The Best Diet for Hemochromatosis

It’s not just how much iron you consume

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.

The amount of iron absorbed from the foods you eat depends on various factors. There are also two types of dietary iron: heme and nonheme.

Heme iron is found in meat, poultry, and seafood. Nonheme iron is mostly found in plants. Heme iron is more bioavailable than nonheme iron, meaning your body absorbs it more easily.

However, some dietary factors can affect the way your body absorbs both types of iron:

• Various forms of calcium might decrease the bioavailability of both heme and nonheme iron.
• 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 whether oxalic acid can reduce iron absorption.
• Phytate, or phytic acid, is a compound found in grains and legumes that decreases iron absorption. Other compounds in plant foods, polyphenols, can also decrease iron absorption.
• Vitamin C (ascorbic acid) enhances the bioavailability of nonheme iron, while meat and seafood can improve the absorption of nonheme iron.

Foods to eat when you have hemochromatosis

For people with hemochromatosis, 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 help manage your condition.

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

If you have hemochromatosis, you may not need to make robust changes to your diet if you are also having other treatment. You can talk with a doctor and a registered dietitian to see how you can maintain a healthy, balanced diet.

Fruits and vegetables

Many of the dietary recommendations for hemochromatosis warn against eating vegetables high in iron, but 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 for those with hemochromatosis.

Dried fruits also contain only nonheme iron.

Grains and legumes

Grains and legumes contain the substance phytic acid that reduces the amount of iron your body absorbs.

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 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 may limit the amount of iron absorbed from other foods.

Fish

Certain fish are lower in iron. These 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 contain a type of protein called phosvitin.

Research suggests phosvitin from eggs may limit iron absorption in adults. In children, however, eggs may increase iron levels.

Tea and coffee

Both tea and coffee contain polyphenolic substances called tannins, also known as tannic acid. The tannins in tea and coffee may 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 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.

Foods, drinks, and supplements to avoid when you have hemochromatosis

To properly manage iron levels in the body and lessen the chance of worsening symptoms or increasing the risk of 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.

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.

Foods rich in vitamins A and C

Vitamin C and vitamin A can increase nonheme iron absorption. Some people may find it helpful to avoid consuming too many vitamin C and A-rich foods to help reduce iron levels.

However, the benefits of nonheme iron-containing foods (such as vegetables) may outweigh the risks. It’s important to consider this while adjusting your diet for hemochromatosis.

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 contribute to high blood iron levels. Check the iron content on nutrition labels before eating these foods to ensure it is a safe level.

Excess alcohol

Alcohol consumption, especially regular alcohol consumption, can damage the liver. Iron overload in hemochromatosis can also cause or worsen liver damage. Try to consume alcohol in moderation if you drink it.

According to the Centers for Disease Control and Prevention (CDC), moderate drinking means 2 drinks or less daily for males or 1 drink or less daily for females.

If you have existing liver disease and hemochromatosis, you might want to avoid alcohol altogether to prevent the risk of further damage to your liver.

Supplements

Though research is limited, it may be best to be careful with the following supplements:

• Iron: According to the American Liver Foundation, people with hemochromatosis should not take iron supplements. As you may 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 increase 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.

Diets and recipes for hemochromatosis

The NIDDK recommends that people with hemochromatosis follow a healthy, well-balanced diet. That said, some research indicates the following diets may be beneficial if you have this condition. This is because they combine foods that are naturally low in iron with foods that limit iron absorption.

• vegetarian
• Mediterranean
• flexitarian

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

The following recipes are great examples of how you can still include meat and other foods containing iron in 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. Add the sauteed vegetables, arranging evenly throughout, and top with the remainder of the shredded cheese.
6. Bake for 40 to 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. Heat olive oil in a large pot over medium heat. 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.

The takeaway

Significant changes to your diet may not be needed if you have hemochromatosis, but they could help you manage the amount of iron your body absorbs. However, it’s important to only make changes under the guidance of a doctor, as large changes may lead to malnutrition.

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.

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