Background
Ferritin is an iron containing protein and acute phase reactant, which may be elevated due to systemic iron overload or inflammation. Various diseases are associated with excess iron, but therapeutic iron chelation is suboptimal. Prior studies suggest that several plant phytochemicals possess iron chelating properties, indicating that a plant-based diet may benefit patients with iron overload.
Objectives
To investigate whether patients who consume a nutrient-dense, dark green leafy vegetable-rich diet, called the Low Inflammatory Foods Everyday (LIFE) diet, experience reductions in ferritin levels.
Methods
This was a retrospective study in which patients were intensively counselled to follow the LIFE diet. Compliance was assessed by patient interviews and serum beta-carotene measurements. Primary outcomes included changes in ferritin, beta carotene, and CRP. Patients with elevated CRP levels at baseline were excluded in order to separate the impact of inflammation from iron overload on ferritin levels. Pre-menopausal women, who lose iron from menstruation, were also excluded.
Results
Thirty-two patients met inclusion criteria. Median follow up was 183 days. Following the dietary intervention, ferritin decreased (-81 μg/L, P = 0.006) and beta-carotene increased (46 μg/L, P < 0.0001), while CRP remained unchanged (-0.02 mg/L, P = 0.86). Adherent patients had greater reductions in ferritin compared to non-adherent patients (-138 μg/L versus 15 μg/L, P = 0.001). Among all patients, there was an inverse relationship between beta-carotene and ferritin (-2.02, P = 0.03).
Conclusion
The LIFE diet, or similar dark green leafy vegetable rich, whole food plant-based diets, may benefit patients with disorders of iron overload and iron-induced oxidative stress.