Hepatitis B is a viral infection affecting the liver, which can lead to severe complications if not well managed. Nutrition and physical fitness are important ingredients for a healthy liver. While there's no specific "hepatitis B diet," a well-balanced eating pattern plays a significant role in supporting liver health, improving immunity, energy levels, and overall well-being. This article explores how to eat for a healthier liver, outlining which foods and drinks to include and avoid, and suggesting beneficial lifestyle changes.
Understanding Hepatitis B and the Liver
Hepatitis B is a viral infection that inflames and damages the liver, hindering its ability to filter blood, process and store nutrients, and convert harmful substances into harmless ones. This inflammation, if left unmanaged, can lead to cirrhosis and life-threatening liver failure.
General Dietary Guidelines for Hepatitis B
For hepatitis B, doctors recommend eating a balanced diet with plenty of carbohydrates, fruits, and vegetables to help the liver function properly. A well-balanced diet should provide all the vitamins and minerals you need. When diagnosed with hepatitis B, focus on eating whole, nutritious foods that promote liver health. A liver-friendly diet for hepatitis B includes fruits, vegetables, whole grains, lean proteins, and healthy fats.
The Importance of a Healthy Diet
Everything a person eats or drinks passes through the liver. This organ filters the blood, removing nutrients and vitamins and metabolizing harmful substances. Following a nutritious, well-balanced diet with whole grains and lean proteins can improve liver function. Simple dietary changes help the liver recover more quickly.
Addressing Malnutrition
When a person’s liver is damaged, they may not absorb nutrients effectively. Researchers note that many are experiencing malnutrition. Working with a nutritionist to change diets can lead to improvement in liver function and a boost in nutrient levels.
Read also: The Hoxsey Diet
Diet as a Supportive Measure
Changes to a diet will not cure hepatitis B but increase the likelihood of the person’s liver recovering completely. Those who continue these eating habits reduce the amount of stress on their liver.
Foods to Include in Your Hepatitis B Diet
People with hepatitis B can enjoy many foods, including lean meats, fish, whole grains, vegetables, and fruit. Eating smaller but more frequent meals throughout the day is also recommended.
Vegetables
All types of vegetables are beneficial, but increasing quantities of broccoli, cabbage, cauliflower, collard greens, and other cruciferous vegetables is particularly helpful. Leafy greens like spinach, kale, and collard greens contain fibre and antioxidants that help remove toxins from the liver. People can eat the vegetables raw or cooked, and frozen, tinned, and fresh varieties all help. Wash fresh fruit and vegetables to remove any preservatives or insecticides that might be on the skin, as these chemicals place a strain on the liver. Aim to fill half your plate with vegetables.
Fruits
Reach for fruits and veggies. A healthy goal is to cover half of your plate with vegetables and fruit. Although fruit has fructose in it, it also has fiber and other nutrients. The liver metabolizes fruit slowly, making it a good choice when you are trying to satisfy a craving for sweets.
Protein
Look for a wide array of proteins, including lean meats, poultry, fish, beans, eggs, nuts, seeds, milk, yogurt and cheese. Aim for 15% of a person’s daily calorie requirement to comprise protein. Lean proteins include fish, chicken, turkey, skim milk, eggs, cottage cheese, and tofu. Plant-based proteins, such as tofu, lentils, chickpeas, and peanuts, are excellent foods for hepatitis patients, as they are low in saturated fat. Sources of plant-based protein are kinder to the liver than meat, especially fatty and fried meats. While animal products may be high in fats, plant-based proteins contain a ton of good-for-you benefits like fiber and antioxidants that the animal foods lack. Plant-based foods like legumes, nuts, quinoa, hemp seeds, and soy are all sources of protein (and the last three are all considered “complete proteins” because they contain all 9 essential amino acids).
Read also: Walnut Keto Guide
Whole Grains
Whole grains, including brown rice, oats, and quinoa, are fibre-rich and can help reduce fat buildup in the liver. These complex carbohydrates also provide steady energy, preventing blood sugar spikes that could put stress on the liver. Most people need to increase their intake of complex carbohydrates and choose more nutrient-dense, whole-grain varieties, including whole-wheat bread and pasta. Aim to fill one quarter of your plate with whole grains.
