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Неактивен Радослав Русинов

  • Администратор на форума - немедицинско лице
  • Степен на активност - Професор
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  • Статус: Хроничен хепатит C
Тук слагам копие от една статия, посветена на диетичното хранене на болните от хепатит C.
Не успях да открия статията на сайта, на който я бях открил: www.garynull.com
Обаче я имам запазена, затова направо ще сложа текста и тук:
Natural Approaches for Hepatitis C, Part 6 - Diet for Hepatitis C
by Dr. Michael B. Wald
This document was provided by:
Dr. Michael Wald
Advanced Medicine of Mount Kisco, P.C.

www.hopeforhepatitis.com
www.drwald.com
Note: The information on this website is  not a substitute
 for the advice of  & treatment by a qualified professional.


A healthy diet is important for everyone, but is especially important for people with HCV. It can go a long way in limiting symptoms and disease progression by providing the body with the nutrition it needs to be strong, fight illness and repair itself. I cannot think of a single illness or disease suffered by humankind that does not in some way relate to nutritional intake, digestion, absorption and assimilation. Conversely, an unhealthy diet can worsen disease symptoms and progression by causing undue burden on an already impaired immune system.
The components of a healthy diet include lots of fresh fruits, vegetables, beans, raw nuts and seeds, whole unrefined grains, legumes, cold water fish, soy products, eggs, poultry and lean meats (if one prefers animal products). Dairy products, red meats, and other sources of saturated (animal) fat should be used on a limited basis.
Whenever possible, foods should be grown organically to reduce the burden of harmful chemicals upon the already diseased liver. Organically grown foods contain far fewer pesticides, fungicides, herbicides and insecticides. Lowering the load of these and other organochemicals will only benefit the liver by not overburdening its detoxification pathways or promoting oxidative (degenerating) damage.
What are organochemicals?
Organochemicals are toxic chemicals that can damage our immune systems, nervous and endocrine systems. Environmental chemicals require detoxification by the liver, intestinal tract and the kidneys and other tissues and organs can be affected by various organochemicals as well. Potential sources of harmful chemicals are varied depending upon the chemicals themselves and their particularly tendencies to collect in our food, water and air supply. Once in our outside environments they inevitable make their way into our internal environment – namely our bodies.
Some of these toxic substances include DDT, PCBs dioxin, 1,4-dichlorobenzene, ethylphenol and xylene just to name a few. These and other toxins are largely fat-soluble and therefore are readily stored in the body. The Environmental Protection Agency, EPA, and other sources claim that the levels of the majority of toxins, although pervasive and unavoidable in our environment, are within acceptable levels, which means they are below known cancer causing or symptom producing limits.
However, virtually no studies have been conducted that examine the combined effects of many environmental chemicals upon individuals. Those with HCV are particularly susceptible to the negative additive effects of these chemicals. It is the liver and intestinal tract and kidneys that bear the brunt of the work involved to carry out detoxification efforts. It is no wonder that we see more degenerative disease than ever before in history since our environment is a virtual breading ground for premature aging and disease.
Nutritionally speaking, constant, daily exposure to organochemicals increases our need for a variety of nutritional factors. Persons who have chronic infections usually have nutritional imbalances that compromise recovery and increase their susceptibility to organochemical accumulation. For example, many HCV infected people are protein deficient. Protein deficiency will compromise important detoxification systems in the liver known as the mixed function oxidase, MFO, system, Phase I and Phase II processes. Toxic chemicals stay in the body longer in those with compromised MFO, Phase I and Phase II systems caused by protein inadequacy. Furthermore, these same chemicals can literally become more toxic in the presence of deficient proteins as compared to in individuals with normal protein intake.
Many other nutritionals are important for detoxification including the B-vitamins folic acid and choline, selenium, vitamin E and zinc. These and other nutritionals will be explored throughout this book. Fortunately, nutrition and healthy lifestyle habits like not smoking or drinking and exercising regularly provide each of us the opportunity to live well. When these techniques are practiced correctly the well person and the HCV infected individual can both improve the quality of their lives.
Healthy diet basics - dos and don'ts
Dos

