The Hidden Truth About Iron Fortification
By Sara Novak
You might be surprised when you look at a box of Cheerios to see that it contains 50 percent of your daily allowance of iron. I remember this from when I was pregnant and was constantly in search of new forms of iron. It seemed strange to think that milled cereal could have almost as much iron as a steak. This led to the realization that cereal and a number of other foods are fortified with iron. This means that iron is added unnaturally to the food. However, not all iron is created equal. Fortified iron is not the same thing as getting your iron from natural sources. Here is everything you need to know about iron fortification.
Table Of Contents:
- What Is Iron
- How To Get Enough Iron, But Not Too Much
- The History Of Iron Fortification
- The Risks Of Iron Fortification
- What Happens If You Get Too Much Iron
What Is Iron?:
Iron is a really important mineral in the human body that is responsible for hemoglobin, the substance in red blood cells that helps carry oxygen throughout the body. When you do not have enough hemoglobin throughout the body it can cause anemia, a condition marked by fatigue, brittle hair and nails, and pale skin.
There is a difference between heme and non-heme sources of iron and it should be noted that heme sources from animal sources are easier for the body to absorb. That is why vegans and vegetarians are much more likely to have anemia than meat eaters. Combining non-heme sources of iron with vitamin C (for example, a glass of orange juice) can make these foods easier for the body to absorb.
How To Get Enough Iron, But Not Too Much?
The average non-anemic person needs around 8-18 mg of iron daily. Most healthy adults who eat a varied diet can get enough iron from the foods they eat, especially in the United States. It is best to get it from foods that naturally contain iron for a number of reasons. For starters, most enriched or fortified iron foods are largely junk foods like cereal and processed breads. In fact, one of the reasons that fortifying still exists is so that we do not have to change our diets in order to get our fill. However, you should be getting the nutrients from a healthy whole foods diet. Some research has also shown that those that give blood are more likely to have the right amount of iron versus those that do not.
Choose a varied diet filled with iron containing foods, these include:
- Organ meats
- Red meat
If you are concerned about your iron levels, you can also take a blood test to see where you fall.
The History Of Iron Fortification:
Food fortification has its roots in doing good. It first started in 1920 with the fortification of salt with iodine in an effort to prevent goiters, abnormal enlargement of the butterfly-shaped thyroid gland below the Adam’s apple. Today around 31 percent of the world’s milled flours are fortified with any number of nutrients including iron, zinc, and a range of B vitamins. The hope is in keeping large populations healthy without having to change diets very much. In areas with malnutrition, this makes good sense. But in parts of the world where access to a wide variety of healthy unprocessed foods are easier, this makes much less sense. Additionally, you could end up getting too much iron. More than you need for your body to function normally.
Food fortification in the United States became more prevalent after the first and second World Wars to help with malnourishment, and surprisingly, to reduce deficiencies in people as foods became increasingly processed. The idea of using processed foods to deal with the problem of processed foods seems strange to me, but whatever. Food shortages also allowed for fortification after the World Wars in places like the United States, Ireland, Spain, and Denmark, and oddly, many of the same fortifying is still going on today.
Let’s be clear, across populations, fortifying foods has done wonders for eliminating population wide diseases like rickets, for example, but individually fortified foods can be problematic. it also can cause people that already get enough through their diets to end up with too much free iron rolling through their systems. Not to mention that in some populations in Africa where iron supplements became a thing, infectious disease deaths also went up, likely due to the way that free iron interacts with the gut.
The Risks Of Iron Fortification:
Iron fortification can be risky because you may end up getting way more than you need. For example, if you are a vegan and you already take an iron supplement, you can still end up getting more than 50 percent of your daily allowance from one bowl of cereal. You can see how it could add up. For children, it can be even more problematic because kids do not need as much iron. So make sure you are not getting too much, especially if you are already supplementing.
“For healthy people eating varied diets adequate in calories, there is little or no evidence that fortification improves health,” Marion Nestle, Ph.D., M.P.H., a professor of nutrition, food studies, and public health at New York University said in Consumer Reports.
Most enriched iron foods are also processed and less healthy.
