Diet

A healthy and well-balanced diet is essential for general good health. The food we consume is responsible for providing us with energy, as well as maintaining and repairing our bodies. It also influences our immune system and our body's response to disease or illness. Although it may be over a very long period of time, in due course an untreated hepatitis C infection will most likely begin to damage your liver. As a result of this your dietary needs may change.

A bad or unhealthy diet can hinder good health and our body’s immune function. The role diet plays in conditions such as coronary heart disease and stroke is well documented. Less well documented is the role diet plays in liver disease. As all foods and fluids must pass through the liver to be metabolised, diet must play an important role.

The most appropriate diet depends on a number of factors. These include age, weight, extent of liver damage, and your symptoms. It is well worth discussing these factors with a dietician (you can ask your GP or consultant for a referral to a dietician). There are some basic changes you can make yourself to your diet that could also help protect your liver.

The most important change that you could probably make at this stage would be the exclusion of any substances that may be harmful to the liver. In particular this refers to alcohol and foods high in fat content, especially saturated fats. Your doctor will be able to advise you about hepatotoxic drugs.

Food to include in your diet

  • Fresh fruit and vegetables.
  • Complex carbohydrates.
  • Adequate amounts of protein.
  • Foods rich in fibre.
  • Foods low in fat.

Foods to avoid

  • Fried foods.
  • Fatty foods especially saturated and hydrogenated fats.
  • Processed food and junk food.
  • Foods containing additives and pesticides.

Protein

Protein is necessary for the building and maintenance of muscle, and the repair and healing of the body. 60-120 grams of protein per day 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 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 to 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 information labels.

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 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 needs 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.

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.

Great leafy vegetables to eat include kale, spinach, cabbage and sprout tops.

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

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  not the same as being overweight. To read about how being overweight can affect people with hepatitis C, go to our health page.

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  so it accumulates in the organs and tissues, including the liver.  Multivitamin tablets often include iron, so check the label.

Vitamin C increases the absorption of iron from food.

Coffee and 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 a one-third reduction in advanced scarring, but higher intake is not believed to produce a further benefit.