Increase the amount of whole, unprocessed foods in your diet (fresh fruit, vegetables, whole grains, beans, raw nuts and seeds) relative to the amount of processed foods you consume (pasta, bread, packaged foods). Unprocessed foods have greater nutritional value.
Diversify your diet by including new and different foods in your meals each week. Rotate the foods you eat so that you don't consume the same thing every day. Diversification helps insure well-rounded nutrient intake and helps avoid malnutrition.
Eat a wide variety of organic fruits. In season fruit in best. Organic frozen fruit is a great option when fresh organic fruit is not available. Fruit sauces (i.e. applesauce) and fruit-only jams are also good sources.
While you need to watch what you eat, a fat free diet is not healthy. Fat should constitute 20-30% of your total diet. Limit saturated fats (fats found in animal products) to less than 10% of your total diet. Avoid fried foods, hydrogenated or partially hydrogenated oils and cottonseed oil. Oxidized fatty acids (fried oils) increase cellular breakdown, adding to the overall oxidative (degenerative) load on the body and liver. Instead, opt for unsaturated essential omega 3, 6 and 9 fatty acids found in flax seed oil, olive oil, canola oil, salmon, cod, tuna, mackerel, currants, raw nuts, seeds, avocado and oats. Store oils, nuts and seeds in the refrigerator to slow down oxidation (rancidity) of the oils.
Eat a high fiber diet, 25-30 mg a day, by consuming a lot of vegetables, fruits, whole grains, beans, nuts and seeds, and minimize meats and refined foods. Ingest a wide variety of organic veggies. In season ones are best. Include salad greens, dark leafy greens (kale, spinach, collard greens, chard), squashes, root vegetables and cruciferous vegetables. Animal products should be limited since they are constipating and congesting in the body, slowing the elimination of toxins and bile acids. Plant foods in the diet increase the elimination of bile acids, drugs and toxic substances from the system. Vegetables and fruits contain thousands of important phytochemicals (plant-derived) that have tremendous health benefits.
Eat enough healthy protein. Try to eat organic only, lean cuts of chicken, turkey, red meat (infrequently), eggs, salmon, tuna, sole, swordfish, mackerel, sardines, herring, and most other fish. Include soy products (tofu, tempeh and miso), beans, bean/grain combos, nuts and seeds.
Consume lots of legumes and beans including lentils, peas, navy beans, chickpeas, black beans, kidney beans, mung beans, soy beans, adzuki beans, black-eyed peas, pinto beans, string beans and others.
Eat a variety of nuts, seeds and nut butters. Try raw or lightly roasted/toasted cashews, almonds, walnuts, sunflower seeds, pumpkin seeds, sesame seeds, tahini, poppy seeds, brazil nuts, pistachio nuts, pecans and soy nuts.
Getting enough grains is also important. Consume rice, millet, buckwheat, oats, rye, barley, quinoa, spelt, amaranth.
Ensure you eat a sufficient amount of protein each day. Protein should comprise about 15-20% of your diet, or 55-70 gm a day. Good protein sources include lean meats, poultry, fish, eggs, soy products, beans, low-fat dairy products, nuts and food combining of grains/beans/vegetables.
Eat a variety of sea vegetables. Try hiziki, arame, nori, dulse, kelp, wakame and other sea veggies, which are high in trace minerals and are very alkalinizing to the body.
Chew your food thoroughly and eat several small meals throughout the day instead of two or three large meals. This helps to balance your blood sugar and energy levels throughout the day. Eating slowly helps to evoke the parasympathetic nervous system, PSNS. The PSNS is in charge of proper secretion of various digestive juices.
Eat organic foods whenever possible since pesticides, herbicides and fungicides on produce and antibiotics/hormones fed to livestock burden the liver's detoxification mechanisms. There is also evidence that these chemicals increase cancer risk. Those with HCV want to reduce the work-load on the liver, intestines and kidneys.
Decrease or eliminate refined and processed sugars from your diet. As a substitute, use natural, unprocessed sugars high in the vitamins and minerals needed to help digest them. Try 100% pure maple syrup, fruit-only jams, fresh fruit, honey, molasses, barley malt, brown rice syrup and carob if allowed by your health care provider.
Drink plenty of water each day (body weight divided by 2, multiplied by 0.8 is the number of ounces your body needs, more if you are exercising). Avoid caffeinated and carbonated beverages, which are diuretics that cause your body to lose fluid. Herbal teas, fresh vegetable and fruit juices are healthy to consume. Diluted bottled juices and naturally decaffeinated beverages are OK in moderation.
Don'ts
Desserts (pastries) and candies are largely sucrose and should be avoided. A diet containing between 25-30% sucrose for just 18 days showed an increase in liver enzymes that returned to normal when the sugar was removed1
Steer clear of fresh shrimp and scallops. Also, stay away from frozen, canned or dried clams, shrimp, crab, lobster or scallops because they are all high in sulfites.
Avoid nitrites and nitrates in cured deli meats. These are converted into chemicals called nitrosamines upon digestion and are know to be toxic, adding strain on the liver.
Don't drink large amounts of fluids with your meal - this dilutes stomach acid vital for digestion.
Avoid sulfites in canned and preserved foods and in alcohol. Sulfites are liver toxic and add undue burden on the liver.
Don't overcook foods. Overcooked foods loose much of their nutritional content. Fish is best baked or broiled; meats are best broiled; vegetables are best steamed and baked; fruits can be eaten raw or baked. Do not microwave food, as the long-term health effects of food prepared in this manner are uncertain.
The Centers for Disease Control (CDC) and the National Institutes of Health (NIH) strongly recommend that people diagnosed with Hepatitis C eliminate all alcohol consumption. Alcohol significantly increases the incidence of liver disease and liver cancer in HCV infected individuals. Alcohol prompts fatty liver, liver inflammation and dysfunction, and increases the rate of liver cell degeneration, fibrosis and cirrhosis.2
Refrain from eating when you're not hungry. Stop eating when you're full. Paying attention to these rules will reduce digestive stress on the gastrointestinal tract.
Don't eat when you're stressed or "on-the-run." Mental or emotional stress as well as chemical, structural and other stressors may cause biochemical responses in the body that affect healing and recovery. For example, low grade chronic stress as well as profound acute stress can result in the production of immune depressing chemicals such as adrenochrome and cortisol. Adrenochrome is the oxidized product of adrenalin. Adrenalin or epinephrine is a normal and necessary part of a healthy response to life's stressors. When prolonged, however, epinephrine is oxidized into this immune compromising product.
Cortisol, like epinephrine, naturally increases during stress as ideal levels tonify the body allowing for a resilient immune response. When elevated in the body for longer than is advantageous, cortisol becomes an immune suppressor. Numerous other chemicals are affected during the chronic stress response that are proven to compromise healing. Viral exposure is an infectious stress that creates a cascade of chemical reactions that when left unchecked may increase nutritional requirements, speed tissue degeneration and compromise overall response to either drug or nutritional therapies.
A study in the Journal of Molecular Pharmacology showed that the immune system of alcoholics produces antibodies (known as autoantibodies) against important enzymes for the liver's detoxification process. These enzymes, known as cytochrome P4502E1 and P4503A, are responsible for removing a variety of toxins from the body gathered from our food, water and air supply. It is likely that cellular changes that accompany alcoholism (such as cirrhosis and fibrosis) are responsible for the body's misdirected immune response towards the cytochrome enzymes. It is also possible that the cellular changes in the livers of those infected with Hepatitis C may experience similar autoimmune problems negatively affecting detoxification enzyme systems.
Allergy elimination
In a broad sense, the term allergy describes the immunological response of the body to airborne, contact and ingested substances. In all cases, the immune system is activated in its attempt to protect itself and its owner - namely you, from harm. The laboratory section of this book briefly describes some of the various allergy tests available. Commonly, the health care provider will check for a few different types of allergy and must therefore order several different tests for this purpose.
The importance of allergy assessment and treatment is entirely unappreciated by the practicing gastroenterologist; the doctor most commonly sought after for the care of the HCV infected individual. Even the allergist, the practitioner who uses allergy testing on a regular basis, often fails to appreciate many of the subtle and pronounced effects that allergies can have upon those with HCV. Ultimately, it is left up to the holistically oriented or alternative health care provider to "put together all of the pieces" involved in assessing and creating a balanced health promoting program for those with HCV.
Allergy testing in the standard allergist's office is limited to assessing environmental and food allergies of an immediate type, known as Type I or immediate hypersensitivities. Other types of allergic responses include Type II, Type III and Type IV. Excellent resources exist that describe in greater detail these types of allergic responses and I refer the reader to the section on further suggested readings. Practically speaking, the health care provider and patient can work together when choosing which types of allergy assessments to perform.
The prevalence of food and environmental allergies is on the rise. This is due to a number of factors including food choices and chemical exposures from food, water and air. These factors also relate to each person's genetic predisposition to food allergies. Infectious states are known to be associated with an increased prevalence with food allergies. Why is HCV infection any different? The answer is, it is not. My clinical experience has shown that those with HCV have a much higher incidence of food allergies when compared to those without HCV. This observation has important implications in terms of treatment strategies.
Food and environmental allergies can cause virtually any symptom in the body. This is not surprising when one realizes that the immune response to allergies may be body-wide, thus causing symptom production in virtually any tissue, organ or organ system. Some common symptoms associated with allergies of any type include: fatigue, muscle pain, depression, chronic infections, malaise, headache, eczema, joint pain, intestinal problems, hypoglycemia (low blood sugar), mal-absorption and many more.
HCV is not caused by food or environmental allergies, but allergies and their immune responses can complicate recovery from the infection and it's many manifestations. A goal of natural therapies is to reduce the overall stress upon the immune system. The extent, if any, that environmental and food allergies complicate recovery from HCV should be assessed. At the very minimum suggestions are made below that outline a reasonable food intake that minimizes
many common allergens. Without proper testing, however, these suggestions only provide a rough guide for reduction of allergic (immunologic) load.

