Tagged with 'anemia'

You’ve been through 40 weeks of pregnancy and your diet was an important piece of the journey. And now that you’re holding your beautiful baby you’re officially in the postpartum period, which lasts six months, and nutrition is still very important.

What Is Iron?

Iron is a critical mineral throughout postpartum. It’s needed to make hemoglobin, a part of red blood cells that transports oxygen and carbon dioxide. Iron picks up oxygen in the lungs, drives it through the bloodstream and drops it off in tissues like skin and muscles. Then, it picks up carbon dioxide and drives it back to the lungs where it’s exhaled. Not getting enough iron results in anemia. Fatigue, weakness, and dizziness are definitely not symptoms you want to experience when you’re already sleep deprived and have a new baby!

Do I Need Postpartum Iron?

Postpartum iron supplementation may be necessary when blood loss is higher than usual during vaginal delivery or the interval between pregnancies is less than two years. Some practitioners may recommend continuing to take your prenatal vitamins for a few months postpartum. The World Health Organization recommends taking an iron supplement for at least three months after delivery. 

During pregnancy, iron needs double, but return to pre-pregnancy levels in the postpartum period, which is 15 mg/day.

Sources of Iron

The body absorbs two to three times more iron from animal sources than from plants. Some of the best dietary sources of iron are: Oysters, lean beef, turkey, chicken, lean pork, and fish.

The body absorbs less of the iron from plants, but every bite counts. Some of the best plant sources of iron are: beans, tofu, dark leafy greens, fortified breakfast cereals, enriched rice, and whole-grain breads. To a lesser extent, potatoes with skin, watermelon, figs, spinach, chard, and dried fruits such as apricots, raisins, and prunes also contain iron.

Tips To Help Replenish Iron Stores:

• Combining vitamin C and iron enhances iron absorption, so eat them together. For example, broccoli and chicken, a peanut butter and jelly sandwich with an orange, a spinach salad with mandarin oranges, cereal with strawberries. Other good food sources of Vitamin C include: strawberries, cantaloupe, citrus fruits, broccoli, cauliflower, cabbage, tomatoes, potatoes, green and red peppers, and citrus juices.

• Cook with cast iron pots to add more iron to your diet.

• Black tea, coffee, whole-grain cereals, unleavened whole-grain breads, and legumes all contain tannic acid, which is shown to inhibit iron absorption. These foods should be consumed separately from iron-fortified foods and iron supplements.

Bottom Line: Eat a balanced diet that includes good sources of iron to prevent any deficiencies. Combine vegetarian sources of iron with vitamin C in the same meal. Ask your healthcare provider if starting an iron supplement or continuing your prenatal supplements is a good idea through the postpartum phase.

In Health and Happiness,

Kelly Harrington, MS, RDN

Registered Dietitian Nutritionist for Healthy Goods

References:

American Dietetic Association. Medical Nutrition Therapy. Chicago, Illinois. 2006. 

WHO. WHO recommendations on postnatal care of the mother and newborn. Geneva, World Health Organization; 2013 

Imagine swimming 2.4 miles with hundreds of people in choppy, cold water. After swimming for 1 hour and 15 minutes, you finally finish; only to climb out of the water, lace up your cycling shoes, and hop on your road bike. You’re beginning a 112 mile ride. This lengthy cycling ride takes you about 6 hours and 30 minutes. As if that’s not enough, now you have to run. Not just any run, but a 26.2 mile run, aka, a full marathon. This may take around 4 hours and 45 minutes. The average triathlete exercises for about 12 hours and 35 minutes straight! Needless to say, after it’s all said and done, you need recovery food!  Lots of it and ASAP!

Is it possible for an endurance athlete to effectively train for a massive competition, successfully compete in, and then completely refuel if they eat vegan? It is safe to say, yes, a vegan diet is able to sustain an active lifestyle at all competitive levels, even Ironman triathlons. Vegans rely on fruits, vegetables, leafy greens, whole grains, nuts, seeds, beans and legumes as their staples. 

Brendan Brazier is a former professional Ironman triathlete and two-time Canadian 50km Ultra Marathon Champion. He also follows a vegan diet. In fact, he is so passionate about eating clean and healthy, he created his own nutrition line to support his eating lifestyle and extreme activity level. Vega products are created using high quality, plant-based superfoods, with little processing. I highly recommend them. Check them out: Vega products 

Overall, a well-balanced vegan diet tends to be lower in saturated fat and cholesterol and higher in fiber, magnesium, potassium, vitamin C, vitamin E, folate, and a wide range of phytochemicals compared to diets that include animal products. 

However, vegans may have lower intakes of protein, vitamin B₁₂, calcium, vitamin D, iron, zinc, and omega-3 fatty acids. Let’s take a closer look at these key nutrients vegan athletes want to pay closer attention to.  

Protein

Needed to maintain and build muscle and other tissues, making it critical for any athlete. Too little protein paired with too many carbohydrates and your performance may suffer.  An athlete’s protein needs vary according to the type of activity and level of training.  Daily needs typically range from 0.5 to 0.8 grams per pound of body weight. But vegans should consume 10% more than the typical recommendations because plant-based protein sources such as soy, legumes, nuts, seeds, grains, and vegetables, are more difficult to absorb than animal sources.    

