthesis is disturbed, lowering red blood cells' oxygen-carrying capacity.

Nutrient Deficiencies

Although the most common type of iron deficiency anemia is caused by deficient iron in the body, deficiencies of other nutrients are also associated with various forms of anemia. For example, vitamin B12 or folate deficiency can cause megaloblastic anemia. Besides vitamin C, vitamins A, E, zinc, and copper involve red blood cell production or function. Thus, deficiencies in other nutrients can contribute to anemia, too.

An Inability to Absorb Iron

Deficiencies of iron and nutrients, including folate and vitamin B12, can cause anemia. Bowel diseases, such as inflammatory bowel diseases, can prevent absorption of these nutrients even if they're taken enough through diet. Medications such as proton pump inhibitors can also disrupt iron absorption. 

Pregnancy

In pregnancy, a woman’s blood volume increases, thus the demand for iron to produce more red blood cells. Enough oxygen supply is critical for the baby's health; severe iron deficiency can interfere with the baby's cognitive and motor development. 

Chronic Inflammation 

Chronic inflammation caused by infection, kidney diseases, autoimmune diseases, and cancer can diminish the synthesis of red blood cells. 

Genetic Diseases

Genetic disorders, such as cell anemia and thalassemia, can cause abnormalities in the structure and function of red blood cells. 

Anemia Symptoms

In anemia, a lack of oxygen causes symptoms, including fatigue, lack of energy and concentration, weakness, and shortness of breath. 

• Weakness and Extreme Fatigue: Fatigue is one of the most common symptoms of anemia. Decreased oxygen capacity can cause suboptimal tissue and organ functioning, leading to fatigue.
• Pale Skin: In anemia, decreased hemoglobin level can cause paleness in surface areas rich in blood vessels such as the face, lips, and lower eyelids. 
• Chest Pain, Fast Heartbeat, or Shortness of Breath: Anemia is associated with heart diseases. Decreased oxygen capacity can cause an increased heart rate because the heart works more to supply more oxygen to tissues and organs.
• Headache, Dizziness, or Lightheadedness: Sudden changes in body position can cause lightheadedness and dizziness due to decreased oxygenization of the brain.
• Cold Hands and Feet: Anemia can cause poor circulation. Decreased blood flow can cause cold hands and feet and even numbness, damaging tissues. 
• Brittle Nails: Anemia can be caused by deficiencies of various nutrients, including iron and zinc, which also cause brittle nails.
• Unusual Cravings for Non-nutritive Substances (Ice, Dirt, or Starch): Some patients with iron deficiency can have pica, a condition in which they crave non-food items such as ice, dirt, and starch. 
• Poor Appetite, Especially in Infants and Children With Iron Deficiency Anemia: Anemia can cause changes in appetite, which can affect the growth and development of infants and children, worsening anemia further. 

What to Eat When You Have Anemia?

Ensuring enough iron intake can help prevent and treat iron deficiency anemia, the most common type of anemia. Recommended dietary allowances (RDAs) for iron are 18 mg for women and 8 mg for men aged 19 to 50. During pregnancy, this recommendation is increased to 27 mg.³

Other nutrients, including vitamin A, B12, folic acid, vitamin C, vitamin E, zinc, and copper, are also involved in the synthesis of blood cells.⁴

Although consuming foods to enhance blood cell synthesis helps prevent and treat anemia, medications or iron supplements are necessary to increase iron levels in some patients. Remember to consult your healthcare provider for the treatment of anemia.

1. Fruits and Vegetables

Fruits and vegetables are a source of antioxidant vitamins, such as vitamins A, C, and E, which are involved in the synthesis of blood cells. 

Vitamin A has a role in iron metabolism; it supports iron absorption and mobilization from iron stores. Vitamin C can enhance iron absorption, and both vitamin C and E, antioxidant vitamins, protect red blood cells from damage by decreasing oxidative stress.

Citrus fruits contain increased levels of vitamin C; thus, health professionals advise eating oranges or other citrus fruits while taking iron supplements or drugs.

