Liver Health and COVID-19

Nutrition so important for liver health, so what should you eat to ensure that your liver can function normally?

If you’re a liver patient, adjust your diet to meet your individual needs, and always talk to your doctor about what’s best for you.

Here are some general food tips for a healthy or healthier liver aka a "liver-healthy diet"?

• Eat a balanced diet from all food groups including grains, fruits, vegetables, meat and beans, milk, and oil.

• Eat food with lots of fiber that helps your liver such as fruits, vegetables, whole-grain breads, rice, and cereals.

• Don’t eat foods high in fat, sugar, and avoid salt.

• Avoid fried foods especially fast food.

• Avoid any raw or undercooked shellfish such as oysters and clams.

• You should avoid alcohol if your liver disease is advanced, so speak to your doctor.

• Drink lots of water to prevent dehydration.

• Note that I drink 4L+ a day of water. Recommend that to all my patients. Especially if they have constipation. Speak to your doctor about what is right for you.

What diet is recommended if I have fatty liver disease (the build-up of fat in liver cells)?

• Limit foods that are high in calories

• Eat foods that have fiber

What diet is recommended if I have Hepatitis C (inflammation caused by the hepatitis C virus)?

• Avoid foods that have high concentrations (amounts) of iron

• Do not use iron pots and pans to cook

• Limit your salt intake and foods that contain a lot of salt

What diet is recommended if I have cirrhosis (scarring and hardening of the liver)?

1. Limit salt and foods that have a lot of salt

2. Talk to your doctor about how much protein to have

What are the most important nutritional qualities liver patients should consider when choosing foods and how can I shop for foods if I have liver disease?

Here is a great list of tips from the American Liver Foundation. See below.

10 Healthy Tips to Follow at the Supermarket

1. Pick out vegetables and fruits without high-calorie sauces or added salt & sugars

2. Choose fiber-rich whole grains

3. Pick up poultry and fish without skin prepared in a healthy way

4. Decide over lean cuts of meat instead of those high in fat

5. Eat fish at least twice a week, especially fish containing omega-3 fatty acids (e.g. salmon, trout, and herring)

6. Make sure your dairy is Fat-free (skim) or low-fat (1%)

7. Avoid foods with partially hydrogenated vegetable oils to reduce trans fat

8. Limit saturated fat and trans fat by replacing them with better fats (monounsaturated and polyunsaturated)

9. Cut back on beverages and foods with added sugars

10. Choose foods with less sodium and prepare foods with little or no salt

What about protein if I have cirrhosis?

People with liver cirrhosis can experience malnutrition which can be managed with a healthy plant-based diet based on a diverse variety of fruits and vegetables. Look for lean proteins, such as legumes, poultry, or even fish. Always avoid raw seafood if you have cirrhosis.

Prevention and management of malnutrition are essential to you if have cirrhosis. It is estimated that 50% to 90% of individuals with cirrhosis have malnutrition. For the best nutrition management, a registered dietitian should be involved.

Here are some great links to use as resources.

• VA | Eating Tips for People with Cirrhosis - Viral Hepatitis and Liver Disease

• Mayo Clinic | Cirrhosis - Diagnosis and treatment

• AASLD | Nutrition Priorities: Diet Recommendations in Liver Cirrhosis

Coronavirus and Liver disease

Are patients with chronic liver disease at greater risk of developing a more severe form of COVID-19 than other population groups and if so, why?

According to the CDC, "Adults of any age with certain underlying medical conditions are at increased risk for severe illness from the virus that causes COVID-19. Severe illness from COVID-19 is defined as hospitalization, admission to the ICU, intubation or mechanical ventilation, or death."

Furthermore, "Having chronic liver diseases, such as alcohol-related liver disease, nonalcoholic fatty liver disease, and especially cirrhosis (scarring of the liver), might increase your risk for severe illness from COVID-19."

Actions to take

• Take your medicine(s) exactly as prescribed.

• Make sure that you have at least a 30-day supply of your medicines.

• Call your healthcare provider if you have concerns about your condition or feel sick.

• If you don’t have a healthcare provider, contact your nearest community health center or health department.

Am I at risk for further liver injury or liver failure in severe COVID-19 cases?

Yes.

In one study, "Of all COVID-positive patients, 45% had mild, 21% moderate, and 6.4% had a severe liver injury. Moderate and severe liver injury was more common in patients who required ICU-level care."

How should liver disease patients support their liver health during a lockdown or social distancing?

If you are worried about your own personal risk, discuss this with your doctor.

How the COVID-19 virus behaves is still an evolving process of learning for the medical community.

What precautions should liver disease patients take during the coronavirus pandemic?

1. Wear a mask.

2. Wear a face cover.

3. Wash your hands.

4. Keep a safe distance.

Learn more here from the CDC: How to Protect Yourself & Others

Tips en Español

Que es NASH (Esteatohepatitis no alcoholica)?

Es un subconjunto de NAFLD aumenta el riesgo de fibrosis y eventualmente cirrosis a un higado graso en la ultima etapa y puede causar complicaciones.

Tratamiento

La condicion se diagnostica con un biopsia del higado con su medico. Al momento no hay tratamientos pero una dieta balanceada y saludable es recomendada.

Listas de comidas

• No comidas altas en grasa.

• 4 galones (litros) de agua.

• No comida rapida o frituras.

• Comidas en fibra alta.

• Vegetales, cereal, arroz.

• Frutas, carnes.

Indece de masa corporal 68% de los adultos Estadunidenses son obesos.

El COVID-19 (corona virus) y la enfermedad del higado.

Segun el cdc (Centro de control y prevencion de enfermedades de salud) si una persona sufre de una enfermedad chronica esto incluye el higado graso, cirrosis, y higado graso corre el riesgo de contrarer el COVID-19. El riesgo es mas alto en paciente que tienen una condicion medica.

Precuasiones contra el COVID-19

• Usar mascara.

• Lavarse las manos.

• Mantener la distancia.

• Visitar a su medico.

Summary

There is no magic formula for long-term, sustainable weight loss.

Balance. Portion control. Keep nutrition simple. Eat Smart. Eat Healthy.