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Nice article
Does that mean for someone following a low carb and higher protein diet, his or her meals should always be paired with tea or coffee to inhibit absorption of iron?
Regarding aspirin, are you aware of any research on the optimal dose and timing for health maintenance?
ReplyIf you want to inhibit iron absorption, then yes, coffee or tea with meals is a good idea. As for aspirin, I’ve always been cautious in discussing it, because most doctors don’t want everyone to take it, and with reason, since it can cause bleeding, sometimes serious. As I wrote in my latest book, the attitude is changing somewhat, since it’s now seen that aspirin, besides being useful in secondary prevention of heart attacks (that is, when the patient has known heart disease), also has strong cancer prevention effects. In epidemiological studies, aspirin’s effects in prevention topped at 80 mg/d, a baby aspirin. More than that had no effect on CVD or cancer prevention, but does have more side effects, like bleeding.
ReplyTea does activate AMPK, not sure about theanine. Theanine does activate heat shock protein http://www.sciencedirect.com/science/article/pii/S1756464612000539
and extend lifespan in C. elegans. http://link.springer.com/article/10.1007/s00394-012-0341-5/fulltext.html
The Nikoley / Dogders article also presented a case that dairy is a strong inhibitor of iron absorption, and even conjectured that the kosher prohibition against eating dairy with meat was actually a pragmatic way of avoiding anemia in an iron-poor desert nomadic lifestyle. So have a cheeseburger instead of a hamburger, and eat steak in the northern Italian style: with a big huck of Parmesan cheese.
ReplyCoffee after meals; wine with meals. Chocolate dessert. It’s humorous in how old-school it is. Jeanne Calment was famous for eating chocolate every day (and smoking).
That AJCN article is interesting. The 39% number was from drip, but they get much better results with instant. “When a cup of drip coffee or instant coffee was ingested with a meal composed of semipurified ingredients, absorption was reduced from 5.88% to 1.64 and 0.97%, respectively, and when the strength of the instant coffee was doubled, percentage iron absorption fell to 0.53%.”
Superstrong instant FTW! I wonder where espresso lies.
ReplyRichard Nikoley recently had a href=”http://freetheanimal.com/2015/05/enrichment-diabetic-chronically.html”>couple of (long) guest posts showing a correlation between obesity and heart disease and iron enrichment in wheat. The French Paradox: they don’t enrich their wheat.
Given what we’re starting to figure about the gut microbiome and “safe starches,” it’s made me wonder if all the paleo/low-carb success was really from abstaining from wheat.
Whether it’s gluten (v. doubtful IMO), glyphosphate (possibly), or iron (Wow, if it’s that), the bad rep wheat has gotten keeps seeming more and more justified, even if it’s not specifically wheat’s fault.
ReplyWell, that’s interesting, I’ll have to add it to my list of things to think about. Check out, e.g., work on the omega-3 index, where blood levels of omega-3 fats are inversely correlated to risk of heart attack. The Omega-3 Index: a new risk factor for death from coronary heart disease? Quote: “The Omega-3 Index was inversely associated with risk for CHD mortality. An Omega-3 Index of ≥8% was associated with the greatest cardioprotection, whereas an index of ≤4% was associated with the least.” See also this chart on the omega-3 index: http://roguehealthandfitness.com/wp-content/uploads/2014/05/nihms-22135-f0002-300×245.jpg
ReplyChris Kresser has written about this in the past. I believe the confounding factor on fish oil may be that the oil in fish oil capsules often is oxidized (i.e. rancid) by the time that it’s consumed. This may neutralize or even reverse it’s potential beneficial health effects.
The solution? Eat actual fatty fish, the way our ancestors would’ve. (But beware of mercury as you go up the food chain..)
Joshua, thanks. the problem is, there’s some evidence that oxidation is required for fish oil’s health benefits. See here: http://roguehealthandfitness.com/how-do-omega-3-fatty-acids-work/
As for fatty fish and oxidation, I’ve heard this argument before, and I don’t understand how it could be thought that the oil in fish that’s cooked at high temperatures could be less oxidized than fish oil that hasn’t been cooked from capsules or bottles.
ReplyGreat post!
