Diet Plan For Hemochromatosis

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Diet plan for hemochromatosis includes foods rich in Iron and antioxidants. A hemochromatosis diet chart to provides Iron along with copper, Vitamin C and Zinc is also given. Hemachromatosis is a type of iron storage disease. It is a genetic disorder in which the body absorbs too much iron from food or supplements. Normally, the body holds onto small amounts of iron. The rest passes out of the body in the stool or out through the urine.

What to Eat When You Have Hemochromatosis

Dietary Recommendations for Better Management

Hemochromatosis is a genetic disorder that causes an excessive build-up of iron in the body. If left untreated, it can cause severe organ and joint damage and even death.

The hemochromatosis diet enables a person with hemochromatosis to avoid foods that are high in iron as well as those that can increase the absorption of iron. The diet consists of foods that will provide ample protein and other nutrients to maintain optimal health without overloading the body with iron.

The Hemochromatosis Diet
Theresa Chiechi / Verywell
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Purpose of the Hemochromatosis Diet

Iron is considered an essential nutrient because the body cannot make it; it must be obtained from food. 

In normal adults, only around 10% to 30% of the iron that a person eats gets absorbed in the gut.1 In people with hemochromatosis, a hormone called hepcidin increases the absorption by as much as 400%, leading to iron overload and iron toxicity.2

The hemochromatosis diet is used to decrease the intake of heme iron, the type of iron most easily absorbed in the gut. Prime sources include red meats and organ meats.1

Less focus is placed on reducing the intake of non-heme iron found in vegetables, fruits, and grains. These foods are considered more beneficial than not. Instead, foods that can increase the absorption of non-heme iron may be limited or avoided.

How the Diet Works

The hemochromatosis diet is intended to meet the unique nutritional needs of a person with hemochromatosis. The diet consists of fresh fruits, vegetables, whole grains, an adequate intake of protein, and a limited amount of red meat, citrus fruits, sugars, and dairy. Whole foods are encouraged whenever possible.

Principles of a Hemochromatosis Diet

While there are no formal guidelines for the hemochromatosis diet, there are guiding principles, namely:

  • The reduction in red meat consumption
  • The avoidance of animal fat and sugar
  • Limitation of vitamin C from all sources
  • The moderate use of alcohol
  • Increased intake of whole grains, rice, and beans
  • The consumption of tea and coffee
  • High intake of fresh fruits and vegetables3

By working with a healthcare provider and dietitian, you can formulate how much red meat you can consume on a weekly basis and find alternative sources of protein. The same applies to vitamin C and other dietary nutrients so that a healthy, balanced diet can be maintained irrespective of the iron intake.

Duration

People with hemochromatosis can adhere to the hemochromatosis diet over the long term under the care of a healthcare provider. Frequent lab work is required to ensure that iron levels are within normal limits.

Dietary adjustments may be needed if the levels either get too high or too low. If left unmonitored, a hemochromatosis diet can cause iron levels to drop excessively, leading to iron-deficiency anemia and the temporary cessation of the diet.

Because symptoms of anemia can mimic those of hemochromatosis, it’s important to see your healthcare provider if you experience extreme fatigue or weakness while on the hemochromatosis diet. Only a blood test can reveal if your iron levels are too high or low.

Never make dietary changes without first consulting your healthcare provider.

What to Eat

There are foods on the hemochromatosis diet you can eat and others that need to be avoided or limited. Non-compliant foods are those that either deliver too much iron or increase the absorption on heme and/or non-heme iron.

Compliant Foods

  • Yogurt
  • Cheese
  • Poultry
  • Fish (including canned rish)
  • Eggs
  • Nuts and seeds
  • Beans and legumes
  • Tofu
  • Whole grains
  • Broccoli
  • Spinach
  • Figs
  • Rhubarb
  • Apples
  • Avocado
  • Olive oil
  • Black tea
  • Coffee
  • Cocoa

Non-Compliant Foods

  • More than limited amount of red meat
  • More than limited amount of citrus fruits
  • Animal fat
  • Alcohol
  • Sugars
  • Food additives with ferric EDTA or chelated iron

People with hereditary hemochromatosis should also avoid raw shellfish because it contains a type of bacteria—called Vibrio vulnificus—that is known to be fatal in those with high iron levels.4

Foods That Decrease Iron Absorption

There are foods in the hemochromatosis diet that are beneficial because they impede the absorption of iron in the gut. A typical meal would include more of the foods rich in the following compounds:

  • Calcium: Calcium found in milk, green leafy vegetables, soy, and oily fish are thought to slow the absorption of iron in the gut. However, it is only at higher doses (around 300 to 600 milligrams) that these foods appear to have a chelating (clearing) effect.5
  • Phosvitin: Eggs contain a protein called phosvitin that binds to iron and helps clear it from the body. Even though egg yolks are rich in iron, phosvitin helps limit the amount of iron the body absorbs from them.6
  • Oxalates: These plant-based compounds found in spinach, kale, beets, nuts, chocolate, tea, wheat bran, rhubarb, and strawberries are thought to lower the absorption of non-heme iron. Even though spinach is rich in iron, oxalates appear to limit their absorption.7
  • Phytate: This stored form of phosphorus found in walnuts, almonds, dried beans, lentils, cereals, and whole grains also impedes heme iron absorption.8
  • Polyphenols: These plant-based chemicals found in coffee, cocoa, peppermint, and apples are a major inhibitor of heme iron absorption.9
  • Tannins: These organic compounds found in black tea, grapes, barley, cranberries, and dried fruits bind to iron and aid in its clearance from the body.10

Swedish cocoa and leaf teas able to inhibit iron absorption by as much as 90%. One cup of coffee, which is high in tannin and chlorogenic acid, can inhibit absorption by up to 60%.

 Blood Iron Levels May Be Key to Healthy Aging

Foods That Increase Iron Absorption

Red meats are not the only foods to be concerned about when embarking on a hemochromatosis diet. Some otherwise nutritious foods can enhance the absorption and promote iron overload. These include:

  • Citrus: Vitamin C is one of the most potent enhancers of non-heme iron absorption. An intake of 100 milligrams (equivalent to two 8-ounce glasses of orange juice) can increase iron absorption by fourfold.11 In addition to citrus, other rich sources of vitamin C include tomatoes, guavas, and red peppers.
  • Alcohol: Non-heme iron absorption increases by around 10% when alcohol is added to a meal. Wine and hard liquor appear to have the same effect.12
  • Sugar: Sugar and foods high in sugars (including high-fructose corn syrup) can boost non-heme iron absorption by as much as 300%.13

Beta-carotene found in brightly colored foods such as carrots, sweet potatoes, beets, and red and yellow peppers are also thought to promote iron absorption. Even so, their nutritional benefits outweigh the potential risks, and foods rich in beta-carotene are not excluded from the hemochromatosis diet.

Hemochromatosis Diet

Hemochromatosis Diet
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Notes on diet for hemochromatosis: 

The most important things to avoid: 

  • Iron supplementation 
  • Fortified foods with iron &/or vitamin C
  • Vitamin C supplements
  • Red meat, shellfish (or consume very infrequently and pair with calcium-rich foods)
  • Alcohol 

The most important things to add into your diet: 

  • Fruits and vegetables
  • Whole plant foods
  • Everything in the “Consume” and “Limit” categories above

The most important things to know about pairing your foods to limit iron absorption: 

Firstly, please know that the current medical therapies you are doing are the most effective for managing hemochromatosis. Next, “the most important things to avoid,” is the next most supportive piece to the equation. Lastly, food pairing and choices are somewhat supportive, but the first two will be the most important. Because plant foods, namely vegetables, have a combination of calcium, vitamin C, iron and other nutrients, they will not have as large of an effect on managing hemochromatosis as the above mentioned. You will notice that some foods are listed in both categories. This is not to confuse you, but rather to show that some of these foods will have multiple of these nutrients. It may be helpful to think of the foods in both categories (ie broccoli) as neutral when pairing. 

  • Calcium-rich foods will inhibit heme and non-heme iron absorption. If you chose to consume non-heme iron sources (plant foods) on occasion, which is harder for the body to absorb than heme sources, you could pair it with some calcium-rich foods. For example, spinach with organic, grass fed yogurt and chia seeds in a morning smoothie. 
    • Yogurt, kefir, cheese, tempeh, broccoli, leafy greens, broccoli, chia seeds, almonds, dried figs, white beans, sunflower seeds, edamame, kale, sesame seeds, collard greens, etc. 
  • Vitamin C-rich foods support iron absorption. Here is a list to help with potential food pairing. Please note that vitamin C is an important nutrient and antioxidant that is necessary to include in your diet.
    • Peppers, cherries, thyme, parsley, kale, kiwi, broccoli, brussel sprouts, lemons, strawberries, oranges

