Adolescence is a period of rapid growth and, for many girls, the onset of menstrual blood loss; both increase iron requirements. Iron deficiency during this time can reduce energy, impair concentration and lower school performance. In many low-resource settings, concurrent factors such as insufficient dietary diversity and parasitic infections amplify risk. Addressing iron status requires dietary strategies that combine food choices, meal patterns that enhance absorption, and targeted use of fortified foods or supplements when indicated.
Dietary sources and meal composition
Prioritize heme iron sources such as lean red meat, poultry and fish when culturally acceptable and available, because they are absorbed more efficiently than plant sources. For those following vegetarian or low-meat diets, focus on iron-rich plant foods like lentils, beans, chickpeas, dark leafy greens and iron-fortified cereals, consumed with a source of vitamin C to enhance nonheme iron uptake. Elizabeth Yetley National Institutes of Health Office of Dietary Supplements explains that vitamin C increases nonheme iron absorption, while polyphenols in tea and coffee and calcium-rich foods can reduce absorption when consumed at the same meal.
When and how to consider supplements and fortification
Population-level guidance recognizes that dietary change alone may be insufficient where anemia prevalence is high. Francesco Branca World Health Organization has contributed to WHO recommendations that daily iron supplementation or food fortification be used as public-health measures in such settings, paired with efforts to identify causes like heavy menstrual bleeding or helminth infection. Supplement use should follow local health guidance and, ideally, screening by a healthcare provider, because unnecessary iron can cause adverse effects and mask other diagnoses.
Menstrual health, cultural food practices and local food environments shape feasible strategies. In communities with predominantly plant-based diets or limited access to animal-source foods, promoting fortified staples and culturally acceptable vitamin C–rich accompaniments is practical. Addressing environmental determinants such as sanitation and deworming programs reduces absorption barriers and the overall burden of anemia. Monitoring outcomes through school health programs or primary care supports timely adjustment of interventions and helps protect cognitive and physical development during adolescence.