What are the key dietary considerations for individuals with hepatitis C. How can nutrition impact liver health and disease progression in hepatitis C patients. Which foods should be limited or avoided with hepatitis C. What dietary changes can help manage symptoms and support liver function in those with hepatitis C.

The Role of Iron in Hepatitis C Management

Iron metabolism plays a crucial role in hepatitis C management. The liver, being central to iron metabolism, can face challenges in individuals with chronic hepatitis C. How does this affect dietary recommendations?

People with chronic hepatitis C often struggle to release iron efficiently, potentially leading to iron overload in the liver, blood, and other organs. This excess iron can exacerbate tissue damage in the liver. As a result, dietary modifications are necessary to manage iron intake.

• Reduce consumption of iron-rich foods such as red meats, liver, oysters, lentils, apricots, and iron-fortified cereals
• Avoid iron supplements unless prescribed by a healthcare provider
• Be cautious with multivitamin tablets that may contain iron
• Limit vitamin C intake, as it enhances iron absorption from food

It’s important to note that while reducing iron intake is beneficial, it shouldn’t be eliminated entirely from the diet. Iron remains an essential nutrient, and complete elimination could lead to other health issues.

Balancing Fat Intake for Liver Health

Fat consumption plays a significant role in liver health for individuals with hepatitis C. What types of fats should be prioritized, and which ones should be limited?

Excessive fat intake can lead to various liver abnormalities, including fatty deposits, fatty inflammation, and fatty cirrhosis. However, it’s crucial to maintain a balanced approach to fat consumption.

• Replace saturated fats with unsaturated fats
• Limit intake of fatty meats, full-fat dairy products, cakes, and biscuits
• Incorporate more fish, olive oil, nuts, avocado, and plant-based margarines

By making these dietary adjustments, individuals with hepatitis C can help lower cholesterol levels and improve overall liver health. It’s important to remember that the effect of consuming fatty foods is distinct from weight gain, though both factors can impact liver health.

Protein Intake and Hepatitis C: Finding the Right Balance

Protein is essential for muscle maintenance, body repair, and healing. However, for individuals with hepatitis C, managing protein intake requires careful consideration. What is the optimal amount of protein for hepatitis C patients?

While protein is crucial for overall health, excessive amounts can lead to a build-up of protein breakdown products in the blood. This accumulation occurs because these products are typically processed by the liver, which may be compromised in hepatitis C patients.

High levels of protein breakdown products can result in a condition called encephalopathy, affecting mental function and often causing brain fog. Historically, studies suggested that reducing protein intake, particularly from meat sources, could improve encephalopathy symptoms. However, more recent research indicates that maintaining adequate protein intake is preferable to prevent malnutrition.

The challenge lies in striking a balance between meeting the body’s protein needs without overloading the liver. Current recommendations suggest consuming approximately 1-1.5 grams of protein per kilogram of body weight daily.

Protein Sources for Hepatitis C Patients

When selecting protein sources, hepatitis C patients should consider options that are easy for the liver to process. What are some liver-friendly protein sources?

• Lean poultry (chicken, turkey)
• Fish (salmon, cod, tilapia)
• Plant-based proteins (beans, lentils, tofu)
• Egg whites
• Low-fat dairy products

These protein sources provide essential amino acids while minimizing the strain on the liver. It’s important to consult with a healthcare provider or registered dietitian to tailor protein intake to individual needs and liver function.

Sodium Restrictions for Managing Ascites in Advanced Hepatitis C

For individuals with advanced hepatitis C who develop cirrhosis, managing sodium intake becomes crucial. How does sodium restriction help in managing ascites, a common complication of end-stage liver disease?

Ascites, the accumulation of fluid in the abdomen, is a symptom of end-stage liver disease that can occur in advanced hepatitis C cases. To manage this condition, healthcare providers often recommend restricting sodium intake to less than 1000mg per day.

Adhering to this sodium restriction can be challenging, as many foods contain surprisingly high amounts of salt. To effectively manage sodium intake:

• Avoid adding salt to food during cooking or at the table
• Carefully check nutritional labels for sodium content
• Use salt-free seasonings and herbs for flavoring
• Choose fresh, whole foods over processed options
• Consider using a sodium tracking app to monitor daily intake

By diligently managing sodium intake, individuals with ascites can help reduce fluid retention and alleviate associated discomfort. It’s essential to work closely with a healthcare provider to determine the appropriate sodium restriction level based on individual health status and disease progression.

Blood Sugar Regulation and Hepatitis C: The Diabetes Connection

Hepatitis C has been linked to issues with blood sugar regulation, increasing the risk of developing diabetes. How does this connection impact dietary recommendations for hepatitis C patients?

