Showing posts with label HCV diet. Show all posts
Showing posts with label HCV diet. Show all posts

Monday, April 23, 2018

HCV, type 2 diabetes & fatty liver disease - Importance of diet and exercise

Importance of diet and exercise 

This Michigander is announcing winter might just be over. I am so done walking on my ugly, hated, overrated treadmill, looking forward to moving my morning routine outside.

If you too are feeling a bit of spring fever, or preparing for a lifestyle change, check out the links provided below and learn about the importance of diet and exercise for people with HCV, type 2 diabetes or fatty liver disease.

On The Radio
To get you started we begin with Dr Norman Swan, the host of Health Report, along with his guest Professor Mike Lean, lead author in a study investigating the impact of weight loss on type 2 diabetes, published in the Lancet 10 February 2018; Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial. The study found after a year, participants who lost weight (around 30 pounds) on a 800 calorie diet, no longer had type 2 diabetes. The diet may be too difficult or not recommended for some people, in the trial patients were followed closely, however, the outcome is amazing. The interview starts at 8:29, listen to the program, here, read the transcript below or visit Health Report.

Transcript
Norman Swan: There's good news, for once, from the west of Scotland where a trial in general practice of an extremely low calorie diet has reversed type 2 diabetes in a large percentage of participants. Mike Lean is Professor of Human Nutrition at the University of Glasgow and is on the line. Welcome to the Health Report.

Mike Lean: Hello, how are you?

Norman Swan: Fine. You say in the paper that this is the first trial of its kind in type 2 diabetes, which is extraordinary.

Mike Lean: We've known about type 2 diabetes and thought of it as a distinct disease growing enormously in numbers and costing perhaps more than any other single disease for about 100 years, and it has been noted in a number of studies that some people if they lose enough weight will get rid of their diabetes. But no study has previously gone out to actually try and do that, to actually get as many people as possible to become non-diabetic, to get rid of their diabetes completely.

Norman Swan: So what did you do in this study?

Mike Lean: Well, this is not rocket science. What we did was we recruited people in primary care, in general practice, who were overweight, BMI over 27, so not enormously overweight but overweight, with type 2 diabetes. And we ask them to follow a formula diet, not a very low calorie but and 800-odd calorie diet for as long as it took, and it took quite a long time in some cases, to lose enough weight to become non-diabetic. And we aimed to get 15 kg weight loss because we knew from other observations that that was likely to do it. And of course not everybody managed, sadly, a lot of people found it really hard. A lot of people did manage. In the end we got about a quarter of our patients to lose that amount of weight. And those who lost 15 kg, almost 90% were no longer diabetic after a year, they were off all their medication, they were off all their diabetic medication and their antihypertensive medication, and they felt a lot better, their quality of life went up.

The remainder who didn't lose 15 kg, none of them got worse. Of those who lost over 10 kg, over half of them were non-diabetic. So you don't need to lose 15 kg but it's much better if you do. And I think what we've learnt from this is what we've regarded as a distinct disease, type 2 diabetes, is actually all part and parcel of obesity when you think about obesity as a disease process…

Norman Swan: We'll come back to the diet in a minute. And what was the recidivism rate, if you want to call it that, in terms of people gaining weight again and returning to diabetes?

Mike Lean: Yes, so that is of course…we've only published the one-year results and there's a lot more to find out. What we did find out was that the proportion of people with diabetes who wanted to have a go at this was very high. It was probably no great surprise because being diabetic is a penalty and it carries terrible medical risks as well as financial. The number within a year who put on any weight was really quite small, but we know very well from earlier studies that it's hard to maintain…the biggest problem is not losing the weight, it's actually maintaining it long term, and that's where our big research effort needs to go.

Norman Swan: So the diet itself…an 800 calorie diet is not something you try yourself at home because you can go into nutritional deficiency. This was a shakes and bars diet, wasn't it, it was a meal plan diet.

Mike Lean: That's correct, it was a formula diet which made sure it had all the vitamins and minerals, everything that was necessary, provided the patients actually followed this. And they didn't have to pay for it, they were given it for the study. And so they did that, so it was perfectly safe, there was no…

Norman Swan: That's my point, so it's one of these things you can buy in the chemist and it comes in various boxes, but we won't talk about the branding.

Mike Lean: The branding doesn't matter, all these things are pretty much the same. What matters is not what comes in the box or out of the packet, it's the support that is given with it, because people who go and get these type of diets from the chemist or from a supermarket generally do it for two or three or four weeks and then they peel off. If you are going to get rid of your diabetes you've got to stick in for probably 12 weeks if you do it full time. There are plenty of people who do it off and on for 12 weeks and need to carry on doing it off and on for a bit longer to lose their 10 or 15 kg. So there are different routes to getting there, you don't half to lose it all in one go but it works better if you do.

Norman Swan: What about complications, like if you lose weight fast when you are overweight you can get gallbladder disease…

Mike Lean: Ah, you're well informed!

Norman Swan: You can low blood sugar if you're on insulin, or diabetes complications. What sort of complications did people get?

Mike Lean: Well, the first thing was for this particular study we didn't include people who were already on insulin, partly because their likelihood of getting a remission is much lower. It had probably done damage to their pancreas by that stage. And what we did on day one was that we stopped all our anti-diabetes medication, so there's no risk of hypoglycaemia at all, and nobody had hypoglycaemia. And the same thing went for the blood pressure tablets, we stopped all their blood pressure tablets on day one because otherwise if you lose weight there is a risk of possible hypotension, and just to pick up your other point, there was one patient amongst the 150 who started, one who developed abdominal pains and we think that was probably by gallstones. That's a common complication of obesity, very common in people with diabetes anyway, and it can be made worse during weight loss.

Norman Swan: These are similar findings to bariatric surgery.

