Awareness Update - Diet For Thalassaemia Pt. 1

Reducing the iron absorbed from food.

Diet is not just about losing weight. Being a Dietician, I often have to try and convince people I meet socially that, no, I don’t spend my time handing out diets to perfectly healthy ladies who need to lose 3kg in order to fit into their evening dresses! Diet is the way we need to eat to optimise our health. This is different for different people and different ages. Thalassaemia is a complex condition and the ideal diet would need to take account of many factors. This article concerns the iron present in food.

In Thalassaemia, although most of the iron overload is due to blood transfusion, increased absorption of iron from the diet is also important. Only a small amount of iron from the diet is absorbed into our body.

The amount absorbed is higher when haemoglobin in the blood is low. People with a low haemoglobin such as those with Thalassaemia Intermedia or those with Thalassaemia Major, in between transfusions could therefore adapt their diet so that not only the total amount of iron in their diet is low but also the amount of iron in their body is low.

There are two kinds of iron in the diet: iron, which is present in red meat (Meat iron) and iron, which is widely distributed in the diet (Non-meat iron).

MEAT IRON
Meat iron is present in red meat such as beef, lamb and pork and the dark meat of chicken as well as in seafood such as sardines, cockles and mussels. Liver is a very rich source of meat iron. Try to cut down on these and perhaps substitute meat with soy protein. It is not, however, a good idea to exclude meat, chicken and fish completely from your diet because they contain other important nutrients, particularly for children.

Choose the white part of the chicken rather than red meat as this contains less iron.On average, after a meal with red meat, about 35% of iron will be absorbed into our body.

However, this may vary between 10-40%, depending mainly on whether the meal contains milk or milk products. The calcium, present in milk, cheese, yoghurt, cream decreases the absorption of meat iron. Try to drink a glass of milk with a meat-containing meal and to use milk in cooking.

Good examples are the white cheesy sauces in lasagne, pasticcio, mousaka and cannelloni, adding lots of cheese in spaghetti Bolognaise and using yoghurt and milk to cook your curries. Milk intake should be at least one pint daily, particularly because it helps to pre vent osteoporosis. If you are worried about your weight, semi-skimmed milk or skimmed milk are =just as rich sources of calcium as whole milk.

NON-MEAT IRON
Non-meat iron is widely distributed in the diet, present in eggs, chocolate, cereals, vegetables, fruits, roots (potatoes, parsnips), beans and lentils. In the UK several foods are fortified with iron, such as breakfast cereals, wheat flour and bread. However, this may not be the case in other countries.

The absorption of non-meat iron from the diet into our body is much less than that of meat iron, but it may vary more than 20-fold, depending on the composition of a meal.

The foods, which decrease its absorption, are:
1) cereals
2) dairy products

The foods which increase its absorption are:
1) fruit and vegetables rich in Vitamin C
2) meat, fish, shellfish and poultry
3) pickles, sauerkraut, soy sauce, vinegar and alcohol

It is difficult to avoid taking non-meat iron because it is present in most foods. However, diet can be modified by taking more of the foods which decrease and less of the foods which increase the amount of iron absorbed into our body.