From the Guidelines
Dietary sourcing of copper should prioritize a balanced intake of 1-3 mg per day, as recommended by the most recent guideline 1, to ensure adequate copper levels for various bodily functions while minimizing the risk of toxicity.
Key Dietary Sources of Copper
- Organ meats (especially liver)
- Shellfish (oysters, lobster, crab)
- Nuts and seeds (cashews, sunflower seeds)
- Whole grains
- Legumes
- Dark chocolate
- Dried fruits
Importance of Balanced Copper Intake
Copper is essential for energy production, iron metabolism, connective tissue formation, and antioxidant defense. Both deficiency and excess can cause health problems, and individuals with certain genetic conditions like Wilson's disease are at higher risk of copper toxicity.
Recommendations for Specific Populations
- Vegetarians should pay particular attention to including copper-rich plant foods in their diet.
- Individuals with copper pipes in their household should flush the system of stagnant water before using water for cooking or consumption to minimize copper intake from water 1.
- Enteral nutrition should provide 1-3 mg copper per day with 1500 kcal, as recommended by the ESPEN micronutrient guideline 1.
From the Research
Dietary Sourcing of Copper
- Copper is an essential mineral that can be sourced from dietary intake, with absorption occurring in the stomach, duodenum, and jejunum 2.
- The uptake of dietary copper into intestinal cells is via the Ctr1 transporter, located at the apical membrane aspect of intestinal cells and in most tissues 3.
- Copper is excreted from enterocytes into the blood via the Cu-ATPase, ATP7A, by trafficking the transporter towards the basolateral membrane 3.
- Dietary sources of copper are important to prevent copper deficiency, which can lead to hematological and neurological sequelae, including macrocytic anemia and myelopathy 2, 3.
- The recommended daily intake of copper is 0.9 mg/d, which can be achieved through a balanced diet that includes copper-rich foods 4.
Factors Affecting Copper Absorption
- Gastric bypass surgery, gastrectomy, and short-bowel syndrome can lead to copper malabsorption 2.
- Zinc is another important micronutrient that can affect copper absorption, although its absorption is slightly different 3.
- Copper deficiency can be caused by hereditary or acquired factors, with acquired factors being more frequent 3, 4.
- Changing nutrition patterns and certain treatments, such as bariatric bypass surgery and prolonged continuous renal replacement therapy, can increase the risk of copper deficiency 4.
Health Effects of Copper Deficiency
- Copper deficiency can affect various physiological systems, including bone marrow hematopoiesis, optic nerve function, and the nervous system 3.
- Clinical manifestations of copper deficiency are nonspecific but can affect all organs and systems, particularly the hematologic and neurologic systems 4.
- Severe copper deficiency can lead to severe hematologic and neurologic complications that may require active intravenous repletion with doses 4-8 times the usual nutrition recommendations 4.
- Copper deficiency has been linked to various health conditions, including ischemic heart disease, connective tissue and neurodegenerative disorders, and non-alcoholic fatty liver disease (NAFLD) 5.