Which food combination maximises iron absorption in pregnancy?

BTSC Staff Nurse 31 July-2025

Applied Nutrition & Dietetics

Hard

Appeared in: BTSC Staff Nurse 31 July-2025

Explanation

This option correctly pairs a plant-based (non-heme) iron source with a potent enhancer of iron absorption.
Lentil soup provides a good amount of non-heme iron, which is common in vegetarian diets.
Orange juice is an excellent source of Vitamin C (ascorbic acid).
Vitamin C significantly increases the bioavailability of non-heme iron by converting it from the ferric (Fe³⁺) form to the more soluble and absorbable ferrous (Fe²⁺) form.
This combination creates a synergistic effect, leading to the highest possible iron absorption among the choices.

Option A: This combination contains an inhibitor of iron absorption. While eggs contain iron, whole-grain toast contains phytates, which bind to iron and reduce its absorption. The meal also lacks a significant source of Vitamin C to counteract this effect.
Option C: This combination pairs an excellent source of heme iron (red meat) with a potent inhibitor. Coffee contains tannins and polyphenols, which significantly decrease the absorption of both heme and non-heme iron.
Option D: This combination contains two substances that work against each other. Spinach contains non-heme iron, but milk is rich in calcium. Calcium competes with iron for absorption pathways in the gut, significantly reducing the amount of iron the body can absorb.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Nutritional principles for maximizing dietary iron absorption during pregnancy as background academic context rather than a clinical decision trigger.
Iron-deficiency anemia is one of the most common nutritional deficiencies and complications during pregnancy, increasing the risk for preterm delivery, low birth weight, and postpartum maternal infections.
Nurses play a crucial role in providing dietary counseling to pregnant women. Teaching them about iron enhancers and inhibitors is a key preventive strategy.
A key nursing intervention is to review the patient's typical diet and suggest simple modifications, such as adding a citrus fruit to their breakfast cereal or separating their daily coffee/tea from their main meals.

How to Approach the Question

First, identify the core question: which food pairing maximizes iron absorption.
Recall the two types of dietary iron: heme (animal-based, easily absorbed) and non-heme (plant-based, less easily absorbed).
Remember the key factors that influence non-heme iron absorption. The most powerful enhancer is Vitamin C. Major inhibitors include calcium, tannins (in tea/coffee), and phytates (in whole grains).
Analyze each option: Look for the presence of an iron source and any enhancers or inhibitors.
Option A: Eggs (iron) + Whole-grain toast (phytate inhibitor). Incorrect.
Option B: Lentils (non-heme iron) + Orange juice (Vitamin C enhancer). This is a strong positive combination.

Concept Tested & Keywords

Concept Tested: Nutritional principles for maximizing dietary iron absorption during pregnancy.
Stem keywords: food combination, iron absorption, pregnancy
Lead-in keywords: maximises

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E6 Nutrition Monika Sharma 3e pp. 213-215, 212-214