Category Archives: iron

Iron and Zinc Intake Linked with PMS

An iron-rich diet lowers the risk of pre-menstrual syndrome (PMS) according to a new study published in the American Journal of Epidemiology (1).

The study is one of the first to investigate whether dietary mineral intake is linked with PMS. The diets of more than 3,000 American women were analysed, with women completing three food frequency questionnaires over a 10-year period. After 10 years, 1,057 of the women were diagnosed with PMS while 1,968 of the women were free from the condition. The researchers then compared the diets of the women with PMS with the diets of the women with no symptoms. The researchers adjusted for factors known to affect PMS such as calcium intake.

The results showed that non-heme iron intake is linked to a lowered incidence of PMS. Non-heme iron is the iron found in plant foods and supplements, rather than iron from animal foods. Senior research Elizabeth Bertone-Johnson said that the women who consumed the most non-heme iron from both foods and supplements had “a 30 to 40 percent lower risk of developing PMS than women who consumed the lowest amount of non-heme iron”. The results also showed that women with the lowest iron intake were almost twice as likely to suffer with PMS compared to women with the highest intake.

“The level of iron intake at which we saw a lower risk of PMS, roughly greater than 20 mg per day, is higher than the current recommended daily allowance (RDA) for iron for pre menopausal women,” Bertone-Johnson says.

The researchers also suggested that iron may be related to PMS because it is involved in producing serotonin, a neurotransmitter that helps to regulate mood.

Vitamin C intake is linked with helping the absorption of iron

While iron supplements may of course be helpful to ensure adequate intake, it’s important to ensure that good dietary sources of iron are included each day. Good plant-based sources of iron include pulses such as lentils, beans and chickpeas, nuts and seeds, dried apricots and leafy greens such as spinach and kale. Iron-fortified cereals are another rich source. Adding citrus fruit or a glass of orange juice is also helpful as Vitamin C boosts iron absorption.

Another mineral was also highlighted by the study as significant in its influence on PMS. “We also saw some indication that high intake of zinc was associated with lower risk” Bertone-Johnson explains. The level of zinc linked to a lower risk of PMS was greater than 15mg each day which again is higher than the RDA.

Zinc is needed for the proper action of many hormones and it can also lower levels of hormones such as prolactin which are implicated in PMS.

Ensuring a good intake of zinc through the diet means eating zinc-rich meats such as venison, beef and turkey, while vegetarians should emphasise foods such as yoghurt, spinach, mushrooms and oats. Zinc from plant sources is less well-absorbed and so vegetarians may benefit from a zinc supplement to ensure adequate intake. It should be noted, however, that excessive levels of zinc can be detrimental to health and should only be taken under the supervision of a health practitioner.

More research is needed in this area to confirm the results of this study. In the meantime, however, ensuring an adequate intake of both iron and zinc seems a sensible measure for those who suffer with PMS.


1. Patricia O. Chocano-Bedoya, JoAnn E. Manson, Susan E. Hankinson, Susan R. Johnson, Lisa Chasan-Taber, Alayne G. Ronnenberg, Carol Bigelow, and Elizabeth R. Bertone-Johnson. Intake of Selected Minerals and Risk of Premenstrual Syndrome. American Journal of Epidemiology, 2013 DOI: 10.1093/aje/kws363.

2.Image courtesy of topfer.


Choosing the Best Supplements: Part Two

In Part One I discussed some guidelines to help ensure that you are getting the best out of your supplements. Read on for more pointers.

Mineral Bioavailability
There isn’t much point in taking a supplement in a form that your body cannot use. Mineral bioavailability simply refers to the proportion of a mineral that is actually absorbed into the blood to be used by the body.

A ‘bioavailable’ mineral must be soluble in the intestine so that it can be absorbed. Minerals should be bound to different compounds to aid their absorption. This binding, or ‘chelation’, helps the mineral to survive the acid environment of the stomach and pass through into the small intestine for absorption.

If the mineral is bound too tightly, or not tightly enough, it can be released at the wrong time.  This is why the ‘form’ of the mineral is an important consideration.

Generally inorganic forms of minerals – carbonates, sulphates and oxides are not well absorbed. On the other hand, organic forms such as citrates, gluconates, aspartates and amino-acid chelates are more bioavailable.

Better quality minerals, i.e. those that are in a bioavailable, organic form do tend to be more expensive. However, cheaper supplements may be a false economy if they are poorly utilised by the body. Choosing a supplement becomes a case of weighing the cost of the supplement against its bioavailability. For example, in the New Optimum Nutrition Bible, Patrick Holford (1) explains that iron amino acid chelate is four times better absorbed than other forms, making it worth the additional cost.

