Hemochromatosis Diet
Low-Iron Foods That Can Help You Manage Iron Build-Up
Medically reviewed by Steffini Stalos, DO
Hemochromatosis is a genetic disorder that causes a buildup of too much iron in your body. A strict hemochromatosis diet is not usually necessary. However, understanding how dietary iron is absorbed may help to manage the condition.
Excessive iron from hemochromatosis can cause severe organ and joint damage and even death. The primary treatment is weekly blood removal to lower iron stores. Maintaining a healthy weight, avoiding alcohol, and reducing the amount of red meat and vitamin C in your diet is also recommended.
This article discusses how to eat on the hemochromatosis diet. It explores the difference between heme and non-heme iron and how they affect your iron levels. It also explains foods that hinder or boost iron absorption and how combining or avoiding different food pairings can help manage hemochromatosis.
Theresa Chiechi / Verywell
Purpose of the Hemochromatosis Diet
The goal of the hemochromatosis diet is to lower the amount of iron the body absorbs. Iron is an essential nutrient. The body does not make it and relies upon dietary sources of iron.
Normally, only 10% to 13% of dietary iron is absorbed in the gut. In people with hemochromatosis, however, iron absorption is dramatically increased. This is due to a genetic deficiency of hepcidin, a hormone produced in the liver that regulates iron absorption.
Understanding different types of dietary iron, how they are absorbed, and the interplay of other nutrients can help you better manage hemochromatosis.
Dietary iron comes in two forms:
Heme iron, found in meat, seafood, and poultry, is more easily absorbed by the body.
Non-heme iron, found in plants, iron-fortified foods, and in smaller amounts in meat, seafood, and poultry, is not absorbed as well as heme iron.
People with hemochromatosis should limit their intake of heme iron. Foods rich in non-heme iron are less restricted but should not be combined with foods that increase the absorption of non-heme iron.
Additionally, several foods can hinder iron absorption. Including them alongside foods rich in heme or non-heme iron can help lower the risk of iron overload.
How the Diet Works
The American Academy of Family Physicians does not recommend a specific diet for people with hemochromatosis. It does, however, recommend the following dietary interventions:
Avoid alcohol
Limit red meat
Limit vitamin C to less than 500 mg daily
Maintain a healthy weight through diet and exercise
In addition, people with hemochromatosis should avoid raw or undercooked shellfish, which can cause a serious infection in people with liver disease.
A healthy hemochromatosis diet focuses on fresh vegetables, fruits other than citrus, whole grains, and protein sources that are low in heme iron. Whole foods are encouraged whenever possible.
Principles of a Hemochromatosis Diet
While there are no formal guidelines for the hemochromatosis diet, research shows the following principles are beneficial for preventing iron overload:
Avoid red meat, processed meat, offal (organ meat), and blood-containing foods
Choose plant-based proteins (legumes, pulses, and soy) and eggs
Include three to five 3.5-ounce servings of fish each week
Limit poultry to two 3.5-ounce servings of lean, white meat per week
Aim for 600 grams (about four cups) of vegetables and fruit daily
Eat fruit as a snack between meals to avoid combining vitamin C with iron-rich foods
Choose whole grain breads and cereals, but avoid iron-enriched products and sourdough
Limit animal fat, full-fat dairy, added sugar, and salt
Drink water, green or black tea, coffee, or low-fat milk with meals
Do not drink alcohol and avoid drinking juice with meals
Work with your healthcare provider and dietitian to determine the right eating plan for you. If you are overweight or obese, losing weight is recommended. Excess weight increases the risk of liver injury in people with hereditary hemochromatosis.
Do not make dietary changes without first consulting your healthcare provider.
Related: What Are Iron Tests?
What to Eat with Hemochromatosis
People with hemochromatosis should eat a varied diet that includes plenty of vegetables and non-citrus fruits, plant-based proteins and fats, low-fat dairy, whole grains, and lean animal proteins in moderation.
