Diet and Haemochromatosis | What to eat with Iron Overload - explained by a DIETITIAN
A healthy person absorbs typically 1-2mg of iron per day. People with haemochromatosis (or iron overload) absorb much more. This iron can build up in your body and cause problems if not treated.
I'll discuss everything you need about diet and haemochromatosis in this article. AND if you are a more visual learner, you can watch the video below.
What is Haemochromatosis?
Haemochromatosis is an inherited disorder that causes the body to absorb excess iron from the diet. It can lead to severe health problems when the excess iron accumulates in vital organs such as the liver, pancreas, joints, and heart. In Ireland, one in five people are carriers of the gene, while one in 83 are at risk of developing the condition. As someone with hemochromatosis, I would love to hear your experience with this condition in the comments below.
Symptoms typically start between ages 30-40 and include tiredness, weakness, headaches, joint pain, and sometimes weight loss. Some may have no symptoms for a long time.
Causes
Haemochromatosis is a condition caused by a defective gene that affects how your body absorbs iron from the food you eat. If both of your parents have the defective gene and you inherit one copy from each, you can develop hemochromatosis. However, inheriting only one copy of the defective gene will not cause hemochromatosis, though there is a possibility of passing the gene to your children. Even if you inherit two copies of the gene, it does not necessarily mean you will develop haemochromatosis. It can be confusing, so do speak to your GP about testing. It's just a simple blood test, so there is no excuse.
Treatment
Hemochromatosis has no cure, but regular venesection or blood removal can reduce iron levels and the risk of damage. Several venesections may be required initially, but maintenance levels require only occasional procedures.
The Role of Diet
Haemochromatosis can't be treated by diet alone. Blood removal or venesections are the primary treatment. Some dietary changes can help limit iron storage between treatments. However, venesection has a more significant impact than diet changes. Remember that dietary changes can't prevent iron overload. However, there are very different things that we can look at:
The amount of iron in your food
How easy or difficult is it for your body to absorb that iron
Adding in foods that reduce iron absorption
Avoiding or limiting foods that increase iron absorption.
The amount of iron in the food
Iron is an essential nutrient, so you don't need to eliminate all iron-rich foods if you have haemochromatosis. However, it's best to limit your consumption of high-iron foods. A list of commonly consumed foods with high iron content can be found on the Irish Hemochromatosis Society's website.
Absorption
Iron in meat is easily absorbed, whereas iron in plant-based foods is tougher for the body to absorb. Haem iron is found in meat and is readily absorbed, while non-haem iron is found in plant-based foods and is harder for the body to absorb. People with haemochromatosis should eat more foods with non-haem iron.
Inhibitors
Inhibitors are foods that reduce iron absorption. They work by binding to or competing with iron. Common inhibitors are phytates (found in nuts, seeds, beans, lentils, and whole grains), polyphenols (found in tea and coffee), calcium-rich foods (like milk and yoghurt), dietary fibre (in whole-grain bread, bran-based cereals, fruits, and vegetables), and oxalates (in green leafy veggies, almonds, beetroot, berries, soy foods, and rhubarb).
Enhancers
These increase the amount of iron your body absorbs. It is best to avoid eating these foods or nutrients when you are eating foods high in iron (haem and non-haem). This helps to reduce the amount of iron that you are absorbing.
Enhancers include: Fructose (found mainly in fruit juices) can increase absorption of iron – limit fruit juices to 150 mls per day and have them around 1 hour before or after meals. Alcohol: Limit alcohol. Vitamin C in fruits and vegetables: No need to avoid. Vitamin C supplements: Best to avoid. If you do need to take a vitamin C supplement, have them at least 1 hour before or after eating
Alcohol
Alcohol is a concern for those with hemochromatosis as it's an enhancer that increases iron absorption. Alcohol can damage liver and heart health, which are already affected by iron overload. It's worth noting that alcohol is a source of iron. Cider, in particular, is very high in iron.
Pregnancy
If you have hemochromatosis and become pregnant, inform your medical staff. Pregnancy changes how your body handles iron, so consult your doctor for individual advice. Avoid iron-rich foods and supplements, and check the labels on any prenatal supplements. Venesections may be paused during pregnancy. Women with hemochromatosis may become iron deficient during pregnancy, so follow your doctor's or dietitian's advice if you find yourself low in iron.
Supplements
Don't take iron supplements; if you are taking a multivitamin, check that it doesn't contain iron; this can actually be quite difficult if you are a female, as most will have iron in them.
Raw shellfish
People with haemochromatosis should avoid raw shellfish like oysters, mussels, and clams, as they may contain Vibrio vulnificus bacteria that thrive on iron and can be fatal. Cooking shellfish at high temperatures destroys these bacteria. Be careful handling raw shellfish, and wash your hands thoroughly with soap and water afterwards.
Fortified foods
We advise people to limit or avoid iron-fortified cereals where possible. If you must consume them, try to find ones that are not fortified.
Maria is a registered dietitian in Ireland and Bermuda. She is passionate about making diet and nutrition education accessible to all. We hope you enjoy these recipes, and please reach out and let us know if you make them. Dietetic appointments and services are available online; email info@marialuceyrd.com. Corporate wellness and health promotion services are available online in Cork, Kerry and Dublin.