Consume

  • Vegetables & Fruits
    • 2-3 cups of Leafy Greens daily (Kale, Chard, Arugula, Bok Choy, etc.) 
    • 2-3 cups of Sulphur daily (Onion, Garlic, Broccoli, Cabbage, Asparagus, Mushrooms, etc.) 
    • 2-3 cups Colorful daily (Berries, Beets, Carrots, etc.) 
      • 1-2 handfuls of berries daily
  • Whole Grains & Legumes
    • 1.5 cups of cooked Whole Grains daily (Barley, Brown/Wild Rice, Buckwheat, Millet, Oats, Quinoa, etc.) 
    • 1.5 cups of cooked Legumes daily (beans, peas, lentils, etc.) 
  • Seeds & Nuts
    • ¼ cup Seeds or Nuts daily (Almonds, Brazil Nuts, Chia Seeds, Hemp Seeds, Pistachios, etc.) 
  • Fish, Game, Poultry (optional)
    • 1-3 servings of wild-caught Fish or Seafood per week (Wild-Caught)
    • 1-2 servings of organic, grass-fed Game or Poultry per week (Turkey, Chicken, Quail, Pheasant, Rabbit, etc.)
  • Herbs & Spices
    • Unlimited salt-free and sugar-free Herbs and Spices (Basil, Bay Leaves, Turmeric, Chili Powder, Rosemary, etc.) 
  • Herbal Tea
    • Unlimited amounts of Herbal Tea (Chamomile, Peppermint, Raspberry, etc.)
  • Water
    • Drink half of your weight in ounces daily
    • Pure water without contaminants

Limit:

  • Fats
    • (Can consume healthy fats – Extra Virgin Olive Oil, Avocados, Full-Fat Coconut Milk, Seeds, Nuts, etc. in moderation)
  • Eggs
    • 2-3 serving of organic, pasture-raised Eggs per week
  • Caffeine
    • 1-2 cups of Caffeinated Beverages per day (i.e. green tea)
  • Dairy
    • (Yogurt, kefir, cheese, etc.) 

Avoid:

  • Meat, Red Meat
    • (Heavily processed meats)
  • Alcohol
  • Fried Foods
    • (French Fries, Burgers, Chicken Nuggets, Onion Rings, Chips, etc.)
  • Processed Foods
    • White Flours and Sugars (Cakes, Breads, Donuts, Ice Cream, Cookies, etc.)
    • Sodas (all sodas, energy drinks, etc.)
    • Packaged Products
  • Added Sugars
    • Added Sugars (sodas, sauces, breads, etc.)
  • Tobacco & Environmental Toxins
    • Tobacco products (cigarettes, nicotine, vaporizers, chew/ dip, etc.)
    • Environmental Toxins (pesticides, herbicides, cleaning chemicals, chemicals in body-care products, etc.) 

Sample Eating Schedule

1:00-6:00 Fast

7:00 Break Fast

  • Steel cut oats with berries, nuts and seeds
  • Protein shake with vegetables, fruits, seeds &/or nuts (grass-fed/organic collagen, whey or egg protein powders)
  • Chia seed pudding with berries and nuts
  • Vegetable hash

10:00 Snack (optional)

  • Chopped vegetables
  • Handful nuts
  • Handful berries

12:00 Lunch

  • Salad (vegetable assortment, legumes, seeds, nuts, healthful dressing)
  • Soup (bone broth, vegetable assortment, legumes, beans, herbs & spices, optional poultry/fish)

15:00 Snack (optional)

  • Chopped vegetables
  • Handful nuts/ seeds
  • Handful olives
  • Two small slices of cheese (occasionally)

17:00 Dinner

  • Soup (bone broth, vegetable assortment, legumes, beans, herbs & spices, optional poultry/fish)
  • Homemade burrito bowl (rice, beans, vegetable assortment, guacamole, optional poultry/fish) 

18:00-24:00 Fast

Last notes: 

I really want to emphasize that consuming lots of fruits and vegetables high in antioxidants and nutrients is extremely important to combat free radicals caused from oxidation. Continuing your recommended medical therapies and following “the most important things to avoid” and “the most important things to add into your diet” are the best steps for management. The pairing of vitamin C and Calcium-rich foods without or with iron is the least important of all of these pieces to the puzzle. It may be beneficial, but that has yet to be studied further in scientific literature.

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