Holford lists the most bioavailable forms of each mineral. All of the following forms are the most readily available to the body. In descending order (the very best first), he lists:

A multi-mineral supplement including Chronium, Calcium, Magnesium, Iron, Zinc, Manganese and Selenium.

Calcium – amino acid chelate, ascorbate, citrate, gluconate, carbonate

Magnesium – amino acid chelate, ascorbate, citrate, gluconate, carbonate

Iron – amino acid chelate, ascorbate, citrate, gluconate, sulphate, oxide

Zinc – picolinate, amino acid chelate, ascorbate, citrate, gluconate, sulphate

Manganese – amino acid chelate, ascorbate, citrate, gluconate

Selenium – Selenocysteine or selenomethionine, sodium selenite

Chromium – Picolinate, polynicotinate, ascorbate, gluconate

Tablets or Capsules?
Deciding between capsules or tablets is often a personal preference. Those who find tablets difficult to swallow often favour easy-to-swallow capsules. Sensitive individuals also tend to prefer capsules which are more likely to be free from fillers or binders. On the other hand, tablets can be compressed meaning that a higher dosage can be delivered in a single pill. They also allow for ‘sustained-release’ formulas. This can be useful for water-soluble vitamins such as Vitamin C, where absorption is better when given as a steady release formula rather than in a single dose.

For very sensitive individuals or for the delivery of light-sensitive nutrients such as coenzyme Q-10, capsules are the best choice. There are of course advantages to both types of supplements, which are listed below.

Capsules Tablets
Superior protection against oxygen and light Low cost
No need for fillers and binders Allows for sustained-release formulas
Odorless and tasteless Can fit more ingredients in through compression
Less gastrointestinal irritation Can be notched to divide the dose

Quality Assurance
The simplest way to be certain of the quality of a supplement is to check that it is GMP certified. Good Manufacturing Practice (GMP) is an assurance of quality of manufacture. While medical drugs are held to these strict standards, it is not currently a legal requirement for food supplements in the UK. However, most reputable supplement companies voluntarily submit their products to GMP certification. This compliance requires thorough record keeping, quality testing, and standards consistent with the manufacture of drugs.


1. Holford, P (2004) Patrick Holford’s New Optimum Nutrition Bible. London: Piatkus.


Sun Chlorella Smoothie Recipes

Healthy eating is one of the most important parts of healthy living. We all try to eat the best quality and the freshest food that we can, but even with our best efforts, sometimes we need to adjust our diets to include supplements.

Introducing Sun Chlorella – once a secret of The Far East, chlorella is now becoming revered in The West as a natural wholefood supplement – good for maintaining optimum health. Simply, Sun Chlorella  supplies your body with some of the important nutrition that your body may be lacking.

Chlorella is rich in a variety of nutrients including:

  • Vitamin B12
  • Vitamin D
  • Vitamin A
  • Iron

Amongst many benefits, they can help to:

  • Fight fatigue/combat tiredness
  • Maintain a healthy immune system
  • Chlorella is also known to help maintain a normal colonic function

Mix up your smoothies and try blending Sun Chlorella into your favourite smoothie. Add fruits such as a kiwi or fresh mango to give sweetness or even tomato for a more savoury flavour. Just remember – all ingredients should be fresh and raw for maximum nutrients! Here are two fantastic smoothie recipes to get you started:

Savoury Smoothie Recipe No 1:

Sun Chlorella Green Smoothie
Sun Chlorella Green Savoury Smoothie


300ml water, 80g cucumber, 80g spinach, 40g rocket, 15 Sun Chlorella tablets, 20–40g avocado (optional), a pinch of salt (optional), half a clove of garlic (optional), 1–2 teaspoons of lemon juice (optional).

Can also add other greens such as fennel bulb, parsley, pak choi, basil, kale, etc.


1. Place water in blender (liquidiser)
2. Chop all ingredients
3. Add all ingredients and blend until smooth
4. Divide smoothie in to two portions (each portion is about 300mls)
5. Consume half before breakfast and second portion refrigerated or placed in a cold thermos flask to be consumed before lunch


Sun Chlorella Sweet Smoothie
Sun Chlorella Sweet Smoothie

Sweet Smoothie Recipe No 2:


300ml water,80g cucumber, 40g spinach, 80g banana, 40–80g strawberries, 20–40g raspberries, 20–40g blueberries, 15 Sun Chlorella tablets.


