I’m iron deficient. Which supplements will work best for me and how should I take them?

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Iron deficiency is common and can be debilitating. It mainly affects women. One in three premenopausal women are low in iron compared to just 5% of Australian men. Iron deficiency particularly affects teenage girls, women who do a lot of exercise and those who are pregnant.

The body needs iron to make new red blood cells, and to support energy production, the immune system and cognitive function. If you’re low, you may experience a range of symptoms including fatigue, weakness, shortness of breath, headache, irregular heartbeat and reduced concentration.

If a blood test shows you’re iron deficient, your doctor may recommend you start taking an oral iron supplement. But should you take a tablet or a liquid? With food or not? And when is the best time of day?

Here are some tips to help you work out how, when and what iron supplement to take.

LittlePigPower/Shutterstock

How do I pick the right iron supplement?

The iron in your body is called “elemental iron”. Choosing the right oral supplement and dose will depend on how much elemental iron it has – your doctor will advise exactly how much you need.

The sweet spot is between 60-120 mg of elemental iron. Any less and the supplement won’t be effective in topping up your iron levels. Any higher and you risk gastrointestinal symptoms such as diarrhoea, cramping and stomach pain.

Three pregnant bellies during a stretching class.
Low iron can especially affect people during pregnancy and women who do a lot of sport. Kamil Macniak/Shutterstock

In Australia, iron salts are the most common oral supplements because they are cheap, effective and come in different delivery methods (tablets, capsules, liquid formulas). The iron salts you are most likely to find in your local chemist are ferrous sulfate (~20% elemental iron), ferrous gluconate (~12%) and ferrous fumarate (~33%).

These formulations all work similarly, so your choice should come down to dose and cost.

Many multivitamins may look like an iron supplement, but it’s important to note they usually have too little iron – usually less than 20 mg – to correct an iron deficiency.

Should I take tablets or liquid formulas?

Iron contained within a tablet is just as well absorbed as iron found in a liquid supplement. Choosing the right one usually comes down to personal preference.

The main difference is that liquid formulas tend to contain less iron than tablets. That means you might need to take more of the product to get the right dose, so using a liquid supplement could work out to be more expensive in the long term.

What should I eat with my iron supplement?

Research has shown you will absorb more of the iron in your supplement if you take it on an empty stomach. But this can cause more gastrointestinal issues, so might not be practical for everyone.

If you do take your supplement with meals, it’s important to think about what types of food will boost – rather than limit – iron absorption. For example, taking the supplement alongside vitamin C improves your body’s ability to absorb it.

Some supplements already contain vitamin C. Otherwise you could take the supplement along with a glass of orange juice, or other vitamin C-rich foods.

A woman pours orange juice into a glass next to a bowl of strawberries and kiwifruit.
Taking your supplement alongside foods rich in vitamin C, like orange juice or kiwifruit, can help your body absorb the iron. Anete Lusina/Pexels

On the other hand, tea, coffee and calcium all decrease the body’s ability to absorb iron. So you should try to limit these close to the time you take your supplement.

Should I take my supplement in the morning or evening?

The best time of day to take your supplement is in the morning. The body can absorb significantly more iron earlier in the day, when concentrations of hepcidin (the main hormone that regulates iron) are at their lowest.

Exercise also affects the hormone that regulates iron. That means taking your iron supplement after exercising can limit your ability to absorb it. Taking your supplement in the hours following exercise will mean significantly poorer absorption, especially if you take it between two and five hours after you stop.

Our research has shown if you exercise every day, the best time to take your supplement is in the morning before training, or immediately after (within 30 minutes).

My supplements are upsetting my stomach. What should I do?

If you experience gastrointestinal side effects such as diarrhoea or cramps when you take iron supplements, you may want to consider taking your supplement every second day, rather than daily.

Taking a supplement every day is still the fastest way to restore your iron levels. But a recent study has shown taking the same total dose can be just as effective when it’s taken on alternate days. For example, taking a supplement every day for three months works as well as every second day for six months. This results in fewer side effects.

Oral iron supplements can be a cheap and easy way to correct an iron deficiency. But ensuring you are taking the right product, under the right conditions, is crucial for their success.

It’s also important to check your iron levels prior to commencing iron supplementation and do so only under medical advice. In large amounts, iron can be toxic, so you don’t want to be consuming additional iron if your body doesn’t need it.

If you think you may be low on iron, talk to your GP to find out your best options.

