Since hepatitis C is a disease of the liver, it is vital to take care of this all-important organ. Living with hep C may sometimes seem like a waiting game in which there is nothing you can do other than bide time until you go on treatment. But, in reality you can take a lot of steps to lessen the damage the virus may do to your liver. It’s all about how you treat your own body; nutrition and physical fitness are important ingredients for a healthy liver.

Being overweight or obese may increase your risk of liver damage, so maintaining a normal weight is one way you can help your liver. Body Mass Index (BMI) is an indicator of healthy weight. Obesity is a BMI greater than 25; morbid obesity is greater than 35. To calculate BMI: (1) multiply your weight (in pounds) by 703, (2) multiply your height in inches by itself, then divide the answer in (1) by the answer in (2). You can find BMI calculators and other fitness tools and tips at www.healthfinder.gov.

Nutrition

The liver metabolizes everything you eat, so a healthy diet is especially important for those living with a liver disease such as hep C. Furthermore, since many people with the disease suffer from low energy or fatigue, a fuel-rich diet is a key way to give your body as much vigor as possible. You should drink plenty of water and observe a good balance between all of the basic food groups, including whole grains, proteins, dairy, fruits, vegetables and fats—making sure to keep the saturated fats in your diet to a minimum. Here are some other nutrition tips:

    • Consider Carbs Carefully and Skip the Sweets
      Carbohydrates fuel the body. There are two kinds of carbs—complex and simple. Foods with starch and fiber are complex carbs, and the body metabolizes these more slowly than it does simple carbs. Minimally processed, “non-white” foods such as beans and whole grains (brown rice, oatmeal, barley, quinoa) are higher quality carbs. Starchy, low fiber foods (rice, potatoes, pasta) are mostly made up of a simple sugar called glucose. These carbs provide poor quality fuel or “empty calories” to our diets.

      While too much glucose will pack on the pounds, fructose is the carb to skip. Fructose is sugar. Fructose is largely broken down in the liver, and excess fructose can raise triglycerides, create insulin resistance, and may cause fatty liver disease. The latest U.S. Dietary Guidelines (2015-2020) 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.
    • Reach for Fruits and Veggies
      A healthy goal is to cover half of your plate with vegetables and fruit. The U.S. Department of Agriculture (USDA) recommends that women older than 30 consume around one and a half cups of fruit and two to two and half cups of veggies per day; the recommendation for men is two cups of fruit and three cups of vegetables. 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 Power
    • Protein is an essential building block your body needs to repair and replace tissue that has been damaged. Look for a wide array of proteins, including lean meats, poultry, fish, beans, eggs, nuts, seeds, milk, yogurt and cheese.
    • 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. Palm oil is highly saturated. Trans fats are used less in food manufacturing since the Food and Drug Administration questioned the safety of them. Also called trans fatty acids, trans fats are formed when hydrogen is added to a vegetable oil to make a more solid shortening or margarine, a process called hydrogenation. Try to avoid trans fats altogether.
    • Color Your World
      Variety is the spice of life. A good rule of thumb when shopping or preparing meals is to ultimately get a good spectrum of color on your plate, particularly when choosing fruits and vegetables. Different natural colors are reflective of a spectrum of important nutrients. Consider the difference between a highly processed, high-fat, sodium-packed fast-food meal of entirely tan food and a nutritious plate of brown rice, bright orange salmon and dark green spinach.
    • Limit Processed Foods and Sodium
      You should try to cut out all processed foods, in particular fast food. In addition to containing fat and caloric levels that can often go through the roof, processed food is typically drenched in salt, also known as sodium. Sodium can be particularly harmful to people with liver disease because when the organ is damaged to the point where it fails to produce enough proteins in the blood, it releases more fluid into the tissues to try to even out the imbalance. Salt can then worsen this effect, because too much sodium causes you to retain fluids in order to lessen its concentration. A result may be swollen legs or bellies. 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.
    • Eat Real Food
      So-called junk foods are low in the nutrients your body actually needs, so consuming them will only narrow the nutritional benefits of your overall caloric intake.
    • Control Portions
      Be sensible and consider how large helpings and high-calorie food can affect your body weight.
    • 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.
    • 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.
    • Drink Coffee
      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. Coffee may also help with HCV treatment. Decaf coffee and green tea have not been shown to benefit or harm the liver.

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.

Talk to your doctor about your nutritional concerns. Since many liver doctors may not necessarily have expertise in this area, 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 hep C.

Exercise

Keeping physically fit can benefit your liver in many ways. 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. Overweight people also respond more poorly to interferon- and ribavirin-based hep C therapies—although this concern will likely stop being as relevant as newer combination therapies increasingly phase out the use of those two drugs in the coming years.

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.

Last Revised: June 22, 2015