The liver plays a crucial role in regulating blood sugar levels by converting consumed food into usable substances and releasing them as energy when needed. In individuals with hepatitis C, especially those with end-stage liver disease, this regulatory function can be compromised.

To address this issue and maintain stable blood sugar levels, consider the following dietary strategies:

• Consume small, frequent meals throughout the day
• Choose complex carbohydrates over simple sugars
• Incorporate high-fiber foods to slow sugar absorption
• Pair carbohydrates with protein and healthy fats to stabilize blood sugar
• Monitor blood sugar levels regularly, as advised by a healthcare provider

By implementing these dietary changes, individuals with hepatitis C can help manage their blood sugar levels and potentially reduce their risk of developing diabetes. It’s important to work with a registered dietitian or healthcare provider to create a personalized meal plan that addresses both liver health and blood sugar regulation.

The Potential Benefits of Coffee Consumption in Hepatitis C

Recent studies have shed light on the potential benefits of coffee consumption for individuals with hepatitis C. What does the research say about caffeine intake and liver health?

Emerging evidence suggests that daily consumption of caffeinated beverages, particularly coffee, may be associated with less advanced liver scarring in people with hepatitis C. Specifically, research indicates that consuming approximately 100mg of caffeine (equivalent to about 2.5 cups of coffee) is linked to a roughly one-third reduction in advanced scarring.

Key points about coffee consumption and hepatitis C:

• Moderate coffee intake (2-3 cups per day) may have protective effects on the liver
• The benefits appear to be associated with caffeinated coffee specifically
• Higher intake beyond 2-3 cups per day is not believed to produce additional benefits
• The exact mechanisms behind coffee’s protective effects are still being studied

While these findings are promising, it’s important to note that coffee consumption should be considered as part of a comprehensive approach to managing hepatitis C, not as a standalone treatment. Individuals should discuss their caffeine intake with their healthcare provider, especially if they have other health conditions that may be affected by caffeine consumption.

The Power of Leafy Vegetables in Supporting Liver Health

Leafy vegetables have shown potential in supporting liver health for individuals with hepatitis C. How do these nutrient-dense foods benefit the liver and overall health?

Studies suggest that incorporating leafy vegetables into the diet can have multiple benefits for individuals with hepatitis C:

• Reduction in fatty acid composition in the liver
• Protection against atherogenic fatty acids, which form fatty deposits in arteries
• Potential reduction in the risk of atherosclerosis, a major risk factor for coronary heart disease
• Provision of essential vitamins and minerals that support overall liver function

To maximize the benefits of leafy vegetables, consider incorporating a variety of options into your diet:

1. Spinach
2. Kale
3. Swiss chard
4. Collard greens
5. Arugula
6. Mustard greens
7. Watercress

These leafy greens can be consumed raw in salads, sautéed as side dishes, or incorporated into smoothies for easy consumption. Aim to include a serving of leafy vegetables in at least one meal per day to support liver health and overall well-being.

Preparing Leafy Vegetables for Maximum Nutrient Retention

To ensure you’re getting the most nutritional benefit from leafy vegetables, consider these preparation methods:

• Steam or lightly sauté greens to preserve nutrients
• Add a small amount of healthy fat (like olive oil) to enhance absorption of fat-soluble vitamins
• Consume raw leafy greens soon after preparation to minimize nutrient loss
• Avoid overcooking, which can lead to significant nutrient degradation

By incorporating a variety of leafy vegetables and preparing them optimally, individuals with hepatitis C can support their liver health and potentially reduce the risk of associated complications.

Hydration and Liver Health in Hepatitis C Management

While not explicitly mentioned in the original text, hydration plays a crucial role in supporting liver health for individuals with hepatitis C. How does proper hydration impact liver function and overall well-being?

Adequate hydration is essential for maintaining optimal liver function and supporting the body’s natural detoxification processes. For individuals with hepatitis C, staying well-hydrated can provide several benefits:

• Assists in flushing toxins from the liver and body
• Supports healthy blood flow, which is crucial for liver function
• Helps prevent constipation, reducing strain on the liver
• Aids in maintaining proper electrolyte balance
• May help alleviate fatigue, a common symptom of hepatitis C

To ensure proper hydration, consider the following guidelines:

1. Aim for at least 8-10 glasses of water per day
2. Include hydrating foods in your diet, such as cucumbers, watermelon, and zucchini
3. Limit or avoid alcohol and caffeinated beverages, which can contribute to dehydration
4. Monitor urine color as an indicator of hydration status (pale yellow indicates good hydration)

It’s important to note that individuals with advanced liver disease or complications such as ascites may need to modify their fluid intake under medical supervision. Always consult with a healthcare provider to determine the appropriate hydration strategy for your specific condition.

Herbal Teas and Liver Health

In addition to water, certain herbal teas may offer benefits for liver health. What are some liver-friendly herbal tea options for individuals with hepatitis C?