Some foods recommended on the hemochromatosis diet include:
Almonds
Apples
Avocado
Beans and legumes
Black or green tea
Broccoli
Chocolate
Cocoa
Coffee
Cranberries
Dried fruit like dates, figs, and prunes
Eggs
Fish, especially oily fish
Grapes
Low- or non-fat cheese, milk, and yogurt
Lean, white meat poultry in moderation
Lentils
Nuts and seeds
Olive oil
Peppermint
Rhubarb
Spinach and other green leafy vegetables
Strawberries
Tofu
Walnuts
Wheat bran
Whole grains
Foods that Decrease Iron Absorption
Another helpful strategy is to include foods rich in nutrients that impede iron absorption. Adding the following nutrients to your meals can help lower your iron uptake:
Calcium: Found in milk, green leafy vegetables, soy, and oily fish, calcium slows 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.
Phosvitin: Eggs contain a protein called phosvitin. This protein 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.
Oxalates: These plant-based compounds are found in spinach, kale, beets, nuts, chocolate, tea, wheat bran, rhubarb, and strawberries. They are thought to lower the absorption of non-heme iron. Even though spinach is rich in iron, oxalates appear to limit their absorption.
Phytate: This stored form of phosphorus is found in walnuts, almonds, dried beans, lentils, cereals, and whole grains. It also impedes heme iron absorption.
Polyphenols: These plant-based chemicals are found in coffee, cocoa, peppermint, and apples. They are major inhibitors of heme iron absorption.
Tannins: These organic compounds are found in black tea, grapes, barley, cranberries, and dried fruits. They bind to iron and aid in its clearance from the body.
Takeaway
Swedish cocoa and leaf teas are 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%.
Related: Blood Iron Levels May Be Key to Healthy Aging
What Not to Eat with Hemochromatosis
People with hemochromatosis should avoid or limit foods that are high in heme iron, nutrients that boost iron absorption, and things that can harm the liver. These include:
Alcohol
Animal fat
Blood-containing foods, like black pudding and blood sausages
Citrus fruit and juice, except in moderation between meals
Fermented vegetables, like kimchi, pickles, and sauerkraut,
Iron-fortified foods or foods containing ferric EDTA or chelated iron
Organ meat, like liver, heart, brains, and intestines
Processed meats, like bacon, beef jerky, cold cuts, corned beef, ham, hot dogs, pepperoni, salami, and sausage
Raw shellfish
Red meat, including beef, veal, lamb, mutton, pork, goat and venison
Sourdough bread
Sugar
Some of these foods should be limited due to their heme iron content. Others enhance iron absorption and promote iron overload.
Foods That Increase Iron Absorption
Some nutrients boost iron absorption. Avoid eating meals that combine iron-rich foods with the following:
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.
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 fourfold. In addition to citrus, other rich sources of vitamin C include tomatoes, guavas, and red peppers.
Fermented foods: Lactic acid, found in fermented vegetables and grains (like sourdough bread), promotes iron absorption and should be avoided. Fermented dairy, like yogurt and kefir, however, are allowed because their calcium content hinders iron absorption and offsets this effect.
Sugar: Sugar and foods high in sugars, including high-fructose corn syrup, can boost non-heme iron absorption by as much as 300%.
Avoid Undercooked Shellfish
People with hereditary hemochromatosis should avoid raw or undercooked shellfish. This is because it contains a type of bacteria called Vibrio vulnificus that is known to be fatal in those with high iron levels.
Don't Use Cast-Iron Cookware
People with hemochromatosis should avoid using cast-iron skillets or pots to cook, especially for slow cooking or preparing acidic foods like tomatoes. Iron from these pots can leech into the food, increasing iron content.
Summary
Watching what you eat can help people with hemochromatosis to slow the buildup of iron in their blood. The hemochromatosis diet emphasizes fresh produce, plant-based proteins, fish, lean poultry, and low-fat dairy while avoiding sources of heme iron, like red meat.
Combine foods that contain iron with those containing nutrients that hinder iron absorption. Dairy, eggs, leafy greens, legumes, nuts, coffee, tea, and chocolate are good options.
Avoid consuming iron-rich foods along with foods that boost absorption, including alcohol, citrus fruit or juice, fermented foods, and added sugar. Eat these between meals instead. Since hemochromatosis is a liver disease, alcohol should be limited or eliminated altogether to preserve liver health.
If you have hemochromatosis, ask your healthcare provider if dietary interventions should be added to your treatment plan. If so, consult a dietitian for guidance to ensure you are getting enough nutrients.
Read the original article on Verywell Health.
