Thalassaemia: Its Types and Nutritional Advice for Those Affected

Thalassaemia is particularly common in the Mediterranean region, the Arab world and Asia.

There is a difference between someone who has the disease and someone who carries it, depending on the deficiency or defect in their genes. A thalassaemia carrier usually has mild anaemia, and their red blood cells are usually smaller than expected (microcytic anaemia), sometimes accompanied by iron deficiency.

Types of Thalassaemia

For people who have the disease, there are two types:

1. Alpha thalassaemia: This usually takes the form of anaemia ranging from moderate to severe, and in most cases the patient does not need blood transfusions.
2. Beta thalassaemia: Known as thalassaemia major, this is the most serious type. It causes anaemia that begins in childhood and lasts throughout the patient's life, and may affect their life expectancy. In this case the patient needs regular blood transfusions and may develop many serious complications, such as osteoporosis, an enlarged spleen, malnutrition, weight loss and delayed growth. Most dangerous of all is the build-up of iron in the body from repeated transfusions, which is highly toxic and poses a risk to the body and the heart. These cases can be treated with a bone marrow transplant.

In beta thalassaemia, it may be important from a nutritional point of view to focus on the amount of iron the patient takes in through food, and to limit it as far as possible.

In general, the human body does not absorb large amounts of iron through the gut. Good-quality iron from animal sources is absorbed better than plant iron from sources such as spinach and green leafy vegetables. In addition, whenever haemoglobin levels in the body are low, the amount of iron absorbed through the gut automatically increases, and vice versa.

Thalassaemia and Iron

These patients should keep to the medicines that maintain the balance of the body's iron stores and remove any excess. The aim is to keep iron intake below 10 mg a day for children under ten, and below 18 mg a day for those aged eleven and over.

Sources of Iron

The most important and richest sources of iron are:

1. Liver and other animal organ meats, such as brain and kidneys.
2. Eggs.
3. Chicken, fish and seafood.
4. Dark green leafy vegetables.
5. Dried fruit.
6. Whole grains and bread.
7. Walnuts, almonds and dried pulses.
8. Some spices, such as turmeric and cumin.

Nutritional Tips for People with Thalassaemia

The following nutritional tips and guidelines may help people with beta thalassaemia who need frequent blood transfusions:

1. Avoid high iron levels by reducing the iron-rich foods you eat, especially at times when your haemoglobin is low.
2. Choose white meat instead of iron-rich red meat, as white meat contains less iron.
3. Drink tea with meals, as tea contains chemicals that bind to iron and prevent the body from absorbing it.
4. Drink milk, or cook with milk and dairy products, alongside iron sources, as they prevent iron absorption. But make sure you get enough calcium and pay attention to its sources, to reduce the risk of osteoporosis and its complications.
5. Do not eat foods rich in vitamin C, such as citrus fruits, together with iron-containing foods, as vitamin C encourages and increases iron absorption.
6. Some whole grains, such as wheat, oats and soya beans, block iron absorption in the gut and limit vitamin C's role in increasing it.
7. Drinking coffee may help reduce the body's iron absorption.
8. Make a habit of reading the nutrition labels on all foods and checking their iron content.

The Main Iron-Rich Foods

Finally, the most important foods that are very rich sources of iron, and which you should keep away from and avoid in your diet, are:

Grains

• Semolina.
• Barley.
• Whole bran cereals.

Protein-rich foods

• Liver.
• Beef.
• Oysters.
• Beans.
• Tofu.
• Peanuts.
• Egg yolk.

Fruit and vegetables

• Peaches and peach juice.
• Watermelon.
• Spinach.
• Green leafy vegetables.
• Broccoli.
• Raisins.
• Peas.
• Broad beans.