Nutrition in hemophilia
Fact-checked by Diet is not a cure for hemophilia, nor can it prevent bleeding episodes. However, maintaining good nutrition in hemophilia can support blood cell recovery, promote healthy weight maintenance to keep joints healthy, and improve a person’s overall quality of life.
There is no one-size-fits all hemophilia diet as individual needs will vary. Patients are advised to work with a registered dietitian and their hemophilia care team to come up with a balanced, nutrient-dense eating plan that makes sense for them.
Why nutrition is vital for hemophilia management
For all people, good nutrition and appropriate physical activity are key to staying healthy and avoiding illness or injury. For people with hemophilia, getting sufficient amounts of key nutrients can also make managing the bleeding disorder easier. Specifically, the right nutrition can:
- help the body make blood components that are lost after bleeding episodes
- support weight management to reduce joint strain
- ease fatigue, boost mood, and support overall well-being
Being overweight or obese is not healthy for anyone, raising the risk of health problems, such as diabetes, heart attack, and cancer. For people with hemophilia, excess weight can put strain on the joints, increasing the risk of joint bleeding. Eating the right foods can help patients stay at a healthy weight and avoid these complications.
Nutrients for blood cell health
There are a number of nutrients that can promote healthy blood cell production, so getting enough of them may help the body stay strong and recover from bleeds.
Iron
Iron is an essential mineral that’s needed for the production of healthy red blood cells and hemoglobin, the protein in red blood cells that enables them to transport oxygen through the body. It’s also involved in several other bodily processes.
Red blood cells contain most of the body’s iron, so blood loss in people with hemophilia can put them at higher risk of low iron levels and anemia, which occurs when the body does not have enough red blood cells or hemoglobin to carry oxygen effectively. Consuming enough iron-rich foods can help replenish the body’s iron stores and support the production of healthy red blood cells. These include:
- animal proteins, including liver, lean red meat, poultry, and seafood
- tofu
- dark green leafy vegetables
- broccoli, string beans, potatoes, cabbage, and Brussels sprouts
- dried beans, lentils, and peas
- grains
- figs, dates, and raisins
- certain nuts and seeds
Combining iron-rich foods with good sources of vitamin C can enhance iron absorption by the body. Vitamin C-rich foods include citrus fruits, strawberries, tomatoes, broccoli, and spinach.
Hemophilia care teams will run blood tests to track iron levels. People with hemophilia do not need to consume extra iron beyond typical dietary recommendations for the general population if lab tests don’t show a deficiency, however, the threshold used to define iron deficiency may be higher than what’s used in the general population. Individuals should never add iron supplements to their diet without a recommendation from a care provider.
Other nutrients
Other important nutrients include:
- vitamin K: supports production of blood-clotting proteins in the liver; found at high levels in leafy greens, certain fermented foods, and vegetable oils
- vitamin B6: helps produce red blood cells; found at highest levels in poultry, certain fish, and starch vegetables
- vitamin B12: required for red blood cell production; found in animal products, such as fish, meat, poultry, eggs, and milk
- copper: helps with red blood cell formation and iron absorption; found in seafood, liver, nuts, and seeds
- folic acid: helps with red blood cell formation; found in leafy greens, beans, nuts, and certain fruits
As with iron, these nutrients are important for everyone, and there are no recommendations stating that people with hemophilia should consume more of them than people in the general population unless a specific deficiency is identified.
Foods to eat
There is no one single hemophilia healthy diet, and the foods each person needs to feel healthy and strong will vary. Always consult with a healthcare provider to identify individual needs before making any dietary changes.
Similar to people in the general population, people with hemophilia are advised to eat a well-rounded and nutrient-dense diet that includes:
- whole grains, including breads, cereals, rice, and pasta
- a variety of fruits and vegetables
- dairy, including milk, yogurt, and cheese
- protein, including meat, poultry, fish, or plant-based products like beans, tofu, nuts, and seeds
- plenty of water
This type of diet provides a range of nutrients that support red blood cell production and overall health.
Foods to limit
There are no foods that must be avoided for all people with hemophilia without exception. In general, foods that may promote unhealthy weight gain or have other adverse health effects when consumed excessively should be eaten in moderation, and this is true for people with or without hemophilia. These include:
- highly processed and prepackaged foods
- sugary snacks and drinks
- alcohol
No foods are known to definitively increase the risk of bleeding episodes in hemophilia.
If iron deficiency is a concern, a doctor may recommend spacing out consumption of iron-rich foods and foods that can reduce iron absorption, such as tea, coffee, eggs, and soy products. However, there is usually no need to avoid these foods entirely.
Tips for home cooking and eating out
Individuals who want guidance on building a balanced and nutrient-rich diet can work with a dietitian to come up with a plan that makes sense given their individual needs and lifestyle. A few tips for cooking at home include:
- making a weekly meal plan that incorporates nutrient-rich ingredients
- preparing meals or meal components in larger batches, to provide a low-effort nutritious meal even when cooking is not convenient or possible
- reading the labels to understand their nutritional content of packaged foods or ingredient
While it can be more challenging to estimate nutrition and make balanced-eating choices when at a restaurant than it is at home, there are no hemophilia-specific restrictions for eating at restaurants — it is OK to enjoy meals away from home.
Food choices when eating out will depend on several factors, including overall health, appetite, activity level, preferences, and any individualized guidance from a healthcare team. A dietitian can help tailor those priorities.
Dietary supplements and bleeding risks
While getting enough key nutrients is important, individuals should never add dietary supplements without discussing it with their care team. There are several supplements that can interfere with blood clotting and may thus increase the risk of bleeding in people with hemophilia. Some common ones include:
- vitamin E
- fish oil
- ginkgo biloba
- garlic and ginger
It is important to note that the amounts of these nutrients obtained naturally through diet are not generally a concern, but the higher concentrations found in supplements can be. Still, scientific evidence for some of these are limited. Patients should talk with their hemophilia care team for individualized advice.
Hemophilia News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
