Why do people with hepatitis C need evidence-based nutrition information?

Most people with hepatitis C will not develop advanced liver disease and their lives will not be shortened by hepatitis C. Everyone, including people with hepatitis C, can optimise their nutritional status and their resistance to infections by selecting a healthy choice of foods. The dietary recommendations for people with hepatitis C are the same as those for the general population (high fibre, reduced fat, especially saturated fat). These guidelines aim to reduce the risks of obesity, cancers, heart disease and diabetes.

Empowering people with hepatits C

People with hepatitis C do not need to follow specific dietary restrictions unless they have advanced liver disease or some other condition such as coeliac disease or diabetes that requires dietary modification.

There is evidence that people with hepatitis C who are obese or who have type 2 diabetes are at greater risk of liver damage (fibrosis) (5,6,).

Overweight people with a body mass index over 25 or a waist to hip ratio of 0.8 for women and 0'9 for men should be advised to lose weight, using diet and exercise (7).  People who have difficulty controlling their weight, increasing activity to limit further weight gain may be more achievable.

(Note: some individuals who 'work out' to develop muscle may have a body mass index over 25 without being obese. Client history and commonsense should guide health care workers’ advice to these clients).

People with advanced liver disease frequently have associated nutritional deficiencies and should be referred to a specialist dietitian at their treatment centre.

People on interferon or combination therapy frequently experience anorexia, nausea and vomiting. Significant weight loss may be a concern. People on treatment experiencing any of these problems should receive individualised advice from a dietitian. People living with HIV/AIDS should be encouraged to ask for a dietetic referral if this service has not been provided automatically.

References

Dietary Guidelines for Australians and Food Guide.  Commonwealth Dept of Health and Aged Care

Hourigan L, Macdonald GA, Purdie D, et al. Fibrosis in chronic hepatitis C correlates significantly with body mass index and steatosis. Hepatology 29:1215-1219, 1999

Mason A L, Lau J Y, Hoang N, et al. Association of diabetes mellitus and chronic hepatitis c infection. Hepatology 29: 328-333,  1999

Harley H, Shaw D and Steven I. Ongoing management of hepatitis C, Australian Family Physician 28: Special Issue, 36-38, 1999

http://www.sesahs.nsw.gov.au/albionstcentre/nutrition/hepatitis_c_evidence_based_nutrition.asp 

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