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Friday, June 16, 2017

Food fad is a diet that is presumed to give health benefits without a solid backing. It generally is very restrictive and the choice of food is very unusual. It more often turns out to be harmful than not.

Liver requires more energy than any other organ to keep its multiple functions going especially when it's affected by the illness like Hepatitis (Jaundice) or Liver Cirrhosis. It derives energy only from the food we eat. 
Liver attempts to regenerate very quickly during an episode of Hepatitis (Jaundice). The regenerative capacity of the liver is by far the best when compared to any other organ in humans. During the regenerative process, it requires generous amounts of energy from carbohydrate and protein as the protein forms building blocks of any tissue.

The most common fad diet I come across in my Gastroenterology practice is feeding a patient of Hepatitis (Jaundice) with boiled green leafy vegetables and no protein and Low-fat diet in patients with liver cirrhosis. The patient feels more nauseated per se especially when fed the boiled green leafy vegetable diet.

Depriving liver any of the three macronutrients (Carbohydrate, protein, fat) will result in the starvation-like situation to the liver thereby affecting its regenerative process and patient recovery from jaundice. Unfortunately, the boiled green leafy vegetables have none of the above macronutrients. 

Carbohydrates (starch and sugar), the most important sources of quick energy are found in sugar, rice, idlis, sooji, as are fruit juices, sweets that need to be given liberally. But, I do not support the use of costly commercially available glucose supplements as a stand-alone treatment of Hepatitis (Jaundice) as used even by many doctors in the day to day practice.

Protein and fat are considered as the worst for liver disease patients by many including doctors and dieticians which are not true. Scientifically it’s been proven that a diet containing protein of 1 to 1.5 g per Kg body weight per day is needed to meet the liver’s increased requirement in Hepatitis (Jaundiced) patients and in patients with liver cirrhosis. Vegetable (daals, rajma, and soy) and animal sources(meat, chicken fish, eggs, milk, curd, and cheese) are equally good for patients with liver illnesses. Typically, an average Indian diet contains less than 0.7g/kg body weight of protein. This deficiency of protein intake is more pronounced among vegetarians. Fat consumption though in moderation is good for the liver. Many at times, I had to counsel even the doctors, dieticians in this regard to maintain good nutritional balance in this group of patients due to lack of awareness about the dietary aspects of liver disorders.

Withholding “haldi” or turmeric from cooking is another common fad with patients of jaundice. This fad stems from associating its yellow color with that of bilirubin, the compound that gives the yellow hue to the eyes and skin in jaundice. The link is as foolish as feeding tomatoes which derive its red color from a pigment called anthocyanin, to anemic patients with low hemoglobin levels. We need to look beyond color! 

At last, the only condition in which I would recommend restriction of fat intake is in a patient of gallstones who turned symptomatic in terms of pain/ jaundice/cholecystitis/pancreatitis but awaiting the removal of gall bladder by cholecystectomy.

Blog by- Dr. C Vasudev, Consultant Gastroenterologist, SevenHills Hospital Mumbai.   


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