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Неактивен Радослав Русинов

  • Администратор на форума - немедицинско лице
  • Степен на активност - Професор
  • *******
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  • Статус: Хроничен хепатит C
Re: Да се спазва ли диета и каква да бъде тя?
« Отговор #1 -: Февруари 06, 2007, 10:05:04 »
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Practically speaking - food allergy testing and implementation
Even though a careful health history, food elimination and reintroduction and allergy testing approach can identify various allergens, sometimes it is difficult to put this information into practical use. It is not uncommon for those with HCV to test positive for more allergens than could possibly be eliminated - that is without creating neuroticism and malnutrition. It is the job of the diligent practitioner and individual to develop an approach that is the most reasonable considering all of the information gathered. Ultimately, a balanced plan that can be followed for an extended period of time and can be put into place in one's daily life is what is needed. In effect, a healthy lifestyle in terms of food and nutritional intake needs to be developed that allows for greater health and recovery for a lifetime.
A properly designed and implemented allergy elimination diet can be very beneficial for one's health. The approach involves avoiding certain foods that are common allergens or that you know or suspect you have a problem with (i.e. cause unpleasant symptoms). Below is a list of foods to eliminate or reduce in your diet to once every four days or less
•   Dairy - milk, cheese, butter, yogurt, cottage cheese, sour cream, whey and casein.
•   Wheat - wheat bread, pasta, baked goods, farina and wheat cereals
•   Eggs - whites and yolks, foods containing eggs (i.e. a lot of baked goods).
•   Citrus fruits - grapefruit, orange, pineapple, tangerine. Lime is the only citrus fruit allowed because it is highly alkaline instead of acidic and generally low allergy.
•   Alcohol - including beer and wine.
•   Caffeine - coffee, black tea and green tea. Only organic, naturally decaffeinated coffee or green tea is allowed. Naturally caffeine-free herbal teas are also allowed, except if they contain citrus.
•   Refined Sugar - white sugar, sucrose, high fructose corn syrup, dextrose, maltodextrose, corn syrup, corn sweetener, glucose, maltose. Artificial sweeteners (aspartame, saccharin) should also be eliminated. Allowable sweeteners are 100% pure maple syrup, raw/unfiltered honey, blackstrap molasses, barley malt and rice malt
•   Food Additives - artificial colors and preservatives, artificial sweeteners, nitrates (cured meats), sulfites (canned foods, condiments, wine and most dried fruit).
•   Pesticides - eat organic foods only or to the greatest extent possible. Only eat organic meats (if you eat meat).
•   Eliminate foods to which you know you are allergic.
•   Any food that you currently eat three or more times per week, eat on a rotation basis of no more often than once every four days.
Don't despair due to this restrictive diet. There are still lots of healthy food options available. Wheat bread alternatives include wheat-free spelt, wheat-free millet, wheat-free rye and wheat-free oatmeal bread. Wheat-free pastas include quinoa-corn, rice and buckwheat soba noodles. Rice crackers, rye crackers, wheat-free waffles, gluten-free/wheat-free pancake mix, wheat-free oat or corn muffins, oatmeal, mueseli (oats/nuts/raisins/unsulphured dates) and wheat-free cereals are other tasty options.
Rice milk, soymilk, almond milk, oat milk, rice cheeses, soy cheeses and almond cheeses are all healthy alternatives to your favorite milk and dairy products.
Juicing
The therapeutic practice of juicing is nothing new to natural health care providers. Juicing enjoys a long history of success and praise for its healing potentials. Juices of fresh fruits and vegetables provide highly concentrated minerals, vitamins, biologically active enzymes, fiber and phytochemicals that could otherwise be consumed from the foods in unjuiced form. Juicing also alkalinizes (i.e. reduces the acidity of) the body - a desired effect since acidity is associated with free radical production, degenerative disease, inflammation and aging.
Virtually hundreds of excellent books are available that describe the daily and medicinal uses of various juicing combinations for virtually any symptom and disease entity. I have included only the "tip of the iceberg" regarding the benefits of juicing that I have found for my patients. The daily practice of juicing can not only be fun and educational, but literally invigorating. Many have reported an immediate return of vitality, mental clarity and energy after just a single day of juicing.
Juicing just once a day can add up to better health over a lifetime of consumption. For the HCV infected, I recommend between four and eight, eight ounce glasses of a healthy juice combination be consumed on a daily basis. It may be possible to gain tremendous health benefits from less than the recommendations given above when practiced in combination with some of the other healthy practices discussed throughout this book. The practitioner and health consumer must decide together the most reasonable approach to take and to what extent juicing is integrated into the healing program.
Some cautions regarding juicing may be in order. Overemphasizing the carrot content of juicing can cause fluctuations in blood sugar that can be harmful. Carrots are listed high on the glycemic index scale, GIS. The GIS was developed so that general food recommendations could be made to diabetics. Foods high on the GIS, like carrots, in some individuals could actually compromise immune function. Also, the presence of allergies to specific "healthy foods" can produce undesirable health effects. For example, if one is allergic to spinach this vegetable is best eliminated as a food choice for juicing purposes. Health care providers trained in food allergy practices and juicing can give the appropriate guidance needed in this important area.
One to three glasses of fresh juice are recommended therapeutically each day. Below are suggestions for healthful and delicious juices.
Fruit juice combinations
•   Apple
•   Pear
•   Apple and pear
•   Apple, pear and pineapple
•   Lemon, orange and grapefruit
•   Watermelon
•   Apple and watermelonApple and grape
•   Apple and cranberry
•   Avocado
Unjuiceable fruits (pulp doesn't separate)
•   Papaya
•   Strawberry
•   Banana
•   Cantaloupe
•   Honeydew
•   Peach
•   Plum
•   Prune
•   Apricot
Carrot-Vegetable Juices
•   Carrot
•   Apple
•   Beet
•   Cucumber
•   Celery
•   Carrot tops
•   Kale
•   Ginger
•   Cabbage
•   Sprouts
Green Vegetable Juices
•   Celery
•   Kale
•   Spinach
•   Cucumber
•   Dandelion
•   Parsley
•   Apple
•   Ginger
•   Sprouts