• Milk thistle tea: Known for its potential liver-protective properties
• Dandelion root tea: May support liver detoxification processes
• Ginger tea: Has anti-inflammatory properties that may benefit liver health
• Green tea: Rich in antioxidants that support overall health

While these herbal teas may offer potential benefits, it’s crucial to consult with a healthcare provider before incorporating them into your diet, especially if you’re taking medications for hepatitis C or other health conditions. Some herbal remedies can interact with medications or affect liver function, so professional guidance is essential.

The Importance of Individualized Nutrition Plans in Hepatitis C Management

Given the complex nature of hepatitis C and its impact on liver function, developing an individualized nutrition plan is crucial for effective disease management. How can patients work with healthcare providers to create a tailored dietary approach?

Managing hepatitis C through diet requires a personalized approach that takes into account various factors:

• Stage of liver disease
• Presence of complications (e.g., ascites, encephalopathy)
• Concurrent health conditions
• Medications and potential interactions
• Individual nutritional needs and deficiencies
• Cultural and personal food preferences

To develop an effective nutrition plan, consider the following steps:

1. Consult with a hepatologist or gastroenterologist specializing in liver diseases
2. Work with a registered dietitian experienced in liver health nutrition
3. Undergo comprehensive nutritional assessment and blood work
4. Discuss dietary restrictions and recommendations based on your specific condition
5. Develop a meal plan that incorporates liver-friendly foods while addressing individual needs
6. Regularly review and adjust the nutrition plan as your condition changes or progresses

By taking a collaborative approach to nutrition planning, individuals with hepatitis C can ensure they’re receiving dietary guidance tailored to their unique health needs and circumstances. This personalized approach can help optimize liver function, manage symptoms, and support overall well-being throughout the course of the disease.

Monitoring Nutritional Status in Hepatitis C

Regular monitoring of nutritional status is essential for individuals with hepatitis C. What are some key indicators that healthcare providers may track to assess nutritional health?

• Body mass index (BMI) and body composition
• Serum albumin levels as an indicator of protein status
• Vitamin D levels, which are often deficient in liver disease
• Iron studies to assess potential iron overload
• Blood glucose levels to monitor diabetes risk
• Lipid profile to assess cardiovascular risk

By regularly monitoring these and other relevant markers, healthcare providers can identify nutritional deficiencies or imbalances early and adjust dietary recommendations accordingly. This proactive approach to nutritional management can help optimize treatment outcomes and quality of life for individuals living with hepatitis C.

Diet | Hepatitis C Trust

Iron

The liver is important to the metabolism of iron.

Although it varies from person to person, most of the iron we consume leaves the body naturally.

People with chronic hepatitis C sometimes have difficulty in releasing iron. This can result in an overload of iron in the liver, blood and other organs. This overload can increase tissue damage in the liver.

Menstruating women are less likely to experience iron overload due to their loss of blood each month.

Because of this, people with chronic hepatitis C should reduce the amount of iron-rich foods in their diets. These include red meats, liver, oysters, lentils, apricots and iron-fortified cereals. However, iron is an essential part of your diet so do not cut it out entirely.

It is important to avoid taking iron supplements, unless advised by your doctor. It can make liver damage worse because the body has no way of removing excess iron and it accumulates in the organs and tissues, including the liver. Multivitamin tablets often include iron, so check the label.

Also, beware that vitamin C increases the absorption of iron from food.

Fat

Fat can cause abnormalities such as fatty deposits in the liver, fatty inflammation or fatty cirrhosis.

Of course, small amounts of fat should be consumed as part of a balanced diet.

Replacing saturated fats with unsaturated fats can improve your health by helping to lower cholesterol levels in your blood.

Saturated fats are mostly found in fatty meats and full-fat dairy products, as well as in cakes and biscuits. Unsaturated fats are found in fish and foods that come from plants. These include olive oil, nuts, avocado and margarines.

The effect of eating fatty foods is a separate issue to gaining weight.

Protein

Protein is necessary for the building and maintenance of muscle, and the repair and healing of the body. 60-120 grams per day of protein is adequate for an adult.

Large amounts of protein in the diet can lead to a build-up of protein breakdown products in the blood. This is because they are normally removed through the liver.

If the levels of protein breakdown products are high, a complication known as encephalopathy can occur. This condition affects mental function and often causes brain fog.

Several older studies illustrate that a diet which cuts out protein from meat improves the symptoms of encephalopathy. However, recent studies suggest it is preferable to continue eating adequate amounts of protein as low protein intake can contribute to malnutrition.

It is difficult to strike a balance between getting the protein that your body needs without causing a build-up of protein breakdown products in the blood. Roughly 1-1.5 grams of protein per kilogram of body weight is advisable.