Mike Lean: Oddly the remission rate was actually a tiny bit better than bariatric surgery if you can lose 15 kg. If you lose 15 kg you will almost certainly get rid of your diabetes, whether or not it's done with surgery. There are of course many fewer hazards doing it without surgery. They produce very similar results, yes.

Norman Swan: Mike, thanks very much for joining us, a fascinating study.

Mike Lean: Thank you very much.

Norman Swan: Mike Lean is Professor of Human Nutrition at the University of Glasgow.

Fatty Liver Disease & Type 2 Diabetes 
"Given the increasing worldwide incidence of obesity and metabolic syndrome, non-alcoholic fatty liver disease (NAFLD) has become the most common cause of chronic liver disease. Recent developments in the field have shown that NAFLD not only is a “liver disease” but also is the underlying cause of an increasing number of extrahepatic manifestations; thus, it should be treated as a multisystem disease. NAFLD is most prominently linked to chronic kidney disease, mellitus type 2 and cardiovascular disease, as well as a number of other severe chronic diseases. These findings demonstrate that NAFLD ranks amongst the most serious public health problems of our time."

Also noted in the article; The prevalence of Nonalcoholic Steatohepatitis (NASH), in people who are obese and have type 2 diabetes may be as high as 40%, whereas it is less than 5% in people without type 2 diabetes.
Read the article, here.

Presented at Liver Congress 2018
Alcoholic liver disease replaces hepatitis C infection as leading cause of liver transplantation in patients without hepatocellular carcinoma in the USA
Two independent studies presented at the conference reported; that alcoholic liver disease has now replaced hepatitis C virus (HCV) infection as the leading cause of liver transplantation in the USA in patients without HCC. Non-alcoholic steatohepatitis (NASH) is also on the increase, now ranking second as a cause of liver transplantation due to chronic liver disease.
Read the article, here.

Hepatitis C & Diabetes
Several studies have demonstrated the risk for development of diabetes is increased in people with chronic hepatitis C infection (HCV), for instance people with HCV have a 2.3 fold increased chance of having type 2 diabetes. According to a 2013 study published in Alimentary Pharmacology Therapeutics; Chronic hepatitis C virus infection is independently associated with presence of metabolic conditions (insulin resistance, type 2 diabetes mellitus and hypertension) and congestive heart failure.

HCV Treatment & Type 2 Diabetes
The good news is with today's high sustained viral response rates using direct antiviral medications to treat HCV, people who successfully reach SVR, or achieve a cure, lower their risk for the development of type 2 diabetes, the recent study was published in the Journal of Viral Hepatitis [published online February 25, 2018]. A quick overview of the study can be found online, here.

Fatty liver is very common in hepatitis C virus (HCV) patients post-SVR
This particular study may be of interest to people with HCV, according to data published Mar 21, 2018 in the online journal World J Gastroenterology, evidence of steatosis was reported to be found in close to half of patients who achieve a sustained virologic response after treating with direct-acting antivirals. Full-text, here....

Tips - Eating Right
Eating better tied to lower risk of liver disease
April 27, 2018
(Reuters Health) - People who make an effort to improve their diet may be more likely to have less fat in their livers and a lower risk of liver disease than individuals who stick to unhealthy eating habits, a U.S. study suggests.

The Liver Loving Diet
"The Liver Loving Diet" is a book that will help you learn to eat well during all phases of liver disease. Karen Hoyt, the author, also blogs about living with and treating hepatitis C, cirrhosis, liver cancer and liver failure.

Mediterranean diet reduces liver fat, risk for NAFLD
March 30, 2018
Improved diet quality based on the Mediterranean-style diet score and Alternative Healthy Eating Index score correlated with less liver fat accumulation and a reduced risk for new-onset nonalcoholic fatty liver, according to a recently published study.
Continue reading @ Healio

Bottom Line
Spring is a great time to start again, experts agree two key elements in the prevention and management of type 2 diabetes and fatty liver disease is weight loss and exercise. In the end, its all good for your liver!

See you soon,
Tina

Sunday, January 28, 2018

HCV Updates & A Look At The Most Intense Flu Season In Years

Welcome, sit back and catch up on notable research articles and blog updates on the topic of viral hepatitis. However, we begin with updates on this year's flu season, with experts reporting it's the worst in nearly a decade

A Look At The Most Intense Flu Season In Years


CDC
Keep up with the latest flu news as it is posted on the CDC's website.

Transcript for CDC Update on Widespread Flu Activity
Tuesday, January 16, 2018
We called this briefing to get you the latest FluView numbers and to provide advice on preventing the flu and information about what people can do to reduce the risk of flu or serious illness.
Listen here

The American Council on Science and Health
This Year's Flu Is Different - It Kills In Two Ways
Jan 29, 2018
It is the 100th anniversary of the 1918 Spanish flu (1,2) pandemic, and the date is not the only similarity between the two. While it is impossible that the morbidity and mortality that is being caused by this year's H3N2 strain (3) will even approach that of the monster that infected 5% of the world, killing 2% of it, there is one troubling feature that this year's strain shares with its centennial cousin. Flu typically kills because of secondary infections, usually pneumonia. While both "18s" do this, they also kill people directly. This is the scary part. The latter is mercifully rare but it dominates the news. Children seem to be more susceptible rapid deaths. Cases have been recently reported in Florida, California, and Connecticut. And it may be growing, especially as new strains emerge (4). The cause of fast deaths is very different from that normally seen in flu death. It is more insidious, harder to prevent and can nothing can be done about it. One hundred years ago there were reports of people dying within hours of becoming ill.

Journal: New England Journal Of Medicine
January 25, 2018
J.C. Kwong and Others
Patients who had a positive laboratory test for influenza were six times as likely to be hospitalized for acute myocardial infarction during the 7 days after specimen collection (the “risk interval”) as during the year before and the year after the risk interval.