Dairy
There is no reason for people with hepatitis to avoid dairy foods. Milk and milk products are excellent sources of nutrients such as calcium, riboflavin, protein and vitamin B12. Low-fat dairy items, including cottage cheese and skim milk, are preferable. Without consuming dairy products, it can be hard to get enough calcium in your diet.
Healthy Fats
Healthy fats, especially from sources like avocados, nuts, seeds, and olive oil, support liver health by providing anti-inflammatory properties. However, use these fats in moderation as they are calorie-dense. You don’t need to cut out all fats and oils just because you have hepatitis. Everyone needs some dietary fat so their body can function well.
Fluids
Drink 2 litres a day of water. It is amazing just how often people forget this, it is the method of the human body for working well. Just a 2 litre jug every day from the fridge as a ritual is very helpful for the kidneys to aid carrying away toxins.
Foods to Limit or Avoid in Your Hepatitis B Diet
Cutting back on certain foods can help the liver function.
Read also: Weight Loss with Low-FODMAP
Processed Foods
Try to cut out all processed foods, in particular fast food. Highly processed foods usually contain a lot of fat, salt, and sugar and make a person’s liver work hard. Also limit processed meats (like hot dogs and deli meats).
Sugary Foods and Drinks
People with hepatitis do not need to completely avoid sugar. However, cutting down on manufactured sugars (such as lollies and sweets) will help your liver and improve your energy. Sugary foods and drinks, including sodas, cookies, and many packaged baked goods, should be reduced or eliminated from the diet. Avoid sugary drinks, such as sodas and fruit juices with added sugars, which can lead to fatty liver. Dietary Guidelines (2020-2025) recommend limiting added sugars to less than 10 percent of calories per day. Other names for sugar are agave, fruit juice concentrates, high-fructose corn syrup, honey, molasses and maple syrup.
Fats and Fried Foods
Go easy on fats and fried foods. While having some fats in your diet is healthy, it’s important not to go overboard. In particular, try to avoid saturated and trans fats. Saturated fats are mostly found in animal products, such as beef, lamb, pork, poultry skin, cheese, butter, whole milk, cream and lard. Try to avoid trans fats altogether. Fatty fried foods are very hard for the liver to digest, they frequently cause pain to longer term patients, creating fatty liver so should be taken rarely. Picture oil on water undigestable or grease in a drain, fat is already a killer and hepatitis makes it harder for the liver to process this highly processed toxin.
Salty Foods
Limit processed foods and sodium. Sodium can be particularly harmful to people with liver disease. While the average American consumes 3,000 to 5,000 milligrams of sodium each day, the limit is 2,300 mg a day. People over 51, African Americans, and those with high blood pressure, diabetes or chronic kidney disease should stick to less than 1500 mg a day. If you have cirrhosis, discuss sodium limits with your health care provider. Patients with hepatitis who have ascites must be on salt restricted diets. Every gram of sodium consumed results in the accumulation of 200 ml of fluid. The lower the salt, the better this fluid accumulation is controlled. Sodium intake should be restricted to 1000mg each day, and preferably to 500 mg per day. For example, one teaspoon of table salt - 2,325 mg of sodium! Meats, especially red meats, are high in sodium a vegetarian diet may often become necessary. Patients with hepatitis without ascites are advised not to overindulge in salt intake, although their restrictions need not be as severe.
Raw or Undercooked Shellfish
Avoid Raw and Undercooked Shellfish. Strictly speaking, this advice is not for nutritional reasons but for safety ones. Raw or undercooked oysters, clams, and other shellfish may harbor Vibrio vulnificus, bacteria that are particularly harmful to people with liver disease.
Alcohol
Alcohol can damage your liver and make the problems caused by hepatitis worse. Abstinence from alcohol is mandatory. Most people who drink alcohol do not suffer damage to the liver. However, years of excessive alcohol consumption can increase the chance of getting alcohol-related liver disease. The amount of alcohol that causes liver damage differs from person to person. Research has shown that on average, consuming more than two drinks per day in women and three drinks per day in men is more likely to have harmful effects on the liver. Drinking in moderation is an important part of looking after your liver.
Other Foods
Forgo Foraged Mushrooms. Certain wild mushrooms contain toxins that can destroy even the healthiest livers. Do not eat foraged mushrooms unless you are 100 percent sure that they are safe. Also make sure to buy your nuts from trusted sources, and to inspect the nuts and grains for any signs of Aflatoxin poisoning (moldy appearance and discoloration).
