The dietary management of secondary overnutrition would logically be to restrict the intake of the nutrients accruing in excess. This is not always facile or feasible, however, due to the intrinsic complexity of foods and beverages, where most are sources of multiple essential micronutrients. Marked reduction in total energy intake can jeopardize the intake of proteins and essential fats. For the metal-storage afflictions such as Wilson's disease and hemochromatosis, removing copper and iron from the diet, respectively, are the fundamental elements of management. Some additional benefits can be gained by blocking the metals' absorption, as with high doses of zinc in Wilson's disease or with strong black tea (tannins) in hemochromatosis. Fundamentally, however, the management of metal-storage diseases requires some interventions to selectively remove the overload by chelating agents in Wilson's disease and recurrent phlebotomy in hemochromatosis. In a related variant condition, African hemosiderosis, common among Bantu in southern Africa, removing concentrated iron sources from the diet, specifically the iron-loaded native beers, provides effective long-term control.
Was this article helpful?