NPR
Rob Stein
The flu is hitting the 65-and-over age group hardest, but the next-hardest hit is the 50-to-64 age group. Usually, children are the second-hardest hit. The reason is unclear. Jernigan says it may be because the strains of the flu to which baby boomers were exposed when they were young are different from the strains circulating this year, so they have less immunity.

Healio
CDC: Flu hospitalizations, deaths high; vaccination still urged
January 26, 2018
Influenza-related deaths this season have remained elevated for weeks, and hospitalization rates are comparable to the severe 2014-2015 influenza…

American Thinker
January 28, 2018
By Rick Moran
“We often see different parts of the country light up at different times, but for the past three weeks the entire country has been experiencing lots of flu, all at the same time,” he said, adding: “We have several weeks to go.”

NBC News
Virus looks like flu, acts like flu, but it's not influenza
by Maggie Fox
Jan.28.2018
There’s another virus out there that could be adding to the seasonal misery, but it’s not being identified. The virus is called adenovirus, and it can cause very severe flu-like symptoms. It’s so risky that the U.S. military vaccinates recruits against two major strains.

In The News
England could become first country to eradicate Hepatitis C in 2025
Jan 29, 2018
NHS leaders today called on the pharmaceutical industry to work with them to provide best value for money for treatments so that in its 70th year, the NHS can commit to eliminating Hepatitis C in England at least five years earlier than the World Health Organisation goal of 2030.

HepCBC
Read today's news or check out the latest issue of Weekly Bull.

CDEC Recommends MAVIRET™ and VOSEVI™ for Reimbursement for Chronic HCV
January 27, 2018
On January 25, 2018 the federal CADTH Canadian Drug Expert Committee (CDEC) released its extensive reviews of two new "pan-genotypic" hepatitis C treatments: Maviret™ (AbbVie) and Vosevi™ (Gilead). In both cases, the drugs were recommended for reimbursement by provincial PharmaCares for "adult patients with chronic hepatitis C virus (HCV) genotype 1, 2, 3, 4, 5, or 6 infection with or without compensated cirrhosis." And, for both, reimburseme...

New Online
Medscape: CME Video
Treating Genotype 1-6
HCV Treatment: Incorporating Glecaprevir/Pibrentasvir and sofosbuvir/Velpatasvir/Voxilaprevir Into Clinical Practice
This 15-minute activity features a brief video introduction by faculty expert Dr. Muir in which he discusses how the new combination therapies glecaprevir/pibrentasvir and sofosbuvir/velpatasvir/voxilaprevir have changed the treatment landscape. The activity then continues with a text-based review of the recent advances in direct-acting antiviral (DAA) treatment for hepatitis C virus (HCV) and the clinical trials that led to the approval of these new agents.
Free registration is required 

Journal Updates
Journal: Alimentary Pharmacology and Therapeutics
Hepatitis C virus re-treatment in the era of direct-acting antivirals: projections in the USA
The introduction of oral direct-acting antivirals (DAAs) has dramatically changed the landscape of HCV treatment. However, a small percentage of patients fail to achieve sustained virologic response (SVR). Understanding the number of people who fail on DAAs and require re-treatment is important for budget impact and disease burden projections.

Journal: World Journal of Gastroenterology                   
This review addresses general aspects of vitamin D deficiency and, in particular, the significance of vitamin D hypovitaminosis in the outcome of HBV- and HCV-related chronic liver diseases. Furthermore, current literature was reviewed in order to understand the effects of vitamin D supplementation in combination with IFN-based therapy on the virological response in HBV and HCV infected patients.

Journal: World Journal of Hepatology
Efficacy of direct-acting antiviral treatment for chronic hepatitis C: A single hospital experience
Direct-acting antivirals have been approved for the treatment of hepatitis C virus (HCV) genotype 1 and 2 infections in Japan since 2011. In the new era of DAA therapy, predictors who fail to respond to DAA might be compromised by resistance-associated substitutions. There have been few reports of daclatasvir/asunaprevir failure because daclatasvir/asunaprevir is limited in Japan. Therefore, it might be important to report these cases for future research and treatment of HCV.

The following articles downloaded and shared by @HenryEChang via Twitter

Journal: Liver International
NVHR and the Center for Health Law Policy and Innovation at Harvard Law co-hosted this webinar on highlights from the "Hepatitis C: State of Medicaid Access" report, including methodology and key findings.

Contagion Live
Hepatitis C-Related Hospitalizations Rise By Almost 50%
EINAV KEET
The new report found that the number of inpatient hospital stays for patients seeking treatment solely for hepatitis C rose by nearly 49% from 2005 to 2014. In addition, hospital stays for hepatitis C patients also seeking treatment for hepatitis B, HIV, or alcoholic liver disease rose by about 11%. Overall, adults ages 52 to 72 years saw a more than 67% increase in hepatitis C-related hospitalizations –the most of any age group –while those ages 18 to 51 years saw a nearly 15% decrease in hospitalizations. Hospital stays involving hepatitis C were also longer, more expensive, and more likely to result in death than stays that did not involve hepatitis C.

HEPATITISC.NET
By Kimberly Morgan Bossley - January 26, 2018
After curing hep C in 2014 many things changed in my life. I sold off half of my company and took the other with me and put in my home. After bringing the...

Getting Dumped with Hepatitis C 
By Karen Hoyt - January 25, 2018
After years of living with hepatitis C, I was very sick. My husband gave up on my low-energy self. He was about done with having a brain foggy wife. Within months of...

By Daryl Luster - January 24, 2018
It has become evident to me that there are people who are treating their hep C with drugs that they purchase from countries where generic drugs are produced. These drugs are produced... 