1. Place water in blender (liquidiser)
2. Chop all ingredients
3. Add all ingredients and blend until smooth
4. Consume as part of breakfast and a portion can be refrigerated or placed in a cold thermos flask to be consumed at lunch



Content, recipes & images courtesy of the team at Sun Chlorella.


Iron Supplementation During Pregnancy Could Prevent Complications

Anaemia occurs when haemoglobin levels fall below the lower safe limits. This is often more common in pregnancy due to the higher demands that the growing foetus puts on the body. The leading cause of anaemia is iron-deficiency which generally results in symptoms such as weakness, fatigue and light-headedness. This happens because iron is a compulsory mineral for transporting oxygen around the body through the blood to tissues as well as being used for enzymes that produce energy. Therefore if the body is deficient, these essential processes will decline and the symptoms will become apparent in the sufferer.

Iron Supplementation During Pregnancy
Iron supplementation during pregnancy could prevent anaemia induced pregnancy complications and newborn abnormalities.

Eating foods containing iron can help this deficit. Eating the following foods can help to increase your iron uptake: Sun dried tomatoes, sunflower seeds, dried apricots, foods from the bean family, tofu, raisins, whole wheat bread and of course, spinach in addition to meats including chicken, turkey and beef.

Females’ iron stores are often already limited due to their monthly menstrual blood losses (which in rare cases may also be present in pregnancy) and, during pregnancy, the body attempts to compensate for the increases in blood quantity caused by the growth of the unborn child. Therefore although the overall nutritional needs of the mother increase significantly in pregnancy, iron needs can surpass other nutrient requirements during this time. The average pregnant woman needs approximately twice as much iron as she would normally require (about 30mg a day) (1), and it is when this need is not met that pregnancy induced iron-deficiency anaemia occurs.

A recently published study (2) investigated the efficacy of iron supplementation in anaemic pregnant women based on incidences of pregnancy complications and birth outcomes. The authors did this by comparing incidences of problems in pregnancy and the outcome of the birth with iron deficiency and iron supplementation in those who gave birth to malformed newborns or healthy babies. The study published in the journal Nutrition in 2011, used medically recorded data from the population based Hungarian Case Control Surveillance System of Congenital Abnormalities, which is a set of information about birthing outcomes. Of the 22,843 cases with abnormalities, a significant 16% had mothers with anaemia.

Early diagnosed anaemic pregnant women who were not supplemented with iron had shorter delivery ages and significantly higher premature births, however this was not found in those who had been supplemented with iron. The authors found a 0.4 week shorter mean gestational age in anaemic women without iron supplementation than those with iron supplementation and preterm births were also lower with iron treatment. The incidence of complications in pregnancy was higher for anaemic mothers, and iron treatment was also found to reduce severe nausea and vomiting. The authors also found that the improvements in complications and birthing outcomes were greater in those that had supplemented with both iron and folic acid together.

Based on these findings, if you are pregnant or are planning on becoming pregnant, you may want to consider supplementing your diet with both iron and folic acid. However, you must always consult your GP or Health Practitioner before embarking on any new supplement regimen.


Written by Lauren Foster


(1) Miller, R.S. (2011) Nutritional needs during pregnancy. Nursing Made Incredibly Easy, 9, 5, 21–24.

(2) Banhidy,F., Acs, N, Puho, E.H., Czaizel, A.E. (2011) Iron Deficiency Anaemia: Pregnancy Outcomes With or Without Supplementation. Nutrition, 27, 1, 65-72.


Iron deficiency is linked to childhood mental and behavioural health

Iron deficiency anaemia is the most common nutritional deficiency worldwide, affecting around 2 billion people.  Here in the UK the National Diet and Nutrition Surveys have revealed that most children under the age of 18 have dietary iron intakes below the RNI (reference nutrient intakes).  This is very worrying as iron is important for normal neurodevelopment (development of the brain and nervous system) and deficiency, with or without anaemia, in infants and children appears to adversely affect social and emotional development, intellectual performance and concentration span and has been linked to ADHD (Attention Deficit Hyperactivity Disorder), hyperactivity, aggressiveness, poor mood and fatigue.

The most recent study was published in an American journal in May(1).  The study leader, Dr Betsy Lozoff, is a leading researcher in the field of iron deficiency in childhood.  The researchers looked at the social and emotional behaviour in a group of infants who were 9 months old at the start of the study.  Tests confirmed that around a third of the children had iron deficiency anaemia, a third had iron deficiency without anaemia and a third had sufficient iron levels.  All infants then received a 3 months course of liquid iron supplement.  The supplement was given to all infants, even those with sufficient iron levels in order to prevent deficiency during their transition to being fed cows milk (which is very low in iron). 