Juicing is always therapeutic, but it's particularly helpful during disease flare-ups. In fact, during acute phases or exacerbations, solid foods should be restricted to brown rice, steamed vegetables and moderate amounts of lean protein sources such as tempeh, fish (i.e. salmon, tuna, mackerel, sword and sardines), free-range chicken and turkey. Ideally, during these periods, the diet should be primarily fluid and should include the following:
Water - The water source should be purified and high in natural minerals. It is recommended that all water sources be analyzed for the presence of parasites, synthetic and organic chemicals, bacterial organisms and other materials, which may burden the liver or other body systems.
Vegetable broths - A vegetable broth is simply a hot source of water that has had a large variety of vegetables soaked in it. The resulting fluid is now heavily mineralized and contains high amounts of vitamins and perhaps enzymes. Absorption and assimilation is very easy on the digestive tract.
Fresh fruit and vegetable juices - The purpose of juicing vegetables and fruits is not for the fiber content, but is instead to concentrate vitamins, minerals, enzymes and perhaps hundreds of phyto- (plant) chemicals. A typical glass of fresh, and preferably organically grown, vegetable juice for example may contain two carrots, an apple, a handful of crisp spinach leaves, a handful of kale (a green leafy vegetable), a stick of celery and a large beet.
Herbal teas - Dozens of herbal teas are readily available in health food stores and some supermarkets. Although herbal teas are too weak to provide strong therapeutic benefits, their continued consumption at low doses (i.e. 2-3 cups per day) can provide a weak, but additive stimulatory effect. For best medicinal value, brew herb teas for a minimum of four hours to create a more potent herbal infusion that can be stored for up to four days.

Detoxification
The health benefit of a nutritionally based detoxification program for the HCV infected person cannot be underemphasized. Besides an individually formulated diet and nutritional supplement and lifestyle changes, detoxification efforts can be dramatically improved with the use of specially formulated medical-nutritional food drinks. Several pleasant tasting products are available for consumers, which take into consideration nutritional needs during one's detoxification efforts.
Detoxification is the process whereby the body removes unwanted substances from itself. The liver and gastrointestinal tract are the primary organs involved in detoxification although the kidneys, skin, and other organs also play important roles. Over our lifetime, toxins accumulate in our bodies, often at a faster rate than our livers and GI tracts are able to get rid of them. Toxins are found in our drinking water, food and air. Medications have toxic effects. Stress produces toxins. Toxin accumulation can cause fatigue, pain, poor memory and concentration, headaches, allergies, hormonal disorders, slow healing, degenerative disease, poor digestion, infertility, weight disorders and more. For people with HCV, detoxification is especially important as a way to cleanse the over-burdened, already impaired liver of harmful substances that, when left to accumulate, increase liver degeneration and worsen the prognosis for HCV.
The liver's detoxification efforts heavily depend upon a series of enzymes known as the cytochromes, the most important of which is cytochrome P450.1 A study by the Institute for Environmental Medicine in Stockholm, Sweden demonstrated that the immune system of some alcoholics has directed itself against the cytochrome P450 enzymes.2 The self-directed attack of the immune system against the detoxification enzymes is known as an autoantibody reaction. It is probable that autoantibodies also direct themselves against the P450 enzymes of the HCV infected. Numerous studies have shown that autoantibodies directed against body tissues and systems are a common phenomenon in HCV infected people (see chapter 2 on autoimmunity).
There are dozens of different ways to accomplish liver and intestinal detoxification. A high quality nutritional detoxification program incorporates the following elements: fasting with liquid food supplements designed to assist detoxification efforts and sustain minimal caloric nutrition; fresh vegetable and/or fruit juice fasting; nutritional, herbal and fiber supplements to promote detoxification; an allergy-elimination diet (avoiding suspected and tested/diagnosed allergies); the vitamin C flush; enemas and education about the on-going integration of healthy diet, nutrition and lifestyle factors into daily living.
Antioxidant nutrients such as ascorbic acid, beta-carotene, vitamin E, CoQ10 and cysteine are very important for protecting the liver from accumulated damage over time. In fact, these and other antioxidants play a pivotal role in helping to ensure that detoxification efforts are successful. In order to emphasize the importance of antioxidants in detoxification I have given a detailed explanation below. The reader can consult the section on antioxidants for additional information.
Here's how antioxidants can help a virally infected person benefit from a nutritionally based detoxification program. HCV precipitates an inflammatory response in the body that is caused and is worsened by oxidative stress. The term oxidative stress refers to the production of highly reactive molecules in the body called free radicals, FR. These FR may damage virtually any tissue in the body. The inflammatory reaction occurs along with the production of FR by causing the body to produce a variety of chemicals that mediate or perpetuate (cause) the inflammatory response. Inflammation is actually a healing response by the body to a variety of stressors including viruses. The problem with inflammation is that it can become prolonged and excessive causing tissue and immune damage.
Chemicals that mediate the inflammatory response are referred to as reactive oxygen intermediates, ROI. Examples of ROI include, but are certainly not limited to, interleukin-1, -2 and -6 (known as cytokines), tumor necrosis factor, granulocyte-macrophage colony stimulating factor, GM-CSF. These and other laboratory markers can be measured and are often abnormally high in those with HCV and other chronic infections.
Additionally, oxidative stress can be indirectly measured by the presence of malondialdehyde, MDA, in the blood or urine. MDA is a breakdown product of oxidative damage to cellular membranes. Antioxidant supplements lower MDA
and other markers of oxidation demonstrating their ability to reduce inflammation and heal tissues. Inflammation can be measured in a number of ways including blood levels of ESR, erythrocyte sedimentation rate, and C-reactive protein (regular or a high specificity test); both of these markers may be elevated in the presence of chronic inflammatory stress. The nutrition and laboratory sections of this book outline many effective ways of reducing inflammation and these blood markers.
During fasting or the intake of reduced calories the body will naturally produce oxidants. Since this is the case, water fasting cannot provide the necessary antioxidants needed to quench excess oxidants because it simply does not contain antioxidants. Oxidants are produced during detoxification. During this breakdown process and removal of old cells and tissues, the body requires antioxidants to protect healthy tissues and to build new tissues. A vegetable juice fast certainly provides some of the needed antioxidants, but in uncertain amounts and is almost certainly not enough to ensure proper healing in HCV infected individuals. For over 10 years I have used a variety of medically designed foods that have been formulated for the specific purpose of providing the necessary antioxidants and other nutrition for adequate detoxification and elimination. These medically-designed foods are called UltraClear, UltraClear Plus, UltraClear Sustain and UltraInflamX.
Basic nutritional supports such as the B-complex nutrients and multi-mineral complexes should not be neglected, as they are critical for normal liver and physiological functions. The so-called lipotropic agents including betaine, methionine, choline, vitamin B5, folic acid and inositol are of particular importance for liver detoxification, as they allow free flow of fats in and out of the liver. Silymarin, dandelion and other herbs nourish the liver and support liver cleansing. In addition, fiber assists the binding and elimination of toxins through the intestines and colon.
Detoxification efforts must be carefully balanced, otherwise excessive degenerative changes could result. Improperly implemented detoxification efforts (i.e. juice fasting, nutritional drinks etc.) will actually increase the breakdown of cells, tissues and organs. Liver detoxification results in increased production of MAO (monoamine oxidase), a singlet oxygen molecule that causes oxidation and degeneration of cells. It is advisable to seek the guidance of a professional trained in detoxification prior to undertaking your initial detoxification program.
UltraClear, UltraClear Plus, UltraClear Sustain and Ultra InflamX are pleasant tasting, patented medical foods made of low allergy potential (pre-digested) rice protein concentrate combined with basic nutrients for detoxification and elimination. All of the ingredients in these products are selected based upon the very latest medical and nutritional research regarding detoxification, liver and intestinal repair and inflammation control. They are each individually balanced with protein, carbohydrates and healthy fats blended with highly absorbable vitamins, minerals and other nutrients. Each was initially developed to support the liver and intestines' ongoing detoxification efforts. They are based on nutritional and scientific evidence regarding what the liver, intestines and general metabolism require for proper processing of toxins and tissue repair. Use of any one of these products is safe and effective for improving overall intestinal and liver function and detoxification, but should only be used under professional supervision. More details regarding these four products are available by calling Metagenics Vitamin Company and mentioning this book (1-800-META-VIT).