HEP Blog
The Fire and Fury of Hep C 
January 26, 2018 
Growing up with Hep C colors the world very differently. Because I knew early, I avoided alcohol from the get-go. I’d like to think it allowed my liver to keep going to thirty. My biggest fear wasn’t dying, but accidentally infecting someone else. Over time I found my paranoia getting the better of me. I abhorred physical contact, because it added to the layered stress of social interaction. Having notified the school of my condition I was kept out of PE. I wasn’t shy about the topic, and the stigma merely fueled my rebellious teenage self. I clung to that rage, it felt justified, but often when we’re young we misidentify the real emotions at play.

By Karen Hoyt
A glimpse at an easily overlooked tool for healing.

Hepatitis C Reactivation: What It Is and What It Isn’t 
By Lucinda K. Porter, RN
Hepatitis C reactivation may occur in people receiving cancer treatment. However, hep C reactivation may not mean what you think it does.

By Greg Jefferys
In Ireland, the rate of Hepatitis C infection is one of the highest in the EU at about twice the international average.
Jennifer Variste, MD
January 27, 2018 
So you heard the flu shot is 10 percent effective. With so many sources of information available, the primary care provider’s role increasingly becomes that of educator. It is important to me that the parents of my patients make informed decisions, so when I have a parent decline the influenza vaccine, I make an effort to ask why. The number one response I hear has been “What’s the point? The flu ...

Hepatitis B Foundation
Timothy Block, PhD
Welcome to Journey to the Cure. This is a web series that chronicles the progress at the Hepatitis B Foundation and Baruch S. Blumberg Institute towards finding the cure for hepatitis B.

Healthy You
Why herbal supplements taken with prescription drugs may be risky



Recommended Reading
Herbal Supplements May Be Dangerous When You Take Certain Prescription Drugs
By Amanda MacMillan
January 24, 2018 
A number of common herbal supplements, including green tea and Ginkgo biloba, can interact with prescription medications, according to a new research review published in the British Journal of Clinical Pharmacology. These interactions can make drugs less effective—and may even be dangerous or deadly. 
The new review analyzed 49 case reports of adverse drug reactions, along with two observational studies. Most people in the analysis were being treated for heart disease, cancer or kidney transplants, and were taking warfarin, statins, chemotherapy drugs or immunosuppressants. Some also had depression, anxiety or neurological disorders, and were being treated with antidepressant, antipsychotic or anticonvulsant medications.
Continue reading: http://time.com/5116664/are-herbal-supplements-safe/

Medical News Today
What to eat if you have hepatitis C
Last reviewed Thu 25 January 2018
By Tom Seymour
Reviewed by Natalie Olsen, RD, LD, ACSM EP-C
Hepatitis C can damage the liver and lead to cirrhosis, or scarring of the liver. Damage to the liver may mean that a person needs to modify their diet.

May we all remain healthy this flu season.
Tina

Tuesday, October 31, 2017

Living With HCV Or Chronic Liver Disease? Updated Videos From Advocate Karen Hoyt

Sometimes it's nice to have a place to call your own, a place that feels very much like home. Karen Hoyt has created such a place some six years ago, a safe haven with a candid look at liver disease from a patients prospective, called: I Help C.

Karen shares her own journey living with cirrhosis and liver cancer, to the emotional ups and downs of her lifesaving liver transplant. If you haven't found Karen yet, she is a master at providing patient-friendly diet and lifestyle tips for liver disease patients, filling a much needed void for people living with the hepatitis C virus (HCV) and fatty liver disease.

While we have effective drugs to cure HCV, in little as twelve to eight weeks, across all six HCV genotypes, including treatment options for people with severe liver damage, such as compensated cirrhosis, not everyone - was or is - diagnosed with HCV before serious liver damage occurs. According to a study published in Clinical Infectious Diseases and presented at CROI 2015, a substantial number of baby boomers are living with advanced liver disease. In data collected between 2010-2013, researchers reported in 2013, close to half of people born during 1945-1965 had severe fibrosis or cirrhosis. In addition, in a prospective study presented at this months Liver Meeting, close to half of people with hepatitis C, who achieved SVR (cure), were found to have fatty liver disease. The article was recently published over at Medscape.

Karen's Been Busy 
A series of  new videos is now available on Karen's YouTube channel. You'll find each video informative; from haircare tips to serious topics such as ascites, hepatic encephalopathy and other liver-related complications. Not that haircare isn't a serious topic, nuff said!

To help guide you through a well-balanced diet, which is essential to help fight or curtail liver damage, Karen published: The Liver Loving Diet. The book is a labor of love, a huge undertaking for someone dealing with Hepatic Encephalopathy (HE), a serious disorder that can happen without warning if you have advanced liver disease, causing confusion, brain fatigue (brain fog) and problems with hand movements, making concentration and typing difficult. Get to know Karen better by reading an excerpt from her book: Emergency Room Diagnosis with Liver Cirrhosis.

In this uncertain world, there are few people who help others without expecting something in return. In her own modest way, with an open heart, Karen is determined to improve the lives of people struggling with liver disease, an act of kindness that does not go unnoticed.

Wednesday, June 28, 2017

The Liver - Super Foods & Supplements

Liver Super Foods



Published on May 30, 2017
Source - American Liver Foundation Great Lakes Division



In The News
Go Easy on the Avocado Toast: ‘Good Fat’ Can Still Be Bad for You, Research Shows
By on

Friday, February 24, 2017

The Liver Loving Diet - A Must Read For People With HCV Or Liver Disease

The Liver Loving Diet

My admiration runs deep for a small group of bloggers who spend hours in front of a computer helping those suffering with HCV. What they accomplish is astounding, why do they do it?

So that no one with this disease ever feels alone.

HCV is a progressive liver disease that can be cured, although cirrhosis is usually irreversible and can potentially lead to life threating complications.

Karen Hoyt understands this only to well, she is devoted to offering support and accurate information to people coping with the effects of liver disease. Karen writes from a patients' perspective about living with and treating hepatitis C, cirrhosis, liver cancer and liver failure on her blog, "Your Best Friends Guide To Hepatitis C."