Lifestyle Modifications for Liver Health
People with hepatitis B also benefit from simple lifestyle changes.
Exercise Regularly
Keeping physically fit can benefit your liver in many ways. Regular exercise has plenty of health benefits, no matter what age, size or shape you are. For people who have or who are at risk of liver disease, it’s an important part of maintaining a healthy lifestyle. If you are overweight, lowering your body mass index can reduce the likelihood and the effects of non-alcoholic fatty liver disease. Weight loss can also decrease the body’s demands on the liver and improve the organ’s ability to metabolize glucose. Going down in waist size can lessen the risk of diabetes or help manage the condition for those who already have it. Regular exercise-at least three times a week for half an hour-has many benefits to your overall health and well-being. It increases muscle mass so you burn more calories throughout the day. It boosts your immune function as well as your mood and energy. A recent study found that middle-age men who exercised at least 240 minutes a week were able to greatly improve damage caused by fatty liver disease. Even brisk walking can be beneficial. Try walking 10 minutes, three to five days a week, and, gradually over the course of several weeks or a few months, make your way up to an hour a day. If you’re more ambitious, strive to vary your program with a mixture of weight training and cardiovascular activities. The best bet is to find something that you enjoy doing, be it a team sport, bike riding, an elliptical or treadmill machine, yoga or Pilates.
Five reasons to stay active:
- It keeps your weight down: Physical activity helps you maintain weight loss and avoid gaining too much. The more intense the activity, the more calories you burn. If you’re short on time, even a few minutes’ walking is good. Try taking the stairs instead of the lift, or walk with a friend instead of catching up over coffee.
- It helps you stay healthy: Want to show your liver some love and avoid making it work overtime? Exercise boosts good cholesterol and decreases unhealthy triglycerides. It helps prevent or manage many health issues, such as diabetes, fatty liver disease and anxiety.
- It’ll help put you in a good mood: What better way to cheer yourself up or de-stress than with a brisk walk or workout? Exercise fires up chemicals in the brain such as dopamine and serotonin, which regulate mood. So it’ll leave you feeling happier, more confident and relaxed, and less anxious.
- It raises your energy levels: Regular exercise sends oxygen and nutrients to your tissues and helps your heart and lungs work more efficiently, so you’ll have more energy to face the day with.
- It can help you sleep better: Regular physical activity can help you fall asleep faster, get better sleep and deepen your sleep. But it’s a good idea not to exercise too close to bedtime or you may have too much energy to sleep easily.
If you’re new to exercise, are pregnant or have any health issues or concerns, please check with your doctor before beginning any fitness programme.
Maintain a Healthy Weight
Being overweight or obese may increase your risk of liver damage, so maintaining a healthy weight is one way you can help your liver. Body Mass Index (BMI) is one indicator of healthy weight.
Avoid Alcohol and Smoking
Quitting smoking, if applicable, and avoiding or cutting back on alcohol are crucial.
Stay Hydrated
Keeping hydrated by drinking lots of water is important for liver function.
Review Medications and Supplements
Stopping any vitamin or herbal supplements that are harsh on the liver is advisable. Also be very careful with medications or herbal remedies and supplements. Some supplements and herbs can do more harm than good. Checking with a pharmacist or doctor before taking any over-the-counter medications is also recommended. We advise all callers with HBV and HCV to restrict vitamin pill use to one multi vitamin tablet a day, as iron and vitamin e can get to toxic levels.
Coffee Consumption
There is no scientific evidence to suggest that coffee or caffeine cause particular problems for people with hepatitis, if these are consumed in moderation. Consumption of caffeinated coffee on a regular basis has been associated with reduced formation of liver fibrosis, slower disease progression, and decreased risk of cirrhosis and liver cancer. Decaf coffee and green tea have not been shown to benefit or harm the liver.
Iron Intake
Avoiding high-iron foods and iron supplements is important. Hepatitis C progression occurs in patients as a result of accelerated hepatic iron uptake and the oxidative stress caused by iron-catalyzed free radical production. Along with phlebotomy, a low-iron diet helps lower the risk for hepatocellular carcinoma in these patients. Notable high-iron foods include red meat, poultry, fish and shellfish, organ meats, and eggs.
