What Should I Do About Nutrition

Nutrition and the liver are interrelated in many ways. Some functions are well understood; others are not. Since everything we eat, breathe and absorb through our skin must be refined and detoxified by the liver, special attention to nutrition and diet can help keep the liver healthy. In a number of different kinds of liver disease, nutrition takes on considerably more importance.

Everything we eat, breathe and absorb through our skin must be refined and detoxified by the liver, so special attention to nutrition and diet can help keep the the liver healthy.

85-90% of the blood that leaves the stomach and intestines caries important nutrients to the liver where they are converted into substances the body can use.

The juice of carrots, beets, cucumber, spinach, celery , wheat grass and parsley are all used in liver cleansing fasts. So I'm assuming they're good for livers.

As for diets in particular, The Alternative Medicine Guide says:
Jonathan Wright, M.D. recommends a diet low in protein to minimize stress on the liver. Whole foods diet that follows a hypoglycemic regime, of small meals throughout the day, avoiding stressor foods such as refined sugars, alcohol, and caffeine. Consume plenty of filtered water. Drinking fresh lemon juice water every morning and evening followed by vegetable juice is one of the most therapeutic regimes for the liver. Do this consistently for two to four weeks and then several mornings a week for several months and whenever liver symptoms reoccur. Have lots of vegetables each day. Ideal is at least one salad and one meal of steamed or lightly sauteed vegetables per day. Grains that are easily digestible, such as millet, buckwheat, and quinoa are very good.

According to the Encyclopedia of Natural Medicine:
A natural diet, low in natural and synthetically saturated fats, simple carbohydrates (sugar, white flour, fruit juice, honey, etc), oxidised fatty acids (fried oils) and animal fat, and high in fibre is recommended.

Natural substances to help your liver detoxify are as close as your kitchen cupboard. Eating foods rich in lecithin (soybean), essential fatty acids (salmon, flax oil) and green leafy vegetables rich in fibre and antioxidants like vitamins C and E, are all gourmet cuisine for your liver. Lowering your intake of saturated fats, refined carbohydrates and animal protein and avoiding excessive amounts of alcohol are other recommmendations that are good both for your liver and overall body health.

Dandelion root and artichoke are both excellent spring time dietary ondiments that are very helpful in improving liver bile flow. In addition to these food choices, supplements like L-methionine are an excellent choice for a congested liver. This sulfur-containing amino acid not only improves bile flow but also helps protect liver glutathione. Glutathione peroxidase is one of the body's major detoxification enzymes and is in part defended by methionine during a toxic challenge to the liver...

The article goes on to describe the function of Milk Thistle. It ncludes that the most potent substances for protecting the liver are Milk Thistle, Dandelion and L-methionine. L-methionine is classed as a "supplement," and Milk Thistle and Dandelion as "botanical medicines." - "Protecting and Enhancing Liver Function," by Ronald G. Reichert, ND , _Alive: Canadian Journal of Health and Nutrition (#161, March 1996): pp. 14-16.

Nutrition and Cirrhosis

Any chronic liver diseases are associated with malnutrition. One of the most common of these is cirrhosis. Cirrhosis refers to the replacement of damaged liver cells by fibrous scar tissue which disrupts the liver's important functions. Cirrhosis occurs as a result of excessive alcohol intake (most common), common viral hepatitis, obstruction of the bile ducts, and exposure to certain drugs or toxic substances.

People with cirrhosis often experience loss of appetite, nausea, vomiting and weight loss, giving them an emaciated appearance. Diet alone does not contribute to the development of this liver disease.
People who are well nourished, for example, but drink large amounts of alcohol, are also susceptible to alcoholic disease.

Adults with cirrhosis require a balanced diet rich in protein, providing 2,000 to 3,000 calories a day to allow the liver cells to regenerate. However, too much protein will result in an increased amount of ammonia in the blood; too little protein can reduce healing of the liver. Doctors must carefully prescribe the correct amount of protein for a person with cirrhosis. In addition, the physician can use two medications (lactulose and neomycin) to control blood ammonia levels.

Persons with cirrhosis often experience an uncomfortable buildup of fluid in the abdomen (ascites) or a swelling of the feet, legs, or back (edema). Both conditions are a result of portal hypertension (increased pressure in the veins entering the liver). Since sodium (salt) encourages the body to retain water, patients with fluid retention can cut their sodium intake by avoiding such foods as canned soups and vegetables, cold cuts, dairy products, and condiments like mayonnaise and ketchup. In fact, most prepared foods contain liberal amounts of sodium, while fresh foods contain almost no sodium at all. The best-tasting salt substitute is lemon juice. In general, a reduction in meat protein which is the most
toxic protein to the brain and substituting vegetable protein is advised when cirrhosis is present.

Food to avoid: Shellfish if uncooked can be very dangerous to take in patients with cirrhosis. Either avoid or be careful. Vibro vulnificus, a bacteria can be contracted by eating raw oysters, etc.

Excerpts from HEPV-L's HEPATITIS C FAQ v1.0 September 13, 1996

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


 

Reviewed Feb 2004
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