Anemia and the Vegetarian

The doctors told me that although it would take me a month-and-a-half to rebuild my blood stores, I could resume my normal activities a few days after my surgery. It's been a week, and I'm exhausted! I was lucky to avoid a blood transfusion, but I had not fully appreciated how I would feel from the anemia caused by my blood loss.

I have had anemia often in my life. My parents say I was a precocious child. I could recite the alphabet when I was two years old. My physical talents were limited, however. So, I was excited when I became the tallest girl in my fifth grade class. This and needing to wear a training bra turned out to be indicators of early menarche at 10 years old. I was so young that my mom had not yet told me about the birds & the bees, much less a girl's "time of the month". I thought I was bleeding to death out of my bottom. My mom gave me a crash course on napkins and tampons.

From that time, I fought with anemia for many years. I had to be hospitalized when I was in 7th grade for passing out during a math test. I had had a period that ran for six weeks, and was very anemic. I got to stay at the Texas Children's Hospital for a week, and was very happy that I had my own TV to watch Dallas on, and that I could get popsicles from the nurse's station each day.

After that incident, I was put on the pill to regulate my cycle, but I still had migraines and fatigue each month due to the iron deficiency anemia associated with menstruation [1]. In my late-20's I discovered depo-provera, which was fabulous because I did not menstruate. Gone were the migraines that typically left me with no option but to turn off all light and sleep for several hours in the late afternoon. This was really life-changing for me. Being suddenly down for the count had been tough to manage with my start-up jobs, and my post-college social life.

Over the past 10 years, I have slid into vegetarianism. I have insisted that I will never become a strict vegetarian because of bacon (bless you, bacon, for your magical impact on hangovers). But, the reality is that I haven't had bacon in a couple years (unfortunately, no correlation with hangover frequency). Why vegetarianism? I love tofu (try it soft, raw with just a bit of ginger and soy sauce). I have lived with several vegetarians over the years, including my husband. So, cooking vegetarian food is natural for me. The health impact of eating meat versus vegetables has also swayed me. Finally, as I have learned about the significant environmental impacts of eating meat versus vegetables, it has become more firm as a way of life. It is how I am choosing to reduce my impact on the earth [2,3]. And, yes, I've become one of those somewhat opinionated but hopefully quiet about it West coast slow/local food folks. Quick plug for our organic produce box: Terra Firma Farms: www.terrafirmafarms.com.

How does this relate to anemia? I need to eat iron-rich foods, and meat contains more iron than vegetables. Happily, one of my surgeons at Kaiser is a vegetarian, and did not think I needed to eat meat to re-build my red blood cells and iron. She told me focus on eating iron-rich vegetables, and take the iron she prescribed. I have been taking 325 mg tablets of ferrous gluconate three times a day. Over the past week I have eaten broccoli, spinach, beans, and tofu. Vegetables have been steamed to retain their iron content, in our cast iron skillet to add iron. Vitamin C helps absorption so I have been drinking orange juice with the iron and vegetables. Each day I would get a headache starting at about noon, and continuing until I gave up and took a long nap in the early evening.

Getting enough iron from vegetables is not issue for healthy females. Healthy females 19-50 years old typically need 18 mg of iron a day. A 1/2 cup of tofu contains approximately 6.7 mg of iron, a cup of lentils 6.6, and a cup of spinach 6.4 [4,5].

That said, iron is more plentiful and more readily available in meat versus vegetables. Cooked beef contains approximately two times the amount of iron as tofu [5]. Generally, the redder the meat the more iron. So beef, more than chicken, etc. Interestingly, beef has 25% more iron than lamb [6]. The heme form of iron in meat makes it more readily available for absorption into the body. Also, meat preparation makes a big difference - shorter cooking keeps the iron in heme form [7].

So two nights ago, I decided to eat beef for one week, lunch and dinner. I have had tenderloin, beef burritos, and beef tacos the past couple days. I'm cooking a hamburger for lunch today - local, grass-fed organic beef, of course. I'm contemplating Blue Plate's meatloaf, though I guess that doesn't rate well on the cooking time scale... Looking forward to warding off those headaches.


References

1. Anemia: http://www.webmd.com/a-to-z-guides/understanding-anemia-basics
2. Environmental impact of meat versus vegetable consumption: http://en.wikipedia.org/wiki/Environmental_effects_of_meat_production
3. Quantification of the environmental impact of different dietary protein choices: http://www.ajcn.org/cgi/content/full/78/3/664S
4. Kaiser Vegetarian Meal Planning booklet
5. USDA National Nutrient Database for Standard Reference at http://www.nal.usda.gov/fnic/foodcomp/search/
6. New Facts about Iron in Meat: http://www.nutraingredients.com/Research/New-facts-about-iron-in-meat
7. Heme, Ferritin and Vegetable Iron Absorption in Humans from Meals Denatured of Heme Iron during the Cooking of Beef: http://jn.nutrition.org/cgi/reprint/116/9/1720.pdf