This compassionate author, HCV advocate, and survivor, once again is doing what she does best, keeping us informed and full of hope. Karen has recently announced her new book, "The Liver Loving Diet" is available to enjoy, a book that will help you learn to eat well during all phases of liver disease. For the cost of a few cups of liver friendly coffee - this book can be yours.

Purchase is now available through PayPal, click here to learn more.

From Karen

Low Sodium, Healthy Protein Plan
After my diagnosis with Hepatitis C and liver failure, I got busy putting together a low sodium, healthy protein plan for eating.

Here at Your Best Friends Guide, you all have blown me away with requests for an easy menu plan. I love the emails pouring in from you all sitting in hospitals, grocery stores, and at home. You’ve begged for recipes. Well, it’s taken some time (2 years), but I heard you and here it is!

Drumroll please….

The Liver Loving Diet Book is a big picture peek at liver disease that helps you understand how valuable it is to eat well during treatments, cures, setbacks, cancer, and transplant. My diet played a huge role in keeping me alive and active. Now I’m handing all that power to you in one tidy package – tied up with love and priced at $4.99. I worked extra hard to give you a simple book with over 300 pages of personal stories and recipes.

Visit Karen on Facebook or follow her on Twitter

Thursday, August 11, 2016

Friday, February 14, 2014

Cirrhosis, Heart Disease And Salt Substitutes

Cirrhosis, Heart Disease And Salt Substitutes

When suffering from a serious heart or liver condition it's likely your healthcare provider will  recommended a low salt diet.

Adjusting to a new diet that involves controlling sodium intake is difficult for anyone, especially for my eighty year old, five foot, salt loving momma.

After momma was diagnosed with a serious heart condition her children came together to devise a master plan to confiscate the beloved salt shaker - it wasn't pretty.

Salt to my mother is what Kanye West is to Kim Kardashian, she knew it was bad for her, but she wanted it anyhow. Sorry, that wasn't very nice mom, you were seventy nine and five foot one.

In any event, my poor momma had no choice but to follow a boring, no taste, low salt diet. In her case the new diet was advised to control fluid retention, which is often the case for people suffering with cirrhosis.

When I asked about salt substitutes to calm my mother and elevate my guilt, the cardiologist recommended against them. At the time I didn't completely understand why, recently after reading an article online at Berkeley Wellness, I learned it was because they contain potassium chloride which can interact with ACE inhibitors, or her heart medications; captopril, lisinopril, benazepril and potassium-sparing diuretics. My mother was on most of those medications, the diuretics were adjusted by me weekly and yes they were potassium-sparing.

According to the article, salt substitutes such as Morton Salt Substitute, NoSalt and Nu-Salt all consist of potassium chloride. Watch out for “Lite” or “low-sodium” salts such as LoSalt and Morton Lite Salt they are a blend of both sodium chloride and potassium chloride. These products can also be dangerous for people with chronic kidney disease.

The University Of Michigan Health System, also warns patients with cirrhosis on a low salt diet against using “salt substitutes” because again, they contain too much potassium. So what about “sea salt,” nope, it has the same amount of sodium as table salt. So what can you use for a substitute? The hospital recommends “Mrs. Dash” or other spices.

Download; Liver Cirrhosis - A Toolkit For Patients
An excerpt from the pamphlet;




The bottom line is avoid salt substitutes if you are controlling sodium intake due to cirrhosis, heart conditions, have kidney disease or on certain medications.

Stay healthy, until next time.
Tina

Credit
Painting - No! I Want it Now!
See more works by Dakota Solt 

Sunday, February 2, 2014

The Mediterranean Diet For Liver Disease

The Mediterranean Diet 

There are few things about which I am obsessive, one is bedbugs, the other is dieting.

For decades advertisements have inspired or tricked us, me mostly, into trying a number of crazy diets. 

For whatever reason folks, years ago, I never met a diet I didn't try.

In my twenties I inhaled the cabbage soup diet, gave up eating anything white during Christmas, even juiced for a few days, and really committed to that cookie diet.  

In my thirties I embraced Dr. Atkins’ Diet Revolution, eggs became my dinner, bacon became my steak, and the water weight I lost impressed my scale.

In my late thirties at a Weight Watchers meeting I met a handsome vegetarian, I dumped the meat, he dumped me, and I moved on to Jenny Craig. Such is life.

In any event, with age comes wisdom. One day, I sat down and looked at my own medical history along with my families, took a few notes to present to my physician. At my very next appointment we discussed any risk factors for disease, such as heart disease and diabetes. Long story short, in the end because of my history of HCV and high risk for diabetes he suggested I try the Mediterranean diet, I took his advice. 

The Mediterranean Way Of Eating - My First Non-Diet Approach To Eating Right

For the last fifteen years I have adopted the Mediterranean way of eating, commonly referred to as the Mediterranean diet. Although, it isn't really a diet, the name evolved as a way to reference a group of healthy foods, or a diet pattern used by people whose countries border the Mediterranean Sea. In these countries, especially Greece, people eat a lot of fruits, vegetables, legumes fish and olive oil.  According to years of research, people living in this region suffer less than most Americans from cancer and cardiovascular disease. 

Everyone should eat a healthy, balanced diet to maintain their health, especially people living with chronic illness. Maintaining a healthy weight is especially important if you have HCV, the risk for developing scarring of the liver; fibrosis and cirrhosis is higher in people who are obese and living with the virus.

Diets come and go, as do hot vegetarians, but for people with liver disease eating foods proven to help preserve, or even improve overall liver health is worth the effort.

Today close to 30% of American adults have nonalcoholic fatty liver disease (NAFLD). In people living with hepatitis C it rises to around 40% and even higher in people with genotype 3. Often referred to in the medical world as HCV-induced steatosis, 60% to 80% people with genotype 3 have moderate or severe steatosis.

