If you have anaemia, you may be able to change your diet to include foods which contain more of the vitamins or minerals you are short of. The sort of foods you should eat will depend on whether you are short of iron, vitamin B12 or folic acid.
Diet and anaemia
Not eating foods with enough iron is sometimes the cause of iron-deficiency anaemia. Some people who have a poor diet with just enough iron to get by, may slip into anaemia if other factors develop. For example, a barely adequate diet combined with one of the following may lead to anaemia:
- A growth spurt in children.
- Heavy periods.
A restricted diet such as a vegan or limited vegetarian diet sometimes does not contain enough iron.
Note: there are other causes of iron-deficiency anaemia, and your doctor will want to check these out first before concluding that you are not eating enough iron. For example, losing blood through your guts, or coeliac disease, or an inherited problem with your blood cells. See the separate leaflet called Iron-Deficiency Anaemia.
Foods to eat for iron-deficiency anaemia
The amount of iron we need depends on our age and sex. The best sources of iron come from animal products - mainly red meat. However, we get a good proportion of iron from non-animal sources too.
Iron sources include:
- Offal: liver and kidneys contain high levels of iron (note that pregnant women should avoid liver).
- Red meat and also poultry and pork.
- Fish and shellfish - for example, octopus, sardines, pilchards, crab, anchovies, shrimps, mussels, tuna, mackerel, bass and trout.
- Cereal and cereal products.
- Wholegrain bread.
- Nuts and seeds - for example, hazelnuts, macadamia nuts, peanuts, pecans, walnuts, sesame seeds, sunflower seeds and pine nuts.
- Green leafy vegetables - for example, broccoli, spinach, watercress and kale.
- Beans and pulses - for example, baked beans, peas, lentils, chickpeas, black-eyed beans and kidney beans.
- Dried fruit - for example, raisins, apricots, prunes, currants and figs.
- Miscellaneous - for example, plain (dark) chocolate, cocoa powder, mango chutney, yeast extract spread (Marmite® or Vegemite®), cherries in syrup, ginger nut biscuits, pastry and curry powder.
Having vitamin C with iron-rich foods will help to absorb the iron more easily. Serve up meals with plenty of vegetables and fruit or have a glass of orange juice with your meal.
Eating meat at mealtimes can also help to absorb the iron from non-animal sources.
Avoid drinking tea with meals as this can actually reduce the amount of iron that is absorbed. Raw wheat bran can also interfere with the absorption of iron so this should be avoided.
Folic acid deficiency anaemia
A lack of folic acid (folate) is one cause of anaemia. The usual cause is not eating enough foods which contain folic acid. It is treated easily by taking folic acid tablets. Pregnant women should also take extra folic acid to help prevent spina bifida and other related problems in the baby.
Foods high in folic acid
We need around 200 micrograms per day of folic acid. However, during pregnancy an additional 400 micrograms are needed, especially for the first 12 weeks of pregnancy. This is usually taken in the form of a supplement, as it is difficult to obtain this required amount through food alone. Good sources of folic acid include:
- Fresh, raw or cooked Brussels sprouts, asparagus, spinach, kale, broccoli, spring beans, green beans, cabbage, cauliflower, okra, lettuce, parsnips, peas and bean sprouts.
- Cooked black-eyed beans and chickpeas.
- Breakfast cereals (with folic acid added to them).
- Liver (note that pregnant women should avoid liver).
- Kidneys, yeast and beef extracts.
- Brown rice.
To ensure you are getting the amount of folic acid you need, aim to include 2-3 portions of these sources daily.
Moderate amounts of folic acid are also found in foods such as fresh fruit, nuts, cheese, yoghurt, milk, potatoes, bread, brown rice, oats, eggs, salmon and beef.
Try not to overcook foods containing folic acid. Steam, stir fry or microwave vegetables to prevent them from losing too much folic acid.
If you are deficient in vitamin B12, this can impair the absorption of folic acid and the way it is used in the body.
Vitamin B12 deficiency
It is unusual to have anaemia due to a lack of vitamin B12 in your diet, although strict vegans may be at risk. It is more common to have vitamin B12 deficiency due to a condition called pernicious anaemia or gut conditions leading to problems absorbing food.
You can find out all about the causes from our leaflet called Vitamin B12 Deficiency and Pernicious Anaemia.
Foods containing vitamin B12
The following foods are good sources of vitamin B12. Including these foods regularly in the diet should help to prevent vitamin B12 deficiency:
- Liver/liver pâté (note that pregnant women should avoid liver/liver pâté).
- Meat - for example, beef, lamb and pork.
- Fortified breakfast cereals.
- Fortified oat, rice and soya milks.
- Fortified soya yoghurts.
- Fortified spreads.
- Fortified yeast extract.
If you are vegan, aim to include foods that are fortified with vitamin B12, at least three times a day. If these foods are not consumed in adequate amounts, the Vegan Society recommends a vitamin B12 supplement of 10 micrograms per day.
Further reading and references
Erythropoiesis-stimulating agents in the treatment of anaemia in cancer patients: ESMO Clinical Practice Guidelines for use; European Society for Medical Oncology (2010)
Guidelines for the Diagnosis and Management of Adult Aplastic Anaemia; British Committee for Standards in Haematology (2015)
Clinical Practice Guideline Anaemia of Chronic Kidney Disease; The Renal Association, 2017 - updated February 2020
Anaemia - iron deficiency; NICE CKS, February 2013 (UK access only)