THE HEALTH AND FITNESS BLOG
September 23, 2022 – By Dr. Haider Khalid
It is important to know How to Avoid Anemia as a Vegan. Anemia is a common health issue affecting mainly women and the elderly. According to a statistical analysis of 2019, around 1.74 billion people were affected by anemia (1). It can be of different types. Each type has its severity. Some are mild, while others can present with potentially serious health complications.
In vegans, however, anemia is primarily due to nutritional deficiencies. For example, vegan diets are low in iron and vitamin B12, whose deficiency increases your risk of this health condition. Therefore, your main goal as a vegan is to avoid anemia by modifying your diet with foods rich in these nutrients.
In this article, you will learn everything about anemia and how you can avoid anemia as a vegan.
What is Anemia?
Human blood contains three types of cells; red blood cells, white blood cells, and platelets. Red blood cells are disc-shaped cells whose sole purpose is to provide transport service to the oxygen from the lungs to the tissues. There are various conditions where the number of normal RBCs decreases, leading to anemia.
Hemoglobin is a unique protein present in the RBCs responsible for oxygen transport. Therefore, less than normal hemoglobin concentration in RBCs is also labeled as anemia. Regardless of the condition, anemia results in inadequate oxygen transport to the tissues. Ultimately, decreased oxygen supply to the tissues leads to fatigue and extreme tiredness.
What Causes Anemia?
Human RBCs have an average life span of hundred and twenty days. Once they have completed their lifespan, they are removed from circulation. Each day, your body produces almost 2 million RBCs while the same amount gets discarded (2). The sole purpose of this process is to keep healthy RBCs within the blood while discarding the old ones, which can no longer effectively transport oxygen.
An imbalance between these two processes, production, and clearance of RBCs, is responsible for causing anemia. In simple words, more than the required destruction of RBCs can result in anemia. In the second state, you can get anemia if your body is not producing enough RBCs.
Most patients, experience low production of iron because of the deficiency of a particular nutrient in the diet. Some essential nutrients are iron, vitamin B12, and folic acid. This happens in vegans, who mostly experience anemia during middle age. Moreover, low production can be because of some chronic diseases, such as kidney failure.
What are the Symptoms of Anemia?
Symptoms of anemia are related to the diminished supply of oxygen to the tissues. Every human cell needs oxygen to extract energy from food. Therefore, in the absence of oxygen, the body cannot function properly. Conclusively, anemic people feel lethargic and tired throughout the day.
You may experience shortness of breath even after inhaling sufficient oxygen from the surrounding air. It happens because your body sends signals to the lungs that the tissues are not receiving enough oxygen. As a result, your respiratory rate increases to counter the oxygen deficiency in the blood. It creates a false perception of breathlessness.
Most of the redness in your palms, fingernails, lips, and probably cheeks is because of the RBCs flowing through the skin’s blood vessels. Low levels of RBCs cause your skin to look pale. Moreover, your heart also beats faster to counter poor oxygen transport. Therefore, anemic patients usually experience increased heart rates. Some also experience chest pain in the late stages of the disease.
How to Know if you have anemia?
You can look for the symptoms described in the previous paragraphs to know if you have anemia or not. However, visiting your healthcare provider to develop a confirmed disease diagnosis would be best. It is because you will need a physical exam of your body and complete health history to say with surety that you have anemia. For that, you would need a medical expert.
Your doctor will advise you on some of the following laboratory investigations to diagnose anemia.
- Complete blood count
- Reticulocyte count
- Serum (blood) iron levels
- Folic acid test
- Vitamin B12 test
What are the Types of Anemia?
Anemia is grouped into five categories depending upon the cause responsible for it. Here is a brief account of all these types that can help you develop a more comprehensive understanding of the present condition.
Iron Deficiency Anemia
When you are not getting enough iron from your diet, you increase your risk of iron deficiency anemia. It is the most common type accounting for 50% of all anemia cases around the globe. Vegan diets are primarily low in iron (3). This is the reason why vegans experience anemia far more frequently than non-vegans.
Vitamin Deficiency Anemia
The second type of anemia is vitamin deficiency. Such people mostly have low levels of folic acid and vitamin B12 in their blood. If you have a vitamin deficiency, you can look for symptoms such as soreness in your mouth and color changes in your skin. This way, you will know that you are suffering from vitamin deficiency anemia. Vegans who don’t eat a variety of plant-based foods experience this type of anemia.