So What Is HCV-induced Steatosis?

Fatty liver disease (steatosis) is a build-up of excess fat in the liver cells, and in some cases may trigger inflammation of the liver.  HCV-induced steatosis develops due to a combination of viral and host factors. Viral factors are genotype specific, with genotype 3 viral-induced steatosis the most common, up to 80% of people with genotype 3 have moderate to severe steatosis. Chronic hepatitis C also alters glucose metabolism resulting in insulin resistance (IR), further promoting hepatic steatosis, which outside of genotype 3 infection has been associated with more advanced liver disease, according to a review published in last months issue of the Journal of Viral Hepatitis. 

Another study published in Nutrition 2013, found HCV patients who participated in a diet and exercise program lowered their grade of steatosis and remarkably, their fibrosis score.

For most people, I raise my hand in shame,  diets are something we jump on and jump off, but eating right is better accomplished when we make it more of a lifestyle. Rather it originated on the boarder of the Mediterranean Sea, or here in the U.S., it only works when we embrace it as a way of life. 

America - Suggested Nutrition Guidelines

In the United States the USDA Dietary Guidelines for Americans, is intended to help people choose an overall healthy diet, based on five food groups. The dietary guide is put together jointly by the Department of Health and Human Services (HHS) and the Department of Agriculture (USDA). A committee of scientific experts review the guide which is  incorporated into a scientific evidence-based report, the next edition will be released in 2015.

The dietary recommendations are aimed at preventing two major health problems in the U.S., which are obesity and heart attacks. Obesity can sneak up on us overtime, the older we get the more calories we consume, more than the body burns. Obesity in turn can cause numerous health problems, such as heart disease, stroke, liver disease, arthritis, high blood pressure, gout, gallstones, and even certain cancers.

In June 2011, the USDA launched a visual guideline depicting a place setting using the five food groups, called  MyPlate. It proved successful and replaced our some twenty year old food pyramid.

Check out this interactive website; ChooseMyPlate, find tons of advice on nutrition, watch a few videos, grab a recipe or take part in an educational program.

 Follow MyPlate on twitter for daily tips.


Cooking according to MyPlate guidelines is possible in any culture, rather you come from Europe, Asian or American. In the video Cris Comerford, prepares an authentic Filipino dish following the MyPlate guidelines and portion size.

For Chef Comerford's recipes, go here:
http://www.letsmove.gov/blog/2013/05/...

Healthy and Traditional Asian American and Pacific Islander Cuisine

Shrimp, Chicken and Vegetable Fried Rice



Links:
ChooseMyPlate.gov features practical information and tips to help Americans build healthier diets


The Mediterranean Diet
As previously mentioned, this is my preferred way of eating. The program includes a high consumption of olive oil, legumes, unrefined cereals, bread, pasta, rice, nuts with less red meat and dairy products than many other diets. Although, red wine is used in moderation, it has never been advisable for people living with hepatitis C, or advanced liver disease. Other food choices are lots of fresh fruit, vegetables and moderate consumption of fish. Fish is rich in omega-3 fatty acids and low in saturated fats. Omega-3 fatty acids can help lower triglycerides and blood pressure.

Clinical research has demonstrated adhering to a diet plan with foods named in the Mediterranean diet may help preserve memory as we age, reduced both liver fat and inflammation, help protect against liver cancer, may have potential benefits for people chronically infected with hepatitis, reduce the risk for diabetes, heart attack and stroke - Whew!  Provided next.is a research summary of the above mentioned health benefits, followed up with a link to each original article and research.

Mediterranean Diet and Memory

Omega-3 fatty acids are also known to benefit the brain and nervous system. A study in the journal Neurology, January 2013, reported adhering to a Mediterranean diet may help to preserve memory.

U.S. researchers studied 17,478 people with an average age of 64 by monitoring their eating habits, and testing their mental ability over a four year period. In that time, 7% developed problems with their memory and ability to think. Those who ate a Mediterranean diet had a 19% reduced risk of mental impairment. 

Mediterranean Diet and Liver Disease

Previous studies have suggested the Mediterranean Diet has additional benefits for people with liver disease, for instance a study published in the July 2013 issue of the Journal of Hepatology demonstrated patients with nonalcoholic fatty liver disease who followed the diet for six weeks not only significantly improved insulin sensitivity, but reduced both liver fat and inflammation.

Mediterranean Diet, Hepatocellular Carcinoma and Viral Hepatitis

This is exciting, according to a study found in the Journal of Hepatology, November 2013;
A closer adherence to the Mediterranean diet appears to be protective against HCC (liver cancer). Our results also point to potential benefits from adhering to a Mediterranean dietary pattern for patients chronically infected with hepatitis viruses. 

Read the full article over at NATAP, abstract here.

Mediterranean Diet and Diabetes

A recent study found patients at high risk for diabetes due to pre-existing cardiovascular conditions reduced the risk for diabetes by 40% by adhering to the traditional Mediterranean diet high in extra-virgin olive oil intake. View the study; Prevention of Diabetes With Mediterranean Diets: A Subgroup Analysis of a Randomized Trial, published in Annals of Internal Medicine -  

Mediterranean diet  and Heart Attack and Stroke

2013-Mediterranean diet  and Heart Attack and Stroke:

Published in the February 2013 online issue of the New England Journal of Medicine, a Mediterranean diet supplemented with extra-virgin olive oil or nuts reduced the incidence of major cardiovascular events (heart attack, stroke, cardiovascular death) by close to 30%, among people with high cardiovascular risk.