Alannah McKay, Postdoctoral Research Fellow, Sports Nutrition, Australian Catholic University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Why is toddler milk so popular? Follow the money

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    Toddler milk is popular and becoming more so. Just over a third of Australian toddlers drink it. Parents spend hundreds of millions of dollars on it globally. Around the world, toddler milk makes up nearly half of total formula milk sales, with a 200% growth since 2005. Growth is expected to continue.

    We’re concerned about the growing popularity of toddler milk – about its nutritional content, cost, how it’s marketed, and about the impact on the health and feeding of young children. Some of us voiced our concerns on the ABC’s 7.30 program recently.

    But what’s in toddler milk? How does it compare to cow’s milk? How did it become so popular?

    What is toddler milk? Is it healthy?

    Toddler milk is marketed as appropriate for children aged one to three years. This ultra-processed food contains:

    • skim milk powder (cow, soy or goat)
    • vegetable oil
    • sugars (including added sugars)
    • emulsifiers (to help bind the ingredients and improve the texture)
    • added vitamins and minerals.

    Toddler milk is usually lower in calcium and protein, and higher in sugar and calories than regular cow’s milk. Depending on the brand, a serve of toddler milk can contain as much sugar as a soft drink.

    Even though toddler milks have added vitamins and minerals, these are found in and better absorbed from regular foods and breastmilk. Toddlers do not need the level of nutrients found in these products if they are eating a varied diet.

    Global health authorities, including the World Health Organization (WHO), and Australia’s National Health and Medical Research Council, do not recommend toddler milk for healthy toddlers.

    Some children with specific metabolic or dietary medical problems might need tailored alternatives to cow’s milk. However, these products generally are not toddler milks and would be a specific product prescribed by a health-care provider.

    Toddler milk is also up to four to five times more expensive than regular cow’s milk. “Premium” toddler milk (the same product, with higher levels of vitamins and minerals) is more expensive.

    With the cost-of-living crisis, this means families might choose to go without other essentials to afford toddler milk.

    Woman holding blue plastic spoon of formula powder over open tin of formula, milk bottle in background
    Toddler milk is more expensive than cow’s milk and contains more sugar.
    Dragana Gordic/Shutterstock

    How toddler milk was invented

    Toddler milk was created so infant formula companies could get around rules preventing them from advertising their infant formula.

    When manufacturers claim benefits of their toddler milk, many parents assume these claimed benefits apply to infant formula (known as cross-promotion). In other words, marketing toddler milks also boosts interest in their infant formula.

    Manufacturers also create brand loyalty and recognition by making the labels of their toddler milk look similar to their infant formula. For parents who used infant formula, toddler milk is positioned as the next stage in feeding.

    How toddler milk became so popular

    Toddler milk is heavily marketed. Parents are told toddler milk is healthy and provides extra nutrition. Marketing tells parents it will benefit their child’s growth and development, their brain function and their immune system.

    Toddler milk is also presented as a solution to fussy eating, which is common in toddlers.

    However, regularly drinking toddler milk could increase the risk of fussiness as it reduces opportunities for toddlers to try new foods. It’s also sweet, needs no chewing, and essentially displaces energy and nutrients that whole foods provide.

    Toddler wearing bib with food smeared on face
    Toddler milk is said to help fussy eating, but it may make things worse.
    zlikovec/Shutterstock

    Growing concern

    The WHO, along with public health academics, has been raising concerns about the marketing of toddler milk for years.

    In Australia, moves to curb how toddler milk is promoted have gone nowhere. Toddler milk is in a category of foods that are allowed to be fortified (to have vitamins and minerals added), with no marketing restrictions. The Australian Competition & Consumer Commission also has concerns about the rise of toddler milk marketing. Despite this, there is no change in how it’s regulated.

    This is in contrast to voluntary marketing restrictions in Australia for infant formula.

    What needs to happen?

    There is enough evidence to show the marketing of commercial milk formula, including toddler milk, influences parents and undermines child health.

    So governments need to act to protect parents from this marketing, and to put child health over profits.

    Public health authorities and advocates, including us, are calling for the restriction of marketing (not selling) of all formula products for infants and toddlers from birth through to age three years.

    Ideally, this would be mandatory, government-enforced marketing restrictions as opposed to industry self-regulation in place currently for infant formulas.

    We musn’t blame parents

    Toddlers are eating more processed foods (including toddler milk) than ever because time-poor parents are seeking a convenient option to ensure their child is getting adequate nutrition.

    Formula manufacturers have used this information, and created a demand for an unnecessary product.

    Parents want to do the best for their toddlers, but they need to know the marketing behind toddler milks is misleading.