Salt

Cirrhosis can lead to an accumulation of fluid in the abdomen. This is known as ascites, and it is a symptom of end stage liver disease.

People who experience ascites should restrict their sodium intake to less than 1000mg per day.

This is difficult as many foods have a surprisingly high salt content. If it is necessary for you limit your sodium intake, avoid adding salt to food and check the salt content of food products you consume.

You might like to use an app such as Sodium Tracker to help you track your sodium intake. It can help you to add up the amount of sodium in every food product you eat each day, which you can find on nutritional informational labels. Please go to this link for more information go here: https://appsto.re/gb/Qxr7B.i

Sugar

There appears to be a connection between hepatitis C and issues with regulation of blood sugar levels. This increases the risk of developing diabetes.

The link between hepatitis C and insulin resistance is expanded upon here: http://www.hepctrust.org.uk/information/hepatitis-c-and-overall-health

The liver regulates blood sugar levels by converting the food we eat into substances the body can use. They are then released as energy when the body need them.

People with end stage liver disease have difficulty in regulating blood sugar. One remedy is to have small, frequent meals that keep blood sugar levels more constant.

Coffee / Caffeine

Recent studies have suggested that daily consumption of caffeinated drinks is associated with less advanced liver scarring in people with hepatitis C.

100mg of caffeine (equivalent to 2.5 cups of coffee) is associated with roughly one-third reduction in advanced scarring, but higher intake is not believed to produce a further benefit.

Leafy vegetables

Studies suggest that leafy vegetables can lessen the fatty acid composition in your liver, and help to protect against artherogenic fatty acids which form fatty deposits in arteries.

A build-up of fatty deposits in arteries can cause a condition called atherosclerosis which is a major risk factor for coronary heart disease. There is more information about hepatitis C’s link to CHD here: http://www.hepctrust.org.uk/information/hepatitis-c-and-overall-health

Great leafy vegetables to eat include kale, collard greens, sweet potato greens, spinach and cabbage.

Juicing

Including juices in your diet can be useful for people with hepatitis C.                                    

Juicing does not necessarily provide more health benefits than eating whole fruit and vegetables, but drinking juices can help to get energy when eating large meals is not possible.

It is also important to keep whole fruit and vegetables as a part of your diet because juices don’t contain any fibre.

What are good combinations to try?

Store-bought juices can be expensive, but making them yourself with a juicer can save you money.

Apples, beetroot, broccoli, carrots, celery, cucumber, ginger, parsley, watercress and wheatgrass can all be good for your liver.  

Popular combinations include:

●     Carrot, apple, beetroot and ginger

●     Cucumber, carrot and beetroot

●     Celery, carrot and beetroot

Diet and Nutrition for Hepatitis

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Nutrients. 2021 Apr; 13(4): 1210.

Published online 2021 Apr 7. doi: 10.3390/nu13041210

Author information Article notes Copyright and License information Disclaimer

The impairment of liver function frequently causes various type of malnutrition, as the liver is one of the most important organs involved in maintaining nutritional homeostasis. Therefore, dietary or nutritional support can restore impaired liver function and improve the prognosis in patients with liver damage. This Special Issue contains nine peer-reviewed articles, including five original articles, which aim to establish novel nutritional interventions for various types of liver damage.

Hepatoprotective medicines are often prescribed to patients with drug-induced hepatitis. However, Nega et al. elucidate beneficial protective effects of probiotic Bacillus spores against acetaminophen-induced hepatic injury in mice [1]. Bacillus species have strong resistance to heat, toxic chemical compounds, and radiation. Thus, spore-forming probiotic bacteria are recognized as a promising alternative to Bifidobacterium and Lactobacillus strains. This study indicates that the probiotic Bacillus spores may make the intestinal barrier stronger and decrease the dissemination of microbial-derived compounds from the intestine, leading to an alleviation of endotoxemia.

The next two studies primarily focus on the efficacy of traditional medicines in experimental animal models of nonalcoholic fatty liver disease (NAFLD). NAFLD is one of the most common metabolic diseases, which is characterized by excessive lipid accumulation in the liver and the absence of alcohol consumption. Therefore, nutritional intervention may have a favorable effect in such patients. Liu et al. verify the utility of 14-deoxy-11,12-didehydroandrographolide (deAND), which is a major component of Andrographis paniculata (A. paniculata), in the experimental animal model of steatohepatitis [2]. A. paniculata is a kind of herb, and it is usually used as a traditional Chinese medicine for colds and diarrhea. It is of interest that the administration of deAND attenuates steatohepatitis in mice via the promotion of antioxidant and anti-inflammatory enzymes or proteins, suggesting that A. paniculata is a potential candidate for use in the treatment of NAFLD. On the other hand, the study by Nishiyama et al. largely highlights the alteration of gut microbiota in the experimental animal model of nonalcoholic steatohepatitis (NASH) after the administration of Bofutsushosan, a Japanese traditional medicine [3]. This medicine has often been prescribed to patients with obesity and obesity-related diseases. The authors demonstrate that the administration of Bofutsushosan formed a cluster of the gut microbiota that was significantly different from that in the control, and also resulted in an improvement in the biochemical liver enzymes and histological improvement in the liver, including reduced cellular lipoid accumulation, hepatocyte ballooning, and inflammatory cell infiltration. This medicine markedly increases the population of Akkermansia muciniphila, which has beneficial effects on various kinds of metabolic abnormalities, in the gut microbiota.

