What diet will you recommend for a beta major thalassemia patient?

Hi,

Welcome to icliniq.com.

Based on your query, my opinion is as follows:

1. Thalassemia is a disease due to reduced globin production in the hemoglobin part of RBC (red blood cells). It is not due to nutritional deficiency, but due to inherited mutation abnormalities.
2. Yes, nutrition requires improvement. Diet rich in vitamin B12, folic acid along with vitamin C like egg, fish, chicken, citrus fruits, etc.
3. However, the main concern is regarding regular blood requirements. She will be requiring regular packed red cells transfusion for life. It needs to be safe and from a limited group of people.
4. We in transfusion medicine, call this as a donor pool. Same blood group, unrelated donors of around 20 to 30 people to reduce the risk of infection and more importantly antibody production. As numerous transfusions occurs, transfusion complications increase.
5. Hemoglobin needs to be maintained above 10 g% at all times. Iron toxicity risk is present, so iron chelation is necessary regularly.
6. Creating a donor pool is important. Contact your nearest transfusion medicine specialist in forming a blood donor pool for your kid for life.

Hi,

Welcome back to icliniq.com.

Sorry, I went a bit overboard in suggesting about overall nutritional improvement and my emphasis on donor pool diverted the answer I was supposed to give.

1. Yes, iron intake should be reduced. However, reducing protein intake will affect immunity. Vitamin B12 and folic acid are essential as they are also necessary for the formation of RBCs. Vegetarian diet will be better as iron content is low.
2. Importantly avoid vitamin C or citrus food up to four hours after food as it helps in improving iron absorption.
3. Reduce non-vegetarian diet and try to maintain intake of iron from the overall diet to less than 18 mg per day.
4. Cereals like wheat bran, maize, oats, rice and soy are helpful. Not sure if she takes, but tea and coffee or even milk during meals will reduce iron absorption.
5. Dairy products like milk, cheese and yogurt will reduce iron absorption, particularly with meals. Make sure, all are non-iron fortified.
6. For the diet, I would recommend cereals, particularly rice, oats or maize along with two cups of tea. You can vary the diet based on taste.
7. If difficult, multivitamin supplementation without iron will be very helpful with a cereal based diet including soy protein.
8. Hemoglobin at all times above 10 g% and formation of donor pool is necessary. Regular chelation therapy to avoid iron overload is necessary.
9. Very high iron sources are found in the following foods; they should be avoided or eliminated from the diet: Avoid protein rich foods like oysters, pork, beans, beef, peanut and butter. Avoid grains such as wheat cream, cornflakes, etc. Avoid fruits and vegetables such as prunes, spinach, green leafy vegetables, dates, raisins, broccoli, etc.