Managing Specific Symptoms
Advanced liver disease can lead to malnourishment, causing significant weight loss. It is important to get enough calories and to make sure they are coming from the best possible sources-in other words, not from fatty foods, sweets or low-fiber carbohydrates. The liver may be having trouble processing proteins, in which case a physician can prescribe nutritional supplements that supply protein in a form that is easier to absorb.
What if I’m too tired to prepare meals?
It can be hard to eat if you are too tired to make meals or are not feeling well. Keep these foods on hand so you can make quick and nutritious meals:
- Oatmeal
- Whole grain bread and pasta, brown or wild rice
- Nut butters
- Yogurt, eggs
- Canned fish, beans and lentils
- Low sodium broth and canned soup
- Frozen and canned vegetables and fruits
- Frozen meat, poultry and seafood that is easy to prepare. For example, lean ground meat, ground turkey, fish fillets or shrimp
When you have the energy to cook, make more than you need. Put the leftovers in the freezer to have another meal.
Try these easy-to-make foods when you need a quick snack or a simple meal:
- Apple or pear slices with nut butter
- Vegetables with hummus, bean dip or a yogurt-based dip like tzatziki
- A hard-boiled egg with fruits or vegetables
- Fresh, frozen, dried or canned fruit with yogurt or soft tofu
- Hot cereal mixed with milk powder and nuts, seeds or trail mix
- Fresh or frozen berries with cottage cheese
- Edamame (green soybeans) with wild rice
- Roasted chickpeas, lentils or fava beans with salad greens
- Canned fish with whole grain crackers or toast
- Whole grain bread, naan, pita, bagels or crackers with cheese or nut and seed butters
- Reduced sodium canned bean or lentil soup with whole grain crackers
If you need help accessing food and would like to learn about grocery and meal programs, call 8-1-1 to speak with a registered dietitian.
What if I’m losing weight?
If you are underweight, losing weight without trying, or have a small appetite, you may not be eating enough calories to meet your energy needs.
To help prevent weight loss, try eating small amounts of food more often and choose foods that are higher in calories. Here are examples of higher calorie foods to include in meals and snacks:
- Nuts, seeds and their butters
- Dried fruit like dates, coconut mango, figs, apricots and raisins
- 2% or 3.25% milk or kefir, yogurt smoothies, soy beverage, meal replacement drinks
- Whole milk powder or canned coconut milk, prepared as drinks or added to sauces, soups, cooked cereals or mashed potatoes
- Higher fat yogurt, sour cream, cream cheese and cheese. When comparing food labels, look for a higher % M.F.
- Poultry, meat, wild game, fatty fish, egg
- Reduced sodium cream soups
- Avocado
- Soft margarine and oils such as olive, canola, peanut, sunflower and safflower. These can be used in cooking, salad dressings and dips
Limit candy, chips, donuts, pop, sweetened specialty coffee and tea, energy drinks and sports drinks. These foods give you energy but do not give you important nutrients like protein, vitamins and minerals.
What if I have extra weight?
If you have extra weight, reaching and maintaining your best weight can help slow liver damage. For people with metabolic dysfunction-associated liver disease, modest weight loss may help improve liver health.
Your weight is not just a result of what you eat or how active you are. Many factors, including genetics, medications, stress and sleep quality also influence your weight. If you would like to discuss your eating and physical activity goals, you can call 8-1-1 to speak with a registered dietitian or qualified exercise professional. Visit your health care provider to learn more about other treatment options.
Important Considerations
Vitamin and Mineral Supplementation
People with hepatitis may not absorb or use nutrients properly. If you are not eating well, you might need a vitamin and mineral supplement. Do not take high doses of any vitamin or mineral, especially iron, unless your health care provider tells you to. High doses of some vitamins and minerals can be toxic and damage your liver. Talk to your health care provider before you take any supplements or herbal products.
Coffee and Caffeine
There is no scientific evidence to suggest that coffee or caffeine cause particular problems for people with hepatitis, if these are consumed in moderation.
The Role of a Registered Dietitian
Talk to your doctor about your nutritional concerns. A registered dietician may also be a good source of information. Ask your clinician for a recommendation and also do some homework on the dietician’s credentials, education and experience to make sure he or she is qualified to give advice tailored to someone with liver disease.