The Best Diet for Hemochromatosis

In a broad sense, the best diet for hemochromatosis involves foods low in iron. Despite this general understanding from researchers and healthcare professionals, there are no established food and nutrition recommendations for managing hemochromatosis.

The amount of iron absorbed from the foods you eat depends on various circumstances. Here are some dietary factors that may affect the way your body absorbs iron:

• Heme vs. nonheme iron: There are two types of dietary iron: heme and nonheme. Heme iron is found in meat and seafood. Nonheme is found in plants, meat, seafood, and fortified products. Heme iron is more bioavailable than nonheme iron, meaning your body more easily absorbs it.
• Vitamin C: Vitamin C, or ascorbic acid, enhances the bioavailability of nonheme iron. In addition, meat and seafood can also enhance the absorption of nonheme iron.
• Oxalic acid: Oxalic acid (oxalate) is a compound found in many plant-based foods, including beans, leafy green vegetables, certain nuts and seeds, and many fruits. Mixed evidence exists on if oxalic acid can limit iron absorption.
• Calcium: Various forms of calcium might decrease the bioavailability of both heme and nonheme iron.
• Phytate and polyphenols: Phytate, or phytic acid, is a compound found in grains and legumes that decreases iron absorption. Other compounds in plant foods, known as polyphenols, can also decrease iron absorption.

Eating iron-rich foods in moderation is only one element of the best diet for hemochromatosis. Other factors, such as the other nutrients in the foods you eat, might affect your iron absorption.

For people with this condition, choosing certain foods that are naturally low in iron or those that limit the body’s ability to absorb and use iron may be a helpful lifestyle measure to manage symptoms.

But, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), changing your diet seems to only have a small effect on iron levels in the body compared to traditional treatments for hemochromatosis. These treatments include removing iron by phlebotomy (taking blood and iron from the body).

In fact, anywhere from only 2-35% of the iron from a diet of mixed foods with both heme and nonheme sources might actually be absorbed by the body. You may not need to make robust changes to your diet to eat less iron if you’re a person with this condition.

You can talk with a doctor and registered dietitian to see how you can eat a healthy, balanced diet if you have hemochromatosis.

Fruits and vegetables

Many of the recommendations for this condition will warn you to stay away from vegetables high in iron. This might not always be necessary.

Vegetables high in iron, such as spinach and other leafy greens, contain only nonheme iron. Nonheme iron is less easily absorbed than heme iron, making vegetables a good choice.

Grains and legumes

Grains and legumes contain substances that inhibit iron absorption — specifically, phytic acid.

For people with hemochromatosis, phytic acid may help to keep the body from over-absorbing iron from foods.

Dairy products

Cow’s milk and foods made with real cow’s milk, like cheese or yogurt, generally contain no iron and can be part of a balanced eating plan if you have hemochromatosis. Additionally, a protein in milk called casein has been found to limit the amount of iron absorbed from other foods.

Fish

Certain fish are lower in iron. These may include:

• tuna
• pollock
• salmon

For example, a 3-ounce can of light tuna in water has only 1 milligram of iron per serving, or 6% of the daily recommended needs.

Eggs

Egg yolks have a type of protein called phosvitin. Research suggests phosvitin from eggs can limit iron absorption.

Tea and coffee

Both tea and coffee contain polyphenolic substances called tannins, also known as tannic acid. The tannins in tea and coffee can inhibit iron absorption. Tea or coffee can be great drinks to try if you have hemochromatosis.

Animal proteins

Protein is an important part of a healthy diet. Many dietary sources of protein do contain iron. But this doesn’t mean that you have to cut meat out of your diet completely.

Instead, plan your meals around protein sources that are lower in iron, such as:

• pork
• turkey
• chicken
• deli meats like ham

If you have this condition, there are plenty of food options available to form an eating plan that works best for you.

To properly manage iron levels in the body and lessen the chance of aggravating symptoms or complications from hemochromatosis, you might try avoiding or limiting certain foods and drinks.

Excess red meat

Red meat, including beef, is a good source of the type of iron that your body can use very easily. So, you may want to watch out for eating too much if you have hemochromatosis. Red meat can be a healthy part of a well-rounded diet if eaten in moderation.

Organ meat and game meats

You may want to limit organ meats, such as liver or kidney due to their high iron content. Game meats, such as venison, are also high in heme iron. You can pair organ or game meats with foods that decrease iron absorption.

Raw seafood

While foods like raw oysters, mussels, or clams by themselves are high in iron, experts believe there’s something in raw shellfish that might be more concerning. Vibrio vulnificus is a type of bacteria in coastal waters that can infect shellfish in these areas.

For people with high levels of iron, such as those with this condition, consider avoiding raw shellfish. That’s because some older research has found that Vibrio vulnificus grows best in the body when iron levels are high.

Foods rich in vitamins A and C

Vitamin C is one of the most effective ways to improve iron absorption. Although vitamin C is a necessary part of a healthy diet, you may want to avoid consuming vitamin C-rich foods in excess.

