Wilson’s disease is a hereditary disorder in which the body retains too much copper. Copper is a trace mineral in the body. This means it is essential for good health, but only a tiny amount is needed. When excess copper accumulates, it is stored in the eyes, brain, kidneys, and liver. Excess copper collecting in the liver causes cirrhosis of the liver, which is a serious, life-threatening condition. However, Wilson’s disease is treatable.
Copper is found in different amounts in a wide variety of foods. Therefore, dietary restriction alone is usually not enough to control Wilson’s disease. Medicines such as Cuprime and Depen (generic name: D-penicillamine) and Syprine (generic name: trientine) are used to help excrete excess copper with the urine. Zinc is also used to reduce copper absorption in the diet. Still, it is helpful to avoid copper-rich foods as much as possible. The dietary intake of copper should be less than 1.0 mg per day.
Nutrition Facts
A low copper diet is generally adequate in all the nutrients necessary for good health. However, patients taking D-penicillamine may develop a deficiency of vitamin B-6 (pyridoxine), and the physician may prescribe a supplement of 25 mg daily.
Special Considerations
- The copper content in a specific food can vary depending on a number of factors. The copper content and the location of the soil in which the food was grown, or the method used to process the food, for example, can affect how much copper is in the food when eaten. In general, the low copper diet is meant to restrict foods that are usually high in copper, especially organ meats, shellfish, dried beans, peas, whole wheat, and chocolate that is high in cocoa such as dark chocolate.
- Drinking water should be analyzed because it may contain too much copper. If the water contains more than 100 micrograms per liter, then bottled demineralized water should be used. This water should contain only 1 microgram of copper per liter. Demineralized water and distilled water are processed differently and may not contain the same amount of copper. Check with the physician or registered dietitian for more information.
- Avoid drinking alcohol. It can be harmful to the liver, and the liver may already be damaged from Wilson’s disease.
- Read food labels; some prepared foods list the copper content. Always check the labels of vitamin/mineral supplements to see if they contain copper.
- For better control of copper intake, choose only average portions or serving sizes of foods. Examples of average portions are 3 to 4 oz of meat, fish, or poultry, 1/2 cup of vegetables, one slice of bread.
- Do not use copper cooking utensils.
- Patient’s with Wilson’s disease should have initial and periodic consultations with a registered dietitian to make sure copper in the diet is being adequately controlled.
| Food Groups | |||
|---|---|---|---|
| Eat as Desired Foods low in copper — less than 0.1 mg/portion. | 6 Portions/Day | Avoid | |
| Meat & meat substitute | beef, eggs, white meat turkey and chicken, cold cuts and frankfurters that do not contain pork, dark turkey, dark chicken, or organ meats, all others not listed on high or moderate list | all fish except shellfish 3 oz, dark meat turkey and chicken 3 oz, peanut butter 2 Tbsp | lamb, pork, pheasant quail, duck, goose, squid, salmon, organ meats including liver, heart, kidney, brain, shellfish including oysters, scallops, shrimp, lobster, clams, and crab, meat gelatin, soy protein meat substitutes, tofu, nuts and seeds |
| Vegetables | most vegetables including fresh tomatoes | bean sprouts 1 cup, beets 1/2 cup, spinach 1/2 cup cooked, 1 cup raw, tomato juice and other tomato products 1/2 cup, broccoli 1/2 cup, asparagus 1/2 cup | vegetable juice cocktail, mushrooms |
| Fruits | most fruits except as listed to right Fruits dried at home are permitted | mango 1/2 cup, papaya 1/4 average, pear 1 medium, pineapple 1/2 cup | nectarine, commercially dried fruits including raisins, dates, prunes; avocado |
| Starches – breads & grains | breads & pasta from refined flour, rice, regular oatmeal, cereals with <0.1 mg of copper per serving (check sweet potatoes, all others not listed on high or moderate list | whole wheat bread 1 slice, Melba toast 4, whole wheat crackers 6, instant oatmeal 1/2 cup, instant Ralston™ 1/2 cup, cereals with 0.1 to 0.2 mg of copper per serving (check label), dehydrated and canned soups 1 cup, potatoes in any form 1/2 cup or small, pumpkin 3/4 cup, parsnips 2/3 cup, winter and summer squash 1/2 cup, green peas 1/2 cup | dried beans including soy beans, lima beans, baked beans, garbanzo beans, pinto beans, dried peas, lentils, millet, barley, wheat germ, bran breads and cereals, cereals with >0.2 mg of copper per serving (check label), soy flour, soy grits, fresh sweet potatoes |
| Fats, oils | butter, cream, margarine, mayonnaise, non-dairy creamer, sour cream, oils, salad dressings (made from allowed ingredients) | olives 2 med | |
| Milk & milk products | Most milk products, milk flavored with carob, cheeses, cottage cheese | all others | chocolate milk, soy milk, cocoa |
| Sweets & desserts | most sweets, jams, jellies, and candies made with allowed ingredients, carob, flavoring extracts | licorice 1 oz, syrups 1 oz | desserts that contain high amounts of ingredients rich in copper, candy with nuts, dark chocolate, or cocoa |
| Beverages, liquids, misc. | coffee, tea, fruit juices, fruit-flavored beverages, lemonade, soups made with allowed ingredients | Postum™ and other cereal beverages 1 cup, carbonated beverages 12 oz, ketchup 2 Tbsp, dehydrated and canned soups | instant breakfast beverages, mineral water, soy-based beverages, copper-fortified formulas, brewer’s yeast, multiple vitamins with copper or minerals |
| Sample Menu | ||
|---|---|---|
| Breakfast | Lunch | Dinner |
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| This Sample Diet Provides the Following | |||
|---|---|---|---|
| Calories | 1,520 | Sodium | 1,500 mg |
| Protein | 69 gm | Potassium | 2,150 mg |
| Carbohydrates | 191 gm | Copper | 0.68 mg |
| Fat | 54 gm | ||