Iron is so widely distributed that to produce an anemia from a lack of it, one must live largely on refined foods. Hemoglobin, many enzymes, and a substance known as myoglobin, which carries oxygen in muscle cells, cannot be produced without iron. Even a mild deficiency so limits enzyme and myoglobin production that chronic fatigue, headaches, and shortness of breath can occur long before anemia develops. When persons with iron deficiency anemia eat beets, the red color is said to appear in the urine; hence eating beets may serve as a test to determine whether anemia results from a lack of iron or from other causes.

Iron-deficiency anemia is common in women of reproductive age whose menstrual flow is heavy; among persons of all ages who eat mostly refined foods; in adolescent girls whose diets are often appalling and whose iron requirements are high because of muscle development, increased blood volume, and menstrual losses; and, because cows' milk contains little iron, among bottle-fed babies and persons who live largely on milk.. Yeast is such an excellent source of iron that anemia can be easily prevented by taking a few teaspoons daily or adding it to a baby's formula.

Blood examinations of thousands of army recruits have shown that iron-deficiency anemia is common in young men, who have unusually high iron requirements because of the large amount of myoglobin being formed in their rapidly developing muscles. Instead of the normal 15 grams of hemoglobin, some recruits had less than 5, and many less than 10. Their shortness of breath on exertion and chronic fatigue disappeared when iron was given them, and they experienced a marked sense of well-being. Because the body uses iron over and over, before so much refined food was eaten, anemia in men was rare except after a loss of blood. Years ago a young man with the iron-storage disease, siderosis, requested from me an iron-free diet; he was an identical twin and his brother had already died of the disease. At first I sincerely attempted to comply, only to discover that it was absolutely impossible to plan an adequate diet free from iron. Meats, eggs, whole-grain breads and cereals, fruits, and vegetables all contain iron in considerable quantity; and a general diet of unrefined foods usually supplies twice the amount of iron recommended by the National Research Council. A diet of nothing except milk and refined foods--vitamin and mineral supplements were unavailable then--could not be recommended, and this young man was too frightened to eat anything else. I never heard how long he lived, but the experience convinced me that if refined foods are avoided, iron supplements are not needed.

All nutrients are essential. Almost every nutrient is needed to produce red blood cells, hemoglobin, and enzymes required for their synthesis; and anemia is usually brought on by several subtle deficiencies existing simultaneously. In addition to the nutrients already mentioned, copper is necessary before iron can be absorbed, carried in the blood, or utilized; cobalt is an essential part of vitamin B12; and hemoglobin cannot be produced without pantothenic acid and 19 different amino acids, many furnished only by complete proteins.

When blood has been withdrawn from animals, the best food to correct the resulting anemia was liver of every variety. Kidneys, chicken gizzards, and egg yolks ran a close second, and muscle meats and brains ranked slightly above green leafy vegetables. Peaches, apricots, and prunes had half the potency of liver. Unfortunately, yeast and wheat germ were not tested in these studies, but most of the nutrients needed for building blood are rich in these foods. When liver is eaten, recovery from anemia is much more rapid than if all nutrients are obtained separately; hence some investigators believe an anti anemia factor is still to be isolated.

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