    Toddler milk is an unnecessary, unhealthy, expensive product. Toddlers just need whole foods and breastmilk, and/or cow’s milk or a non-dairy, milk alternative.

    If parents are worried about their child’s eating, they should see a health-care professional.

    Anthea Rhodes, a paediatrician from Royal Children’s Hospital Melbourne and a lecturer at the University of Melbourne, co-authored this article.The Conversation

    Jennifer McCann, Lecturer Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University; Karleen Gribble, Adjunct Associate Professor, School of Nursing and Midwifery, Western Sydney University, and Naomi Hull, PhD candidate, University of Sydney

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • How To Avoid Carer Burnout (Without Dropping Care)

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    How To Avoid Carer Burnout

    Sometimes in life we find ourselves in a caregiving role.

    Maybe we chose it. For example, by becoming a professional carer, or even just by being a parent.

    Oftentimes we didn’t. Sometimes because our own parents now need care from us, or because a partner becomes disabled.

    Philosophical note: an argument could be made for that latter also having been a pre-emptive choice; we probably at some point said words to the effect of “in sickness and in health”, hopefully with free will, and hopefully meant it. And of course, sometimes we enter into a relationship with someone who is already disabled.

    But, we are not a philosophy publication, and will henceforth keep to the practicalities.

    First: are you the right person?

    Sometimes, a caregiving role might fall upon you unasked-for, and it’s worth considering whether you are really up for it. Are you in a position to be that caregiver? Do you want to be that caregiver?

    It may be that you do, and would actively fight off anyone or anything that tried to stop you. If so, great, now you only need to make sure that you are actually in a position to provide the care in question.

    It may be that you do want to, but your circumstances don’t allow you to do as good a job of it as you’d like, or it means you have to drop other responsibilities, or you need extra help. We’ll cover these things later.

    It may be that you don’t want to, but you feel obliged, or “have to”. If that’s the case, it will be better for everyone if you acknowledge that, and find someone else to do it. Nobody wants to feel a burden, and nobody wants someone providing care to be resentful of that. The result of such is two people being miserable; that’s not good for anyone. Better to give the job to someone who actually wants to (a professional, if necessary).

    So, be honest (first with yourself, then with whoever may be necessary) about your own preferences and situation, and take steps to ensure you’re only in a caregiving role that you have the means and the will to provide.

    Second: are you out of your depth?

    Some people have had a life that’s prepared them for being a carer. Maybe they worked in the caring profession, maybe they have always been the family caregiver for one reason or another.

    Yet, even if that describes you… Sometimes someone’s care needs may be beyond your abilities. After all, not all care needs are equal, and someone’s condition can (and more often than not, will) deteriorate.

    So, learn. Learn about the person’s condition(s), medications, medical equipment, etc. If you can, take courses and such. The more you invest in your own development in this regard, the more easily you will handle the care, and the less it will take out of you.

    And, don’t be afraid to ask for help. Maybe the person knows their condition better than you, and certainly there’s a good chance they know their care needs best. And certainly, there are always professionals that can be contacted to ask for advice.

    Sometimes, a team effort may be required, and there’s no shame in that either. Whether it means enlisting help from family/friends or professionals, sometimes “many hands make light work”.

    Check out: Caregiver Action Network: Organizations Near Me

    A very good resource-hub for help, advice, & community

    Third: put your own oxygen mask on first

    Like the advice to put on one’s own oxygen mask first before helping others (in the event of a cabin depressurization in an airplane), the rationale is the same here. You can’t help others if you are running on empty yourself.

    As a carer, sometimes you may have to put someone else’s needs above yours, both in general and in the moment. But, you do have needs too, and cannot neglect them (for long).

    One sleepless night looking after someone else is… a small sacrifice for a loved one, perhaps. But several in a row starts to become unsustainable.

    Sometimes it will be necessary to do the best you can, and accept that you cannot do everything all the time.

    There’s a saying amongst engineers that applies here too: “if you don’t schedule time for maintenance, your equipment will schedule it for you”.

    In other words: if you don’t give your body rest, your body will break down and oblige you to rest. Please be aware this goes for mental effort too; your brain is just another organ.

    So, plan ahead, schedule breaks, find someone to take over, set up your cared-for-person with the resources to care for themself as well as possible (do this anyway, of course—independence is generally good so far as it’s possible), and make the time/effort to get you what you need for you. Sleep, distraction, a change of scenery, whatever it may be.

    Lastly: what if it’s you?

