Thalassemia diet: What to eat and avoid

People with thalassaemia either produce no or very little haemoglobin. So, their diet needs be given importance. On World Thalassemia Day, we tell you the best diet for people with thalassaemia.

Thalassemia is a blood disorder that is passed on from parents to their children through genes. It happens when the body is not able to make enough protein called hemoglobin. Having the right diet can help in improving the quality of life for people with thalassemia. Like everybody else, they need to eat nutritious foods, but they have to be careful when it comes to iron consumption. On the occasion of World Thalassemia Day, which falls annually on May 8, let us tell you all about the thalassemia diet.

What is thalassemia?

Thalassemia is a genetic blood disorder characterised by abnormal hemoglobin production, leading to a reduction in red blood cells and hemoglobin levels in the body. Hemoglobin, a protein found in red blood cells, does the job of carrying oxygen throughout the body. Thalassemia results from mutations in the genes responsible for producing hemoglobin, leading to either reduced production or abnormal structure of hemoglobin.

Foods rich in iron
Check iron content in your diet if you have thalassemia. Image courtesy: Freepik

Most people with thalassemia start experiencing health problems such as
anaemia, pale skin, and weakness from a few months after birth, as per UK’s National Health Service. Thalassemia testing during pregnancy is vital. It can help in early detection of thalassemia trait, assessment of risk to the baby, and early intervention and treatment. Early detection of thalassemia in the fetus enables doctors to plan for appropriate medical interventions and treatments soon after birth. This may include blood transfusions, iron chelation therapy, and other supportive measures to manage the symptoms of thalassemia and improve the child’s quality of life, says obstetrician and gynaecologist Dr Chetna Jain.

What are the different types of thalassemia?

Hemoglobin is made of two different parts — alpha and beta.

1. Alpha thalassemia

Alpha thalassemia minor occurs when a person inherits one mutated alpha globin gene (from one parent) and three normal alpha globin genes (from the other parent). People with alpha thalassemia minor usually have mild anemia, says the expert. In the case of alpha thalassemia trait, an individual inherits two mutated alpha globin genes (one from each parent) and two normal alpha globin genes. Most individuals with alpha thalassemia trait do not exhibit symptoms, but are carriers of the condition. Hemoglobin H Disease is a more severe form of alpha thalassemia caused by the deletion of three alpha globin genes (inherited from both parents). Individuals with hemoglobin H disease may experience moderate to severe anemia and may require occasional blood transfusions.

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2. Beta thalassemia

Beta thalassemia minor occurs when an individual inherits one mutated beta globin gene (from one parent) and one normal beta globin gene (from the other parent). People with beta thalassemia minor usually have mild anemia, says Dr Jain. Beta Thalassemia Intermedia is an intermediate form of beta thalassemia that causes moderate to severe anemia, but generally does not require regular blood transfusions for survival. Beta thalassemia major or Cooley’s Anemia is the most severe form of beta thalassemia, resulting from the inheritance of two mutated beta globin genes (one from each parent). People with beta thalassemia major have severe anemia from early childhood and require lifelong regular blood transfusions for survival.

What diet should people with thalassemia follow?

People with thalassemia can benefit from following a well-balanced and nutritious diet to support overall health. Specific dietary recommendations may vary depending on the type and severity of thalassemia, as well as individual health needs.

Here are some general dietary guidelines that may be beneficial for people with thalassemia:

1. Vitamin and mineral-rich foods

Include different types of fruits and vegetables in your diet to ensure adequate intake of vitamins, especially vitamin B9, and minerals (such as calcium and magnesium). Vitamin B9 is essential for red blood cell production and can be obtained from leafy greens, beans, fortified cereals, and citrus fruits. Calcium and magnesium are important for bone health and can be found in dairy products, fortified plant-based milks, nuts, seeds, and leafy greens.

2. Adequate protein intake

Have lean protein such as poultry, fish, eggs, beans, lentils, and tofu, says the expert. It is needed for growth, repair, and maintenance of your body tissues.

3. Hydration

Stay well-hydrated by drinking plenty of fluids, especially water and fresh juices. Proper hydration supports circulation and can help prevent complications like blood clots.

A woman staying hydrated
Stay hydrated to manage thalassemia. Image courtesy: Freepik

4. Balanced meals

Eat balanced meals that include carbohydrates (whole grains like brown rice, quinoa, and whole-wheat bread), proteins, healthy fats (avocado, nuts, seeds, and olive oil), and a variety of fruits and vegetables.

What foods to avoid?

People with thalassemia should be cautious about certain foods to help manage their condition effectively. Here are some things to avoid:

1. Iron supplements

In beta thalassemia minor, iron levels are typically normal or slightly elevated. So, it is important to consume a balanced diet without excess iron supplementation unless advised by a doctor. In beta thalassemia major, iron overload due to frequent blood transfusions is common. There may be too much iron build up in the blood, so foods high in iron may need to be limited, as per the Centers for Disease Control and Prevention. Eat less iron-rich foods such as fish, meat and vegetables like spinach. Instead, focus on foods with moderate iron content like beans, lentils, tofu, and leafy greens.

2. Vitamin C supplements

Vitamin C enhances iron absorption from plant-based sources. While this can be beneficial for people with low iron levels, it may contribute to iron overload in people with thalassemia who already have excess iron stores.

3. Alcohol

Alcohol consumption can lead to liver damage, which is a concern for people with thalassemia who may already be at risk of liver complications due to iron overload or transfusion-related iron toxicity. Minimise or avoid alcohol consumption to protect your liver.

4. Excessive calcium and dairy

Some iron chelation medications used to reduce iron overload can bind with calcium, reducing their effectiveness. Excessive calcium intake from supplements or dairy products may interfere with the treatment.

5. Limit sugar and processed foods

Minimise consumption of sugary snacks, candies, sodas, and processed foods high in unhealthy fats and additives. These foods can contribute to inflammation and may negatively impact overall health, says Dr Jain.

6. Raw seafood and undercooked meats

People with thalassemia may have a weak immune systems or be more susceptible to infections. Consuming raw or undercooked foods, especially seafood and meats, increases the risk of foodborne illnesses.

People with thalassemia should eat fruits and vegetables, and limit processed food intake. Depending on the type of thalassemia, they should also keep an eye on their iron intake.