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Experts say there are many ways to increase the iron in your blood, including diet and supplements. Harald Walker/Stocksy
  • Researchers say people who are iron deficient in middle age could have a higher risk of heart disease later in life.
  • They add, however, that more research is needed to establish a stronger linker between iron levels and heart health.
  • Experts say you can increase your iron levels through diet, either with meat or vegetarian items, as well as with supplementation.

Not getting enough iron in middle age can lead to about a 10 percent increase in heart attack risk within a decade.

That’s according to a study published this week in ESC Heart Failure, a journal of the European Society of Cardiology.

However, one of the study’s authors says there’s no need to panic and start gobbling iron supplements like Halloween candy.

“This was an observational study and we cannot conclude that iron deficiency causes heart disease,” wrote Dr. Benedikt Schrage, a physician at the University Heart and Vasculature Center in Hamburg, Germany. “However, evidence is growing that there is a link and these findings provide the basis for further research to confirm the results.”

Previous research has shown that iron deficiency was linked to more severe outcomes such as hospitalizations and death for people with cardiovascular disease.

Treatment with intravenous iron, however, improved symptoms, functional capacity, and quality of life.

Based on those results, researchers went back and looked at the impact of intravenous iron supplementation in people with heart failure. The most recent study also examined whether the association between iron deficiency and various outcomes was observed in the general population.

The study looked at 12,164 individuals from three European population-based cohorts. The median age was 59, and 55 percent were women.

Cardiovascular risks factors such as smoking, obesity, diabetes, and cholesterol were assessed through blood samples. People were assessed as iron deficient or not.

Researchers followed up with participants for incident coronary heart disease and stroke, death due to cardiovascular disease, and all-cause death, with researchers analyzing each for associations with iron deficiency.

At baseline, 60 percent of participants had absolute iron deficiency, and 64 percent had functional iron deficiency.

In following up with participants over 13 years, functional iron deficiency was associated with a 24 percent higher risk of coronary heart disease among those who died. Another 26 percent had a higher risk of cardiovascular mortality, and 12 percent had an increased risk of all-cause mortality.

Absolute iron deficiency was associated with a 20 percent raised risk of coronary heart disease, compared with no absolute iron deficiency, but without being linked to mortality.

“This analysis suggests that if iron deficiency has been absent at baseline, about 5 percent of deaths, 12 percent of cardiovascular deaths, and 11 percent of new coronary heart disease diagnoses would not have occurred in the following deaths,” Schrage said.

Iron deficiency was highly prevalent in middle-age study participants, with nearly two-thirds having functional iron deficiency.

“Iron is essential for hemoglobin synthesis, which is the main oxygen-carrying molecule in the bloodstream,” Siddhartha Angadi, PhD, a cardiovascular exercise physiologist and professor at the University of Virginia, told Healthline. “Iron is also critically involved in the Kreb’s cycle – the essential pathway for aerobic production of energy.”

Sylvia Melendez-Klinger, RD, a nutritionist and founder of food consulting company Hispanic Food Communications, told Healthline that about 20 percent of women are iron deficient, which rises to 50 percent among pregnant women, compared to about 3 percent of men.

“For most of them, consuming more foods high in iron is the solution,” said Melendez-Klinger. “If they are not vegetarians, this can start with including a wide variety of animal foods, such as red meats, fish, and poultry in their diet because they are rich in heme iron, which is derived from hemoglobin and is better absorbed by your body than non-heme iron.”

Melendez-Klinger said that if meat isn’t your thing, non-heme iron still works. It can be found in beans, tofu, and enriched/fortified breakfast cereal, pasta, and bread.

“All this said, if dietary changes do not eliminate an iron deficiency, you should consult a healthcare professional and possibly begin taking an iron supplement,” Melendez-Klinger said.