For example, a 140-pound runner requires 70 to 112 grams of protein per day. If the athlete is vegan, a more appropriate protein recommendation is 77 to 123 grams per day, or an extra 2 Tablespoons of nut butter and a vegan bar. For a 220-pound football player, protein needs are 132 to 176 grams per day. If the player is vegan, the recommendations jumps to 145 to 193 grams of protein, or an additional ½ cup to 1 cup of peanuts daily.

Calories

Vegan athletes often have to consume more food than non-vegans to meet caloric needs, maintain body weight, and optimize training. Many vegan diets are nutrient-dense but may not be calorie-dense, so athletes need to make sure they are meeting their calorie needs. Vegan athletes should plan ahead to have food with them as much as possible and snack on high-calorie options like nuts, nut butters, seeds, and dried fruit. Vegan sports bars also come in handy when you need a quick snack.

Vitamin B₁₂

This critical vitamin is only found in animal products. Vitamin B₁₂ is required for the production of red blood cells and in tissue repair and maintenance, including the central nervous system. Severe B₁₂ deficiency may result in megaloblastic anemia, which results in tired and weak bodies, and will reduce endurance performance. Adding a B₁₂ multivitamin or consuming ample vitamin B₁₂-fortified foods such as whole grains, soy milk, meat alternatives, or bars, is essential to getting the recommended 2.4 mcg a day. 

Calcium

Athletes may be prone to stress fractures and muscle cramps. Calcium plays a key role in optimizing bone strength and is an essential component for proper muscle contraction. Since a vegan diet doesn’t include dairy products, a main calcium source, vegans tend to fall below the daily recommendations of 1,000-1,300 mg/day.

Structured vegan diets should contain ample sources of highly bioavailable calcium from items such as broccoli, collards, calcium-set tofu, fortified fruit juices, and some fortified almond/soy milks.

Still, a calcium supplement is often recommended to meet the body’s needs.

Iron

Even marginal iron deficiency can hurt athletic performance. Iron carries oxygen from the lungs to the working muscles. When your iron is low, you are likely to feel fatigued, have a drop in your performance, and a weakened immune system. Athletes who are at the highest risk of suffering from iron-deficiency anemia include the following:

• Vegetarians/Vegans who don’t eat red meat (the best dietary source of iron) or iron-enriched breakfast cereals.
• Marathon runners, who may damage red blood cells by pounding their feet on the ground during training.
• Female athletes who lose iron through menstrual blood.
• Endurance athletes, who may lose iron through heavy sweat losses. Iron requirements for endurance athletes, especially distance runners, are increased by approximately 70%.
• Teenage athletes, particularly girls, who are growing quickly and may consume inadequate iron to meet expanded requirements.

One pitfall about iron…iron from plant-based foods is not absorbed as well as iron from animal foods, so the recommended intake for vegans is 1.8 times greater. For example, an adult female should consume 32 mg of iron daily versus 18 mg for a non-vegetarian, and an adult male vegan requires 14 mg per day rather than 8 mg.

A multivitamin containing iron is generally added to a vegan diet. 

Iron Tip: The iron in sprouted grains, legumes, and fermented foods, such as miso and tempeh is absorbed more readily.

Vitamin D

Vegan or not, this is one vitamin many people are low in. Athletes who train primarily indoors throughout the year, such as gymnasts, wrestlers, and figure skaters, are at risk for poor vitamin D status. Vitamin D is critical for bone health and increases calcium absorption. It’s also involved in immune system function. Having inadequate levels of Vitamin D can increase your risk of developing stress fractures and other bone-related problems, plus a suppressed immune system makes you vulnerable to getting sick more often. To meet your needs, consider a combination of vitamin D fortified foods, exposure to sunlight, and vitamin D supplementation.

Omega-3 Fatty Acids

Following a vegan diet makes it difficult to obtain the recommended 1.1 to 1.6 grams per day of omega-3 fatty acids, which are found in fatty fish and fish oils. Omega-3s are critical for overall cardiovascular health, brain health, disease prevention, and they have the potential to decrease inflammation. However, omega-3 fatty acid deficiency may become less of a concern by combining nuts, seeds (especially flax), vegetable oils, algae, and some leafy greens with fortified foods such as soy milk, rice milk, and vegan bars.

Refueling

For the endurance athletes out there, don’t forget to eat a well-balanced diet within 30 minutes of completing your workout—high in carbohydrates with some protein. The extra carbohydrates, along with a little protein, will replenish your depleted glycogen muscle stores. This makes for a better workout the next day and will reduce your risk of “hitting the wall.”

Bottom Line: Take careful consideration when choosing your food in order to get the recommended amounts of all the nutrients your body needs to reach its peak performance. Consider taking supplements for the nutrients you have a hard time getting from your food.

In Health and Happiness,

Kelly Harrington, MS, RDN

Registered Dietitian Nutritionist for Live Superfoods

References:

1. The Academy of Nutrition and Dietetics Position Paper: Vegetarianism.

2. The Academy of Nutrition and Dietetics Position Paper: Nutrition and Athletic Performance.

3. Kundrat, Susan, MS, RD, CSSD.  Veggies Galore.  Training-Conditioning: Oct. 2013.