The diet dilemma and hepatitisC.pdf
http://www.hepatitisc.org.au/edu/documents/ThedietdilemmaandhepatitisC.pdf
The diet dilemma and hepatitis C: separating fact from fallacy
By Simon Sadler, Dietitian, Albion Street Centre.
Introduction
What is a healthy diet
The five food groups
Low protein diets
Sugar
Alcohol
Dairy
Juice
Caffeine
Further information
Introduction
For people living with hepatitis C, HIV and some other chronic diseases the dilemma of nutrition can be particularly confusing. The purpose of this page is to examine healthy eating and hepatitis C (HCV)/HIV co-infection and dispel a number of the dietary myths surrounding nutrition and HCV.
What is a healthy diet?
Dietary advice should be based on individual circumstances and will depend on any symptoms being experienced at a particular time. In general terms a healthy or 'balanced' diet consists of a regular meal plan that incorporates foods from each of the five food groups. This also means eating a variety of foods from within each group, for example, trying to include three different coloured vegetables in your main meal. If someone is not experiencing any symptoms relating to infection or medication, a balanced diet is usually sufficient to meet the bodies needs.
Following a regular meal plan provides your body with a constant supply of 'macronutrients' such as protein, fat and carbohydrate and 'micronutrients' such as vitamins and minerals. This prevents large swings in metabolism, which is important for weight maintenance and other factors such as mood.
The five food groups are:
Bread, cereals, rice, pasta, noodles
Vegetables
Fruit
Milk, yoghurt, cheese
Meat, fish, poultry, eggs, legumes (beans) and nuts
It is also important to eat a variety of food regularly, as the food we eat contains a number of other important substances that nutrition scientists are still learning about. These substances have important interactions with each other as well as the vitamins, minerals, proteins, fats, and carbohydrates. Eating a variety of foods, rather than relying on vitamin and mineral supplements, will ensure a balanced intake of all nutrients.
A recent survey of people living with hepatitis C found that many people were following some form of dietary restriction that was often difficult to implement and not supported by any evidence. Following is a few examples of common dietary questions.
Should I follow a low protein diet?
No. Protein is important in the growth and repair of nearly every structure in the body including the liver and the immune system. A diet that is low in protein may reduce your body's ability to grow or maintain cells.
What about sugar?
There is no published scientific evidence to suggest that people with hepatitis C have problems metabolising sugar. The most important consideration is to maintain good oral hygiene, by brushing after every meal and visiting a dentist regularly.
Can I drink alcohol?
Opinions about alcohol intake and hepatitis C vary greatly. Some researchers believe that alcohol and hepatitis C work together to damage the liver and recommend people with hepatitis C avoid drinking altogether. This is particularly true for those seeking drug treatment for HCV or awaiting a liver transplant.
Many health care professionals advise clients to consult the Commonwealth Department of Health Alcohol Guidelines. These contact specific advice for people with health conditions, including hepatitis C (see below).
Can I eat dairy foods?
Yes. There is no justification for avoiding dairy foods. Milk and milk products are inexpensive and provide a source of calcium, riboflavin, protein and other nutrients. Some people with high cholesterol levels should choose low fat dairy foods. Other 'full fat' dairy products can be used in moderation as part of a balanced diet.
Should I be drinking juices?
A common misconception is that diets should include large quantities of fruit and vegetable juices. Juicing fruits and vegetables concentrates nutrients, combining to form levels much greater than our daily requirement.
Large amounts of certain substances such as B-carotene (precursor of vitamin A found in carrot juice), and oxalic acid (spinach and beetroot juice) have been shown to be toxic to the liver in large doses.
Can I drink tea and coffee and other caffeine containing food/drinks?
If consumed in moderation there is no evidence to suggest that people living with hepatitis C should not consume caffeine-containing drinks. Recommendations on quantities are given in terms of actual amount of caffeine in milligrams as the caffeine content of a drink (such as coffee) varies greatly depending on how it is brewed. The general recommendation for a safe level is less than 600mg, and 200mg during pregnancy.
Drink/Food
Caffeine content
Coffee Percolated
60-100 mg per cup
Coffee Instant
80-350 mg per cup
Tea (Teabag)
8 - 90 mg per cup
Chocolate Bar (200g)
20 - 60 mg
Cola Drink
35 mg per 250ml serve
Where can I get more information?
The information outlined in this page comes from a group of health care professionals from Royal Prince Alfred Liver Transplant Unit, the Albion Street Centre and the Hepatitis C Council. For more information about diet and hepatitis C contact a dietitian in your area or check out a few of the websites below:
www.daa.asn.au
www.sesahs.nsw.gov.au/albionstcentre/clinical/nutrition/hepc.asp#4
www.haemophilia.org.uk/nutrition.html
www.foodwatch.com.au
http://www.alcoholguidelines.gov.au/summary.htm