    If you’re reading this and you’re the person who has the higher care needs, then firstly:all strength to you. You have the hardest job here; let’s not forget that.

    About that independence: well-intentioned people may forget that, so don’t be afraid to remind them when “I would prefer to do that myself”. Maintaining independence is generally good for the health, even if sometimes it is more work for all concerned than someone else doing it for you. The goal, after all, is your wellbeing, so this shouldn’t be cast aside lightly.

    On the flipside: you don’t have to be strong all the time; nobody should.

    Being disabled can also be quite isolating (this is probably not a revelation to you), so if you can find community with other people with the same or similar condition(s), even if it’s just online, that can go a very, very long way to making things easier. Both practically, in terms of sharing tips, and psychologically, in terms of just not feeling alone.

    See also: How To Beat Loneliness & Isolation

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  • Cherries’ Very Healthy Wealth Of Benefits!

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    Cherries’ Health Benefits Simply Pop

    First, be aware, there are different kinds:

    Sweet & Sour

    Cherries can be divided into sweet vs sour. These are mostly nutritionally similar, though sour ones do have some extra benefits.

    Sweet and sour cherries are closely related but botanically different plants; it’s not simply a matter of ripeness (or preparation).

    These can mostly be sorted into varieties of Prunus avium and Prunus cerasus, respectively:

    Cherry Antioxidants: From Farm to Table

    Sour cherry varieties include morello and montmorency, so look out for those names in particular when doing your grocery-shopping.

    You may remember that it’s a good rule of thumb that foods that are more “bitter, astringent, or pungent” will tend to have a higher polyphenol content (that’s good):

    Enjoy Bitter Foods For Your Heart & Brain

    Juiced up

    Almost certainly for reasons of budget and convenience, as much as for standardization, most studies into the benefits of cherries have been conducted using concentrated cherry juice as a supplement.

    At home, we need not worry so much about standardization, and our budget and convenience are ours to manage. To this end, as a general rule of thumb, whole fruits are pretty much always better than juice:

    Which Sugars Are Healthier, And Which Are Just The Same?

    Antioxidant & anti-inflammatory!

    Cherries are a very good source of antioxidants, and as such they also reduce inflammation, which in turn means ameliorating autoimmune diseases, from common things like arthritis…

    Efficacy of Tart Cherry Juice to Reduce Inflammation Biomarkers among Women with Inflammatory Osteoarthritis (OA)

    …to less common things like gout:

    Cherry Consumption and the Risk of Recurrent Gout Attacks

    This can also be measured by monitoring uric acid metabolites:

    Consumption of cherries lowers plasma urate in healthy women

    Anti-diabetic effect

    Most of the studies on this have been rat studies, and the human studies have been less “the effect of cherry consumption on diabetes” and more a matter of separate studies adding up to this conclusion in, the manner of “cherries have this substance, this substance has this effect, therefore cherries will have this effect”. You can see an example of this discussed over the course of 15 studies, here:

    A Review of the Health Benefits of Cherries ← skip to section 2.2.1: “Cherry Intake And Diabetes”

    In short, the jury is out on cherry juice, but eating cherries themselves (much like getting plenty of fruit in general) is considered good against diabetes.

    Good for healthy sleep

    For this one, the juice suffices (actual cherries are still recommended, but the juice gave clear significant positive results):

    Pilot Study of the Tart Cherry Juice for the Treatment of Insomnia and Investigation of Mechanisms ← this was specifically in people over the age of 50

    Importantly, it’s not that cherries have a sedative effect, but rather they support the body’s ability to produce melatonin adequately when the time comes:

    Effect of tart cherry juice (Prunus cerasus) on melatonin levels and enhanced sleep quality

    Post-exercise recovery

    Cherries are well-known for boosting post-exercise recovery, though they may actually improve performance during exercise too, if eaten beforehand/

    For example, these marathon-runners who averaged 13% compared to placebo control:

    Effects of powdered Montmorency tart cherry supplementation on acute endurance exercise performance in aerobically trained individuals

    As for its recovery benefits, we wrote about this before:

    How To Speed Up Recovery After A Workout (According To Actual Science)

    Want to get some?

    We recommend your local supermarket (or farmer’s market!), but if for any reason you prefer to take a supplement, here’s an example product on Amazon

    Enjoy!

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  • Walnut, Apricot, & Sage Nut Roast

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    It’s important to have at least one good nut roast recipe in your repertoire. It’s something that’s very good for making a good dish out of odds and ends that are in your house, and done well, it’s not only filling and nutritious, but a tasty treat too. Done badly, everyone knows the results can be unfortunate… Making this the perfect way to show off your skills!

