What to Eat When You Have Chronic Hepatitis

Dietary Recommendations for Better Management

Basket of vegetables in grocery basket
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The goal of a hepatitis diet is to minimize stress on your liver, which is already compromised by the inflammation that defines the condition. Perhaps surprisingly, an ideal eating plan for chronic hepatitis is simply one that aligns with healthy eating guidelines for all adults provided by the U.S. Department of Agriculture (USDA). A nutritious diet can help you maintain an optimal weight and may help you to preserve healthy liver function.

While you may need to adjust your diet based on your specific diagnosis, the guiding principles of basic nutrition are likely to give your body what it needs without further taxing your liver.

Benefits

When hepatitis, of which there are several types, persists for longer than six months, it is deemed chronic. Symptoms may not develop until the condition becomes more severe, usually when liver damage has already begun.

Diet can support the liver and help manage symptoms of hepatitis. Constant fatigue is the most common one; others include diarrhea, joint pain, and trouble eating full meals. Research has demonstrated that malnutrition and loss of muscle mass become more common as the condition progresses. Some people also have a difficult time maintaining a healthy weight.

Following the eating guidelines recommended by nutritional experts and endorsed by the USDA will help you to sustain energy levels throughout the day, maintain muscle mass, and keep your body at a healthy weight. You can tweak your plan as needed to manage symptoms such as stomach discomfort as they arise.

In some people, chronic hepatitis progresses and more significant liver damage occurs. Certain nutritional adjustments may be required. For example, people with decompensated cirrhosis develop extensive liver scarring and may need to follow a special diet to accommodate a liver that can no longer function properly.

Your healthcare provider can help you determine how tailored your diet should be.

How It Works

The 2015-2020 Dietary Guidelines emphasize eating a wide variety of nutrient-dense foods—that is, those that provide great nutritional value and few calories. People are also encouraged to develop an overall pattern of healthy eating rather than focusing on single food groups.

By nature of it being a regular plan for healthy eating, a hepatitis diet is rather straightforward. That said, if following it means a drastic change in your previous eating habits, adjusting to it—like any other diet—will take some time and effort.

Duration

Since eating for chronic hepatitis is no different than eating for optimal health, it's important to think about adopting the healthy eating pattern for life.

Even if you don't experience hepatitis symptoms or issues like loss of muscle mass or malnutrition, a healthy diet will help you improve your wellness and prevent other chronic diseases, such as heart disease and diabetes.

What to Eat

Compliant Foods

  • Vegetables

  • Fruits

  • Grains

  • Fat-free or low-fat dairy

  • Protein foods

  • Coffee

  • Healthy fats

Non-Compliant Foods

  • Saturated fat

  • Trans fat

  • Excess sodium

  • Excess sugar

  • Excess iron

  • Alcohol

Fruits and vegetables: Fruits and vegetables provide your body with vitamins and minerals important for a healthy body. Consuming these fiber-rich foods may also help you decrease your intake of less healthy foods, such as fatty meats or sugary treats, as they are quite filling.

Consumption of leafy green vegetables, in particular, may provide benefits to those managing hepatitis. Studies have shown that these can lessen the fatty acid composition in your liver.

Grains: Foods in the grain category include bread, pasta, rice, and oats. Dietary guidelines suggest that at least half of the grains you consume be whole grains, rather than refined grains (such as white bread, white rice, or white pasta). Whole grains help boost your protein intake, which can help you to maintain muscle mass.

Protein foods: Consuming the right amount of protein is important when you have chronic hepatitis. Eating enough protein can help you to avoid malnutrition and muscle wasting. But consuming too much protein can lead to complications including a condition known as encephalopathy. Experts advise that you consume 1 to 1.5 grams of protein per kilogram (kg) of body weight (1 kg equals about 2.2 pounds). Lean meats, milk, nuts, and cheese are all good sources of protein.

Coffee: Studies have shown that drinking a caffeinated beverage like coffee reduces the risk for advanced liver scarring in people with chronic hepatitis. So far, evidence suggests that consuming two large cups of coffee—or about 100 milligrams (mg) of caffeine—is associated with a significant reduction in advanced scarring.

