When you discover you are Hepatitis C positive

Keeping your body in optimum nutritional health is your primary goal. This involves attention to several components of your daily diet.

What should my daily diet be like everyday?

First, if you are drinking alcohol, even moderately, you will want to stop. Not only does alcohol have a toxic effect on liver cells, it also provides no nutritional value to the diet.

Second, a diet rich in calories and nutrients on a daily basis is critical. A significant unintentional loss of body fat and body protein stores can often occur with cirrhosis (a complication of Hepatitis C) that can lead to malnutrition. Your body will have a better chance of health and survival with a well-nourished body. Therefore, prevention is the key. Eat a healthy diet following the USDA Food Guide Pyramid guidelines. (For a free copy of Dietary Guidelines for Americans,write: USDA, 1120 20th St., NW, Suite 200, North Lobby, Washington DC 20036. Or call: 202-606-8000).

Specifically for the person with Hepatitis C, the following are critical nutritional areas:

1. Adequate protein is necessary to help the body repair damaged liver tissue and everyday needs such as production of new blood cells. Meat, cheeses, milk, yogurt, tofu, dried beans and peas, nuts and seeds are the highest sources of protein. At the early stages of the disease without significant cirrhosis, you will need at least 1 gram per kilogram of your body weight (unless you are over 130% of your ideal weight). Your Registered Dietitian (R.D.) can help you discover your exact amount, but generally it will be an amount between 50 and 85 grams per day.

2. Adequate energy or calories are needed to avoid unnecessary body weight loss . Malnutrition associated with significant and severe weight loss is a frequent occurrence during latter stages of the disease and can decrease your chances of survival.(See below, "What about my weight?")

3. "Strive for five" everyday. Servings that is, of fruits and

vegetables. These provide important vitamins, minerals, and antioxidants for healthy persons as well as those carrying Hepatitis C. Scientists have discovered recently that certain nutrients and natural chemicals found in plant foods (called phytochemicals) act as "antioxidants", allowing the body to rid itself of harmful chemicals called "free radicals". These harmful "free radicals" make their way into the body through normal metabolism and through common foods. The good news is that our bodies have a weapon in the plant foods we eat as these "phytochemicals" they contain behave like powerful antioxidants "gobbling up" the destructive free radicals. Not only fruits and vegetables, but soy products, dried beans, and certain herbs and spices as well contain abundant phytochemicals. When Grandmother said, "Eat your greens!", she somehow knew you needed the health benefit found in these foods which cannot be found in a vitamin pill. Grandmother was wise.

Below are some nutrition questions asked frequently by those discovering they carry the Hepatitis C virus:

Should I use only organic produce?
There are advantages and disadvantages that must be looked at before you decide. Although organic produce is not grown with the use of pesticides, it does not necessarily mean that it is "pesticide free". That's because chemicals can enter the soil through air and groundwater contamination of nearby lands. Another disadvantage is price. Organic produce often always carries a higher price tag. You may consider growing your own produce. You not only receive the benefit of organic foods, but the pleasures and rewards of gardening as well. Whatever you choose, it is important that all fruits and vegetables be thoroughly washed with both water and a small amount of dish soap. This will allow you to avoid bacterial contamination as well as intake of unnecessary chemical residues.

Should I take multivitamin/mineral supplements?
A low-potency multivitamin and mineral supplement taken daily is

usually helpful and tolerated well during the early stages of the disease before cirrhosis develops. If you were consuming alcohol regularly, you may need additional thiamin and folate (two B vitamins) as well. Ask your RD or pharmacist to recommend the appropriate supplement to you.

What about my weight?
It is wise to begin weighing yourself monthly to keep track of any significant changes in your body weight. Keep a chart as it will help your health professionals as they evaluate your nutritional health. If you are overweight, this is not the time to follow a weight loss program unless your doctor has an overriding medical reason for you to do so. Even then, weight loss should be slow, not more than 1-2 pounds lost per week on a highly nutritious plan that includes all food groups. Your doctor can recommend that you see a Registered Dietitian (R.D.) for this.

If you are currently underweight, an R.D. can also make specific dietary recommendations based on your individualized nutritional assessment. Many times dietary supplement drinks and single nutrient powders can be of help without causing you to feel "stuffed" and uncomfortable. Supplement drinks modified in certain nutrients are also available. These "disease- specific" supplements promote optimum nutrient absorption and avoidance of uncomfortable gastrointestinal symptoms that can occur with more advanced disease.

I've read about certain vitamin and herb preparations that can help. Do they really work?
Be cautious about inflated, almost miraculous claims to cure or slow down Hepatitis C with the use of one or numerous herbal or vitamin/mineral combinations. Although there may indeed be benefit in using certain herbs, there are as yet no sound, well-controlled scientific studies to prove many claims made on them. Some herbs are actually toxic to the liver. It's sad to say, but people with incurable disease often fall prey to quackery which promises more than it can deliver at an often high price tag. Refer to What about herbs and vitamins? for more specific information and further resources.