Investigating the Role of Diet and Dietary Factors in the Therapeutic Management of Iron Overload: A Scoping Review

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Abstract
Iron overload (IOL) results from excessive iron accumulation and presents as primary (genetic) or secondary (from transfusions or iron therapy). Management is predominantly invasive—phlebotomy and iron chelation—which, while effective, are costly and can impair quality of life. No standardized dietary guidelines exist. The aim of this scoping review was to map the evidence on diet and dietary factors in the therapeutic management of IOL–associated conditions. We followed Joanna Briggs Institute (JBI) scoping review methodology and a Population/Concept/Context (PCC) framework to define eligibility. A targeted, JBI 3-step search strategy was run in PubMed (National Library of Medicine), Web of Science (Clarivate), Embase (Elsevier), and CINAHL Ultimate (EBSCO), supplemented by gray-literature sources. Records were managed in Covidence; duplicates were removed, then citations were screened by title/abstract using prespecified eligibility criteria and research questions. Search quality was guided by the Peer Review of Electronic Search Strategies (PRESS) checklist, and the study selection is reported in a PRISMA-ScR flow diagram. Research articles were assigned JBI levels of evidence. Evidence was synthesized descriptively and mapped by dietary factor in narrative summaries and tables. Forty sources (38 peer-reviewed articles; 2 gray-literature articles) met the inclusion criteria. The reported dietary factors potentially relevant to IOL management included polyphenols; vitamins and minerals; diet alteration; foods/food additives; alcohol; and amino and fatty acids. The findings were integrated into a visual workflow, and the current evidence on dietary factors in the therapeutic management of IOL was mapped. Substantial gaps were identified, including limited high-quality clinical trials and inconsistent reporting of the effects of specific dietary factors on iron metabolism. The available literature suggests that diet and selected dietary factors may contribute to improved patient outcomes, highlighting the need for rigorous, well-designed studies to develop unified, evidence-based dietary strategies to complement the standard therapies.

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