WHAT IS THE RELATIONSHIP BETWEEN DIET AND HEPATITIS C ?
Hepatitis C is a virus that infects the liver. Up to 85% of people
exposed to this virus develop chronic liver disease. Progression to
cirrhosis { irreversible scarring of the liver } occurs in about 25% of
individuals. While not as yet totally defined, many factors influence the
rate of disease progression. Diet likely plays an important role in this
process, as all foods and beverages that we ingest must pass through the
liver to be metabolized.
ALCOHOL AND HEPATITIS C
Alcohol is a potent toxin to the liver. Excessive intake can lead to
cirrhosis and its complications, including liver cancer. Heavy drinkers are
not the only individuals at risk for liver disease, as damage can occur in
even some moderate "social drinkers". The hepatitis C virus has
frequently been isolated from patients with alcoholic liver disease. In
fact, these patients have been found to have a higher incidence of severe
liver damage, cirrhosis, and a decreased lifespan, when compared to
individuals without the virus. It is suggested that the combination of
alcohol and hepatitis C accelerates the progression of liver disease.
The consensus statement concerning management of hepatitis C released March
1997 from the National Institutes of Health, further warned about the
dangers of excessive alcohol use in patients with hepatitis C. These
recommendations stressed limitation of alcohol use to no more than one drink
per day. Therefore, patients with hepatitis C would be unwise to drink
alcohol in excess, and total avoidance of all alcohol intake is recommended
.
IRON AND HEPATITIS C
The liver plays an important role in the metabolism of iron since it is the
primary organ in the body that stores this metal. The average American diet
contains about 10- 20 mg of iron. Only about 10% of this iron is eliminated
from the body. Patients with chronic hepatitis C sometimes have difficulty
excreting iron from the body. This can result in an overload of iron in the
liver, blood, and other organs. Excess iron can be very damaging to the
liver. Studies suggest that high iron levels reduce the response rate of
patients with hepatitis C to interferon. Thus, patients with chronic
hepatitis C whose serum iron level is elevated, or who have cirrhosis,
should avoid taking iron supplementation. In addition, one should restrict
the amounts of iron rich foods in their diet, such as red meats, liver, and
cereals fortified with iron, and should avoid cooking with iron coated
utensils.
FAT AND HEPATITIS C
Overweight individuals are often found to have abnormalities related to the
liver . Examination of liver specimens may display a spectrum of
abnormalities ranging from fatty deposits in the liver,[ steatosis], to
fatty inflammation [ fatty hepatitis], or even fatty cirrhosis. This
condition is called Nonalcoholic Steatohepatitis [ NASH ]. It occurs
predominantly in middle-aged obese women with diabetes mellitus and
hypertriglyceridemia [excess fat in the blood]. However, this disease may
also occur in individuals of normal weight, without other associated
diseases, and can also affect men. The presence of fat in the liver can
cause the liver to become enlarged and may result in elevations in liver
related blood work { liver function tests [LFT's] }. The addition of NASH in
patients with hepatitis C may worsen liver related blood work and physical
exam. This may confuse interpretation of results and diagnosis. Controlled
studies need to be done to determine if the addition of this disease worsens
the prognosis of patients with underlying chronic hepatitis C. In overweight
patients with a fatty liver who subsequently lose weight, liver- related
abnormalities improve. Therefore, patients with chronic hepatitis C are
advised to maintain a normal weight. For persons who are overweight, it is
crucial to start a prudent exercise routine and a low fat, well balanced,
weight reducing diet. In diabetic patients, a sugar- restricted diet should
be adhered to. A low cholesterol diet should be followed in those with
hypertriglyceridemia. In individuals with NASH who are of normal weight, a
low fat diet may be advantageous. It is essential that patients consult with
their physician prior to the commencement of any dietary or exercise
program.
PROTEIN AND HEPATITIS C
Adequate protein intake is important to build and maintain muscle mass and
to assist in healing and repair. Protein intake must be adjusted to one's
body weight. Approximately 0.8 grams of protein per kilogram of body weight
is recommended in the diet each day. Therefore, protein intake should be
between about 60 - 120 grams a day in patients with hepatitis C, unless a
complication of cirrhosis known as encephalopathy occurs. Encephalopathy is
an altered mental status. The exact cause is not fully understood and is
probably multifactorial. It has been shown that restriction of the diet of
animal protein and maintaining a total vegetarian diet, helps reverse this
condition and improve mental capacity.
SODIUM AND HEPATITIS C
Advanced scarring of the liver [ cirrhosis ] may lead to an abnormal
accumulation of fluid in the abdomen referred to as ascites. Patients with
hepatitis C who have ascites must be on sodium [salt] restricted diets.
Every gram of sodium consumed results in the accumulation of 200 ml of
fluid. The lower the salt content in the diet, the better this excessive
fluid accumulation is controlled. While often difficult, sodium intake
should be restricted to 1000mg each day, and preferably to 500 mg per day.
One must become an careful shopper, diligently reading all food labels. It
is often surprising to discover which foods are high in sodium. For example,
one ounce of corn flakes contains 350 mg of sodium; one ounce of grated
parmesan cheese - 528mg of sodium; one cup of chicken noodle soup - 1108 mg
of sodium; and one teaspoon of table salt - 2,325 mg of sodium! Most fast
food restaurants are a no no. Meats, especially red meats, are high in
sodium content, and adherence to a vegetarian diet may often become
necessary. Patients with chronic hepatitis C without ascites, are advised
not to overindulge in salt intake, although their restrictions need not be
as severe.
Source:
http://www.liverdisease.com/diet.html
Diet for liver disease