Encouraging elimination - coffee enema
Administering a coffee enema rectally promotes liver detoxification by stimulating phase II conjugation, the process by which fat-soluble toxins in the liver are converted into water-soluble toxins for easier removal from the body. Overuse of the coffee enema and other types of enemas is not suggested. Although they can aid the detoxification and elimination process, they are not reparative in nature. Overuse can result in inflammation and irritation to the rectum and lower colon; removal of the mucous-immune blanket that coats the intestinal lining and removal of healthy endogenously produced bacteria. Adding in manufactured forms of healthy flora is not the same as the healthy flora produced within your colon.
To perform a coffee enema is quite simple. Percolate or boil 3 heaping tablespoons of ground organic regular coffee (not decaffeinated or instant) in one quart of filtered or distilled water. Simmer for 15 minutes. Strain and cool to body temperature. Lubricate the nozzle lightly with vitamin E oil or olive oil. Lie on your left side and administer the enema very slowly in an enema bag and tubing. It should take at least 15 minutes for the entire fluid to enter the rectum slowly. Then, still lying on your side, massage your abdomen and try to retain the enema for another 15-20 minutes before releasing the content of your bowels.
Other detoxifying enema recipes include:
4 cups of chamomile tea (brewed for at least 2 hour)
Allow it to cool to room temperature.
Fill the enema bag allowing at least 15 minutes for the entire fluid to enter the rectum slowly.
Juice of one lemon in 4 cups of warm water
Fill the enema bag allowing at least 15 minutes for the entire fluid to enter the rectum slowly.

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Re: Да се спазва ли диета и каква да бъде тя?
« Отговор #2 -: Февруари 06, 2007, 10:19:06 »
Друга статия, свалена е от: http://www.natap.org/2001/ddw/ddw_14_diet080101.htm
Diet and Hepatitis C
     Written for NATAP by Jocelyn Rodriguez

Jocelyn Rodriguez, MPH, RD, CDN is a nutritionist specializing in HIV/HCV. She received her graduate training at University of California at Berkeley and is an alumnus of Hunter College, CUNY. Presently she works with the substance abuse population, where the rate of Hepatitis C infection is high.
The HIV epidemic redefined interdisciplinary medical care toward infectious chronic diseases. As infectious diseases became manageable via medication, education and lifestyle changes, nutritional intervention played a greater role in helping to achieve good quality of life. Hepatitis C embodies this new paradigm (approach to treatment of diseases) and nutritional advice on eating habits and supplements has proliferated since Hepatitis C was identified in the early 1990’s from the former Non A, Non B Hepatitis. Dietary interventions have been used since the first days of treating cirrhosis, but seldom have doctors and dietitians advised dietary changes as prevention of or delay to the progression of the liver toward a cirrhotic state. The Europeans are ahead of the United States in focusing on liver health, ie. milk thistle for liver function assistance and amino acid formulas for liver regeneration, however results remain inconclusive. Nonetheless, we may yet benefit from their treatment suggestions in the management of Hepatitis C.