Healthy fats: Dietary guidelines advise that you consume less than 10% of calories per day from saturated fats and eliminate trans fats completely. They suggest that you replace both of these with healthier fats. Saturated fats are found in red meat and full-fat dairy products. Trans fats (partially hydrogenated oils) are being gradually eliminated, but you may occasionally still find them in some foods including fried snack foods or processed baked goods.

Healthy plant-based fats such as olive, sunflower, or avocado oils provide polyunsaturated and monounsaturated fatty acids that are associated with health benefits including a reduced risk for heart disease. However, all fats and oils should be consumed in moderation.

Consuming too much fat can lead to problems, especially for those living with chronic hepatitis, including fatty deposits in the liver, fatty inflammation, and fatty cirrhosis.

Excess salt: Per the USDA's guidelines, a healthy eating pattern limits added sodium/excess salt. Heavily processed foods, including snack foods, fried foods, convenience foods, and microwavable meals often are what put someone over the limit, which is 2,300 mg a day for most people. (Ideally, you should consume less.)

If chronic hepatitis progresses to liver cirrhosis, there can be an accumulation of fluid in the abdomen, a condition called ascites. People with ascites should restrict their sodium intake to less than 1000 mg per day.

Excess sugar: Nutrition experts are increasingly concerned about added sugars contained in many popular foods. As such, nutritional guidelines suggest that you consume less than 10% of calories a day from added sugars, which are often found in sweetened sodas, juice drinks, and other sugary treats.

People with hepatitis should be especially careful to consume sugar in moderation. Studies have shown that hepatitis is associated with an increased risk of diabetes. Reducing your intake of added sugar can help to decrease this risk.

Excess iron: The liver plays a key role in the metabolism and excretion of iron. Some people with chronic hepatitis aren't able to release iron properly from the body and may experience iron overload, increasing the risk of tissue damage in the liver. For this reason, people with chronic hepatitis may need to reduce the amount of iron-rich foods in their diets. These foods include red meat, liver, oysters, lentils, apricots, and iron-fortified cereals. 

However, iron is an essential part of your diet, so do not cut it out entirely. It is also important to note that vitamin C increases the absorption of iron from food. If you've been advised to reduce your iron intake, you may also need to reduce your intake of foods that are high in vitamin C, like citrus fruits, strawberries, kale, and broccoli.

You may also want to speak to your healthcare provider before taking a multivitamin, as most contain both nutrients.

Alcohol: Alcohol consumption causes increased stress on your liver and can put you at higher risk for liver damage. If you have chronic hepatitis, experts advise that you avoid alcohol.

Recommended Timing

There is no specific meal timing pattern recommended for those with chronic hepatitis. But many people with the condition prefer to consume small frequent meals rather than two to three large meals each day to maintain energy levels.

One of the jobs of the liver is to store glycogen, which is used by the body for immediate energy. Most people can store relatively large amounts of glycogen in their livers, but when the liver is damaged, scar tissue takes away valuable storage space. As a result, the liver can't store as much glycogen as it once could.

Consuming small, frequent meals (making sure to include carbohydrates) allows your body the chance to replace its glycogen reserves on a steady basis.

Cooking Tips

There are several healthy cooking tips that may be especially helpful for you when managing chronic hepatitis:

  • Use low-fat cooking methods: One important function of the liver is to produce bile, which the body uses to process dietary fats. However, depending on the damage to your liver, you might not be able to prepare enough bile to properly process a meal that's high in fat. As a result, you might suffer indigestion. One solution is to eat lower-fat foods (such as fruits, vegetables, and low-fat dairy). You can also use lower-fat methods to prepare your food. Roast or grill lean meats, veggies, and seafood. Many cooks use applesauce instead of butter in baked goods or use non-stick cooking spray instead of oils when cooking.
  • Add flavor without sodium: Use fresh herbs and spices to add flavor to your meals without adding salt. You might also be able to flavor your food with citrus or vinegar. Some seasoning blends may also be helpful, but be careful to read labels. Certain brands use salt as a primary ingredient in their blends and may not be as helpful in lowering your sodium intake as you might hope.
  • Learn to make healthy juices or smoothies: Some hepatitis support organizations suggest you drink homemade juices when you aren't comfortable consuming whole meals. Juice doesn't provide the same health benefits as eating whole fruits or vegetables, but it can provide quick energy and some vitamins and minerals. Keep in mind that store-bought juices and smoothies may contain added sugars.
  • Do some prep work: There may be days when you are too tired to prepare a full meal. On those occasions, you might be tempted to make less nutritious, but more convenient, choices. Try to take advantage of your higher-energy days and prepare meals and snacks in advance. Make healthy, "quick-grab" selections like veggies sticks and hummus or fruit slices with peanut butter. You can also prepare full meals (e.g., chicken breast with vegetables and brown rice) to be stored in the refrigerator or freezer and reheated.

Modifications

Those who follow special diets and have been diagnosed with chronic hepatitis can still adhere to the healthy eating recommendations provided by the USDA with simple modifications.

For example, health experts suggest that vegetarians and vegans increase the consumption of soy products (particularly tofu and other processed soy products), legumes, nuts, seeds, and whole grains when meat, poultry, and seafood are eliminated.

If you follow a gluten-free diet, choose grains such as quinoa, oats, millet, or buckwheat that don't contain the allergen.

Considerations

While most experts simply recommend that you follow basic nutritional guidelines when managing chronic hepatitis, there are a few considerations to take into account.

Calories

In order to maintain your energy, it is important that you consume the right number of calories each day. You can work with your healthcare provider and get a referral to a registered dietitian who can provide personalized recommendations.

You can also use a calorie calculator to make sure that you are getting the right number of calories each day. Calorie estimates are based on your age, gender, and activity level.

General Nutrition

Some people with chronic hepatitis, especially those with alcoholic hepatitis or advanced cirrhosis, may not be getting enough of the fat-soluble vitamins and necessary minerals they need.

Some people are able to get these vitamins and minerals by making adjustments to their diet, but others may need physician-prescribed supplements. Follow-up with any testing that your doctor recommends to check your levels, and avoid taking any supplements without your doctor's OK, as some may contain ingredients that are harmful to your liver.

Toxins

The liver has an amazing capacity to keep doing its job even while damaged, but eventually, too much damage will reduce liver function. Therefore, it's in your best interest to reduce its exposure to toxins such as:

  • Unnecessary medicines: Even though medicines are beneficial, they are still toxic chemicals that must be processed by your liver. It's important to follow your doctor's advice and take the medicines that you need (as directed) and avoid the ones that you don't. Check with your doctor before taking any new medication.
  • Pesticides and herbicides: Though these can be absorbed through your skin, they are still toxins ultimately processed by the liver.
  • Household chemicals: We use chemicals daily, sometimes without a second thought. People with chronic hepatitis should take extra caution to reduce exposure to these through fumes, ingestion, and skin absorption.
  • Tobacco products: Studies have found that there is an interactive effect between cigarette smoking and different types of hepatitis. For that reason, smoking is not advised if you have been diagnosed with chronic hepatitis.
  • Recreational drugs: The use of recreational drugs can significantly impair your energy levels and your health in general. As such, they should be entirely avoided.

Exercise

There is limited research investigating the relationship between exercise and chronic hepatitis. While the USDA guidelines suggest that regular physical activity can help people achieve and maintain good health and reduce the risk of chronic disease, the diminished energy levels experienced by many who have chronic hepatitis can make regular physical activity challenging.

However, if energy levels allow, studies suggest that patients with chronic hepatitis can and should enjoy regular physical exercise limited only by symptoms.

A Word From Verywell

Healthy eating recommendations are important for everyone, but choosing nutritious foods is especially important if you are managing chronic hepatitis. Take some time to learn about the healthy eating guidelines provided by the USDA. Fill your kitchen with nutritious foods so healthy snacks and small bites are ready when you need quick energy. Work together with your healthcare provider and a registered dietitian so that you can develop a meal plan that helps you keep your energy levels stable and your weight healthy.

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