Iron for Vegetarians and Vegans: Plant Sources, Absorption and Official Statements

What official and professional bodies say

• Dietetic position (US). The Academy of Nutrition and Dietetics states that appropriately planned vegetarian, including vegan, diets are healthful and nutritionally adequate, and appropriate at all life stages including pregnancy, lactation, childhood and for athletes. [1] The abstract we read does not give an iron-specific figure.
• NHS (UK) on vegans. A vegan diet can be high in iron, although iron from plant-based food is absorbed less well than iron from meat. [4] The NHS advises eating foods containing vitamin C at the same time and avoiding tea or coffee during or after main meals. [4]
• NHS on vegetarians. Vegetarians are more likely to have lower iron stores than people who eat meat, because iron from plants is not as easy to absorb. [2] It also says vegetarians need to make sure they get enough iron and vitamin B12. [2]
• Health Canada. The dietary reference intake tables carry a footnote: the requirement for iron is 1.8 times higher for vegetarians due to the lower bioavailability of iron from a vegetarian diet. [5]
• US Office of Dietary Supplements. We could not read its iron fact sheet (access refused), so we do not quote a US vegetarian figure.

Intake levels for reference

Amounts are milligrams (mg) of iron per day as each source lists them. They are group reference values, not instructions, and they were set mostly for mixed diets. Health Canada's RDA is 18 mg for women 19 to 50 and 8 mg for men 19 and older. [5] The US RDA, as printed by MedlinePlus, is the same: 18 mg for women 19 to 50 and 8 mg for men 19 and older. [6] The NHS lists 14.8 mg for women 19 to 49 and 8.7 mg for men 19 and older. [7] Health Canada's footnote says vegetarian needs are 1.8 times higher but does not give a separate vegetarian row. [5] What that means for one person is a question for a registered dietitian. See RDA, AI, DV and UL.

What studies found

Evidence labels: established (replicated physiology), mixed, insufficient, and Proper evidence not found.

The meta-analysis pooled studies of many designs, so it describes group averages. It cannot tell you your own level. [3]

Plant sources and absorption notes

The NHS lists pulses (beans, chickpeas, lentils), dark green leafy vegetables, wholemeal bread and flour, iron-fortified breakfast cereals, nuts and dried fruit such as apricots, prunes and figs. [4][2] For pregnancy it adds sesame and pumpkin seeds. [9] Details are on Foods high in iron and Minerals for vegetarians and vegans.

Absorption: MedlinePlus says iron from vegetables, fruits, grains and supplements is harder to absorb and that foods rich in vitamin C also increase iron absorption. [6] Studies of beverages and phytates are summarized on Iron absorption: what helps and what blocks it; the NHS tells people with iron deficiency anemia that large amounts of tea, coffee, dairy and foods high in phytic acid make absorption harder. [10] Soaking and other preparation steps are covered on Plant-based mineral absorption. MedlinePlus also notes cooking in a cast-iron skillet can increase the iron in food. [6]