Vegetarian? Australia’s iron figures say you need about 80 per cent more

Eighteen milligrams a day. That is the iron Australia’s nutrient reference values recommend for a woman aged 19 to 50. In a vegetarian dal-and-roti household, it is only where the official arithmetic on vegetarian iron begins.

The sum is short. The values put iron absorption at about 18 per cent from a mixed western diet that includes animal foods, and about 10 per cent from a vegetarian one. Eighteen per cent over 10 per cent is 1.8, and the values conclude in the same breath: “so vegetarians will need intakes about 80% higher.” Their page on iron never turns that into milligrams.

Iron has not been revised since the values were first published in 2006. In 2013, a review in the Medical Journal of Australia questioned what the 80 per cent rests on.

Why the day starts at 18

The values cover Australia and New Zealand and sit on the government’s Eat For Health website. They recommend 8 mg of iron a day for men, and for women over 50. Pregnancy takes it to 27 mg. Women aged 19 to 50 are set at 18 mg, more than twice their average requirement of 8 mg, a gap the page puts down to how widely needs vary with menstrual losses. The same 80 per cent applies to children and adolescents, and in pregnancy and breastfeeding.

Vegetarian iron: two kinds of meal

Published online on 29 October 2013 in a supplement to the journal, the review traces Australia’s recommended intake for iron to research by the US and Canadian Institute of Medicine, which recommended that vegetarians’ requirement be 1.8 times the regular one. To justify that, its four authors write, the institute’s committee “appears to have used a single 1991 study”.

By their account, one group in that study was given meals designed to maximise the absorption of non-haem iron, with meat and vitamin C-rich fruit and vegetables; another got meals designed to inhibit it as far as possible, without those foods and with foods and drinks high in inhibitors; and the committee based its vegetarian figure on the second group. That choice, in their view, is “of questionable validity, as the study was not looking at a typical Western vegetarian diet”.

Their wider reading is that in Western countries such as Australia, with a varied food supply, vegetarians are no more likely than non-vegetarians to have iron deficiency anaemia, though they may often have lower serum ferritin, a blood measure of iron stores, still within the normal range. What that means for the body, the authors say, is unknown. They ask whether it is really necessary to recommend a higher requirement for vegetarians “when adaptive processes respond to lower iron stores”, and conclude that the limited absorption studies to date have not yet made clear how much iron Western vegetarians need each day.

The review was commissioned by the supplement’s editors and externally peer reviewed, and its lead author declared employment with the supplement’s sponsor.

The National Health and Medical Research Council says the values are reviewed “in an ongoing manner as resources allow”. Its current work covers a methodological framework, iodine, selenium, sodium and vitamin B6. Iron is not on that list.

The guava and the teacup

Eat For Health says nuts, seeds and legumes, tofu included, can provide some iron for people who eat no animal foods, and that the vitamin C in fruit and vegetables will help the absorption of iron from them. Its iron page also says phytates, found in legumes, rice and other grains, can inhibit absorption. On that reckoning, the legumes that go into dal cut both ways: they can provide some iron, and they carry phytates. The Dietary Guidelines for Indians note that boiling or pressure cooking greatly reduces the phytic acid in legumes and makes minerals such as iron absorbable.

Revised in 2024 by the ICMR-National Institute of Nutrition, the same guidelines take up iron in their guideline on pregnancy and breastfeeding and put the gap plainly: iron’s bioavailability is “poor from plant foods but is good from flesh foods” such as meat, fish and poultry. Fermented and sprouted grains and foods rich in vitamin C can improve bioavailability, they say, naming guava, pineapple, lemon and orange. They add that drinks such as tea bind dietary iron and make it unavailable, and that tea should be avoided before, during or soon after a meal, or while taking the daily iron and folic acid tablets they advise for pregnant and breastfeeding women.

Anaemia, there and here

Answering a question in the Lok Sabha on 9 February 2024, India’s Ministry of Women and Child Development put anaemia among women aged 15 to 49 at 57.0 per cent in the fifth National Family Health Survey, for 2019-21, up from 53.1 per cent in the fourth, for 2015-16. On the causes, it cited a global figure from a World Health Organization report on anaemia prevalence in 2011: half of anaemia cases are attributed to iron deficiency. In August 2026, after fact sheets from the sixth survey, for 2023-24, had appeared, India’s health ministry said it would adopt anaemia figures from what it called an independent survey by the Indian Council of Medical Research.

In Australia, a study published in BMC Pregnancy and Childbirth on 21 August 2023 compared Indian-born mothers with Australian-born and other overseas-born mothers. National data did not routinely record maternal medical conditions, so its anaemia comparison rests on 2014 records from Monash Health in Victoria. In those records, Indian-born mothers had the largest proportion with anaemia of the three groups, and the authors describe it as iron deficiency anaemia. They note that only first-generation Indian-born mothers could be identified, and that some pre-existing medical, obstetric and gynaecological factors were not reported.

The review asked its question in 2013. For a vegetarian woman aged 19 to 50, the values still answer as they did in 2006: 18 mg a day, and about 80 per cent more.