Iron and Irritable Bowel Syndrome

Iron and Irritable Bowel Syndrome (IBS)

A key nutrient at risk when following a low FODMAP diet is iron. Iron plays an important role in the body as it is found in red blood cells, carrying oxygen from our lungs to the rest of our body.

There are two types of iron that exist: haem iron which comes from animal foods and non-haem iron found in mostly plant-based non-animal sources. When following a low FODMAP diet, it’s important to not restrict any food group unnecessarily as this may likely lead to nutritional inadequacy (low nutrients in the body). Following a low FODMAP diet to ease symptoms associated with IBS does not require complete restriction of any of the five food groups (e.g. fruit, vegetables, grains, meat/alternatives and dairy/alternatives).

Iron deficiency occurs when your body doesn’t have enough iron to produce haemoglobin (a part of your red blood cells that gives blood its red colour and allows red blood cells to carry oxygenated blood throughout the body).
In general, great sources of iron such as meat are not limited on a low FODMAP diet. However, for people following a vegetarian/vegan diet alongside a low FODMAP diet, they may be at risk of iron deficiency. This is especially predominant if they are also avoiding large serves of legumes (a primary source of protein and iron for vegetarians/vegans). If this sounds similar to your diet we reccomend consulting with your doctor or dietitian.

Who is most at risk of low iron/ iron deficiency?

– People with a menstrual cycle
– A person not consuming enough iron in their diet or who does not absorb enough iron
– Pregnant women
– People avoiding certain food groups (eg. Animal products)
– People who have issues absorbing nutrients from food, such as those with untreated coeliac disease

Symptoms of low iron/ iron deficiency

– Pale skin
– Fatigue
– Weakness
– Shortness of breath
– Headaches

Although these symptoms may indicate low iron; the only way to know for sure is through a blood test. Symptoms may vary depending on the individual but if you have any of these symptoms and you think you may have low iron, speak to your doctor about getting tested. It’s also important to be aware that the symptoms listed above may be linked to another medical condition or problem. Consult your doctor for advice if you have any of these symptoms.

What are some low FODMAP yet high iron food sources?

A diet high in lean meats, legumes, nuts/seeds, wholegrains, iron-fortified cereals and green leafy vegetables provide great sources of iron. Unfortunately many of these foods may be limited or reduced when following a low FODMAP diet. However, with a good understanding of suitable low FODMAP portion sizes of these foods, you are likely to be able to consume adequate iron in your diet.

So, what are some suitable options?
– Plain meats, poultry and fish (no serving restriction)
– Firm tofu (100g)
– Tempeh (3/4 cup)
– Peanuts (32 peanuts)
– Pumpkin seeds/pepitas (1/4 cup)
– Dark Chocolate 85% (30g= 2 squares)
– Spinach (1/2 cup)
– Potato (1 medium with skin)
– Broccoli (1/2 cup)
– Oats; instant + cooked (3/4 cup)
– Quinoa (1 cup)

Tips and tricks to increase iron absorption

– Vitamin C enhances the absorption of iron as it captures non-haem sources and stores it in a form that is more easily absorbed in the body. Therefore, consuming foods high in vitamin C (e.g. citrus fruits, strawberries, kiwi fruit, capsicum) with your main meals may help to increase the absorption of iron.
– Tea and coffee can decrease iron absorption. It may be helpful to minimise having tea and coffee with your meals to ensure maximal iron absorption.
– Choose a variety of foods. Having balanced meals which contain both haem and non-haem sources of iron throughout the week can increase your iron
– The addition of an iron supplement if recommended by your GP following blood test results. Speak to your GP if you’re concerned about your iron

So, what is the main take home message?

While low iron/iron deficiency occur in some people who have IBS, it can certainly be managed while following a low FODMAP diet.
For additional help and support on this topic be sure to consult an Accredited Practising Dietitian or your doctor.