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Hepatitis and nutrition – HEP can’t wait!

Every 30 seconds, someone dies from a hepatitis related illness. That is 120 people per minute across the globe. In Australia alone, it is estimated that 335,000 people live with Hepatitis B or C. For those living with Hepatitis, it can cause many dietary related issues. The inflammation of the liver weakens liver function which commonly causes malnutrition, nutritional deficiencies and gastrointestinal symptoms. What you eat and drink has significant impact on the liver. Let’s find out more about Hepatitis including tips to manage your diet from a Dietitian.

Hepatitis and nutrition

What is Hepatitis?

The word hepatitis means there is inflammation of the liver. The liver is a vital organ in our body that processes nutrients, clears the blood of unwanted impurities, and fights infections. When the liver is inflamed or damaged, its function can be affected.


Types and causes of hepatitis

There are many types of hepatitis, which cause different symptoms that range from mild to very serious. Having one type of hepatitis doesn’t stop you from getting other types. The five types of viral hepatitis are:

​Hepatitis A

An illness that can last from a few weeks to 6 months. Caused by ingestion of contaminated food or water with the faeces of an infected person. Common in low to middle income countries with poor sanitation.

​Hepatitis B

A serious, chronic infection that can lead to liver damage or cancer. Caused by contaminated needles (injecting drugs, tattooing, piercing), exposure to bloody or bodily fluid of an infection person, or transmission from a mother to child at birth.

Hepatitis C

​A blood borne virus that is now easily treatable through vaccines. Caused by reused or contaminated syringes/needles in healthcare settings or contaminated syringes/needles.

​Hepatitis D

​A disease that only affects people infected with hepatitis B, and is a rarer type of hepatitis in Australia. Caused by contact through infected blood, blood products, or contaminated syringes/needles.

​Hepatitis E

​A short-term virus that is rare in Australia. Caused by contaminated drinking water, common in low to middle income countries with poor sanitation.

Signs and symptoms of hepatitis

Depending on the type of hepatitis, the symptoms vary but may include:

  • Jaundice - a yellowing of the skin and eyes

  • Fatigue

  • Nausea and loss of appetite

  • Abdominal and joint pain

  • Fever

  • Clay coloured stools

  • Dark urine

Someone with hepatitis can also present without any symptoms.


Did you know there are other types of hepatitis that are not infectious?

These include Autoimmune Hepatitis which is a chronic, long-term inflammatory liver disease. Exact cause is unknown, however is more common in individuals with pre-existing autoimmune conditions. And Alcoholic Hepatitis which can be an acute, temporary inflammation of the liver or a chronic condition that leads to permanent damage. Caused by alcohol ingestion (either heavy alcohol use or extreme sensitivity to alcohol).


Dietary and nutritional problems associated with Hepatitis

When the liver is already inflamed, in the case of hepatitis, it can lead to scarring over time, known as cirrhosis, which usually reduces liver function. The impairment of liver function can cause many dietary related issues, as the liver is one of the most important organs involved in maintaining and processing your body’s nutrition.


Malnutrition

Malnutrition is common in liver disease, particularly those with liver cirrhosis or advanced liver disease. It is related to an increased risk of mortality, higher occurrence of liver-related complications, infections and longer stays in the hospital.


Symptoms of poor appetite, feeling full quickly (due to ascites, where there is a fluid build-up in the abdomen), weakness and fatigue, can make it difficult to meet increased protein and energy requirements. Loss of muscle mass and body fat stores is common as Hepatitis progresses.


This is because the body uses energy from the breakdown of muscles to survive. However, despite being malnourished, body weight may appear normal due to the excess fluid build-up in the abdomen (ascites).


Nutritional deficiencies

Liver diseases such as hepatitis and cirrhosis may change the way our body uses nutrients from food. Deficiencies in fat-soluble vitamins, such as vitamin A, D, E and K are common. This is because when the liver is damaged, it reduces the absorption of fat eaten in your diet (fat malabsorption). Without the proper absorption of fat, fat-soluble vitamins are unable to be used and absorbed by the body.


GASTROINTESTINAL SYMPTOMS

Individuals with hepatitis often experience gastrointestinal symptoms such as nausea, vomiting, and diarrhoea, which affect both nutritional and fluid status.