(Editorial Note: recently reported research data suggested that Milk Thistle might cause a drug interaction with HIV medications, thus affecting the blood levels of HIV medications. At the IAS Conference in Buenos Aires (July 6-11, 2001), Steve Piscitelli (Pharmacologist) reported on new recently completed research from the NIH. Preliminary results of exploring indinavir (Crixivan) and Milk Thistle for 3 weeks did not show clinically significant interactions. This suggests that Milk Thistle should not have a drug interaction with HIV antiretroviral medications such as protease inhibitors and NNRTI) However, there is a question whether milk thistle is effective. There is a little preliminary research suggesting milk thistle may be helpful for the liver. However, the evidence is not strong. In taking herbal supplements for the liver, the question one needs to ask is –is the herb potentially harmful to me? Some herbs have been shown to be harmful to the liver. It appears as though milk thistle may not be harmful, but the data on interactions with HIV meds from Steve Piscitelli is preliminary and still being analyzed).

The question remains whether we should be proactive about early dietary changes for persons infected with Hepatitis C but who have not manifested symptoms of liver failure? While an ounce of prevention is worth a pound of cure, changing eating habits is very difficult to make and harder to adhere to. Recommending vitamin and herbal supplements can get expensive and may not significantly increase quality of life. This by no means implies that person with Hepatitis C should not pay attention to their dietary habits and nutritional requirements. Each individual will need to be evaluated by a dietitian with experience in liver disease to determine his or her own requirements. The reason for this is because people do not select their diets based on physical and/or medical requirements alone, but also from their cultural upbringing, access to food/meals, and certain habits set by choice and convenience.
A nutritional foundation of dietary practices should be the guide for persons with Hepatitis C, especially at times when there are no gastrointestinal symptoms and liver function tests are normal or mildly elevated with no other clinical abnormalities:
1.   Get half of your daily calories in carbohydrates. Whole grain starches, vegetables and fruits should be the mainstay of carbohydrates. Sugar and sugary foods, like donuts and candy bars, should be minimized.
2.   Keep protein intake up. Have some protein at every meal. Portion matters more than kind of protein. Make sure to include beans and tofu products, nuts, and dairy products.
3.   Moderate fat consumption. Cutting back sugary foods tend to reduce fat intake. Nuts and tofu, which are protein sources, have a healthy amount of unsaturated fat. Use vegetable oil and butter sparingly. The goal in reducing fat intake is mainly for weight purposes.
4.   Maintain or achieve desirable body weight. Those who are obese, more than twenty pounds over their ideal weight for height, should lose weight. Those who are mildly overweight should watch out for insidious weight gain.
There is controversy regarding eating red meat for the HCV-infected person. There is preliminary and limited research suggesting that iron accumulation in the liver may accelerate HCV progression, and eating red meat or eating excessive amounts of red meat may contribute to iron accumulation in the liver. However, it has not been established by research that eating red meat actually has clinical effect of accelerating HCV. If a person has decompensated liver disease certain diet restriction is considered. Many leading hepatitis doctors do not feel restricting intake of red meat is recommended for HCV-infected patients with chronic infection. It is important to bear in mind that in a person coinfected with HIV and HCV, anemia may be a concern and adequate intake of red meat may be important.
Marion Peters, MD, Hepatologist and GI specialist at UCSF says: if a patient has encepholopathy, which can occur as part of decompensated cirrhosis, they should limit their protein intake, but not necessarily eliminate red meat. Iron accumulation can be a problem only if you eat excessive amounts of red meat. Otherwise, eating red meat is fine and in fact could be part of your diet. Just don’t eat red meat three times per day. If you are taking HCV therapy (IFN, IFN/RBV) you should indulge yourself a little to increase caloric intake and particularly it’s ok to eat red meat. Dr Peters says the studies suggesting iron accumulation in the liver can be a problem is when iron intake is very high and excessive.
On the topic of iron storage in the liver and it’s potential harm, Ms Rodriguez says:
From a nutrition perspective, the following is known--
1.   Iron is poorly absorbed through the GI tract. Heme-iron (ie. meats) have a better absorption rate but is not 100%. Non heme-iron (ie. Fortified flour, cereals, spinach, etc) is better absorbed with meats, yet still not at 100%. Therefore, at any given high iron meal a maximum of 40-50% of iron is absorbed. Iron supplementation helps increase the likelihood for absorption.
2.   During inflammation (ie. Fever) iron storage in liver is increased. Diabetics and certain substance abusers may have conditional hemochromatosis. (a hereditary disorder of iron metabolism characterized by excessive accumulation of iron in tissues, diabetes, liver dysfunction, and a bronze skin pigmentation).
3.   As for HCV, earlier studies suggested that increased liver iron levels elicit liver oxidative stress, with consequent steatosis (fatty liver) and glutathione depletion. (Iron storage, lipid peroxidation and gluthathione turnover in chronic anti-HCV positive hepatitis. J. Hepatol 1995 Apr;22(4):44-56 , Therapy of hepatitis C: other options. Hepatology 1997 Sep;26 (Suppl 1): 143S - 151S.) Therefore, in disagreement with Dr Peters Rodriguez feels that this information suggests high iron levels may be harmful to the liver.
However, Ms Rodriguez says the question of whether to restrict iron intake needs to be considered individually, taking into consideration person's dietary habits, bloodwork, meds, physical health, and medical history. It is safe to say, that for men with elevated iron levels (serum ferritin especially), taking a multivitamin without iron is recommended.

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Още една статия, която имам, свалена е от: http://frontline-hepatitis-awareness.com/diet.htm
Relationship to Hepatitis C & Your Diet

WHAT IS THE RELATIONSHIP BETWEEN DIET AND HEPATITIS C ?
Hepatitis C is a virus that infects the liver. Up to 85% of people exposed to this virus develop chronic liver disease. Progression to cirrhosis { irreversible scarring of the liver } occurs in about 25% of individuals. While not as yet totally defined, many factors influence the rate of disease progression. Diet likely plays an important role in this process, as all foods and beverages that we ingest must pass through the liver to be metabolized.