In addition, vitamin A has also been shown to increase the absorption of iron.

Many leafy green vegetables contain vitamin C, vitamin A, and iron. But, since nonheme iron in vegetables isn’t as easily absorbed, the benefits may outweigh the risks.

Fortified foods

Fortified foods have nutrients added to them. Many fortified foods contain high amounts of vitamins and minerals, such as:

• calcium
• zinc
• iron

If you have hemochromatosis, eating iron-rich fortified foods in excess may increase your blood iron levels. Check the iron content on nutrition labels before eating these foods.

Excess alcohol

Alcohol consumption, especially chronic alcohol consumption, can damage the liver. Iron overload in hemochromatosis can also cause or worsen liver damage. Try to consume alcohol in moderation.

According to the Centers for Disease Control and Prevention (CDC), moderate drinking means two drinks or less daily for males or one drink or less daily for females.

If you have existing liver disease and hemochromatosis, you might want to avoid alcohol, which could further damage your liver.

Supplements

There aren’t many recommendations for additional supplements when you have hemochromatosis. This is because research is limited on dietary programs for this condition. Still, it may be best to be careful with the following supplements:

• Iron: According to the American Liver Foundation, people with this condition should not take iron supplements. As you can imagine, taking highly absorbable iron in the large amounts found in these supplements could place you at risk of having dangerous amounts of iron in the body.
• Vitamin C: Avoid vitamin C supplements if you have hemochromatosis, even though vitamin C is a popular supplement for iron-deficiency anemia. This is because the high concentration of vitamin C found in these supplements can be easily used by the body to improve iron absorption.
• Multivitamins: If you have hemochromatosis, you may want to speak with a doctor before taking multivitamins or supplements with multiple minerals. Multivitamins may contain high amounts of iron, vitamin C, and other nutrients that can enhance iron absorption. Always check the label and consult with a doctor.

Additional research is needed to better understand the relationship these foods, drinks, and supplements might play in worsening symptoms of hemochromatosis.

Iron from cast-iron pots, pans, or skillets could get into food during cooking. This may be problematic as it might increase the amount of dietary iron available to the body, even when the foods might naturally have little or no iron.

If you are a person with this condition, you may want to avoid cooking with pans made from cast iron.

The NIDDK recommends that people with hemochromatosis follow a healthy, well-balanced diet. That said, some researchers suggest the following diets may be beneficial if you have this condition because of the combination of foods naturally low in iron and foods that limit iron absorption.

• vegetarian
• Mediterranean
• flexitarian

Dietary recommendations for people with this disease are largely based on the knowledge of iron levels in foods. More research is needed to see how these diets might impact the health of people with this disease.

The following recipes are great examples of how you can still incorporate meat and other foods containing iron into your diet when you have hemochromatosis.

These recipes could also fit into a vegetarian, Mediterranean, or flexitarian diet.

Vegetable quiche

Ingredients

• 1 tbsp. olive oil
• 1/2 cup green onion, chopped
• 1/2 cup onion, chopped
• 1/2 cup zucchini, chopped
• 1 cup spinach
• 3 eggs, beaten
• 1/2 cup milk
• 1 1/2 cups shredded cheese
• 1 deep dish pie crust, precooked

Directions

1. Preheat the oven to 350°F (177°C).
2. In a large skillet, heat the olive oil. Add the green onion, onion, and zucchini. Cook for 5 minutes.
3. Add the spinach. Cook for an additional 2 minutes. Remove the cooked vegetables from the skillet and set aside.
4. Whisk the eggs, milk, half of the cheese, and salt and pepper in a mixing bowl to taste.
5. Pour the egg mixture into the pie crust. Top with the remainder of the shredded cheese.
6. Bake for 40–45 minutes or until the eggs are cooked throughout.

Turkey chili

Ingredients

• 1 tbsp. olive oil
• 1 lb. ground turkey
• 1 large onion, chopped
• 2 cups chicken broth
• 1 (28-ounce) can red tomatoes, crushed
• 1 (16-ounce) can kidney beans, drained and rinsed
• 2 tbsp. chili powder
• 1 tbsp. garlic, chopped
• 1/2 tsp. each cayenne, paprika, dried oregano, cumin, salt, and pepper

Directions

1. In a large pot over medium heat, heat olive oil. Add the ground turkey and cook until browned. Add the chopped onion and cook until tender.
2. Add the chicken broth, tomatoes, and kidney beans. Add remaining ingredients and stir thoroughly.
3. Bring to a boil, then reduce heat to low. Cover and simmer for 30 minutes.

Significant changes to your diet may generally not be needed if you are a person with hemochromatosis, but it could help you manage the amount of iron your body absorbs.

If you’re concerned about getting too much iron in your diet, talk with a doctor or registered dietitian. They can help you figure out the healthiest, most balanced diet for your condition and ensure foods you enjoy are included.