This causes me to reconsider many nutrition issues. Vegetables are good for health Well, vegetables have compounds that inhibit iron absorption. Whole grains (at least relative to white flour) are good for you. They also contain compounds that inhibit iron absorption and avoid the iron added to fortify white flour. Some fruits have polyphenols that reduce iron absorption too.
Another problem: citrate increases iron absorption. But magnesium citrate is the best form of magnesium supplement. So take magnesium on an empty stomach?
A high tannin and high phytate diet for lower iron absorption? More potatoes and wheat bran? Here is a table of phytate (inositol hexaphosphate) in foods.
ReplyPeople have been using IP6 (inositol hexaphophate) supplements to chelate iron and reduce serum ferritin for years.
http://www.longecity.org/forum/topic/67219-help-with-ip6-iron-chelation-safety/
http://www.longecity.org/forum/topic/65948-recommended-brands-of-ip6-dosing/
If your goal is to reduce iron for general health reasons and you’re not eligible to donate blood, then IP6 might be an alternative. Few, if any, doctors would approve therapeutic phlebotomy unless you suffer from hemochromatosis and have a massively elevated iron level.
LEF was publishing articles about iron 15+ years ago so the idea isn’t new, but there’s much more evidence to bolster the case now. So I’m glad to see it’s getting renewed attention here and elsewhere.
ReplyThis is an excellent discussion of phytate, cancer risk, iron.
I think one should eat foods with vitamin C separate from foods that contain iron in order to reduce iron absorption.
ReplyThis is another reason to avoid processed food, since so many are fortified with iron.
In middle school science class our homework was to put cereal in a bag and crush it as fine as possible. Then in class we put it in a beaker with water and put a magnet next to it. My ubiquitous brand of oat cereal looked like it had a nail filed into it. The whole class was disgusted more than when we had dissected animals. Probably because we weren’t eating the animals.
ReplyActually, iron food enrichments are poorly absorbed—which is why they add so darn much of it. What most people aren’t considering is that all that unabsorbed iron from the enrichments just irritates the gut and blooms pathogens. And there is plenty of research showing this (not to mention it’s well known that iron pills promote gut problems).
Check this out…
Solving iron’s solubility problem
However, there are two major problems [with iron supplements]. The chemical environment in the gut, particularly the rapid pH change from the acid of the stomach to the essentially neutral small intestine, as well as the presence of reducing agents like ascorbate, will promote redox cycling between the Fe(iii) and Fe(ii) states. Therefore, any iron that doesn’t get absorbed – which can be up to 70% of the content of a supplement tablet – can cause serious problems, since this redox cycling generates free hydroxyl radicals through Fenton-type chemistry, which leads to inflammation. The second problem is that any remaining soluble iron will travel to the lower bowel, where it is absorbed by pathogenic bacteria. ‘The iron-hungry pathogens can then outcompete the more favourable gut microflora,’ Pereira explains, ‘which is when you get side effects like diarrhoea.’
And research shows that iron supplements can promote gastric distress even at low doses.
When all that poorly absorbed iron fortification passes to your gut, I’d imagine that it impairs our flora’s ability to process gluten. This might explain why the gluten free fad is so popular in fortified countries. And I’d imagine that it’s no coincidence that gluten only became an issue in Sweden and the US when iron enrichments were significantly increased. Sweden banned iron fortification in 1995 and the Swedish coeliac epidemic was said to have ended in 1996 (now attributed to either breastfeeding changes or vitamin D supplementation changes). Frankly, I don’t understand why they haven’t looked into the obvious inflammatory properties of iron fortification and its correlations to iron enrichment increases in the US and Sweden.
Interestingly, food enrichments are associated with obesity (Zhou 2014) but not for why you’d think. The B vitamins they add to refined foods are done to “normalize” your appetite, which would otherwise falter on a diet of pure refined foods. This has been known since the 1920s when Osbourne & Mendel discovered that vitamin enrichments were necessary to sustain appetites.
The government has now been forced to recommend “whole and enriched grains” thanks to lobbying from the food industry. 90% of Americans eat enriched grains and their health falters. Without the enrichments, they’d be naturally compelled to crave their nutrients elsewhere (what happens in most of Europe). Having no fortification requires people keep traditional cooking alive—those traditions were invented to manage appetites with naturally occurring nutrients and to promote health. If people tried to eat lots of pure refined nutrition-less grains they’d become deficient and stop eating (pellagra, beri beri). Actually this used to happen during the 19th century—it was called “dyspepsia” and people lost their appetites from eating refined foods. The cure was fiber-rich bread and fiber-rich cereals (see Kellogg’s sanitarium and Graham bread).