A total of 7447 persons were in the study (age range, 55 to 80 years); 57% were women. None had cardiovascular disease when they enrolled in the study, but they did have a high cardiovascular risk.
The participants were broken down into three cohorts. The first group followed a Mediterranean diet with extra-virgin olive oil, the second a Mediterranean diet supplemented with nuts, and the last group (control) followed a low-fat diet. Statistical analysis showed that compared to those following the control (low-fat) diet, participants on the Mediterranean diet with extra-virgin olive oil were 30% less likely to experience a cardiovascular event, and those on the Mediterranean diet with nuts were 28% less likely. Researchers reported on the importance of the results  "... the results of the PREDIMED trial are of utmost importance because they convincingly demonstrate that a high vegetable fat dietary pattern is superior to a low-fat diet for cardiovascular prevention."

Read the article, here 

2014-Mediterranean diet: lower risk of peripheral artery disease (PAD):

A multicenter study that previously reported a reduction in heart attack and stroke with a Mediterranean diet supplemented with extra-virgin olive oil or with nuts now also reports a lower risk of peripheral artery disease (PAD), according to a study in the January 22/29 issue of JAMA.

"To our knowledge, this is the first randomized primary prevention trial to suggest an association between a dietary intervention and [reduction in] PAD. These results are consistent with previous observational studies and relevant from a public health perspective," the authors write.
Read the article here..........

****Related- Feb 2014:Increased prevalence of coronary artery disease risk markers in patients with chronic hepatitis C – a cross-sectional study
Chronic hepatitis C is a global health problem and has been associated with coronary artery disease. Our aim was to examine the prevalence of coronary artery disease risk markers including endothelial biomarkers in patients with chronic hepatitis C and matched comparisons without manifest cardiovascular disease or diabetes in a cross-sectional design.
 
Mediterranean Diet and Longevity 

A few months ago, an observational study published in the Annals of Internal Medicine , November 2013 issue, suggested middle-aged women who follow a Mediterranean diet may live longer.

The 15 year study primarily funded by the National Cancer Institute, National Institutes of Health, examined 10,670 women aged late 50s and early 60s.

The purpose of the study was to examine the association between dietary patterns in midlife and prevalence of healthy aging.

In the end, after 15 years, middle-aged women who followed the Mediterranean diet had a 40% more chance to live up to age 70, then those who followed a different eating style.

Read more about the history of the diet, here.  

What Is the Mediterranean Diet?

Excerpt: The Mediterranean Diet and Good Health
There is no one typical Mediterranean diet. Many countries border the Mediterranean Sea and variations in the Mediterranean diet exist between these countries. However, according to the American Heart Association, traditional Mediterranean diets have the following characteristics in common:

An abundance of plant foods:
Fruits
Vegetables
Breads and cereals
Potatoes
Beans, nuts, and seeds

Olive oil used as a common monounsaturated fat source
Low-to-moderate amounts of fish and poultry
Small amounts of red meat
Low-to-moderate amounts of dairy products (mostly cheese and yogurt)
Low-to-moderate amounts of eggs (zero to four times per week)
Low-to-moderate amounts of wine (one to two glasses of wine per day), normally consumed with meals

* Skip the wine if you hepatitis C or advanced liver disease 

Comparison With the American Diet

 The American diet is characterized by:

Animal products daily, as main source of protein
White starches, predominantly
Moderate to low in fruits and vegetables
High in saturated and trans fats

Unlike the typical American diet, the traditional Mediterranean diet is high in fiber and low in saturated fat. However, the Mediterranean diet is not necessarily low in total fat. But, the types of fats emphasized in the Mediterranean diet are "healthy" monounsaturated fats, like those found in olive oil, which do not raise cholesterol levels.
Read more here........ 

Links:
Mediterranean diet: A heart-healthy eating plan
Mayo Clinic Staff
How to Follow the Mediterranean Diet
Offers a quick guide
The Mediterranean diet: 4 recipes to try  
You've heard the health benefits of the fruit & fish-packed Mediterranean diet, now it's time to test it out in the kitchen. We turned to ‘Cook Yourself Sexy’ chef Candice Kumai for these delicious recipes, loaded with omega-3s and nutrients.

The goal of healthy eating is to develop a plan that you can maintain for life. For people living with hepatitis C,  keeping your weight under control can lower your risk for developing fibrosis, liver cancer, and diabetes.

Whatever healthy plan you try, or use now, may you remain safe, healthy and happy.

Until next time, Tina

Thursday, December 19, 2013

Hepatitis C Update: What's Happened In 2013 and Taking Medications as Directed

December Newsletter Update

Christmas is just around the corner, have you finished your shopping yet?

While shopping feverishly for a fairy doll that flies, have you heard of it? Anyhoo, I ran into Santa, he asked me to update this months index of HCV newsletters - of course I said yes!

The American Liver Foundation just published their December Newsletter with a focus on hepatitis C. One featured topic is the importance of taking prescription medications as directed, also included is information on both newly approved HCV drugs, Sovaldi and Olysio.

Over at  Hepatitis C News, a video looking back at what's happened in 2013 is now available for your viewing pleasure.

At my house, a new fairy doll is wrapped and under the tree for the little people in my life.

Merry Christmas!

*All December newsletters, information on future and current direct-acting antivirals including a quick summary of Gilead's clinical trial data can found here.

Updates

American Liver Foundation
 

Living With Hepatitis C: Importance of Taking Medications as Directed
Prescription drugs can provide important benefits to individuals living with hepatitis C, but taking these medications as prescribed can be difficult. Some individuals struggle with drug side effects and costs while others may forget to take medication on time or order refills. Fortunately there are steps that can help address these challenges and better manage this condition through medication.


HEPATITIS C UPDATE

American Liver Foundation Hails Promise of Cure Signaled by Approval of New Hepatitis C Treatments
The FDA has approved two new treatments for hepatitis C: Sovaldi, to be used in combination with other anti‐virals; and Olysio, the first once-daily protease inhibitor. Welcoming the approval of these breakthrough drugs, American Liver Foundation National Board Chair Tom Nealon said: "This is the beginning of a new, gentler, era in the treatment of hepatitis.”