Savic et al. overview the clinical relevance of L-carnitine in patients with NAFLD. L-carnitine plays a crucial role in transporting fatty acids into mitochondria for β-oxidation and exporting excess acetyl-CoA from the mitochondrial matrix [4]. Therefore, L-carnitine deficiency is likely to impair fatty acid oxidation and subsequently cause triglyceride accumulation in the liver. Supplementation with L-carnitine may be a promising strategy as a novel treatment for NAFLD.

Recent advances in molecular biological technologies have enabled us to demonstrate that the alteration of genomics, epigenetics, microRNAs, and/or microbiota is involved in the development of nutritional disorders. Another goal of this Special Issue was to elucidate the novel mechanism of liver damage caused by the alteration of nutrition status, taking advantage of these molecular biological technologies. Mori et al. explore the effects of dietary iron overload on chemically induced liver injury in mice [5]. The dietary iron overload leads to iron deposits in the periportal hepatocytes of mice. Hepatic lipid peroxidation and hepatocellular DNA damage are increased in iron-overloaded mice that have been administrated with allyl alcohol, while they are decreased in iron-overloaded mice administrated with carbon tetrachloride (CCl₄). These results imply that iron-overloaded livers may alter the susceptibility to drugs or chemical agents.

Kamada et al. document the clinical significance of the serum Mac-2 binding protein (M2BP) level in patients with fatty liver [6]. M2BP is a glycoprotein that contains seven potential N-glycosylations. Serum M2BP levels have been identified as a valuable hallmark for liver fibrosis. Surprisingly, serum M2BP levels were significantly correlated with serum triglyceride and alanine aminotransferase (ALT) levels, as well as body mass index (BMI), while they were negatively correlated with the high-density lipoprotein cholesterol (HDL-C) level in patients with fatty liver. However, the serum M2BP level was not significantly correlated with the FIB4-index, another indicator of liver fibrosis, in such patients. These data indicate that the synthesis of M2BP may be primarily associated with hepatic inflammation and an abnormality of lipid metabolism in the enrolled patients.

The review article by Zhou et al. overviews the impairment of autophagy and the initiation of endoplasmic reticulum (ER) stress in the pathogenesis of NAFLD [7]. The authors find that high fat and/or carbohydrate intake may trigger the impairment of autophagy and the initiation of ER stress in such patients. They also mention the putative mechanism by which high fat and/or carbohydrate consumption results in these phenomena.

The next review article by Uchida et al. reveals that oxidative stress has been recognized as a cancer-initiating response, while it can also become an anti-cancer agent that regulates the proliferation of cancer cells [8]. In the cancer stage, oxidative stress usually participates in a favorable response under treatment with molecular-target agents, such as sorafenib, regorafenib, or lenvatinib. This review article largely highlights these paradoxical effects of oxidative stress in the pathogenesis of chronic liver diseases, including carcinogenesis.

Finally, we summarize the current trends of essential trace elements in chronic liver diseases [9]. This review article primarily focused on the close correlation between the development of chronic liver diseases and metabolic abnormalities related to four essential trace elements: zinc, copper, selenium, and iron. We also introduce novel mechanisms by which an excess or deficiency of these trace elements leads to the development of chronic liver diseases.

In conclusion, this Special Issue provides many novel insights into how diet and nutrition can affect liver diseases for the readers of Nutrients. As a guest editor, I greatly appreciate the authors who submitted articles to this Special Issue and the reviewers who gave valuable feedback to the authors.

This research received no external funding.

The author has no conflict of interest to declare.

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.

