Big bill for iron deficiencies
As the amount of red meat Kiwis eat shrinks, hospitalisations for iron deficiency anaemia are on the rise.
And it’s costing millions. The cost of hospitalisations – primarily due to iron deficiency anaemia – has crept up from an annual $3.2 million to $6.7m over the past 10 years, according to Ministry of Health figures released under the Official Information Act.
Over the past three years, the ministry has spent close to $20m for treatment.
The Waikato District Health Board recorded a doubling of iron deficiency anaemia diagnoses over the past decade, from 951 in
2008 to 1986 last year and 1725 by November 2018. The cost of treatment increased from $668,000 in
2008 to $1.6m last year.
DHB chief medical officer Dr Gary Hopgood said there was no clear reason for the increase.
For hospital-level anaemia, there was often another underlying condition, a Ministry of Health spokesman said.
But a lack of iron-rich foods such as red meat, seafood or leafy greens, is one of the biggest factors of low iron.
Data from the most recent OECD and Food and Agriculture Organisation of the United Nations Agricultural Outlook shows in the 10 years to 2017, the average New Zealander’s annual red meat consumption dropped 22 kilograms. Lamb and mutton consumption dropped by 15.3kg.
Jessica Featherstone was first diagnosed with iron deficiency anaemia when she was 14.
After a two-year stint as a vegetarian, it’s taken years for her iron to go back to normal.
A decade later, she takes supplements daily and eats red meat at least twice a week.
Featherstone remembers being plagued by dizziness, light headedness and an unshakeable fatigue. Her skin became pale with a ‘‘yellowish tinge’’ with dark circles under her eyes.
Featherstone was never made aware of a clear underlying condition, but anaemia is more common in women of child-bearing age, say experts.
Changing lifestyles as a result of New Zealand’s changing demographic could be contributing to an increase in anaemia, Dr Claire Badenhorst, a Massey University iron deficiency researcher, said.
Some cultures, particularly South Asian women – a fast growing population in New Zealand – are prone to low iron, possibly due to different eating cultures.
An increase in vegetarianism – whether due to soaring meat prices or environmental concerns – could be at work, too.
‘‘There is potentially a correlation between that decline in meat intake,’’ Badenhorst said. ‘‘Where people are becoming a bit more environmentally conscious and more people adopting a vegetarian and vegan lifestyle.’’
Iron in animal products such as red meat is generally more easily absorbed than plant-based iron, with two to three servings of red meat a week recommended.
But vegetarians can be healthy, with a well-thought out diet.
Symptoms of low iron are subtle at first, so people often take too long to get checked by a health professional, Badenhorst said.
Caffeine inhibits iron absorption so coffee won’t help.
‘‘People just think I’ll sleep in a bit more, maybe I’ll have nap or some time to myself. It’s a symptom that I think sometimes people think is a part of life.’’
Yet, it only gets worse over time.
‘‘You’ll be out of breath really
quickly, you’ll be tired really quickly. You physically just don’t know how to move.
‘‘Essentially you’re starving your body of oxygen.’’
It would be hard to pinpoint one reason for an increase in hospitalisations, New Zealand Society of Gastroenterology chair Michael Schultz said.
‘‘[Hospitalisations are] for the people where it gets quite bad,’’ Schultz said. ‘‘Usually they get admitted with side effects of iron deficiency anaemia which is your tiredness, light-headedness, shortness of breath, heart palpitations. Things like that will get people into hospital.’’
And it’s far more common in older people with underlying conditions such as inflammatory bowel disease or cancer. In younger people, conditions such as coeliac disease can be behind it.
But it’s a wild field.
‘‘When I get referred a [younger] person with iron deficiency anaemia, the first thing I’m going into is diet.
‘‘So has this patient suddenly started to become a vegetarian and is not eating red meat or any kind of by-products that could replace the iron?
‘‘Usually vegetarians are educated on being a vegetarian. They know how to counteract that and they know what to eat.
‘‘Newly convinced vegetarians who don’t have much experience might think, oh well, I’ll leave out the meat and eat the rest as I always do, and that just doesn’t work.’’
Women are more at risk, too. ‘‘[Anaemia] should not be taken lightly. Young men should not get iron deficiency anaemia.
‘‘In younger men iron deficiency anaemia is something that needs to be taken quite seriously.’’