    You will need

    • 1 cup walnuts
    • ½ cup almonds
    • ¼ cup whole mixed seeds (chia, pumpkin, & poppy are great)
    • ¼ cup ground flax (also called flax meal)
    • 1 medium onion, finely chopped
    • 1 large carrot, grated
    • 4 oz dried apricots, chopped
    • 3 oz mushrooms, chopped
    • 1 oz dried goji berries
    • ½ bulb garlic, crushed
    • 2 tbsp fresh sage, chopped
    • 1 tbsp nutritional yeast
    • 2 tsp dried rosemary
    • 2 tsp dried thyme
    • 2 tsp black pepper, coarse ground
    • 1 tsp yeast extract (even if you don’t like it; trust us; it will work) dissolved in ¼ cup hot water
    • ½ tsp MSG or 1 tsp low-sodium salt
    • Extra virgin olive oil

    Method

    (we suggest you read everything at least once before doing anything)

    1) Preheat the oven to 350℉ / 180℃, and line a 2 lb loaf tin with baking paper.

    2) Heat some oil in a skillet over a moderate heat, and fry the onion for a few minutes until translucent. Add the garlic, carrot, and mushrooms, cooking for another 5 minutes, stirring well. Set aside to cool a little once done.

    3) Process the nuts in a food processor, pulsing until they are well-chopped but not so much that they turn into flour.

    4) Combine the nuts, vegetables, and all the other ingredients in a big bowl, and mix thoroughly. If it doesn’t have enough structural integrity to be thick and sticky and somewhat standing up by itself if you shape it, add more ground flax. If it is too dry, add a little water but be sparing.

    5) Spoon the mixture into the loaf tin, press down well (or else it will break upon removal), cover with foil and bake for 30 minutes. Remove the foil, and bake for a further 15 minutes, until firm and golden. When done, allow it to rest in the tin for a further 15 minutes, before turning it out.

    6) Serve, as part of a roast dinner (roast potatoes, vegetables, gravy, etc).

    Enjoy!

    Want to learn more?

    For those interested in some of the science of what we have going on today:

    Take care!

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  • Younger – by Dr. Sara Gottfried

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    Does this do the things it says in the subtitle? In honestly, not really, no, but what it does do (if implemented) is modify your gene expression, slow aging, and extend healthspan. Which is all good stuff, even if it’s not the snappy SEO-oriented keywords in the subtitle.

    A lot of the book pertains to turning certain genes (e.g. SIRT1, mTOR, VDR, APOE4, etc) on or off per what is sensible in each case, noting that while genes are relatively fixed (technically they can be changed, but the science is young and we can’t do much yet), gene expression is something we can control quite a bit. And while it may be unsettling to have the loaded gun that is the APOE4 gene being held against your head, at the end of the day there are things we can do that influence whether the trigger gets pulled, and when. Same goes for other undesirable genes, and also for the desirable ones that are useless if they never actually get expressed.

    She offers (contained within the book, not as an upsell) a 7-week program that aims to set the reader up with good healthy habits to do just that and thus help keep age-related maladies at bay, and if we slip up, perhaps later in the year or so, we can always recommence the program.

    The advice is also just good health advice, even without taking gene expression into account, because there are a stack of benefits to each of the things in her protocol.

    The style is personable without being padded with fluff, accessible without dumbing down, and information-dense without being a challenging read. The formatting helps a lot also; a clear instructional layout is a lot better than a wall of text.

    Bottom line: if you’d like to tweak your genes for healthy longevity, this book can help you do just that!

    Click here to check out Younger, and enjoy the difference!

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  • The Food For Life Cookbook – by Dr. Tim Spector

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    We’ve previously reviewed Dr. Spector’s “Food For Life”, and while that was more of an “explanatory science” book, this one takes that science (reiterating it more briefly this time, by way of introduction) and makes a cookbook of it.

    The nutritional emphasis in these recipes is on two things: maximizing fiber, and maximizing plant diversity. The recipes are not all vegan or even vegetarian, but they are plant-centric, and if the reader is vegetarian/vegan, then substitutions are easy to make.

    The recipes themselves are simple without being boring, and are easy to follow, with full-page photos to accompany them. The science parts are very clear, accessible, and pop-science in style.

    Bottom line: if you’d like to incorporate more fiber and more plants into your diet without it being a burden, this book is great for that.

    Click here to check out the Food For Life Cookbook, and get cooking for life!

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