Again, it’s a natural defense mechanism innate in all animals to lose appetites from a diet of mostly refined foods and it was well documented in the early medical literature on vitamins. That doesn’t happen anymore thanks to enrichments. Enrichments enable humans and animals to eat foods they would otherwise not be compelled to eat without some form of supplementation (Banting kept his appetite high from exercise and by supplementing his refined foods with yeasty vitamin B-rich beer).
It’s the food industry that did this—mainly led by the American Bakers Association (ABA). Look at their website and you’ll be amazed at how much lobbying they’ve done to promote enriched grains into the food pyramid. It’s shocking. The ABA singlehandedly lobbied to raise the enrichment levels right before the obesity epidemic started. That’s not a coincidence. It was done to keep people from losing their appetites for enriched foods (Americans were eating significantly less carbs than any other Western nation at that point in history and the food industry was trying to reverse that trend). The enrichments “normalizes” the appetite so that you can keep eating that otherwise refined food. (The lack of key minerals like Mn and Cu/Zn reduces the body’s ability to process its own oxidative stress). The ABA promotes enrichments, like the idea that folic acid reduces birth defects, claiming a relative reduction of NTDs by 36% when in reality it’s only an absolute reduction of -0.015% in NTDs from fortification. Can you imagine? In what world does any industry spend that much time lobbying for the ability to dose all men, women and children of all ages with something that reduces a health issue in just pregnant women by only 0.015%. It’s totally nuts.
The healthiest countries are the ones that don’t enrich their foods. France actually has a purity law that prevents “traditional” bread from having additives. So the French eat a lot of white flour but are compelled to get their nutrients elsewhere (i.e. traditional foods and beverages) and they are healthier for it.
ReplyShawn, thanks for the interesting comment. Not to dispute what you say, as it makes a lot of sense, but it seems rather speculative. Have you come to these conclusions on your own? Or is there anyone else out there who’s saying this? Because this line of thought is all new to me.
ReplyGreat article! I remember first hearing about the rather scary implications of iron overload about 4 years ago when I read Anthony Colpo’s The Great Cholesterol Con. I had no idea it was even a potential issue, especially so for men, and I’d never even seen the iron issue discussed anywhere else.
Though, I’ve definitely noticed the iron topic gaining traction in just the last year or so. Richard Nikoley recently posted a whopper of an article that strongly implicates iron enrichment to various foods as being a significant culprit behind the rather insidious iron overload problem in the developed world.
I’m not sure how this issue hasn’t gotten more attention from the mainstream medical industry, especially when it’s rather simple and easy to treat, i.e., bloodletting.
ReplyAs someone who has recently shown a slight increase in iron levels and has lost family members due to hereditary hemochromatosis this issue keeps me vigilant about my overall health. In the very near future I plan to be donating blood on a quarterly basis.
ReplyDo you know if black tea (India tea/Orange Pekoe/Tetley tea bags) has the same iron chelating effects as green tea? A cursory look on the web, the studies seem to be all about the good effects of green tea.
I like white flour and make my own bread. I wonder if I could throw a couple of mg of IP6 into the mix and mop up the added iron (which is about 20mg/lb flour = 3.3mg per bagel), since all white flour is enriched in the US.
It’s interesting the calcium is sort of an antagonist of iron (I think that’s why dairy is good at anti-chelating), ie more calcium absorbed implies less iron absorbed. On the other hand, calcification of blood vessels is one of the pre-cursors of cardiovascular disease, which sort of implicates calcium. I don’t have a deep knowledge of any of this and was wondering if you had an opinion if calcium has been redeemed.
ReplyThe tea used in the study on iron absorption was black tea, so that should work just as well in decreasing iron absorption. Most of the work on the health benefits of tea has been done on green tea, but every time I see a study using black tea, it seems to work just as well for whatever it’s being tested for. As for calcium, I don’t think it’s been redeemed as a supplement, since it’s associated with higher mortality. As part of dairy however it seems quite good, and full-fat dairy eating is associated with lower mortality.
