Hepatitis C is the most common blood-transmitted infection in the United States, affecting nearly 2.7 million people, according to the U.S. Centers for Disease Control and Prevention. The ongoing battle between the virus and the immune system can harm the liver through scarring, potentially leading to a loss of liver function. If you have hepatitis C, some diet choices can potentially make your condition worse by contributing to liver damage or complications of the infection. Foods that are best to avoid include alcohol, wild mushrooms, undercooked shellfish and foods high in fat or sugar.
The liver processes the nutrients from the foods you eat and drink, and removes toxins from your blood -- including alcohol. Alcohol can damage liver cells, compounding the damage already caused by the hepatitis C virus.
The authors of an April 2013 research study report published in "Alimentary Pharmacology and Therapeutics" found that people with hepatitis C who drank even moderate amounts of alcohol -- up to roughly 1 drink per day -- were more likely to die of liver-related disease than those who didn't drink. The risk was even higher among heavy drinkers. The American Association for the Study of Liver Diseases and the Infectious Diseases Society of America recommend that all people with hepatitis C avoid alcohol entirely.
Avoiding high-fat foods is important for people with hepatitis C because the disease often causes fat buildup in the liver, especially among those who are obese or have unhealthy blood fat levels. The excess fat can accelerate hepatitis C-related liver damage, increasing the risk for cirrhosis -- severe liver scarring. The "Dietary Guidelines for Americans" recommends limiting daily fat intake to no more than 30 percent of your total daily calories, but your doctor may recommend a lower level.
Avoiding foods with saturated and/or trans fats will help you maintain healthy blood fat levels and reduce the risk for fat buildup in your liver. Examples of foods to avoid include butter, whole-milk cheeses, fatty beef, poultry skin and foods that contain coconut oil or palm oil. Unsaturated fats are a healthier choice, especially monounsaturated fats like olive, canola, sesame and peanut oils. These fats are least likely to further aggravate liver inflammation caused by the hepatitis C virus.
People with hepatitis C have a higher risk of type 2 diabetes and prediabetes because the virus affects how the liver processes sugar and fats. Eating foods with large amounts of sugar -- such as desserts, full-calorie sodas and candy -- can further tax the liver's ability to manage sugar and fat metabolism and contribute to the development of diabetes or prediabetes. These conditions can increase the rate of hepatitis C-related liver damage.
Many processed, sweet foods contain added sugar in the form of manufactured fructose. A small study published in the "Journal of Hepatology" in December 2013 found an association between high levels of manufactured fructose in the diet and liver scarring severity in people with hepatitis C. However, a similar study published in July 2013 in the "Journal of Clinical Gastroenterology" found no association between dietary fructose and liver scarring severity. More research is needed to sort out these conflicting findings. In the interim, limiting your sugar intake to natural sources, like whole fruit, is a healthy choice.
Because hepatitis C attacks the liver, foods that may be poisonous or contain liver-damaging toxins can be extremely damaging to people who have the virus. Two of these foods to be cautious about are wild mushrooms and shellfish.
There are poisonous and nonpoisonous varieties of wild mushrooms -- and the two can look very similar. Poisonous mushrooms can cause liver and kidney failure and even death within days. Raw or undercooked shellfish might contain a certain type of bacteria that is particularly harmful to people who already have liver disease, such as hepatitis C. The bacteria are most commonly found in oysters and clams harvested from warm coastal waters, such as the Gulf of Mexico. If you’re unsure about whether these choices are safe, it’s best to avoid them completely.
It’s important for everyone to limit salty foods like potato chips, pretzels and processed foods because of the link between a high-salt diet and high blood pressure. But a low-salt diet is especially important for people with hepatitis C who have advanced cirrhosis with liver failure. One complication of advanced cirrhosis is a buildup of fluid caused by high pressure in the liver blood vessels. This fluid accumulates in the belly and often in other parts of the body, such as the feet and ankles.
The American Association for the Study of Liver Disease recommends limiting salt in the diet for people who have advanced cirrhosis with fluid buildup. Avoiding salty snacks, canned or processed foods, bottled dressings and sauces -- and not adding salt to meals -- helps limit this swelling.
A healthy diet can be a valuable tool in preserving your liver health as part of your overall hepatitis C treatment plan. Discuss your diet with your doctor, especially if you have liver failure, diabetes, high blood pressure or other health problems. You may need a customized diet to stay in good health.
Medical advisor: Tina St. John, M.D.