Hemochromatosis is a genetic disorder that increases iron absorption in the body. Excess iron accumulates in the body over time, leading to tissue and organ damage. We are unable to excrete excess iron, hence it must be removed by regular blood removal (phlebotomy). People with hemochromatosis can also control their iron absorption with dietary changes. However, it is not advisable to completely avoid iron intake, as many foods that are rich in iron also contain other essential nutrients. In general, people with hemochromatosis should be advised to consume food that can lower iron absorption and avoid foods that can improve iron absorption. There are two types of dietary iron: heme iron and non-heme iron. Heme iron is the most easily absorbed form of iron, and is found in animal sources such as beef and lamb. Non-heme iron is less well absorbed, and is mostly found in vegetables, fruits, nuts and grains. Substances that can inhibit iron absorption include calcium, tannin, fiber, eggs and oxalates. Dietary recommendations for people with hemochromatosis – the Hemochromatosis Diet 1. Avoid iron pills and iron-fortified foods As the iron level in the body is already high in people with hemochromatosis, taking iron supplements can further elevate the iron level, which can cause iron overload, leading to organ damage. Additive iron compounds added to enrich foods have higher iron absorption capabilities. Therefore, iron-fortified foods such as certain breakfast cereals, breads and snacks should be avoided. 3. Reduce the amount of red meat and foods high in animal fats Although consuming foods naturally containing irons is acceptable, red meat consumption should be limited, as it contains a high level of heme iron that can be easily absorbed by the body. Foods with high animal fat should also be avoided, as fats can generate free radical activity when combined with free unbound iron, which can cause damage to DNA. 3. Do not take vitamin C supplements As vitamin C increases the absorption of non-heme iron, supplements with high doses of vitamin C should be avoided completely or should be taken four hours between meals. Consuming fruits and vegetables that naturally contain vitamin C is ok. 4. Avoid raw shellfish Raw shellfish may be contaminated with bacteria called Vibrio vulnificus, which can be fatal to people with iron overload because it grows vigorously in the presence of high iron. Special care should be taken when handling raw shellfish or even walking barefooted on places where shells may be present. Shellfish should only be consumed when they are cooked at high heat to ensure bacteria has been destroyed. 5. Avoid sugary foods and beverages Food and beverages with high amount of sugar should be avoided from the diet, as sugar can enhance iron absorption in the body. 6. Avoid alcohol Alcohol consumption should be limited. Alcohol can increase iron absorption, and can also increase the risk of developing cirrhosis and liver cancer. Alcoholic beverages should be avoided completely for people who already have liver damage. 7. Consume eggs and dairy products Eggs contain a compound called phosvitin, and it can impair iron absorption due to its iron binding capacity. Calcium inhibits the absorption of iron, thus combining dairy products or eggs with meats can reduce the amount of dietary iron absorbed. 8. Drink tea and coffee Coffee and many teas (black, green, oolong) contain a chemical called tannin. Tannin helps to inhibit iron absorption by the body, and tea or coffee with meals is recommended for people with hemochromatosis. 9. Consume fruits, vegetables, nuts and grains Fruits and vegetables such as spinach and kale should be consumed regularly, as they contain non-heme iron, antioxidants and oxalates. Antioxidants can inhibit free radical production, and oxalates can impair iron absorption. Non-heme iron present in fruits and vegetables is less well absorbed by the body compared to heme iron present in red meat. Nuts and grains should also be consumed, as their high fiber content helps to promote digestion and inhibit absorption of non-heme iron. References: Duchini A, Klachko DM, Sfeir HE (2014). Hemochromatosis. Hemochromatosis.org. Provided by Iron Disorders Institute. Iron Disorders Institute. Advancing cures for Iron-Out-of-Balance. Hemochromatosis. National Heart, Lung, and Blood Institute. National Institutes of Health.