ReplyUnfortunately, the Red Cross doesn’t let one donate blood if one were in the UK for more than 3 months between 1980 and 96 owing to mad cow/Jakob Creutzfeld disease.
Replyok,, so that is why there was a research before taht followed people who drank coffee and they found out that the ones who drank more mugs a day have lower mortality rate…
might be because of iron inhibition
ReplyLove the website PD. I just donated blood for the first time after reading this article.
Question: I donated a pint of whole blood (ok every 56 days), but other options include platelet donations, double red blood cell donations (only every 112 days) and plasma donations. Any thoughts on what might be the best type of donation for health issues?
ReplyThanks, J. Platelet and plasma donations will not deplete iron, only whole blood donations will. Body iron is mainly stored in hemoglobin, a component of red blood cells. A whole blood donation is approximately half red blood cells and half plasma. So, for your own health, whole blood donations are the way to decrease your ferritin (iron) levels.
As for pint vs double donations, it probably comes down to how much you value convenience – a double donation only takes time every 4 months – vs recovery time – a double donation will leave you feeling less energetic for longer than a single whole blood donation. You probably couldn’t handle a gym session for a while after a double donation for instance. Personally I’d probably go for the single whole blood donation.
ReplyPD – good stuff!
Here’s one for you: *When* to donate, relative to one’s workout?
Just Before: Maybe you’re tired, but perhaps presents a positive (hermetic) stress to the body?
Just After: Cells damaged during workout (muscle, otherwise) will have a greater chance of being bled out than having to float around and have the body deal with.
How to time vis a vis hormonal release (older guys, say). Immediately just after workout, the GH hasn’t spiked, so dumping blood won’t ‘waste’ any GH, but perhaps donating four hours, say, after a workout might give away valuable GH?
Do you really think you’d be fatigued after double red? Whenever I’ve given whole blood (middle-aged, here) I’ve never tired at all. Just impatient at “having to sit” and wait. How could giving double red (a massive ferritin benefit) possibly fatigue one days later for a workout?
Thanks for any thoughts.
Great pic, BTW. Post more?
ReplyThanks, Ross. What happens with a blood donation is that you lose about 10% of your red cells. Plasma volume is quickly replenished, while red cells will take a few weeks to get back to normal, using iron stores remaining in the body. The result is for a few weeks you have a lower than normal hematocrit, which is the percentage of red cells in the blood. You might go from a hematocrit of, say, 42, to one of 38. Your VO2 max will decrease, since red cells are the oxygen carriers to your muscles and organs. So, it is possible you wouldn’t feel fatigued as such, but you would almost certainly have lower exercise capacity. That all goes double for a double whole blood donation.
I don’t have any particular setup, whatever works for you. But if you feel weak or lightheaded working out in the days after a donation, best tread lightly, go easy on the workouts, maybe even skip one.
I have had in mind to post some more pics, one of those things that I can’t seem to get around to, but I will.
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Reply“With iron, the only method the body has to control it is to increase or decrease absorption; there is no way to get rid of it, while cholesterol can be metabolized.”
I wonder how it is that we could accumulate such excess iron if we still have the ability to regulate its absorption. I imagine that there circumstances that would cause the body to uptake larger than usual quantities of iron but wouldn’t our physiologies likewise, regulate the further absorption in an effort to balance the bodies total iron stores and thus, mitigate oxidative damage?
ReplyThat’s a good question. In some people, perhaps, iron regulatory mechanisms don’t work well. For instance, it’s not uncommon for a middle-aged man to have a ferritin of 300, while the average is about 150. Why would someone have a ferritin that high? Conditions like diabetes cause a dysregulation of iron. Also, some observers think that iron supplements and fortification play a role – although again, why the body doesn’t just cease absorbing iron, I don’t know. In evolutionary terms, natural selection doesn’t really care if you accumulate a lot of iron when older, since iron is a growth factor, and all nature cares about is if you have enough to grow and reproduce.
ReplyNon-heme iron must be combined with vitamin C, in order for the body to absorb it efficiently. Vitamin C is a powerful antioxidant.
Maybe that’s the body’s way of saying “i’m only going to absorb as much iron as I can handle”. Unfortunately, heme iron will bypass that mechanism.
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