Hepatitis C: Diet and Remission

Hepatitis C can bring out the best in people. Katherine, an intravenous drug user for over thirty years, contracted hepatitis C and only consulted a doctor when her liver had become so weak that her blood had been robbed of clotting factors. She was bleeding profusely with every cut and bruise.

Told she would die without a liver transplant, Katherine decided to stop drugs and beat the disease. Somehow finding the psychological resources within herself, she stopped drugs and drinking. She began to beat hepatitis C even before she got her transplant, by following some of the nutritional guidelines to which she has contributed here. Because she had begun her recovery before her transplant, her new liver has been healthy, and she has found a new and happy life at the age of 50.

Nearly 4 million Americans are infected with the hepatitis C virus (HCV). Worldwide, nearly 170 million people have HCV. Infection due to HCV accounts for 20 percent of all cases of acute hepatitis, an estimated 30,000 new acute infections, and 8,000-10,000 deaths each year in the United States.

Hepatitis C infections can live in the liver for years and even decades causing little damage. People with hepatitis C who continue to drink heavily are 27 times more likely to die of the disease than those who abstain from alcohol completely. Among people infected with the virus who avoid alcohol and drugs, only about 1 in 5 develops cirrhosis of the liver. Most of these unfortunate few share a common and treatable condition, insulin resistance.

Insulin resistance is an inability of the body to move sugar out of the bloodstream and into cells in response to the hormone insulin. The condition is usually associated with overweight, specifically with abdominal fat. Lowering fat in the diet and losing weight usually lessen insulin resistance.

In hepatitis C, insulin resistance causes a cascade of changes in the liver’s need to process hormones and fat. Insulin in the skin and muscles ordinarily puts a brake on the action of hormone sensitive lipase, the enzyme responsible for releasing fatty acids from fat cells. In insulin resistance, this hormone is no longer suppressed. Fat cells churn out free fatty acids that are ultimately stored in the liver.

In addition, stress hormones, growth hormone, and the sugar-releasing compound glucagon are increased in response to increased levels of insulin. The liver is forced to recycle these hormones at the same time it deals with the stress of hepatitis C. Moreover, the fatty acids themselves stimulate the formation of fat in the liver. The result is an ever-increasing burden of fatty acids and hormones adding to the liver’s stress.

What can be done about insulin resistance? Australian researchers tested 19 people with chronic hepatitis C in a 90-day test of diet and exercise. Some participants had previously been treated with interferon and some had not, but all had some degree of fibrosis (leading to cirrhosis), steatosis (significant of risk of developing diabetes), and inflammation (indicating tissue death). All 23 participants were significantly overweight and all had measurable insulin resistance.

The Australian test participants modified their diet by a simple rule: Eat less. Average food consumption in the group was lowered from 2740 to 1620 calories per day from 50 percent carbohydrate, 20 percent protein, and 30 percent fat, enough for most to lose 1 pound a week. Participants gradually increased exercise to 30 minutes a day. Participants engaged in aerobic exercise, such as a brisk walk, but did not do strength training.

The diet and exercise changes in this program were hardly rigorous, but the results were impressive. Serum ALT, a measure of liver tissue destruction, steadily decreased as the participants lost weight. Fatty liver, fibrosis, and inflammation improved in almost all the participants. Most importantly, in four of the participants, smooth muscle antibodies, the measure of damage to the liver by the immune system itself, completely disappeared.

The Australian research teams believes that any man with a waist measure of more than 37 inches (94 cm) and any woman with a waist measurement of more than 32 inches (80 cm) can benefit from gentle changes in diet and exercise to lose weight. Massive weight loss is not necessary. Losing as little as 2-1/2 percent of one’s total body weight frequently is enough to stop the progression of the disease.

As every dieter knows, losing even 2-1/2 percent of total body weight is not an easy challenge. Here are some foods that are low in calories that also contain chromium to help you overcome insulin resistance. A teaspoon of cocoa powder or two teaspoons of chocolate syrup contains about 25 mcg of chromium, about one-quarter of the amount of your body’s daily needs. Canned tomatoes—probably because of the chromium content of the can—and canned pineapple slices are excellent sources of chromium, one serving of either providing all the chromium your body needs every day. The best source of all food sources of chromium, however, is egg yolks, gram per gram containing 50 percent more chromium than yeast, 1 egg yolk providing a day’s supply of chromium—and cholesterol.