Hepatitis and nutrition

6 nutrition tips for those with hepatitis from a Dietitian

If you have a liver condition, there may be some special considerations you need to make to your diet to manage your condition. Some of these are specific to certain liver diseases, while others depend on how advanced your liver disease is.


What you eat and drink has significant impact on the liver. By including foods that are easy on the liver and exclude foods that cause the liver to work harder, this can help optimise and manage symptoms of hepatitis by maintaining a healthy weight, rebuilding muscle mass, and sustaining energy levels.

A general rule of thumb is to aim for a high protein, high carbohydrate, and moderate fat diet divided in to six to eight meals.

Avoid alcohol consumption

Alcohol is a strong toxin and causes more stress on your liver. If you already have a liver condition such as hepatitis, it is even more difficult for your liver to break down these toxins. Avoid any type of alcohol.


Eat more protein rich foods

Protein is essential for repairing and replacing damaged liver cells. Choose lean proteins with foods like fish, nuts, eggs, soy, and pulses.


In the case of liver cirrhosis, it is recommended to consume foods higher in protein to reduce the risk of muscle wasting. However, try not to go overboard with consuming too much protein, as it can affect mental functioning and often causes brain fog (a condition known as encephalopathy).


See a Dietitian for personalised support, like us!


Eat Small, regular, frequent meals

One of the jobs of the liver is to store glycogen, which is used by the body for immediate energy. Usually, one can store relatively large amounts of glycogen in the liver. But when the liver is damaged, scar tissue takes away valuable carbohydrate storage space, meaning it can’t store as much glycogen as before.


Consume small, frequent meals that contain a source of carbohydrates at each meal. This allows your body to steadily replace its glycogen stores.


Consume a late-night snack

For those with liver cirrhosis, overnight fasting is discouraged to prevent further loss of muscle. A late evening snack containing about 50g carbohydrate is recommended. This gives your body the energy it needs overnight and reduces muscle loss, wastage and fatigue.

The following snacks all contain approximately 50g of carbohydrate:

  • 300ml milk and 3 plain or chocolate biscuits

  • 5 plain of chocolate biscuits

  • 2 thick slices toast with jam

  • 40g cereal with 100ml milk and chopped banana

  • 1 large pita bread with 50g hummus

Limit salt and sodium intake

Sodium raises your blood pressure and cause swelling. If you develop fluid retention (known as ascites or oedema), it is advisable to follow a low salt diet.

  • Aim to avoid adding additional salt to your food, both when cooking and at the table.

  • Try alternative flavourings, such as fresh or dried herbs and spices

  • Minimise consumption of processed foods, which typically have a higher salt content

  • Consider using Apps on your smart phone such as “Sodium Tracker” to help track sodium intake.

Food Safety is in important

One of the most common causes of Hepatitis is contamination. Some ways to prevent the risk of food contamination as much as possible include:

  • Avoid raw or undercooked shellfish, as these foods can harbour viruses and bacteria

  • Wash all meats, fruits and vegetables to remove harmful residues

  • Hand wash before and after handling foods

  • When travelling, always boil or cook food and water for more than 1 minute at 85°C to inactivate the hepatitis A virus.

How can a Dietitian help?

It is important to seek guidance from a health professional before starting any special diets. If you are experiencing symptoms such as loss of appetite, nausea, low energy levels, fluid retention in the legs or accumulation of fluid in the abdomen (ascites), you will likely need to follow a more specialised diet.


An Accredited Practising Dietitian, like us can:

  • Assess if your diet is providing adequate nutrition to meet your needs

  • Identify nutritional risks based on your current diet e.g.) sodium, protein and alcohol consumption

  • Give guidance on a meal plan appropriate for your liver condition

  • Provide advice on the use of nutrition supplements.

It is important that you talk to your doctor as well as regarding this information.

To reach out to OSCAR Care Group for personalised support through one of our Accredited Practising Dietitians, call (03) 9560 1844 or click here for more information. Our Team of Dietitians is here to help.


Celebrating World Hepatitis Day, HEP can’t wait!

World Hepatitis Day is celebrated every year on 28 July, as an opportunity to encourage engagement and highlight the need for a greater global response to this virus. The date of 28 July was chosen because it was the day that scientist Dr Baruch Blumberg discovered the hepatitis B virus and developed a diagnostic test and vaccine for the virus.


To find out more, visit https://www.worldhepatitisday.org.au/ or call the National Hepatitis Infoline 1800 437 222







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