Vitamin B12 deficiency can be because of the dysfunction of intrinsic factors. It is a substance produced by the stomach wall to help absorb B12 into the blood. Under certain conditions, intrinsic factors become deficient, leading to a condition specifically called pernicious anemia. It is pretty common in people above 50.
Hemolytic Anemia
Hemolysis is the term used to describe the destruction of RBCs. When the destruction becomes more significant, it will lead to hemolytic anemia. Hemolytic anemia is not a common condition. However, it can occur due to a variety of health problems. Some of which are discussed here.
The most common forms of hemolytic anemia are genetic conditions such as sickle cell anemia. Malaria parasite also destroys RBCs. In addition, certain toxins and medications can also be responsible for destroying normal RBCs.
Aplastic Anemia
In aplastic anemia, your bone marrow is defective. Bone marrow is a tissue that produces blood cells. Some autoimmune diseases destroy bone marrow leading to the decreased production of RBCs. As the bone marrow is dysfunctional in these patients, they also have low levels of white blood cells and platelets in the blood. Therefore, such patients are at risk of developing infections and bleeding disorders.
Anemia of the Chronic Disease
Finally, the last form is anemia due to chronic disease or inflammation. The exact of this disease is not known. However, experts usually say that inflammation in chronic diseases alters the working of the human body. One of the effects of that is low RBC in the blood. Tuberculosis, chronic kidney disease, autoimmune diseases, and cancer can cause anemia in patients.
Anemia is more common in Vegans: Myth or Fact!
According to a study that compared the prevalence of iron deficiency anemia in women, 40% of vegans were anemic compared to only 7% of non-vegans (4). Another study compared the serum iron levels in the blood of vegans and non-vegans. The findings clearly state that iron deficiency is more common in vegans, with an overall prevalence of 21% compared to 6% in non-vegans (5).
These findings will help you understand that anemia is more common in vegans, and it is a fact. But you can still get enough iron or vitamins from your vegan diet. It simply means that vegans are not eating the variety of foods they need to eat to fulfill their daily nutritional requirements.
If you are a vegan, you can also experience such problems in your life. Therefore, you must know your daily nutritional requirements. You should also know that plant-based foods are rich in iron, folic acid, and vitamin B12. Only then can you avoid anemia as a vegan. You need not worry, as you will learn everything from this article.
Nutritional Requirements to Prevent Anemia
Nutritional requirements vary significantly according to age and sex. For example, women of reproductive age need more iron than men due to blood loss during menstruation. In this segment, you will learn the daily requirements of two important nutrients whose intake can help you avoid anemia as a vegan.
Iron
According to the recommendations for people aged 19 to 50, the daily iron intake should be according to the following table. People above 50 need to take 8 mg of iron daily regardless of gender (6).
| Men | 8 mg |
| Women | 18 mg |
| Pregnant Women | 27 mg |
| Breastfeeding Women | 9 mg |
Vitamin B12
Vitamin B12 is very important for the effective production of hemoglobin and RBCs. In vitamin B12 deficiency, people experience anemia and dramatic neurological damage. Therefore, as a vegan, you must take the recommended amount of this vitamin to avoid anemia.
According to the guidelines, you must take 2.4 micrograms of vitamin B12 daily. The requirement is slightly higher in pregnancy and breastfeeding, i.e., 2.6 micrograms and 2.8 micrograms, respectively. You need to eat B12-rich foods to get this recommended amount, or you can also try supplements.
Iron Rich Foods for Vegans
Here are the five categories of foods that you can eat to avoid iron deficiency anemia as a vegan (7).
Legumes
A single cup of soybeans contains 9.9 mg of iron, which is more than 50% of a woman’s daily requirement. Lentils are also rich in iron-containing around 6.5 mg of iron in a cup full of lentils. Other legumes such as chickpeas, red kidney beans, and black-eyed peas are rich iron sources among vegan foods.
Here are a few recipes from my blog with beans and legumes that will help to build iron levels in anyone:
Nuts
Almonds, cashews, and pine nuts are some amazing iron sources. In addition to iron, they also provide your body with healthy fats, fibers, proteins, and other nutrients essential for proper functioning (8).
