Background – Hereditary haemochromatosis is one of the commonest genetic disorders in Australia. There is considerable variability in the rate of end-organ disease in people with susceptible HFE genotypes for hereditary haemochromatosis, possibly due to variability in the rate of iron accumulation.
Objectives – To estimate the association between dietary iron and other nutrients, and iron status.
Design – A community cross-sectional survey of 114 men and 119 women with different HFE genotypes conducted in northern Tasmania. Macro- and micro-nutrient intake was assessed by food-frequency questionnaire.
Outcomes – 67% of men and 71% of women with C282Y homozygous genotype had elevated transferrin saturation. The median ferritin in C282Y homozygous men under age 35 was 151 μg/dL and 809 μg/dL over age 35. Only 33% of C282Y homozygous women (all over age 50) had ferritin levels over 350 μg/dl. Serum transferrin saturation and ferritin levels were strongly associated with dietary fat intake in C282Y homozygotes, but not in heterozygous and normal genotypes. Serum ferritin levels were strongly associated with dietary haem iron in homozygotes with ferritin > 350 μg/dL but not below this. When the two factors were analysed together in this group, 1 SD increase in haem iron increased serum ferritin by 470 μg/dL (CI95% 82 to 857; P=0.03) and 1 SD total fat increased serum ferritin by 310 μg/dL (CI95% 31 to 589; P=0.036). There was no association between dietary non-haem iron and iron status.
Conclusions – There is a strong association between haem iron intake and ferritin in C282Y homozygotes with elevated ferritin levels. Total fat intake had an independent strong association. In these people dietary change may slow iron accumulation and may delay the need for venesection.