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Wednesday, December 10, 2008

Dietary Management of Hepatitis

Objectives
  • To provide adequate nutrition
  • To relieve symptoms
  • To aid in the regeneration of liver tissues
  • To prevent further liver damage

    Dietary modifications

    Energy: A high-energy diet is advised to promote weight gain and to ensure maximum protein utilization. However, initially the patient may not be able to eat enough due to anorexia. Gradually the energy intake should be increased.

    Proteins: Protein intake needs to be increased to promote regeneration of the liver. However, a very high protein load may not be tolerable and needs to be adjusted depending on the extent of liver damage.
    In acute cases, with extensive liver damage, the protein intake may have to be decreased even below normal.

    Carbohydrates: A high carbohydrate diet is recommended to meet the increased energy needs. This may be mainly in the form of carbohydrates like glucose, sugar, honey, fruits, and fruit juices and also from starches like cereals and root vegetables such as potato, carrot, radish etc.

    Fats: In case of hepatitis, the digestion and absorption of fat is impaired. Therefore, it is advisable to decrease fat intake, though not severely. In fact, inclusion of moderate amounts of fat in the diet not only increases the palatability of food but also promotes recovery.
    Emulsified fats such as fat from milk, butter, cream, eggs should be given as they are easily digested. Medium chain triglycerides present in coconut oil are better tolerated since they are directly absorbed without undergoing digestion.

    Minerals: The diet should provide all minerals, particularly calcium and iron, in adequate amounts.

    Vitamins: The requirement of vitamin A, B, C and K are increased and should be met partially by diet and partially by the help of supplements.

    Sample diet plan

    MealMenu
    BreakfastDalia / suji kheer / sewian kheer (use toned milk preferably)
    Bread with jam
    Papaya / apple / any other fruit
    Mid-morningSprouted dal and vegetable chat
    LunchVegetable khichri
    Curds / raita
    Salad
    Mid-afternoonFruit yoghurt / rasgulla
    Evening teaOrange juice
    Paneer sandwich
    DinnerVegetable soup
    Boiled egg
    Rice with vegetables
    Salad
    Jelly with custard
    Bed timeMilk


    To remember

    • Patient should be encouraged to eat.
    • Food served should be well cooked, attractive and appetizing.
    • Likes and dislikes of the patient should be kept in mind.
    • Normal to soft diet should be given in three main meals with in between snacks.
    • Avoid large meals.
    • Foods to be included: sugar, honey, glucose, cereals, pulses, milk and milk products, eggs, fruits, and vegetables.
    • Foods to avoid: fried and fatty foods, fats, oils, nuts and oilseeds, strongly flavoured vegetables and foods
    • Avoid alcohol and restrict at least for a year after the attack.

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