Abstract
Vegetarian diets may compromise iron status, as they provide non-haem iron which has low bioavailability. Spanish lacto-ovo vegetarians (n = 49) and vegans (n = 55) were recruited and haematological and biochemical iron parameters were analysed. Food and supplements consumption, body composition, physical activity, menstrual blood losses and hormonal contraceptive use were assessed. Four groups were studied: Iron deficiency anaemia (IDA), iron depletion (ferritin <15 ng/mL), iron deficiency (ferritin ≥15 to ≤30 ng/mL), and iron sufficiency (ferritin >30 ng/mL). IDA was uncommon (n = 5, 4.8%), 27.9% of participants were iron-depleted, and 30.8% were iron-deficient. Serum ferritin was lower in women than men (p < 0.001) and IDA and iron depleted individuals were all women. There were no differences attributed to diet type, time being vegetarian or physical activity. The menstrual period length was negatively associated with transferrin saturation (ρ = −0.364, p = 0.001) and hormonal contraceptive use (ρ = −0.276, p = 0.014). Iron supplements were consumed most frequently by IDA and iron-deficient subjects (p = 0.031). Conclusions: Iron status did not vary between lacto-ovo vegetarians and vegans and there was not an influence of the time following a vegetarian diet. Although men were iron-sufficient, iron deficiency was frequent in women, who should apply strategies to increase iron bioavailability, especially if they experience intense menstrual blood losses.
Highlights
Planned vegetarian diets provide health benefits, but they are associated with a higher risk of iron deficiency than omnivorous diets [1]
Iron deficiency may lead to iron deficiency anaemia (IDA), activate bone resorption, affect the immune system, and limit physical activity [2,3]
Prolonged insufficient iron supply to tissues eventually leads to IDA, characterised by low haemoglobin, ferritin, transferrin saturation (TSAT), mean corpuscular haemoglobin (MCH) and mean corpuscular volume (MCV) [3,5]
Summary
Planned vegetarian diets provide health benefits, but they are associated with a higher risk of iron deficiency than omnivorous diets [1]. The maintenance of adequate levels of this micronutrient is essential for oxygen transport, energy storage, and protein synthesis [2]. The most specific measure of iron stores is serum ferritin, additional tests are recommended. Transferrin and soluble serum transferrin receptor (sTfR), considered early indicators of functional iron deficiency, are related to iron transport and their concentrations are increased with iron depletion [5,6,7]. Prolonged insufficient iron supply to tissues eventually leads to IDA, characterised by low haemoglobin, ferritin, transferrin saturation (TSAT), mean corpuscular haemoglobin (MCH) and mean corpuscular volume (MCV) [3,5]. Iron absorption increases, as the synthesis of hepcidin, a downregulator of iron absorption, is stimulated [2,6]
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