ALCOHOL AND HEPATITIS C
Alcohol is a potent toxin to the liver. Excessive intake can lead to cirrhosis and its complications, including liver cancer. Heavy drinkers are not the only individuals at risk for liver disease, as damage can occur in even some moderate "social drinkers". The hepatitis C virus has frequently been isolated from patients with alcoholic liver disease. In fact, these patients have been found to have a higher incidence of severe liver damage, cirrhosis, and a decreased lifespan, when compared to individuals without the virus. It is suggested that the combination of alcohol and hepatitis C accelerates the progression of liver disease.
The consensus statement concerning management of hepatitis C released March 1997 from the National Institutes of Health, further warned about the dangers of excessive alcohol use in patients with hepatitis C. These recommendations stressed limitation of alcohol use to no more than one drink per day. Therefore, patients with hepatitis C would be unwise to drink alcohol in excess, and total avoidance of all alcohol intake is recommended.

IRON AND HEPATITIS C
The liver plays an important role in the metabolism of iron since it is the primary organ in the body that stores this metal. The average American diet contains about 10- 20 mg of iron. Only about 10% of this iron is eliminated from the body. Patients with chronic hepatitis C sometimes have difficulty excreting iron from the body. This can result in an overload of iron in the liver, blood, and other organs. Excess iron can be very damaging to the liver. Studies suggest that high iron levels reduce the response rate of patients with hepatitis C to interferon. Thus, patients with chronic hepatitis C whose serum iron level is elevated, or who have cirrhosis, should avoid taking iron supplementation. In addition, one should restrict the amounts of iron rich foods in their diet, such as red meats, liver, and cereals fortified with iron, and should avoid cooking with iron coated utensils.

FAT AND HEPATITIS C
Overweight individuals are often found to have abnormalities related to the liver . Examination of liver specimens may display a spectrum of abnormalities ranging from fatty deposits in the liver,[ steatosis], to fatty inflammation [ fatty hepatitis], or even fatty cirrhosis. This condition is called Nonalcoholic Steatohepatitis [ NASH ]. It occurs predominantly in middle-aged obese women with diabetes mellitus and hypertriglyceridemia [excess fat in the blood]. However, this disease may also occur in individuals of normal weight, without other associated diseases, and can also affect men. The presence of fat in the liver can cause the liver to become enlarged and may result in elevations in liver related blood work { liver function tests [LFT's] }. The addition of NASH in patients with hepatitis C may worsen liver related blood work and physical exam. This may confuse interpretation of results and diagnosis. Controlled studies need to be done to determine if the addition of this disease worsens the prognosis of patients with underlying chronic hepatitis C. In overweight patients with a fatty liver who subsequently lose weight, liver- related abnormalities improve. Therefore, patients with chronic hepatitis C are advised to maintain a normal weight. For persons who are overweight, it is crucial to start a prudent exercise routine and a low fat, well balanced, weight reducing diet. In diabetic patients, a sugar- restricted diet should be adhered to. A low cholesterol diet should be followed in those with hypertriglyceridemia. In individuals with NASH who are of normal weight, a low fat diet may be advantageous. It is essential that patients consult with their physician prior to the commencement of any dietary or exercise program.

PROTEIN AND HEPATITIS C
Adequate protein intake is important to build and maintain muscle mass and to assist in healing and repair. Protein intake must be adjusted to one's body weight. Approximately 0.8 grams of protein per kilogram of body weight is recommended in the diet each day. Therefore, protein intake should be between about 60 - 120 grams a day in patients with hepatitis C, unless a complication of cirrhosis known as encephalopathy occurs. Encephalopathy is an altered mental status. The exact cause is not fully understood and is probably multifactorial. It has been shown that restriction of the diet of animal protein and maintaining a total vegetarian diet, helps reverse this condition and improve mental capacity.

SODIUM AND HEPATITIS C
Advanced scarring of the liver [ cirrhosis ] may lead to an abnormal accumulation of fluid in the abdomen referred to as ascites. Patients with hepatitis C who have ascites must be on sodium [salt] restricted diets. Every gram of sodium consumed results in the accumulation of 200 ml of fluid. The lower the salt content in the diet, the better this excessive fluid accumulation is controlled. While often difficult, sodium intake should be restricted to 1000mg each day, and preferably to 500 mg per day. One must become an careful shopper, diligently reading all food labels. It is often surprising to discover which foods are high in sodium. For example, one ounce of corn flakes contains 350 mg of sodium; one ounce of grated parmesan cheese - 528mg of sodium; one cup of chicken noodle soup - 1108 mg of sodium; and one teaspoon of table salt - 2,325 mg of sodium! Most fast food restaurants are a no no. Meats, especially red meats, are high in sodium content, and adherence to a vegetarian diet may often become necessary. Patients with chronic hepatitis C without ascites, are advised not to overindulge in salt intake, although their restrictions need not be as severe.
Source: Diet for liver disease

« Последна редакция: Февруари 06, 2007, 10:24:22 от Radoslav Rusinov »
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Re: Да се спазва ли диета и каква да бъде тя?
« Отговор #3 -: Февруари 06, 2007, 10:31:22 »
--------
Друга, свалена е от: http://www.hepcnet.net/nutritionandhepc.html
Nutrition & HepC

Nutrition and Diet Recommendations for people with Chronic Hepatitis C

Nutrition and the Liver:
The liver is the major organ responsible for regulating and responding to your body's metabolic demands. Your liver must be functioning well to maintain normal metabolism of carbohydrates, fats, and protein; it is also responsible for processing and using several vitamins. This section deals with the role and healthy liver (and a healthy, well-balanced diet) plays in these nutritional processes.

Carbohydrate Metabolism:
The most common sources of dietary carbohydrate are sugars, such as sucrose (table sugar), fructose (corn syrup), and lactose (milk sugar), and starches, such as breads, pasta, grains, cereals, fruits, vegetables, and potatoes. When you eat carbohydrates, specialized enzymes in the pancreas and gut process them to yield simple sugars (glucose, galactose, fructose, maltose).

These sugars are absorbed by intestinal lining cells, enter the portal circulation, and travel to the liver via the portal vein. During overnight fasting, blood sugar levels dip to a relatively low level, insulin secretion is suppressed, and blood insulin levels diminish. After a meal, blood sugar increases (stimulating the release of insulin from the pancreas), and insulin levels rise. Insulin, which rises in response to a meal, is the hormone that stimulates the liver to take in more glucose and to move the glucose into storage -- mainly in the form of glycogen. The liver can then release glycogen to your muscles for energy during periods of fasting or exercise. Although the liver can store considerable amounts of glycogen, it is the first energy source used during periods of prolonged fasting or caloric deprivation, and it can be depleted rapidly. After glycogen, the body taps other energy sources -- including protein and fat.