1. Neag M.A., Catinean A., Muntean D.M., Pop M.R., Bocsan C.I., Botan E.C., Buzoianu A.D. Probiotic Bacillus spores protect against acetaminophen induced acute liver injury in rats. Nutrients. 2020;12:632. doi: 10.3390/nu12030632. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

2. Liu Y.T., Chen H.W., Lii C.K., Jhuang J.H., Huang C.S., Li M.L., Yao H.T. A diterpenoid, 14-deoxy-11,12-didehydroandrographolide, in Andrographis paniculata reduces steatohepatitis and liver injury in mice fed a high-fat and high-cholesterol diet. Nutrients. 2020;12:523. doi: 10.3390/nu12020523. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

3. Nishiyama M., Ohtake N., Kaneko A., Tsuchiya N., Imamura S., Iizuka S., Ishizawa S., Nishi A., Yamamoto M., Taketomi A., et al. Increased Akkermansia muciniphila by a diet containing Japanese traditional medicine Bofutsushosan in a mouse model of non-alcoholic fatty liver disease. Nutrients. 2020;12:839. doi: 10.3390/nu12030839. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

4. Savic D., Hodson L., Neubauer S., Pavlides M. The importance of the fatty acid transporter L-carnitine in non-alcoholic fatty liver disease (NAFLD) Nutrients. 2020;12:2178. doi: 10.3390/nu12082178. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

5. Mori M., Izawa T., Inai Y., Fujiwara S., Aikawa R., Kuwamura M., Yamate J. Dietary iron overload differentially modulates chemically-induced liver injury in rats. Nutrients. 2020;12:2784. doi: 10.3390/nu12092784. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

6. Kamada Y., Morishita K., Koseki M., Nishida M., Asuka T., Naito Y., Yamada M., Takamatsu S., Sakata Y., Takehara T., et al. Serum Mac-2 binding protein levels associate with metabolic parameters and predict liver fibrosis progression in subjects with fatty liver disease: A 7-year longitudinal study. Nutrients. 2020;12:1770. doi: 10.3390/nu12061770. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

7. Zhou X., Fouda S., Li D., Zhang K., Ye J.M. Involvement of autophagy-ER stress axis in high fat/carbohydrate diet-induced nonalcoholic fatty liver disease. Nutrients. 2020;12:2626. doi: 10.3390/nu12092626. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

8. Uchida D., Takagi A., Oyama A., Adachi T., Wada N., Onishi H., Okada H. Oxidative stress management in chronic liver diseases and hepatocellular carcinoma. Nutrients. 2020;12:1576. doi: 10.3390/nu12061576. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

9. Himoto T., Masaki T. Current trends of essential trace elements in patients with chronic liver diseases. Nutrients. 2020;12:2084. doi: 10.3390/nu12072084. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

Articles from Nutrients are provided here courtesy of Multidisciplinary Digital Publishing Institute (MDPI)

Hepatitis C diet

03/22/2020

Viral hepatitis C (HCV) is a viral infection, with a predominant lesion of the liver, a tendency to a chronic course, with the development of liver cirrhosis, primary hepatocellular carcinoma.

Healthy nutrition is an important part of feeling great on the road to recovery.

The diet in the treatment of hepatitis C helps to accelerate the recovery of functions, the structure of the liver, and has a positive effect on metabolism.

Indications for the presented diet therapy:

acute hepatitis, chronic hepatitis, liver cirrhosis, hepatocellular carcinoma.

The diet for hepatitis C in adults limits the use of foods that cause fermentation in the intestines, active bile secretion.

Therefore, it is necessary to minimize the consumption of fats, soybeans, it is recommended to boil, bake, periodically stew, frying is prohibited!

Any kind of alcohol is strictly excluded!

It is advisable to switch to fractional meals 4-5 times a day.

This table provides a list of foods that need to be included or excluded from daily nutrition.

The menu takes into account the content of proteins, carbohydrates (with a slight decrease), fats (limited), vitamins, microelements.

The daily diet includes eating every three hours in small portions, in a calm atmosphere, before going to bed – kefir (1% -2%).

Monday

Breakfast: a plate of buckwheat, toast, mozzarella cheese (70 gr. ), tea.

3 hours later – apple dessert with quinoa (a cup of quinoa, an apple, 1/4 cup of milk, honey, 5 g butter).

Lunch: a bowl of soup (zucchini, broccoli, carrots, a spoonful of sour cream), turkey breast, bulgur, dried strawberry jelly.

Snack – marmalade (4 pcs.), Tea

· Dinner: a portion of wild rice, baked fish, avocado sauce / white sauce, 1/2 cucumber, 2 toasts, peach compote.

Tuesday

Breakfast: a bowl of oatmeal, a piece of boiled turkey, white sauce, tea.

· After 3 hours – sweet pumpkin pudding, fruit drink.

Lunch: a bowl of vegetable soup (carrots, tomato slices, rice), wheat croutons, buckwheat, veal, fresh cucumber, jelly.

· Snack-: fruit salad (apple, banana, tsp jam).

Dinner – dried fruits, cottage cheese, seasoned (optional) with yogurt / a spoonful of sour cream, chamomile decoction.

Wednesday

breakfast: millet porridge, a slice of turkey meat, rosehip broth.

After 3 hours – pieces of dried melon, yogurt, apple compote.

