Popeye's Prescription

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Safeguard your child from the number one nutritional deficiency: inadequate iron

Bethany McCoy's freshman season on the Metamora High School cross-country team felt all wrong. "My leg muscles burned after races," says the 19-year-old. "I was exhausted just climbing stairs." Diagnosed with anemia, McCoy bounced back after a few weeks of taking iron supplements and won six track-and-field medals at the Illinois state championship. "Three or four other girls on my team told me they've had anemia, too," she says. "I'm surprised how common it is-and how much better I felt once I started getting enough iron."

Despite its abundance in the American food supply (think fortified infant formulas, iron-enhanced cereals, and our fondness for meat), dietary iron is the number one nutritional deficiency, especially in fast-growing toddlers and teens. An estimated 7% of toddlers, 9 to 22% of teen girls, and 15 to 35% of teen athletes of both genders have low iron stores simply because their bodies need more than they're taking in. And a recent Yale University study found that iron deficiency is twice as common in overweight as in healthy-weight teens.

Iron is a magnet for hemoglobin, the oxygen-bearing protein in red blood cells. As blood volume increases during growth spurts, kids need to eat more iron to make healthy red blood cells. Girls, who may have iron to spare before they begin menstruating, can become anemic as they lose blood with their monthly periods. But even when growth occurs at a slower rate, youngsters are vulnerable to deficiency if they axe exceptionally active or if they turn up their noses at iron-fortified cereals, meat, and leafy green vegetables.

• Check your child's iron stores Determining iron levels is not always a simple matter of a routine finger-stick blood test. This hemoglobin test checks for full-blown anemia, but it may not pick up a mild iron deficiency, which tends to develop slowly. Symptoms may be subtle or not what you'd expect--weakness, irritability, poor school performance, and frequent colds and infections. A child who looks pale, tires easily, or whose mind meanders at school should have her blood tested for ferritin, the protein that stores iron in the body, suggests Melvin B. Heyman, MD, a pediatric gastroenterologist at the University of California, San Francisco, Children's Hospital.

• Boost absorption More than half of all 1- to 2-year-olds and 75% of adolescent girls don't get enough iron, reports the CDC. Yet small servings of meat, chicken, or fish can double or even quadruple the amount of iron your child gets from meals and snacks, says Marilyn Tanner, RD, clinical study coordinator at the Washington University School of Medicine.

If your child is a vegetarian or doesn't enjoy eating meat, here's how to increase his iron intake:

Add a side of C Vitamin C-rich fruit-strawberries, kiwifruit, oranges, and grapefruit--or juice can at least double iron absorption from other foods eaten at the same time, says Janet Hunt, PhD, RD, an iron researcher at the USDA's Grand Forks Human Nutrition Research Center in North Dakota.

Simmer foods in an iron pot Acidic foods like tomato sauce can extract usable iron from cast-iron cookware, says Tanner. "Make it the first thing you put on the stove and the last thing you take off."

• Limit moo drinks Cow's milk is low in iron and can interfere with the mineral's absorption. Give toddlers no more than 24 ounces a day, the American Academy of Pediatrics recommends, so they aren't too full to eat iron-rich foods.

Iron pills might seem like a good safety net, but they can be dangerous: "Our bodies don't get rid of excess iron easily, so too much can be toxic," says Tanner. If you suspect that your child's diet is lacking, ask your pediatrician about a multivitamin with iron.

PHOTO (COLOR): Iron boost: cereal plus C-rich fruit

PHOTO (COLOR): Slow learner or just low iron?

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By Sarí N. Harrar

Sarí N. Harrar is a health and science writer who writes frequently for Prevention.