Wilson's disease, how to choose copper-containing foods?

Wilson's disease is an autosomal recessive copper metabolism disease. When the body cannot metabolize copper normally, copper will accumulate in important organs such as the liver and brain, causing a variety of symptoms such as cirrhosis, eye damage, and kidney and nervous system damage.

For patients with Wilson's disease, a reasonable diet is the key to treatment.

We can check the copper content in different foods according to the "Chinese Food Composition Table: Standard Edition (Sixth Edition)" and try to choose foods with relatively low copper content.

1. Foods with very low copper content, generally per 100g raw weight

<0.05mg. Based on the dietary recommended amount, there is no special restriction on the amount of this type of food. This type of food mainly includes:

1. Staple foods: indica rice, rice flour, wheat flour (enriched flour), steamed buns (enriched flour), noodles (enriched flour), cornmeal, corn grits, japonica rice porridge, and pea starch.

2. Vegetables: white radish, water radish, green radish, eggplant, winter melon, chayote, cucumber, pumpkin, tomato, zucchini, gourd, pakchoy, Chinese cabbage, chicken feather cabbage, baby cabbage, rapeseed, cabbage, lettuce, and broccoli.

3. Animal food: pork (tenderloin), beef (tenderloin), beef (shoulder), beef brisket, chicken breast, chicken legs, shredded eel, silver carp, small yellow croaker, large yellow croaker.

4. Soybeans: tofu (Southern tofu).

5. Fruits: red grapes, oranges, grapefruits, papayas, ginseng fruit, bayberries, carambolas, mangosteens, cantaloupes, melons, and watermelons.

6. Milk and eggs: whole milk, whole fresh milk, yogurt, goat's milk, egg white (black-bone chicken), and sea duck eggs.

2. Foods with low copper content, generally 0.05-0.20 mg per 100 g of raw weight. This type of food can be selected based on the dietary recommended amount. Except for fruits, there is generally no special restriction on the amount of consumption. This type of food mainly includes:

1. Staple foods: vermicelli, pea vermicelli, wheat flour (standard flour), corn starch, flower rolls, steamed buns, corn (fresh), noodles, fried dough sticks, water gluten, vermicelli, black rice, japonica rice (standard one), red bean paste (peeled).

2. Vegetables: carrots, kohlrabi, lentils, sword beans, beans, cowpeas, green beans, bean sprouts, mung bean sprouts, black bean sprouts, eggplant, loofah, cucumber, onion, leek, shepherd's purse, kale, spinach, amaranth, celery, bamboo shoots, spring bamboo shoots, water celery, wild rice stem, lotus root, water chestnut, taro, fresh mushrooms, and kelp.

3. Animal food: pork (lean meat, leg meat), beef (ribs, tenderloin), lamb, chicken, sea cucumber, sea bass, grouper, bream, pomfret, hairtail (cut into sections), prawns, clams (hairy clams).

4. Soybeans: tofu (northern tofu), tofu (lactone), soy milk, dried tofu (dried vegetables), and vegetarian ham.

5. Fruits: apples, pears, peaches, grapes, pomegranates, mulberries, tangerines, grapefruits, lemons, pineapples, mangoes, lychees, loquats, durians, bananas, and sea buckthorn.

6. Eggs: goose eggs, chicken eggs, duck eggs, preserved eggs, chicken egg whites, and duck egg whites.

3. Foods with medium copper content generally contain 0.21-0.50 mg per 100 g of raw weight. These foods should be consumed in limited quantities under the guidance of a doctor and a registered dietitian. These foods mainly include:

1. Staple foods: lotus root starch, japonica rice (premium refined rice), indica rice (standard grade one), cornmeal (white), brown rice, rice noodles, and rice.

2. Vegetables: fresh edamame, fresh peas, fresh kidney beans, coriander, shepherd's purse, water chestnut, yam, straw mushrooms, and mushrooms.

3. Animal food: duck, prawns, pig heart, duck heart, mackerel, razor clams, crabs (small), shrimps, squid (fresh), scallops (fresh), shrimps, and goose.

4. Soybeans: vegetarian assorted, tofu pudding (old tofu), tofu shreds (dried), vegetarian chicken, fried tofu, dried tofu (stinky dried tofu), dried tofu (fragrant dried tofu), tofu rolls, and thousand sheets.

5. Fruits: red bananas, apples, rambutan, and sour dates.

6. Nuts: chestnuts (fresh), walnuts.

4. Foods with high copper content generally contain

>0.50mg. Avoid eating this type of food or eat it in small amounts under the guidance of a nutritionist. This type of food mainly includes:

1. Staple foods: fragrant rice, millet, yellow rice, wheat germ flour, adzuki bean (dried), broad bean (with skin), kidney bean (dried. red), mung bean (dried).

2. Vegetables: fresh beans and most dehydrated vegetables.

3. Animal food: lobster, river shrimp, swimming crab, sea crab, river crab, oyster, chicken gizzard, duck liver, beef (lean).

4. Soybeans: dried tofu (braised), bean curd sheets, bamboo shoots, vegetarian large intestine, soybeans, tofu skin, large green beans (dried), large black beans (dried).

5. Fruits: figs, kiwis.

6. Nuts: chestnuts (dried), walnuts (dried), cashews (cooked), pistachios (cooked), almonds (cooked), peanuts, sunflower seeds, and sesame seeds.

In addition to paying attention to copper in food, other aspects that may increase copper intake also need attention.

Copper pots and utensils are not recommended.

Well water or water transported through copper pipes is not recommended for drinking and should be checked for copper content.

If the copper content of the water is high, it is recommended to use a water purification system.

Finally, patients need to work together under the guidance of doctors and registered dietitians to reasonably control copper and live a healthy life according to different ages and disease conditions.

Author: Niu Yang, Sheng Jinye, Feng Yi, Tang Qingya

Department of Clinical Nutrition, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine

Project source: Shanghai Health Science Popularization Young Talents Special Project **(JKKPYC-2022-06)**