Dark green leafy vegetables (i.e., Swiss chard, collard greens) are a source of folic acid, a deficiency of which is associated with a type of anemia called megaloblastic anemia. 

Eating five portions of fruits and vegetables can provide fiber and nutrients to increase iron absorption and prevent red blood cells from oxidative damage. 

2. Nuts and Seeds

Trace elements such as magnesium, selenium, zinc, cobalt, and copper are involved in hematopoiesis. Deficiencies of those elements were associated with anemia. For example, zinc is a cofactor of an enzyme that utilizes iron to synthesize red blood cells.⁵

Nuts and seeds are good sources of minerals such as magnesium, selenium, copper, and zinc. 

3. Red Meat, Poultry, and Fish

Meat contains iron and vitamin B12, whose deficiencies cause anemia. Organ meats, especially, are rich in iron, vitamin B12, and minerals such as zinc and copper. Three ounces of cooked beef liver contains about 5 mg of iron. 

Fish and shellfish (oysters and clams) also contain iron in various amounts. Three ounces of cooked oysters provide 8 mg of iron, three ounces of canned sardines provide 2 mg of iron, and three ounces of light canned tuna contain 1 mg of iron. 

4. Grains

Although grains are not naturally iron-rich, fortified, whole grains can provide extra iron. You can find iron-fortified breakfast cereal, wheat, and pasta. For example, some breakfast cereals contain 100% of the daily value of iron per serving. 

5. Beans and Legumes

Iron is found in animal and plant foods: heme and non-heme iron. The bioavailability of iron from animal sources is superior to plant sources. Still, beans and legumes can contribute to the daily iron intake of vegans and vegetarians. 

One cup of canned beans provides 8 mg of iron, equal to men's daily iron intake and almost half of women's. One-half cup of cooked lentils contains about 3 grams of iron, followed by chickpeas and kidney beans, providing less iron.  

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Foods to Consume in Moderation When You Have Anemia

Some nutrients and non-nutrient compounds have inhibitory effects on iron consumption. 

1. Dairy 

Calcium inhibits the absorption of iron.⁶ A study showed that 165 mg of calcium as milk or cheese inhibits iron absorption by 50 to 60%.⁷

Remember, calcium is crucial for bone health. You should keep consuming calcium-rich foods; however, separating their consumption from iron-rich foods can help the absorption of dietary iron. 

2. Tannin-Rich Foods

Tannin is a phenolic compound naturally found in some foods and drinks, including wine, tea, cacao, legume seeds, nuts, and green vegetables. A study showed that 1 cup of tea with meals decreased iron absorption by around 37%. When administered 1-hour after a meal, it reduced iron absorption by 18%.⁸

A Meal Plan for Anemia

A healthy and balanced diet plan is crucial to help prevent and treat anemia because iron and many other nutrients are involved in synthesizing red blood cells. Here are some ideas for meal planning for anemia.

Breakfast: Most people consume cereals, oatmeal, or bread for breakfast. If you eat these foods regularly, replacing them with iron-fortified alternatives can contribute to daily iron intake. 

Snack: You can consume calcium-rich foods at snack times to prevent decreasing meal iron absorption. Drinking a cup of milk with your coffee alongside a trail mix of nuts, seeds, and dried fruits can prove essential minerals to support the synthesis of blood cells. 

Lunch or Dinner: Lean meat options are excellent sources of iron. You can create many meals with red meat, chicken, or fish. You can cook beef, steak, and salad, which provide folic acid and antioxidant vitamins. 

If you're vegan or want an easier lunch, white beans with brown rice can also contribute to your daily iron intake. Another alternative for vegans can be tofu-containing meals since ½ cup of firm tofu provides 3 mg of iron. 

Throughout the day, it's essential to include iron-containing foods in your meals. Eating from all food groups is also necessary to prevent other nutrient deficiencies which may contribute to anemia.

Remember to consult a healthcare provider or a registered dietitian for personalized meal planning to meet your dietary requirements and needs. Your doctor will give you medications or iron supplements if you need more than an iron-rich diet.

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