Vegetables
If you heard someone saying that vegetables are not a good source of iron, then he is saying the exact opposite. Vegetables are excellent sources of iron. You need to correct a variety of vegetables to add a significant amount of iron to your diet. Leafy green vegetables, tomatoes, and potatoes are among the top vegetable sources of iron (9).
You can enjoy some of these juice recipes: Best Juices to Drink and may find them helpful for building iron.
Fruits
Most of you need to eat more fruits. The outcome of this is that you experience nutritional deficiencies. Therefore, it would be best to eat iron-rich fruits if you want to avoid anemia as a vegan. Apples, mulberries, and olives are some examples of iron-rich foods. Moreover, they are also a rich source of fiber which help in the proper absorption of nutrients from your gut (10)
Vitamin B12 Rich Foods for Vegans
Until now, we have discussed vegan foods that are rich in iron and can help you prevent iron deficiency anemia. So, let’s move on to the next nutrient, vitamin B12. First, I will mention some of the vegan sources that contain moderate amounts of this vitamin (11).
One of the most important sources is nutritional yeast. If you are a vegan, you probably heard about it as the vegan’s secret weapon or vegan cheese alternatives. However, you should know one thing you should not only rely on this as your sole source of B12. You can also use other fortified foods such as fortified soy and almond milk, fortified cereals, and plant-based meat to get the recommended amount of vitamin B12.
Vegan foods are not rich sources of vitamin B12. Therefore, if you are a vegan, you should use vitamin B12 supplements and pills to take the recommended amount daily because experts have mostly regarded B12 fortified foods as the most reliable source for vegans. However, if you are getting enough vitamins from your diet, there is hardly any chance of developing anemia.
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References
1. Gardner W, Kassebaum N. Global, Regional, and National Prevalence of Anemia and Its Causes in 204 Countries and Territories, 1990–2019. Current Developments in Nutrition. 2020 May 29;4(Supplement_2):830–0.
2. Higgins JM. Red Blood Cell Population Dynamics. Clinics in Laboratory Medicine [Internet]. 2015 Mar [cited 2022 Sep 23];35(1):43–57. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4717490/
3. Warner MJ, Kamran MT. Anemia, Iron Deficiency [Internet]. Nih.gov. StatPearls Publishing; 2018 [cited 2022 Sep 23]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448065/
4. About The Buzz: Vegetarians Have Higher Rates of Anemia? [Internet]. Have A Plant. [cited 2022 Sep 23]. Available from: https://fruitsandveggies.org/stories/buzz-vegetarians-higher-rates-anemia/#:~:text=RESULTS%20OF%20THE%20STUDY&text=However%2C%20all%20vegetarian%20women%20had
5. Pawlak R, Berger J, Hines I. Iron Status of Vegetarian Adults: A Review of Literature. American Journal of Lifestyle Medicine [Internet]. 2016 Dec 16 [cited 2022 Sep 23];12(6):486–98. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6367879/
6. Drakesmith H, Prentice AM. Hepcidin and the iron-infection axis. Science (New York, NY) [Internet]. 2012 [cited 2022 Sep 23];338(6108):768–72. Available from: https://www.ncbi.nlm.nih.gov/pubmed/23139325
7. 21 Vegetarian Foods That Are Loaded With Iron [Internet]. Healthline. 2017 [cited 2022 Sep 23]. Available from: https://www.healthline.com/nutrition/iron-rich-plant-foods#TOC_TITLE_HDR_2
8. Nuts and Human Health Outcomes: A Systematic Review. Nutrients. 2017 Dec 2;9(12):1311.
9. Cooperstone JL, Tober KL, Riedl KM, Teegarden MD, Cichon MJ, Francis DM, et al. Tomatoes protect against development of UV-induced keratinocyte carcinoma via metabolomic alterations. Scientific Reports [Internet]. 2017 Jul 11 [cited 2022 Sep 23];7:5106. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506060/
10. Singh AK, Kim WK. Effects of Dietary Fiber on Nutrients Utilization and Gut Health of Poultry: A Review of Challenges and Opportunities. Animals. 2021 Jan 14;11(1):181.11. Jones L. Vitamin B12 for Vegans & Vegetarians: Best Natural Sources [Internet]. Fresh n’ Lean. 2019 [cited 2022 Sep 23]. Available from: https://www.freshnlean.com/blog/vegan-b12-sources/
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