Hepatitis
Hepatitis is inflammation of the liver, most often by viruses A to E. The diet is high-carbohydrate, high-protein, moderate-fat in small frequent meals.
At a glance
Dietary principles
| Nutrient | Recommendation | Why |
|---|---|---|
| Energy | High: about 35 kcal/kg (books give 30-40) | Poor appetite and fever cause weight loss; energy spares protein |
| Protein | About 1-1.5 g/kg of good-quality protein (some books go up to 2 g/kg): milk, curd, egg, fish, paneer, dal | Rebuilds liver cells |
| Carbohydrate | High; give glucose, sugar, honey, fruit juices, cereals freely | Restores liver glycogen and spares protein; sweet drinks are easy to take when appetite is poor |
| Fat | Moderate (about 20-25% of energy; books differ), easily digested (milk fat, a little butter); avoid fried food | Older books advised fat-free diets; moderate fat now keeps food tasty and energy up |
| Fluid | 2.5-3 litres a day; more with vomiting | Prevents dehydration |
| Vitamins | B-complex, vitamin C; vitamin K if clotting is slow | Liver stores and uses these vitamins |
| Alcohol | None, for at least 6 months | Alcohol is directly toxic to liver cells |
Foods to include and avoid
| Food group | Include | Avoid or limit |
|---|---|---|
| Cereals | Rice, idli, soft chapati, rice flakes, ragi kanji, bread | Fried puri, paratha with ghee |
| Protein foods | Skimmed or toned milk, curd, paneer, egg white, steamed fish, moong dal | Fatty meats, mutton curry, fried fish |
| Vegetables and fruits | Cooked vegetables, papaya, banana, sweet lime, grapes, pomegranate | Raw salads from unsafe sources |
| Sugars and drinks | Glucose water, fresh juices made hygienically, tender coconut water | Street juices with ice (risk of hepatitis A and E) |
| Fats and spices | Small amounts of oil or butter | Deep-fried snacks, rich gravies, pickles, alcohol |
Sample one-day menu (acute viral hepatitis)
| Meal | Menu |
|---|---|
| Early morning | Glucose water or sweet lime juice |
| Breakfast | Idli (3) with tomato chutney (little oil); skimmed milk with sugar |
| Mid-morning | Tender coconut water; banana |
| Lunch | Soft rice, moong dal, carrot-beans poriyal (little oil), curd |
| Evening | Ragi kanji with jaggery; papaya |
| Dinner | Soft chapati (2), steamed fish or paneer curry (low fat), bottle gourd kootu |
| Bedtime | Skimmed milk with sugar or honey |
In the jaundice ward, appetite is lowest in the morning and nausea comes with fatty smells, so the dietitian sends sweet drinks often and keeps meals small, bland and low in fried fat.
2 marks: “Which hepatitis viruses spread through contaminated water?” Hepatitis A and E, by the faeco-oral route.
5 marks: “Explain the dietary principles in viral hepatitis.” High energy and carbohydrate, protein 1-1.5 g/kg, moderate easily digested fat, plenty of fluids, vitamins, no alcohol, small frequent meals.
10 marks: “Discuss the causes, symptoms and dietary management of hepatitis with a sample menu.” Define, types of virus with route, symptoms in two phases, principles table, foods to include and avoid, one-day menu, prevention.
Hepatitis diet: sweet, soft, small and often, with no alcohol. A and E come from water; B and C from blood.