· Lunch: French soup (pumpkin, potatoes, celery, olive oil – a few drops, milk 30 ml), wheat croutons, zucchini rolls stuffed with minced chicken, toast, compote.

Dinner: cottage cheese and blueberry casserole, chamomile decoction.

Thursday

· breakfast: puffed omelet, rice (butter 5 gr.-optional), tea.

After 3 hours: cottage cheese, dried berries, a spoonful of sour cream (optional), compote.

Lunch: carrot puree soup, wheat croutons, mashed potatoes, three veal meatballs, grated beets, olive oil (a few drops), juice.

· Snack: six crackers, apple jam, yogurt, berry jelly.

· Dinner: shrimp pasta, broccoli, avocado sauce, grated cheese (optional), chamomile tea.

Friday

· Breakfast: salad (vegetables, apple, pieces of veal), tea.

· after 3 hours – carrot pudding (add yogurt, strawberry jam).

Lunch: soup (carrots, zucchini, potatoes, 20 ml of milk), rye croutons, broccoli, baked fish seasoned with white sauce (optional), fruit drink.

· Snack – milk peach jelly, berry compote.

Dinner – buckwheat (optional – 5 g of butter), steamed turkey, toast, a slice of cheese, chamomile decoction.

Saturday

· Breakfast: boiled potatoes, two or three meatballs (milk sauce optional), two toasts, tea.

· after 3 hours: 6 slices of dried melon, a glass of water.

Lunch: vegetable soup with broccoli, wheat croutons, pasta (avocado slice, squid, cheese, seaweed), compote.

· Snack – marshmallows 2-3 pieces, fruit drink.

dinner – 4 cheesecakes, a spoonful of sour cream / jam, chamomile decoction.

Sunday

· Breakfast: one baked potato with white sauce, two chicken cutlets, toast, tea.

After 3 hours: one grated carrot with a spoonful of berry jam or honey.

Lunch: beetroot (you can add a spoonful of sour cream), a bun on unleavened dough, bulgur, rabbit meat, cucumber and tomato salad ..

· For an afternoon snack: a baked apple, sprinkle with pieces of dried apricots, cottage cheese, honey 1 tsp, jelly.

Dinner – Couscous (with sugar syrup / jam and prunes), berry compote.

An individual approach to therapeutic nutrition allows you to achieve an improvement in the general condition of the patient and increase the effectiveness of other

types of treatment.

Author: resident doctor of the University Clinic H-Clinic Pushik Elena Pavlovna

Medical editor: Head of the University Clinic, PhD, infectious disease doctor Danila Sergeevich Konnov

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Hepatitis E: symptoms, diagnosis and treatment

Hepatitis E is an infectious disease that affects the liver. Its causative agent is a virus that contains an RNA molecule. The danger of infection lies in the defeat of the entire structure of the liver, which is accompanied by severe acute symptoms and puts the patient’s health at risk. The disease is often diagnosed in people under 30 years of age. The causative agent enters the body by the fecal-oral route through the excrement of a sick person.

The structure of the virus is destroyed under the influence of low and high temperatures, disinfectants from the halogen group, but has the ability to remain in fresh water for a long time. Outbreaks of the disease are observed in the warm season, when climatic factors are favorable for the vital activity of the virus. In the winter season, it is almost never found. Epidemics occur in hot, overpopulated areas with unfavorable sanitary and hygienic conditions, when contaminated faeces enter the drinking water. At risk are residents of territories where hostilities are taking place, refugees, persons in places of deprivation of liberty, residents of settlements without running water and sewerage. Age binding of the disease – persons 10-30 years old.

Ways of transmission

The main cause of infection is the use of raw water, which got into the feces of a sick person. Less commonly, there are cases when the virus enters the body through poorly processed animal meat or raw shellfish that live in fresh water. Their ability to carry the virus and serve as a source of infection has been proven in numerous laboratory studies. Transfusion of infected donor blood to a healthy person will invariably cause the disease of the latter. Also, the virus is characterized by a transplacental method of transmission of the virus from a sick mother to the fetus. In isolated cases, the causative agent of hepatitis E enters the body through dirty hands, poorly washed vegetables and fruits.

The presence of RNA without an envelope in the structure of the virus makes the pathogen vulnerable to any temperature effects – both hypothermia and heating. The conditions of stay in fresh water are relatively favorable for him, contributing to intensive reproduction. The risk of infection increases due to the asymptomatic course of the initial stages of hepatitis E. A person who does not feel signs of pathology leads a normal life, but his feces contain a significant amount of the pathogen and can cause infection of another person. Carriers can be detected in only 20% of infected individuals, while diagnosis due to pronounced symptoms increases this level to 50%.

