Nutritional Principles for Haemacramotosis

    Hemochromatosis is a metabolic disorder characterized by excessive iron absorption due to a deficiency in Hepcidin, which is particularly common in Northern Europe and worldwide. It results from mutations in the genes located on chromosome 6.

    Hepcidin is a hormone synthesized in the liver that plays a role in iron metabolism. Its function is to regulate iron stores by inhibiting the absorption of iron in the intestinal mucosal cells. Therefore, in the absence of Hepcidin, iron is excessively absorbed and accumulates in the body. The accumulated iron can create toxic effects in the body.

The main principle in the nutritional treatment of this disease is to control portion sizes of iron-rich foods and create a nutrition plan by combining them with other nutrients that reduce iron absorption.

Both in terms of quantity and ease of absorption, the best source of iron is meat. Red meat contains more iron than white meat. Additionally, foods rich in iron include eggs, grape molasses (made by concentrating grape juice and other fruit juices), dried fruits, legumes, and nuts such as hazelnuts, peanuts, and sesame. However, other nutrients in these foods also affect the absorption rate of iron.

How to Eat and What to Pay Attention to?

  • Since vitamin C enhances iron absorption, taking vitamin C supplements can be risky. Therefore, patients with hemochromatosis should avoid vitamin C supplements unless specifically prescribed by their doctor. It is also important to check whether multivitamins contain iron and vitamin C.
  • The portion sizes and timing of consumption for vitamin C-rich fruits (such as oranges and mandarins) should be considered. These fruits should not be consumed with meals, but rather as snacks between meals.
  • The consumption of foods with high heme-iron content should be limited. Therefore, it is important to limit red meat consumption. Opting for fish instead of red meat is a healthier choice.
  • Since iron accumulation may occur in the liver due to the disease, it is also crucial to protect the liver. Processed foods, which contain excessive amounts of fat and sugar, should be avoided. Fructose syrup increases iron absorption by three times, so it is essential to read the labels of food products. Foods containing fructose syrup should be avoided.
  • Alcohol is not recommended as it increases the absorption of non-heme iron by 10% and also affects the liver.
  • Vegetables and fruits containing beta-carotene also enhance iron absorption (such as carrots, sweet potatoes, beets, red and yellow peppers, broccoli, spinach, tomatoes, and zucchini). Therefore, it is better not to use these vegetables in recipes with red meat or consume them alongside red meat at the same meal.
  • Cookware choice is important! Cast-iron pans are not recommended.
  • Calcium, phosphatidins, oxalates, phytates, and polyphenols are other nutrients that inhibit iron absorption. Polyphenols are found in cocoa, coffee, and tea. Consuming coffee and tea with meals will reduce iron absorption.
  • Fats such as walnuts, almonds, legumes like dried beans and lentils, grains, and whole wheat products contain phytates that reduce iron absorption.

    Based on these principles, you should enrich your weekly menus by combining legumes with grains to ensure adequate and balanced protein intake. It is recommended to consume 200-300 grams of fish per week. Limit red meat consumption to 100 grams once a week and combine it with a salad made of vegetables that do not contain beta-carotene, a portion of yogurt or ayran, and whole wheat bread. By consuming vitamin C-rich fruits as snacks, you can prevent them from increasing iron absorption during the main meals.



KAYNAK

  1. O. Albayrak ve M. A. Çürük , "Hemokromatozis", Arşiv Kaynak Tarama Dergisi, c. 18, sayı. 4, ss. 268-275, Ara. 2009
  2. V. Göral, Herediter Hemokromatozis-2020, Güncel Gastroenteroloji Dergisi, c. 24, sayı 1, ss. 10-29, Mart 2020
  3. N. T. Milman, Managing Genetic Hemochromatosis: An Overview of Dietary Measures, Which May Reduce Intestinal Iron Absorption in Persons With Iron Overload, Gastroenterology Res. 2021 Apr; 14(2): 66–80
  4. Baysal A. (2012) Beslenme, Hatipoğlu Yayınları, 14. Baskı

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