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
  
  

  Meal	Menu
  Breakfast	Dalia / suji kheer / sewian kheer (use toned milk preferably) Bread with jam Papaya / apple / any other fruit
  Mid-morning	Sprouted dal and vegetable chat
  Lunch	Vegetable khichri Curds / raita Salad
  Mid-afternoon	Fruit yoghurt / rasgulla
  Evening tea	Orange juice Paneer sandwich
  Dinner	Vegetable soup Boiled egg Rice with vegetables Salad Jelly with custard
  Bed time	Milk

  
  
  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.