Symptoms of viral hepatitis E

The disease is characterized by a long incubation period, when the pathology does not betray its presence in the body. In some cases, symptoms did not appear within 50-70 days after the fact of infection. In children, the signs of the disease are mild, in young and middle-aged patients they are more often obvious. Among the most characteristic symptoms of the so-called preicteric period are weakness, loss of appetite and nausea. In the next, icteric phase, patients complain of:

• increased body temperature up to 38 degrees;
• soreness of the stomach and right hypochondrium;
• staining of the mucous membrane and skin in an icteric shade;
• Darkening of the urine and lightening of the stool.

On palpation, there is an increase in size and softening of the structure of the liver. If the disease is severe, there may be signs of internal bleeding, traces of blood in the urine, symptoms of bleeding in the uterine cavity and organs of the gastrointestinal tract. After a few weeks, all of these factors disappear, and normal laboratory tests are noted a month or two after infection.

If the hepatitis E virus attacked the body of a person with a weakened immune system, among the characteristic symptoms there is a feeling of dry mouth, an apathetic state, and a short pain in the back of the head. During the so-called prodromal period between incubation and the main stage, the patient may notice:

• problems with orientation in space;
• tremor, permanent freezing;
• feeling of aggression or depression;
• deterioration of mental activity;
• fluctuations in body temperature;
• sleep disorders, insomnia.

At the clinical stage of hepatitis E, all signs of liver damage are noted: an increase in the size of the organ, stool disorders with a change in its color, a feeling of heaviness and bloating, and yellowness of the skin. The patient loses his appetite, there is pain in the right hypochondrium and darkening of the urine.

In a separate category, the so-called fulminant form of hepatitis E was identified. Its main symptom is a sharp increase in blood pressure in the portal vein, which serves as a form of protection of the body from harmful substances penetrating the liver. This disease can manifest itself in the form of pathologies such as:

• abdominal dropsy;
• intestinal hemorrhage;
• hepatic dystrophy;
• arrhythmia;
• marked swelling of the extremities;
• protrusion of a network of veins on the skin.

The prognosis for this form of hepatitis E in most cases is unfavorable.

When to see a doctor

Self-medication for hepatitis E is a serious mistake, the consequences of which are unpredictable. Your best assistant in the fight against the symptoms of the disease will be a competent infectious disease specialist – a highly qualified doctor with vast experience. Through his efforts, a treatment course will be developed that guarantees the elimination of unpleasant signs of the disease and the return of lost health.

Complications

Under the condition of timely diagnosis and treatment, the course of which is developed by competent specialists, liver cells are completely restored. Moreover, for this disease, there were no cases of transition to the chronic stage. The exception is women during pregnancy. Infection usually leads to spontaneous miscarriage and serious health complications for the expectant mother.

In immunocompromised patients, hepatitis E can cause serious complications, including:

• lack of liver enzymes;
• hypertension;
• cirrhosis;
• hepatic tissue atrophy;
• bleeding in the digestive tract.

These complications can lead to death if left untreated.

Diagnostics

With a high degree of accuracy, the presence of the hepatitis E virus in the body can be established by such forms of laboratory and instrumental studies as:

• blood test for specific immunoglobulins IgM and IgG;
• PCR reaction to detect traces of viral infection RNA;
• coagulogram to clarify the parameters of blood clotting;
• liver tests;
• ultrasound and magnetic resonance imaging of the liver.

Treatment

The basis of treatment is nutrition according to the dietary table No. 5 and No. 5a, respectively, for patients with acute or chronic liver diseases. It is recommended to eat five times a day in small portions with a predominance of foods containing a significant amount of fiber.

The drug course involves symptomatic treatment designed to alleviate the patient’s condition. With a deterioration in well-being, hospitalization with a stay in the intensive care unit is possible. An additional measure is detoxification of the body in the form of intravenous infusions to remove decay products. As a dropper substance, glucose or saline solution with calcium and magnesium is used.

Prophylaxis

In the vast majority of cases, the probability of infection depends only on external conditions, and a person cannot foresee the risk of becoming a carrier of the infection. However, it is in his power to do everything necessary to minimize possible contact with pathogenic microorganisms. If there is a threat of infection, you should:

• change living conditions;
• take care of high-quality purification of drinking water;
• carefully handle food;
• give up bad habits;
• engage in physical education.

If there is a risk of mass infection, the population is vaccinated. Also, vaccination is recommended for pregnant women from areas that are unfavorable in terms of sanitary and hygienic conditions.

How to make an appointment with an infectious disease specialist JSC “Medicina” (clinic of Academician Roitberg)

You can make an appointment with the infectious disease specialist of JSC “Medicina” (clinic of Academician Roitberg) on ​​the website: an interactive form allows you to select doctors from the general list of specialists and set the date of the visit.

Our clinic is located on the territory of the central administrative district of Moscow at the address: 2nd Tverskoy-Yamskoy lane, building 10.