Why cereal is recommended for iron deficiency

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Calcium and iron basically cancel each other out, and according to the doctor, should be eaten 2 hours apart. So why is “iron-fortified cereal” on nearly every list of iron-rich foods?

In: 5

As [this](https://pubmed.ncbi.nlm.nih.gov/21795430/) study found out a calcium dose of 800 mg diminished absorption of 5 mg heme iron by 37.7% in nonpregnant women.

A bowl of milk has 300mg of so it shouldn’t dimish a huge amount of iron when consumed with cereal.

Calcium and iron don’t cancel each other out. That’s much too strong a statement.

There is some research that suggests calcium impairs iron absorption in the body. There is also research that contradicts or nuances those findings. E.g. this [review paper](https://pubmed.ncbi.nlm.nih.gov/19087437/), surveying a bunch of experimental literature, up to that point draws the following conclusion:

>The general conclusion is that dietary Ca supplements are unlikely to have a biologically significant impact on Fe balance in Western societies unless Ca consumption is habitually very low; however, increased consumption of dairy products may have a small negative effect that could be functionally important in pregnancy if Fe supplements are not taken.

In other words, if you normally eat enough calcium in your diet, then it’s unlikely to have much of an effect on your iron absorption. Even if you’re not used to much calcium, you’re probably still fine – you may absorb a little less iron but still enough. Also if you change your diet to have more calcium in it (e.g. by regularly eating cereal with dairy), your body will adapt and so the negative effect of calcium will decrease. So unless you really need to get as much iron as possible as quickly as possible *and* your body isn’t used to calcium, it’s not really an issue.

Iron supplements in particular can lead to gut discomfort when taken on an empty stomach. This is too bad because for optimal iron absorption it’s best if iron supplements *are* taken on an empty stomach (or with a vitamin-C rich drink, which some evidence suggests may help iron absorption). But if you habitually need to supplement your iron, the best way to do it is the way that you can manage to actually make a habit. So yeah, maybe the iron in your cereal would be better absorbed if taken as a pill in between mealtimes. But if that pill gives you stomach cramps, you’re probably not going to take it every day. Which means that, in the long run, you’re better off having that pill with your breakfast, or incorporated into it in the form of an iron-fortified food.