At 12 months the infants were assessed.  Those with poorer iron status were more shy, harder to sooth, less likely to be engaged in their surroundings and less likely to orientate themselves in their surroundings.  The associations were present in iron deficient infants regardless of anaemia status.  Dr Lozoff concludes that the results need to be confirmed in larger trials but her findings do add to the ever growing body of evidence that links iron deficiency in children and developmental problems.

Iron is essential in the diet as it is used by the body in the manufacture of the blood protein haemoglobin, which is responsible for the transport of oxygen from the lungs to all cells in the body so that they can generate energy.  If iron levels are very low it can cause a condition in the body called iron deficiency anaemia.  This can be checked via tests which screen for haemoglobin in the blood.  However, individuals can become deficient in iron without becoming anaemic.  Iron deficiency without anaemia is widespread and not detected by the most commonly used screening procedures.  Both deficiencies are related to low mood, fatigue and mental ‘slowness’ in adults(2,3) and a host of behavioural and mental developmental issues in children(4).  It is not entirely understood why iron deficiency is linked to childhood behavioural issues, such as ADHD, but it may be related to the fact that iron is essential for the normal development of the brain and the functioning of dopamine, a brain chemical.  The most accurate way to check for overall iron status is to screen for ‘serum ferritin’ levels, this will pick up on iron deficiency (with or without anaemia).

In infants breast feeding for less than 6 months duration, the use of non iron-fortified infant formula and the introduction of cow’s milk before 1 year of age are risk factors for iron deficiency and in children dietary deficiency is common.  There are two forms of dietary iron: Haem iron (found in meat sources) and non-haem (found in non-meat, vegetarian sources) iron; and the extent to which iron from food is absorbed depends upon the form it is in.  Haem iron is the most easily absorbed form.  However, absorption is greatly affected by other factors. Most importantly vitamin C, found abundantly in fruits and vegetables, is important in promoting the absorption of non-haem iron.  Adding fruits and vegetables high in vitamin C to a meal may triple iron absorption from foods such as wholegrain cereals and pulses.  On the contrary tea and coffee reduce the amount of iron that is absorbed from all foods.  Try avoiding tea and coffee with meals as they can reduce iron absorption by 50%.  Calcium also reduces iron absorption, drinking a glass of milk with a meal can also half iron absorption.  Phytic acid (also known as inositol hexaphosphate) found in peanuts, wholegrains and seeds can greatly reduce the absorption of iron. 

For individuals who are vegetarian or rarely consume meat, wholegrain cereals, eggs, nuts, dried fruit and pulses (beans and peas) will provide adequate iron if consumed as part of a high vitamin C containing meal.  If you are relying on non meat sources of iron you may wish to consider taking a 100-200mg vitamin C supplement with your main meal to ensure good absorption.

Iron is a nutrient that can accumulate in the body and an excess can be damaging so ALWAYS get iron levels checked prior to embarking on a supplementation programme.  When asking the doctor for a test for yourself or your child, be sure to ask for a ‘serum ferritin’ test (rather than a test for anaemia) as this will provide a better indication of bodily iron status. 

Unfortunately, in the UK there is no consensus among doctors as to what a ‘normal’ blood ferritin level should be.  Many doctors who regularly employ complementary medicine would suggest that in children a ferritin level of less than 30ng/ml (30ng ferritin per 1ml blood) or 50mcg/l in adults would indicate a deficiency.  If you have any concerns do talk them through with your GP.


(1)Lozoff B et al.  2008.  Dose-response relationships between iron deficiency with or without anemia and infant social-emotional behaviour.  J Pediatr.  152:696-702
(2)Khedr E et al.  2008.  Iron states and cognitive abilities in young adults: neuropsychological and neurophysiological assessment.  Eur Arch Psychiatry Clin Neurosci. Jun 20. [Epub ahead of print]
(3)Patterson AJ et al.  Dietary and supplement treatment of iron deficiency results in improvements in general health and fatigue in Australian women of childbearing age.  J Am Coll Nutr. 2001 Aug;20(4):337-42
(4)Lozoff B et al.  2006.  Long-lasting neural and behavioral effects of iron deficiency in infancy.  Nutr Rev.  64(5 Pt 2):S34-43; discussion S72-91

Written by Ani Kowal