LOOKING BACK AT 2013

The Year in Pictures
Here’s a sampling of pictures to illustrate how we promoted the need for liver disease awareness during 2013. One of the highlights: A photo showing members of our Run for Research Team symbolically completing the Boston Marathon nearly three weeks after the event was the site of a shocking bombing. Their message: “We are Boston Strong!”


CHECK YOUR SCORE: HOW MUCH DO YOU KNOW ABOUT YOUR LIVER?
For the festive season, when you get a moment to relax, find out how much you know about the liver. This multiple choice quiz poses intriguing questions such as: Where did the first successful liver transplant take place? And why would we ask a question where the answer could be Michael Jackson, Ray Charles, John Lennon or Frank Sinatra?


HEALTHY RECIPES FOR THE HOLIDAYS
Looking to cook up something healthy and out of the ordinary for the holidays? The American Liver Foundation has the answer! Two celebrated chefs, who are involved with our annual Flavors events, suggest these mouthwatering recipes: Chestnut Stuffing (Chef Beau MacMillan) and Soup of Red Bell Pepper (Chef Christopher Gross). Happy cooking…and eating!

 
Hepatitis C News
 
Visit HepatitisCNews.com, an online community for those living with hepatitis C
 
The December edition of Hepatitis C News, where we take at look at what's happened in 2013
 
 


 
See You Soon
 
 
 

Tuesday, November 26, 2013

Good Gravy: HCV, Fatty Liver, And Thanksgiving

Good Gravy: HCV, Fatty Liver, And Thanksgiving 

My timing, like my cooking, is terrible, no one wants to eat my turkey or read about fatty liver disease two days before Thanksgiving.

Maybe if I ease into the good, the bad, and the ugly, you may forgive me.

Fun Fat Fact
This year the average American will consume 4,500 calories and 229 grams of fat on Thanksgiving day, according to the Calorie Control Council.

Oh, you heard that fun fact. Yeah, me too.

The Shame
I tried to deliberately sneak in the popular tagline "The average American will consume 4,500 calories and 229 grams of fat on Thanksgiving day"  into an otherwise almost profound festive holiday article. Why? I read the tagline today, here and here, and last year at Time.com, the temptation became to great not to use it. I get excited.

Enter. Did You Know?

Did You Know?

Hepatitis C, Genotype 3 And Fatty Liver
Did you know that hepatitis C can directly cause fatty liver - particularly in HCV genotype 3? Steatosis (fatty liver) is extremely common in people with chronic hepatitis C, close to 40% of people with hepatitis C have steatosis, compared to about 14% to 31% of the general population. All genotypes can trigger the condition, but people with genotype 3 have a higher risk at 60% - 80% for developing moderate or severe steatosis. The full text article published April 2013 can be found, here.

Key Enzyme May Explain How Hepatitis C Infection Causes Fatty Liver
Did you know that in 2008 researchers from the University of Pittsburgh found a key enzyme highly elevated in human liver cells exposed to the hepatitis C virus? The enzyme is known to participate in fat production and may explain how hepatitis C infection causes fatty liver, the study was published in Hepatology.

Hepatitis C, Liver Cancer And Fatty Liver
Did you know that several clinical papers have repeatedly found an association between fatty liver and hepatocellular carcinoma development in people with chronic hepatitis C?  Check out the data published online June 2007, in Cancer.

Happy Thanksgiving Mr. President 
Did you know the president recently reported within the next 5 years fatty liver disease may surpass hepatitis C as the leading cause of liver transplantation? Not Obama, the other president - AASLD president, J. Gregory Fitz, MD.

AASLD coverage @ Healio

Gregory FitzOnce considered largely benign, fatty liver disease may overtake hepatitis C as the leading cause of liver transplant within 5 years, American Association for the Study of Liver Disease President J. Gregory Fitz, MD, said at The Liver Meeting opened here, particularly considering recent improvements in HCV therapies. 
"Suddenly it’s realistic to think that we'll be able to cure most patients with hepatitis C" Fitz said, noting that almost simultaneously, however, fatty liver disease has moved from being considered “an incidental accompaniment of obesity or diabetes; now it’s crystal clear that this alone can go ahead and cause liver fibrosis and scarring and liver failure.” 
Despite the rapid advances in HCV treatments which Fitz characterized as a "revolution,” he noted physicians still have an uphill battle ahead of them with the disease.
Continue reading...

What Is Steatosis?
Steatosis is the build up of fat within the liver, also known as ‘fatty liver. The accumulated fat can trigger inflammation which may eventually lead to fibrosis, or scarring of the liver.  As mentioned, research has shown the significance and relationship of steatosis to the hepatitis C virus (HCV).

Weight loss in overweight people with chronic HCV will help reduce inflammation, slow down disease progression (liver damage) and improve liver function. A 2013 study published in Nutrition found exercise, a low-fat or low-calorie diet in people with HCV improved fibrosis, steatosis and insulin resistance.

*A comprehensive collection of liver health articles can be found, here.

How Not to Gain Weight This Thanksgiving

Here are a few helpful suggestions;

1-Try to sit across from a skinny in-law, it works for me. But, not so much after she leaves.
2-Sit at the children's table, learn from them, they only eat half of what we crave.
3-Take a walk after dinner
4-Take a walk on Friday, after you sneak another piece of pie.
5-Take a walk on Saturday, after you eat another "microwave mini" meal, complete with good/bad gravy.
6- Take a walk on Sunday, after you finish all the leftovers.
7-Please consider eating foods low in fat - all year long.
5-Smile, love your liver, love life, do it for your family.

See you all after the holiday, stay healthy and safe.

Happy Thanksgiving