has been described as a chemical workshop of the
human body. All the nutrients and other
substances absorbed from the intestines pass
through the liver before entering into the
systemic circulation. Thus the liver is
vulnerable to the damage caused by a host of
infections and toxic agents. Several types of
viruses and alcohol are by far the commonest of
these agents. The impairment of the liver
function usually manifests as jaundice.
Persistent infection and continuing impairment of
function may be followed by death unless these
changes can be controlled.
changes in liver damage can manifest as fatty
liver, hepatitis, cirrhosis of the liver and
cancer of the liver.
planned dietary regimen is of utmost importance
in the prevention and treatment of most hepatic
disorders. It has been proved beyond doubt that
some of the proteins derived from animals are
responsible for producing persistent symptoms
related to liver disease. Thus vegetarian diet,
as mentioned below, has gained momentum in the
treatment of hepatic disorders.
are no antiviral agents against hepatitis,rest,
abstinence from alcohol and dietary modifications
form the mainstay of the treatment. Most patients
have nausea and lack of appetite. They should be
served with attractive and well cooked foods.
Small meals served separately will be better
tolerated than three large meals. A diet
containing approximately 2000 kcal which can be
provided by 20-25 gms fat, 80-90 gms pro teins
and 400 gms carbohydrate is suitable. This
requirement can be fulfilled by glucose, sugar,
fruits, fruit juices, bread, cereals, vegetables,
salads, jelly, jam, rice, boiled potatoes and
puddings made with cereals and sugar. Though
diets high in their fat content do not ultimately
influence the course of the disease they are
poorly tolerated by jaundiced patients. Fried
food, milk and butter cause dyspepsia and should
be avoided. Thus a vegetarian diet is better
tolerated by the patients suffering from viral
Most of the
patients of cirrhosis of liver are severely
malnourished and require a high calorie and high
protein diet. A high protein diet, particularly
if derived from animal proteins, carries a high
risk of precipitating hepatic encephalopathy. The
best source of vegetarian proteins is milk, its
products and Casilan. Choline present in foods
like wheat germ, soyabean, peanuts and skimmed
milk may prevent the formation of a fatty liver.
It is also believed that cerebral disturbances
due to liver damage are caused by the type of
protein in the diet. Cirrhotic diet prescribed in
a standard Indian books on diet and nutrition
does not contain proteins derived from animal
sources. A diet high in carbohydrate and proteins
low in fat and fortified with vitamins would be
most suitable. Thus a vegetarian diet is more
suited to patients having cirrhosis of liver.
stages of cirrhosis fluid accumulates in the
abdominal cavity due to failure of the liver to
synthetize plasma albumin. For such patients, a
high protein diet which is low in sodium would be
most suitable. But since these patients have no
appetite, milk is the only practical diet which
can supply the above requirements.
when the liver fails - the condition is known as
hepatic encephalopathy. There is a strong
incidence of animal protein intake increasing the
incidence of hepatic encephalopathy. The clinical
features of this syndrome are sleep disturbances,
restlessness, drowsiness, impaired intellectual
function, confusion and stupor progressing to
coma. Significant number of these patients
develop chronic encephalopathy and can be managed
successfully at home. They should be given 20 gms
of protein in the diet. This should mainly be
derived from skimmed milk.
Thus, it is
very obvious that a vegetarian diet is more
useful in the treatment of all liver disorders
including the last stage of liver failure.
F.P. Clinical dietetics and
nutritionOxford publication, 1975,
Diet and Hepatic Encephalopathy
(editorial) Lancet 1983, 1:625-6.
C.H., Channon H.J. & Ridout J.H.
Choline and Dietary Production of Fatty
Liver J. Physiol (Lon.), 1934, 81, 409.
C.H ., Lucas C.C. & Ridout J . H.
Vitamins and the protection of the liver
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W.S., Bouchier I.A.D., Allan J.G. et al.
Alcoholic liver disease in Scotland &
features in 510 patientsQ.J. Med.
H.P. The liver and its disease., 2nd edn.
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O. Srivasta R.N., Younos M.S. et al. An
outbreak of hepatic venoocclusive disease
in North-Western Afghanistan Lancet,
V., Deo M.G., Sood S.K. Protein
deficiency in Rhesus monkey In: Progress
in meeting protein needs of infants and
preschool children. Proceedings of an
international conference. Publication no.
843. National Academy of Sciences,
Washington D.C. 1967.
V., Nayak N.C. Liver Disease in India.
Prog. Liver Dis. 1970,
E. Lieber E.S. Alcohol induced hepatic
injury in nonalcoholic volunteersN.
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