Nutrition in Hemophilia

Taking charge of your health when you have hemophilia is of great importance. Regardless of your hemophilia type — A, B or C — the goal is to keep your joints strong and healthy, and to keep extra weight off to avoid muscle strains and bleeding in vulnerable joints.

Obesity is a worsening problem in the hemophilia patient community, as it is in the population at large, with obesity rates tripling from 1980 to 2008 among all children, according to the Centers for Disease Control and Prevention. Others, looking at similar sources, report that teenagers and children with hemophilia are almost twice as likely to be overweight as the general population. Whether obesity among hemophilia patients is on par with the population or above the national norm, excessive weight puts strains on joints that can lead to bleeds, and these patients need to pay extra attention to their diet and try to maintain a healthy weight.

Programs like ‘Choose my Plate’ can help in adopting a healthy eating style.

Maintaining iron levels is also particularly important for people with hemophilia, as an estimated 0.75 micrograms of iron is lost with each 15 ml of blood. Iron-rich foods include liver, lean red meat, poultry, leafy green vegetables, broccoli, dried beans, grains, and raisins. Combining iron-rich foods with good sources of vitamin C (such as orange juice) can enhance iron absorption by the body.

What to eat and what to avoid

The stress of keeping up with a busy schedule can easily lead to poor dietary choices, and eating healthy is sometimes easier said than done. It is generally recommended to stick to a diet rich in whole grains, fruits and vegetables, and low in fats, added sugars and salt (sodium).

Gradual changes in eating habits can lead to long-term positive results. These changes include:

  • Increasing your consumption of fruits and vegetables – dark, leafy greens and orange fruits and vegetables are very good sources of vitamins and minerals. They are also a good source of fiber, which helps with intestinal health.
  • Increasing your whole grain intake – making half of your grain consumption come from oats, barley, whole wheat, bran, brown rice, or pasta is a good way to satiate your appetite, lower your cholesterol, and stabilize your blood glucose levels.
  • Switching to low-fat dairy products – skimmed milk or low-fat cheeses are good sources of vitamins and minerals as well as calcium, without the unnecessary fats. If you don’t drink milk, look for other sources of calcium, such as iceberg lettuce, oranges, and almonds.
  • Choosing baking, boiling, or grilling instead of frying – to cook lean meats, like poultry and fish, avoid frying or using heavy gravies, sauces, and toppings, which are full of calories.
  • Having meat-free meals during the week – incorporate dried beans, nuts and seeds into your menus. Dried beans are an excellent source of protein, are high in fiber and low in fat, and have zero cholesterol.
  • Choosing ‘good fats’ more often than ‘bad fats’ — such as those derived from olive or canola oils. Avoid using butter, shortening, and others bad fats.
  • Reducing portion sizes, learning to read labels and avoiding “easy snacks” – high-fat foods generally offer low-to-zero nutritional value. Be mindful of your portion sizes and watch out for hidden sources of excess calories or sugar, like large glasses of juice or soft drinks.

The key is to be realistic and not to set your goals too high. Make small healthy choices during every meal, and set your own pace to introduce these changes. It’s natural to eat a piece of cake at a party, but remember to compensate with fresh vegetables at your next meal.

It can sometimes be difficult to stick to your plans when you are eating eat out, but there are ways to avoid overeating or choosing a meal that might not be good for you.

When eating out, remember to:

  • Keep your portions small – avoid XL combos or meal packages that lead to being overweight
  • Avoid fried side dishes or order small sizes – baked snacks like pretzels are low in fat
  • Try to eat slowly and if you can, bring half the food home to be eaten later
  • Beware of “healthy smoothies” as they pack lots of sugar
  • Avoid high-fat condiments like mayonnaise or ketchup — choose mustard instead, which is low in calories;
  • Ask if whole grain meals can be prepared
  • Choose salad dressing on the side – this way you can control the amount you use. The nutritional value of a salad is lost if you use too much high-calorie dressing
  • Choose lean meats, skip the cheese, or chose a low-fat cheese if it’s available

Iron, vitamins, and dietary supplements

People with bleeding disorders need to maintain normal blood volume and blood cell production.

The main nutrients involved in red blood cell production are iron, protein, copper, vitamin C, vitamin B12, vitamin B6 and folic acid — vitamin E is also involved in red blood cell production, but it can increase the risk of bleeding in high doses.

If you are considering dietary supplements, discuss your choices with your doctor before taking any supplements, as some might increase bleeding tendency or clotting times in the same way as aspirin or non-steroidal anti-inflammatories. Some supplements — such as vitamin E, fish oil, gingko biloba, bromelain, flax seed, garlic, or ginger — may need to be avoided.

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.