What Happens If You Get Too Much Iron?:
When I was pregnant, I had to look at all the places where I was getting caffeine to ensure I did not end up with too much. The same is true of iron because it can accumulate in your system. Iron is a “double-edged sword” because you need a certain amount for the body to function normally, but too much is toxic. Here is what can happen if you overdo iron (which is most likely only if you’re overdoing fortified foods and are supplementing). Some research has even shown that a mild iron deficiency among non-pregnant adults actually reduced their risk of cancer and other diseases. Too much iron can cause the following conditions:
- Heavy metal toxicity
- Liver disease
- Heart problems
- Declines in gut health
- Growth impairment in children
- Free radicals
Too much iron can cause hemochromatosis. This can happen if you ingest too much iron or if you have a largely hereditary condition that causes you to absorb too much iron from the foods you eat. It is usually diagnosed in childhood, but in some cases, it can cause serious health problems. According to Mayo Clinic, “excess iron is stored in your organs, especially your liver, heart and pancreas. Too much iron can lead to life-threatening conditions, such as liver disease, heart problems and diabetes.” It is a balance of getting the amount of iron you need without ending up with too much in your system.
2. Toxic Metals
Iron is a heavy metal that can be toxic. As mentioned above, if it sits on top of your organs, it can do real damage. We need iron for our bodies to function normally, but beyond that, it becomes toxic. Iron toxicity often happens gradually. You might not even know that you are doing it to yourself, especially if you are piling loads of iron enriched items on top of one another. The bottom line is that iron overload increases the risk of human disease.
If you are a woman, you are much less likely to get too much iron because of the blood loss that you will endure in your lifetime due to menstruation and childbirth because more blood loss equals less iron. In fact, if you regularly give blood, you are less likely to ever have excess iron in your system. But if too much iron builds up on your organs, it could lead to arthritis, heart disease, diabetes, hypothyroidism, and other chronic conditions.
According to the National Institutes of Health, “high doses of iron can also decrease zinc absorption. Extremely high doses of iron (in the hundreds or thousands of mg) can cause organ failure, coma, convulsions, and death. Child-proof packaging and warning labels on iron supplements have greatly reduced the number of accidental iron poisonings in children.” If you have children around, you will want to make sure that iron supplements are not out where they can cause real harm if accidentally ingested.
3. Gut Health
Some research has also shown that iron fortification can impact gut health. Basically, while iron is important to counter anemia, which is common in Sub-Saharan Africa where the foods containing natural iron are less common, the downside has been an increase in death from infectious disease. A study published the American Journal of Clinical Nutrition found that “an increase in colonic iron through fortification or supplementation may shift the colonic microbiota equilibrium and favor the growth of pathogenic strains over healthy barrier strains.” Additionally, the study authors write “in high-income countries, because little is known about how dietary iron intakes in infants and young children affect the gut microbiome, more research is needed, particularly in the context of the high-iron fortification of infant formula such as in the United States.” Another study published in the Yale Journal of Biological Medicine found that Somali nomads that had a lower iron diet were less at risk of infectious disease. Their diets were naturally made up of foods that did not contain high levels of iron and very little fortified iron, which seemed to impact their overall health.
4. Growth Impairment
Iron fortification may be particularly problematic in young children. Research published in The American Journal of Pediatrics found that “free iron” or excess iron in the system, meaning that it is not attached to hemoglobin and used to transport oxygen in the blood, can have negative health repercussions. Too much free iron may impair growth as well as causing severe gastrointestinal problems like diarrhea, vomiting, fussiness, and constipation. The authors write “the gastrointestinal tract of the young infant is particularly vulnerable to any imbalances that can alter the mucosal barrier function.” The bottom line, according to the study authors, “infants assigned to the high iron formula scored lower on all developmental outcomes tested.” It is all the more reason to avoid too many iron fortified foods with your children in mind, especially in the form of fortified breakfast cereals, flours, and breads. A healthy balanced diet should provide all the iron your child needs.
5. Free Radicals
Free radicals cause aging in the body as well as all sorts of diseases, which is part of the reason that too much iron is a problem. The ability of iron to carry oxygen in the blood is based on how it easily loses or gains electrons. However, this is also the downside of iron. When it goes from the ferrous (Fe++) to the ferric (Fe+++) state, it becomes a free radical, and this is when the damage can be done causing the body to age as well as a host of diseases. According to The Conversation, “it also means it can be a potent pro-oxidant – it catalyzes the production of free radicals which can destroy cells and tissue, and thereby contribute to cancer and heart disease.”