This is another column in a series taken from the book “Nourish, The Definitive Plant-Based Nutrition Guide for Families.” Last week’s column was about vitamins and minerals. Today’s column is about the micronutrients iron, calcium and vitamin D. Some people falsely believe that iron and calcium intake are inadequate on a plant-based diet. And many people of all ages have low vitamin D levels, no matter what they eat.

IRON is important in making hemoglobin, which carries oxygen from lungs thoughout the rest of the body. It also plays a role in many enzymes, the immune system and hormone production. Iron deficiency is the most common nutritional deficiency in the world. It causes anemia (low red blood cell count), which results in multiple symptoms and should be checked for periodically in early childhood.

On the other hand, too much iron causes problems as well, the most common cause being the genetic disease hemochromatosis. Dietary iron is available in both animal and plant foods, but the type of iron differs. Animal products contain heme iron, which in large quantities acts as a pro-oxidant (causing harmful oxidation), and is linked to heart disease, diabetes and cancer. Plants have non-heme iron, the absorption of which the body controls. Non-heme iron is not linked to oxidation or any diseases.

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Following are steps that “Nourish” recommends that parents take to ensure adequate iron levels in their children: 1) Avoid cow’s milk in the first year of life, because it is low in iron, inhibits iron absorption and can cause blood/iron loss in the stool. 2) Between ages 1 and 5, if cow’s milk is given, keep intake under 3 cups a day. 3) Don’t allow more than small amounts of other dairy products such as cottage cheese, cheese and yogurt. 4) At around 6 months, when you add solid foods to breast milk or formula, consider iron-fortified cereals and continue throughout toddler years. 5) For plant-based or plant-predominate children, include iron-rich foods such as lentils, beans and tofu. 6) Serve iron-rich plant foods with foods that enhance absorption, such as those with vitamin C. For example, squeeze some fresh lemon on food before serving. 7) Limit foods that reduce iron absorption such as concentrated wheat bran.

CALCIUM is critical for bone formation and for several other aspect of human health. Children ages 4-8 years, women up to age 50 and men up to 70 need 1,000 mg. a day. In spite of what the dairy industry would like you to believe, you can get plenty of calcium from plants. According to “Nourish,” “prior to the advent of animal husbandry, humans averaged an estimated 1,000 to 1,500 mg without a single drop of cow’s milk.” Furthermore, 70 percent of the global population is lactose-intolerant, plus milk is linked to prostate, breast and other cancers. Although it’s counterintuitive, studies show the more milk a population drinks the higher the incidence of osteoporosis.

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Following are plant-based measures you can take to ensure your child gets adequate calcium: 1) Include plant foods with significant absorbable calcium, such as broccoli, bok choy, Chinese greens, kale, napa cabbage, watercress, mustard and turnip greens, tofu set in calcium, legumes, nuts, seeds, oranges, figs and blackstrap molasses. 2) Use non-dairy milks such as unsweetened soy milk (a cup has 300 mg. of calcium). 3) Sodium increases calcium loss through the urine, so keep salt intake low. 4) For bone health, encourage weight-bearing exercise and maintenance of ideal body weight. 5) In general, avoid calcium supplements because the very high blood calcium levels that result can cause health problems.

VITAMIN D, the “sunshine vitamin,” has the chemical structure of a steroid and is the only vitamin considered a hormone because of its many actions throughout the body. One of its primary functions is to regulate calcium and phosphorus, and normal blood levels of D are necessary for strong bones. Low D levels are associated with bone diseases such as rickets, which decades ago was extremely common, and which is making a resurgence because of low D blood levels.

On his website nutritionfacts.org, Dr. Michael Greger provides evidence that when humans were evolving over millions of years in equatorial Africa, where they were running around mainly naked, they had D levels of 100. In the U.S. the lower cutoff for vitamin D levels is 20-30, although some experts argue it should be 50. A large percentage of Americans have levels lower than 30.

According to “Nourish,” vitamin D supplementation should start during pregnancy and continue during infancy (whether on breast milk or formula) and throughout life. Following are recommended age-related dosages, in international units (i.u.): 0-12 months 400 i.u.; 1-70 years 600; over 70 years 800; during pregnancy and lactation 600. On his website nutrionfacts.org, Dr. Greger presents evidence supporting a daily dose of 2000 i.u. of D3 for adults.

Dr. Feinsinger is a retired family physician with special interest in disease prevention and reversal through nutrition. Free services through Center For Prevention and The People’s Clinic include: one-hour consultations, shop-with-a-doc at Carbondale City Market and cooking classes. Call 970-379-5718 for appointment or email gfeinsinger@comcast.net.