Good nutrition and good health go hand in hand, and a healthful diet is especially important when you have a liver disorder like hepatitis C. The liver functions as the primary interface between your digestive system and the rest of your body. Although there is no special diet recommended for people with hepatitis C, what you eat can support or stress your liver -- and some dietary choices might make your liver disease worse. A healthful diet is an important component of your hepatitis C management plan, but nutrition alone cannot "treat" hepatitis C as it cannot cure the disease or halt its progression.
Fruit and Vegetable Cornucopia
Fruits and vegetables provide an array of vitamins, minerals and other nutrients that support your liver and immune system. Many are rich in antioxidants, compounds that neutralize potentially damaging substances called free radicals. Hepatitis C inflames your liver, leading to high levels of free radicals that contribute to liver damage. The hepatitis C virus itself also contributes to excess free radical accumulation in the liver. Including antioxidant-rich fruits and vegetables in your diet helps your liver protect itself from this source of hepatitis C-related damage. Examples of fruits and vegetables with high concentrations of antioxidants include:
-- Blackberries, strawberries, cranberries, raspberries, blueberries and sour cherries.
-- Artichokes, pinto beans, spinach, potatoes, sweet potatoes, rapini, broccoli and red peppers.
Protein is an essential component of a healthful diet. Hepatitis C provokes destruction of liver cells, which must be replaced to keep your liver functioning. This requires an adequate supply of the 20 protein building blocks, known as amino acids, which are largely supplied by dietary protein. Additionally, your immune system requires amino acids to function normally.
Complete protein foods supply the full complement of amino acids, making them a good choice for your healthful diet. Amino acids from animal-derived proteins are typically easily absorbed from the digestive tract. Healthful choices include:
-- Low- or nonfat milk, cheese and yogurt.
-- Egg whites, lean red meats, skinless poultry and fish.
Plant-derived proteins from sources such as dried beans, peas, rice and corn don't provide all the amino acids individually, but they can supply you with the protein you need if you combine them in your nutrition plan.
Nutritious Carbs and Grains
Carbohydrates -- including sugars, starches and grains -- serve as the primary fuel your body uses to generate energy. Your liver plays a critical role in processing carbohydrates and regulating sugar metabolism. The hepatitis C virus, or HCV, interferes with blood sugar regulation and frequently causes a complication known as insulin resistance. With this condition, body tissues fail to react normally to the blood-sugar-lowering hormone insulin. Insulin resistance can lead to type 2 diabetes.
Dietary choices can potentially reduce the burden of impaired blood sugar metabolism accompanying hepatitis C. While carbohydrates are an important component of a healthful diet, it’s advisable to avoid or limit high-sugar foods and beverages such as regular sodas, candies, pastries and desserts. More healthful carbohydrate food sources include fresh fruits, beans and whole-grain breads and cereals.
Limited, Healthful Fats
The liver serves a principal role in your body’s regulation and metabolism of fats. HCV can alter these processes, leading to abnormal fat accumulation within your liver cells, known as steatosis. Steatosis can accelerate liver damage associated with hepatitis C. In general, it’s helpful to avoid overwhelming a stressed liver with excessive dietary fat.
Unsaturated fats, especially monounsaturated fats, are the preferred fats if you have hepatitis C because they are least likely to promote liver inflammation. Examples of monounsaturated fats include olive, peanut, almond and canola oil. Trans fats are harmful to your liver and cardiovascular system. These fats are most frequently found in processed foods. Check the nutrition label, which includes the trans fat content. Also look at the listed ingredients for partially hydrogenated oils, another way of referring to trans fats.
Fresh Foods, Energy Balance and Alcohol Avoidance
Fresh foods are a healthful choice because they contain no additives that the liver needs to metabolize and eliminate. It’s also important not to overeat because being overweight or obese can worsen the harmful effects of HCV infection. Finally, it’s critical not to compound the negative effects of hepatitis C by consuming alcohol. HCV and alcohol both damage the liver, and the combination is particularly risky. Guidelines from the American Association for the Study of Liver Diseases and the Infectious Diseases Society of America recommend complete abstinence from alcohol for all people with hepatitis C.
There is no one-size-fits-all when it comes to nutrition. The best nutrition plan for you depends on many factors, including your weight, activity level, hepatitis C disease status and other health conditions you might have -- such as high blood pressure, heart disease, diabetes and kidney disease. A dietitian is best able to provide you with a customized nutrition plan that aligns with your health needs. Talk with your doctor about referral to a dietitian if you have nutrition concerns.
Medical advisor: Tina St. John, M.D.
- Virology Journal: Oxidative Stress and Hepatitis C Virus
- American Journal of Clinical Nutrition: Content of Redox-active Compounds (i.e., Antioxidants) in Foods Consumed in the United States
- Nutritional Sciences: From Fundamentals to Food; Michelle McGuire and Kathy Beerman
- Hepatitis C Virus: From Molecular Virology to Antiviral Therapy; Ralf Bartenschlager
- Journal of Hepatology: Facts and Fictions of HCV and Comorbidities: Steatosis, Diabetes Mellitus, and Cardiovascular Diseases
- AASLD/IDSA/IAS–USA: Recommendations for Testing, Managing, and Treating Hepatitis C: When and in Whom to Initiate HCV Therapy
- U.S. Food and Drug Administration: Final Determination Regarding Partially Hydrogenated Oils (Removing Trans Fat)
- Alimentary Pharmacology and Therapeutics: Moderate, Excessive or Heavy Alcohol Consumption: Each Is Significantly Associated With Increased Mortality in Patients With Chronic Hepatitis C
- The Encyclopedia of Nutrition and Good Health, Second Edition; Robert A. Ronzio