11th March 13:57
Nutrition and Diet Recommendations for people with Chronic Hepatitis C (carbohydrates diet down electrolytes cholesterol)
Nutrition and the Liver:
The liver is the major organ responsible for regulating and responding to your
body's metabolic demands. Your liver must be functioning well to maintain
normal metabolism of carbohydrates, fats, and protein; it is also responsible
for processing and using several vitamins. This section deals with the role and
healthy liver (and a healthy, well-balanced diet) plays in these nutritional
The most common sources of dietary carbohydrate are sugars, such as sucrose
(table sugar), fructose (corn syrup), and lactose (milk sugar), and starches,
such as breads, pasta, grains, cereals, fruits, vegetables, and potatoes. When
you eat carbohydrates, specialized enzymes in the pancreas and gut process them
to yield simple sugars (glucose, galactose, fructose, maltose).
These sugars are absorbed by intestinal lining cells, enter the portal
circulation, and travel to the liver via the portal vein. During overnight
fasting, blood sugar levels dip to a relatively low level, insulin secretion is
suppressed, and blood insulin levels diminish. After a meal, blood sugar
increases (stimulating the release of insulin from the pancreas), and insulin
levels rise. Insulin, which rises in response to a meal, is the hormone that
stimulates the liver to take in more glucose and to move the glucose into
storage -- mainly in the form of glycogen. The liver can then release glycogen
to your muscles for energy during periods of fasting or exercise. Although the
liver can store considerable amounts of glycogen, it is the first energy source
used during periods of prolonged fasting or caloric deprivation, and it can be
depleted rapidly. After glycogen, the body taps other energy sources --
including protein and fat.
We take in dietary protein from dairy products, produce, and meats. Enzymes
produced by the pancreas and intestine break down the protein into its amino
acids and small peptides. The intestine rapidly absorbs the amino acids with
specific transport systems within its lining cells and then delivers the amino
acids to the liver via the portal vein. When they reach the liver, they are
used for energy or for making (synthesizing) new proteins. The newly
synthesized proteins perform specific body functions.
In general, fats are neutral lipids (triglycerides), acidic lipids (fatty
acids), and sterols (cholesterol, plant sterols). Triglycerides (dairy
products, meats, oils, butter, margarine) are the most common type of dietary
fat and represent a major source of energy. The liver is uniquely suited to
regulate and process triglycerides.
Dietary triglyceride is digested in the intestine by lipase, an enzyme secreted
by the pancreas in response to meals. Bile, secreted by the liver, makes the
digested fat soluble and promotes its absorption. Absorbed fat is then
repackaged and transported into blood, where the liver ultimately removes it
from the circulation. Fat that reaches the liver is processed in three ways:
(1) stored as fat droplets in liver cells, (2) metabolized as a source of
energy, and (3) repackaged, secreted back into blood, and delivered to other
cells in the body.
The liver is also intimately involved with the processing of dietary
cholesterol and is the main source of newly synthesized cholesterol in the
body. Liver disease may be associated with both high or low blood cholesterol
levels. In general, as liver disease progresses in patients with hepatitis C,
the blood level of cholesterol drops.
The liver produces and secretes a fluid (bile) that enters the intestine to aid
in digestion and absorption. Bile is clear yellow to golden-brown and contains
water, electrolytes (salts), cholesterol, bile salts (detergents),
phospholipids, and proteins. Bile helps to activate enzymes secreted by the
pancreas and is essential for the digestion and absorption of fat or fat-
The liver plays a role in several steps of vitamin metabolism... Vitamins are
either fat-soluble (Vitamins A, D, E, and K) or water-soluble (Vitamin C and
the B-complex vitamins).
Patients with advanced liver disease may become deficient in water-soluble
vitamins, but this is usually due to inadequate nutrition and poor food intake.
Vitamin B12 storage usually far exceeds the body's requirements; deficiencies
rarely occur due to liver disease or liver failure. When dietary intake drops,
however, thiamine and folate commonly become deficient. Oral supplementation is
usually all that you need to restore thiamine and folate stores to the normal
Fat-soluble vitamins require not only adequate dietary intake but also good
digestion and absorption by the body. That's why normal production of bile is
essential. Bile in the gut is required for the absorption of fat-soluble
vitamins into the body because these vitamins are relatively insoluble in
water. Bile acts as a detergent, breaking down and dissolving these vitamins so
they may be properly absorbed.
If bile production is poor, oral supplementation of vitamins A, D, E, and K may
not be sufficient to restore vitamin levels to normal. The use of a detergent-
like solution of liquid vitamin E (TPGS) improves the absorption of vitamin E
in patients with advanced liver disease. The same solution may also improve the
absorption of vitamins A, D, and K if the latter are taken simultaneously with
the liquid vitamin E.