Download Highest Copper Food Sources

Aunt Cathy’s Guide to Nutrition:
Sanford Medical Center
A Poem to Help Remember the
Highest Copper
Food Sources
Cathy Breedon PhD, RD, CSP, FADA
Clinical & Metabolic Nutrition Specialist
Sanford Medical Center, Fargo, ND
and UND School of Medicine
And some thoughts about
Managing Wilson’s Disease
The point of this little poem is that it is hard to memorize all the individual foods
that are high in copper, but the poem identifies some food groups to keep an eye on by
naming an example of each of those food groups. [I wrote this poem to solve my own
nutrient memorization problems in 1991, and … hey! I still remember it! ]
The poem can be helpful in identifying healthy and nutritious copper-rich food
groups to eat a good amount of (for most folks.)
It can also serve exactly the opposite function for people with Wilson’s Disease.
In this rare condition, people can absorb copper from food and beverages, but they cannot
get rid of it normally. Over time, the excess copper can build up and cause very serious
injury, especially to the liver and nervous system.
1
So, here’s how to interpret the poem:
Of meats, lamb tends to be the highest, and liver from all animals is generous in
copper. (And of these, lamb liver is really high. Luckily, it is pretty easy to avoid
lamb liver!)
Of seafood, the mollusks are highest (oysters, clams, etc.) They are much higher than
fin fish.
Nuts (e.g. almonds), beans (like pinto beans), seeds and the germ of grains have a
generous amount of copper. The way to think about them is that they are the
group of foods (or parts of foods) that would ordinarily be able to turn into
“Baby Plants.”
These are very healthy foods for most people, but not for people with Wilson’s
Disease. However, leaving them out can reduces our intake of magnesium and
chromium and some other nutrients, so people with Wilson’s DFisease will want
to work with a dietitian/nutritionist who can guide you toward other foods to
provide these critical nutrients and/or assist with identifying appropriate
supplementation.
Cooking with copper pans or other implements and running water through copper
pipes can add copper to your food. It’s easy to pick non-copper cookware, but
copper pipes are very commonly around, and for most people (i.e. people without
Wilson’s Disease) they are more healthy than many other pipe materials. [And of
course, lead pipes aren’t good for ANYBODY!]
One way that may help to lower exposure from pipes is to let the tap run for a
while to try to remove some of the water that has been sitting there in contact with
the pipe. This is not necessary for water that will not be taken into the body as
beverages or through cooking. (If you are concerned about wasting water, you
can collect it to water plants, wash socks or put it in the doggie dish.)
Another more effective solution is a “Reverse Osmosis” water treatment system
for the drinking and cooking water. However, not all types of water treatment
products or systems remove significant copper, so you need to ask about this
detail.
They can also be fairly expensive. You could ask your insurance company if the
water system could be covered as medically necessary if your physician orders it.
The “change her name to Penny” line is so that after getting through the whole
poem I could still remember what nutrient I was looking at. Pennies are copper
colored.
2
Some Additional Issues for People with Wilson’s Disease:
Limiting dietary copper will not be sufficient to protect you from copper
build-up. It is just one of the necessary tools. Your doctors will have other tools to
use as well, such as medications to do “chelation therapy” … a treatment to remove
excess copper from your body. Triethylenetetramine or D-penicillamine are medications
of this kind. Providing generous supplemental oral zinc can also be useful, as it
competes with dietary copper for absorption. For some people liver transplant is
necessary.
Another nutrition issue that appears to be helpful for people with Wilson’s Disese
is providing generous antioxidants. These include vitamins E and C, and the colorful
pigments in fruits and vegetables (a class of plant chemicals … “phytochemicals” … that
can provide even greater antioxidant protection than vitamins E and C.) Recent research
suggests that the need for generous antioxidant protection is higher in people with
Wilson’s Disease, as it is demonstrated to be in people with many types of metabolism
problems, like diabetes or hemochromatosis.
Some investigation with certain B vitamins, like vitamin B1 (thiamin) are being
evaluated as possibly of use in decreasing the increased risk of liver cancer sometimes
seen in Wilson’s Disease. Some particular lipid metabolism issues are also emerging
involving “HDL” (High Density Lipoproteins) --- the so-called “Good Kind” of cholesterol.
However, even though excess copper is dangerous for you, copper is still an
essential nutrient. Allowing copper DEFICIENCY to develop is also very injurious.
Your health care professionals will need to monitor your copper status to be sure that you
are safe from excessive copper, but not deficient in copper!
For everyone, assuring an adequate intake of ALL nutrients is very
important. For example, maintaining a blood vitamin D level of 40-50 mg/dL is
associated with decreased risk of cancer in general, and it is a factor in risk and treatment
of liver cancer, which is a particular risk in Wilson’s Disease. For more information on
the antioxidants, magnesium and chromium, omega -3 fats and vitamin D, please see:
“My Current Top Five Easy Ways to Improve Your Family’s Nutrition”
(subject to change at any moment! )
Your health care professionals will help you determine which approach(es) will
be best for you. [As always, my papers are NOT intended to take the place of careful
management of this dangerous and complex condition by your physicians. They are
just an attempt to help your care-givers sort through the nutrition end of this problem to
facilitate your overall control of the disease.]
3
Here are a few of the most recent references that I found in the scientific literature:
Diagnosis and care of Wilson disease with neurological revelation. Arch Pediatr. 2012 Jan 17.
Thiamine supplementation attenuated hepatocellular carcinoma in the Atp7b mouse model of
Wilson's disease. Anticancer Res. 2011 Oct;31(10):3395-9.
Long-term exclusive zinc monotherapy in symptomatic Wilson disease: experience in 17 patients.
Hepatology. 2009 Nov;50(5):1442-52.
Potential of vitamin E as an antioxidant adjunct in Wilson's disease. Med Hypotheses. 2009
Dec;73(6):1029-30.
Alterations of lipid metabolism in Wilson disease. Lipids Health Dis. 2011 May 19;10:83.
Excess copper chelating therapy for Wilson disease induces anemia and liver dysfunction. Intern Med.
2011;50(14):1461-4.
Inherited Copper Transport Disorders: Biochemical Mechanisms, Diagnosis, and Treatment.
Curr Drug Metab. 2011 Aug 12.
Wilson disease. A case report and review of the literature. Rev Med Inst Mex Seguro Soc. 2011 MayJun;49(3):331-4.
Fragmentation of mitochondrial cardiolipin by copper ions in the Atp7b-/- mouse model of Wilson's
disease. Chem Phys Lipids. 2011 Jul;164(5):393-400.
Wilson disease. Best Pract Res Clin Gastroenterol. 2010 Oct;24(5):531-9.
A primer on Wilson disease for the general practitioner. Rev Med Suisse. 2011 Sep 7;7(307):1690-2,
1694-5.
Antioxidants as therapeutic agents for liver disease. Liver Int. 2011 Nov;31(10):1432-48. doi:
10.1111/j.1478-3231.2011.02604.x.
Repeated transplantation of hepatocytes prevents fulminant hepatitis in a rat model of Wilson's
disease. Liver Transpl. 2012 Feb;18(2):248-59. doi: 10.1002/lt.22466.
Acute Gallbladder Hydrops and Arthritis: unusual initial manifestations of Wilson's Disease (WD):
Case Report. Prilozi. 2011 Dec;32(2):207-15.
A clinical study of Wilson's disease: The experience of a single Egyptian Paediatric Hepatology Unit.
Arab J Gastroenterol. 2011 Sep;12(3):125-30.
4