Protein Metabolism:
We take in dietary protein from dairy products, produce, and meats. Enzymes produced by the pancreas and intestine break down the protein into its amino acids and small peptides. The intestine rapidly absorbs the amino acids with specific transport systems within its lining cells and then delivers the amino acids to the liver via the portal vein. When they reach the liver, they are used for energy or for making (synthesizing) new proteins. The newly synthesized proteins perform specific body functions.

Fat Metabolism:
In general, fats are neutral lipids (triglycerides), acidic lipids (fatty acids), and sterols (cholesterol, plant sterols). Triglycerides (dairy products, meats, oils, butter, margarine) are the most common type of dietary fat and represent a major source of energy. The liver is uniquely suited to regulate and process triglycerides.

Dietary triglyceride is digested in the intestine by lipase, an enzyme secreted by the pancreas in response to meals. Bile, secreted by the liver, makes the digested fat soluble and promotes its absorption. Absorbed fat is then repackaged and transported into blood, where the liver ultimately removes it from the circulation. Fat that reaches the liver is processed in three ways: (1) stored as fat droplets in liver cells, (2) metabolized as a source of energy, and (3) repackaged, secreted back into blood, and delivered to other cells in the body.

The liver is also intimately involved with the processing of dietary cholesterol and is the main source of newly synthesized cholesterol in the body. Liver disease may be associated with both high or low blood cholesterol levels. In general, as liver disease progresses in patients with hepatitis C, the blood level of cholesterol drops.

Bile:
The liver produces and secretes a fluid (bile) that enters the intestine to aid in digestion and absorption. Bile is clear yellow to golden-brown and contains water, electrolytes (salts), cholesterol, bile salts (detergents), phospholipids, and proteins. Bile helps to activate enzymes secreted by the pancreas and is essential for the digestion and absorption of fat or fat-soluble vitamins.

Vitamins:
The liver plays a role in several steps of vitamin metabolism... Vitamins are either fat-soluble (Vitamins A, D, E, and K) or water-soluble (Vitamin C and the B-complex vitamins).

Patients with advanced liver disease may become deficient in water-soluble vitamins, but this is usually due to inadequate nutrition and poor food intake. Vitamin B12 storage usually far exceeds the body's requirements; deficiencies rarely occur due to liver disease or liver failure. When dietary intake drops, however, thiamine and folate commonly become deficient. Oral supplementation is usually all that you need to restore thiamine and folate stores to the normal range.

Fat-soluble vitamins require not only adequate dietary intake but also good digestion and absorption by the body. That's why normal production of bile is essential. Bile in the gut is required for the absorption of fat-soluble vitamins into the body because these vitamins are relatively insoluble in water. Bile acts as a detergent, breaking down and dissolving these vitamins so they may be properly absorbed.

If bile production is poor, oral supplementation of vitamins A, D, E, and K may not be sufficient to restore vitamin levels to normal. The use of a detergent-like solution of liquid vitamin E (TPGS) improves the absorption of vitamin E in patients with advanced liver disease. The same solution may also improve the absorption of vitamins A, D, and K if the latter are taken simultaneously with the liquid vitamin E.

Source: "Living with Hepatitis C: A Survivor's Guide" by Gregory T. Everson, M.D., and Hedy Weinberg. 1997, Hatherleigh Press.

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Ето и малко информация на български, публикувана на страницата на Хепасист - национално сдружение за борба с хепатита.
Статията е свалена от: http://hepasist.org/index.php?page=menu7&sub=7_1

Каква диета трябва да спазваме при чернодробни заболявания?

Има различни видове чернодробните заболявания – някои протичат благоприятно, докато други могат да причинят тежки увреждания. При някои от чернодробните заболявания е необходимо да се спазва стриктна диета.

Затова при наличие на чернодробно заболяване ние Ви препоръчваме винаги да се съветвате с Вашия личен лекар, диетолог или да се обадите на телефон 0700 10 515.
Най-общо препоръките към хора с чернодробно заболяване са:

    * Увеличаване на приема на въглехидрати. Те се усвояват лесно от организма и не натоварват черния дроб.
    * Ограничаване на приема на мазнините, поради по-трудното им усвояване от организма на човека. Те натоварват черния дроб.
    * Дневното количеството на белтъците, които се приемат с месото и млякото трябва да са приблизително 1 грам на килограм телесна маса. Например ако човек е 70 килограма, той трябва да приема 70 грама белтъци на ден. Те се равняват на 240 гр. приготвено месо или 500 мл. прясно мляко.
    * Допълнително количество белтъчини се приема и чрез зеленчуците, например картофи.
    * При хора с тежко увреден черен дроб може да се наложи да се намали количеството на белтъци с храната. По този начин те се предпазват от тежко мозъчно увреждане.
    * Ограничаване на приема на алкохол до минимум.
    * Прием на витамини, които се синтезират в черния дроб – особено витамините от група В.
    * Ограничаване на количеството на солта при наличие на чернодробна цироза, особено при излив на вода в коремната кухина (асцит) и отоци по тялото.

Как да се храним при остри хепатити?

    * Хората с остри вирусни хепатити трябва да се стараят да спазват здравословния начин на хранене.
    * Препоръчително е да приемат повече белтъци и въглехидрати.
    * Ограничаване на мазнините.
    * Забранява се приемът на алкохол - понеже алкохолът директно уврежда чернодробните клетки. Освен това при острите хепатити черният дроб не може да преработва алкохола и да предпазва от вредните му въздействия.
    * Забраняват се пържените храни.
    * Забранява се приемът на кафе и чай.
    * Препоръчва се да се спре тютюнопушенето.
    * Трябва да се ограничат тежките физически натоварвания, в това число и спорта.
    * Здравословното хранене е много важно за възстановяването. При болни с остър хепатит обаче може да се наблюдава гадене и загуба на апетит.

Как да се храним при хронични хепатити?

    * Хората с хронични вирусни хепатити трябва да се стараят да спазват здравословния начин на хранене.
    * Препоръчително е да приемат повече белтъци и въглехидрати.
    * Ограничаване на мазнините.
    * Препоръчително е да се ограничи приемът на алкохол до минимум.
    * Ограничават се пържените храни, които дразнят стомаха и затрудняват черния дроб при преработката на мазнините.

Как да се храним при чернодробна цироза?

Хората с чернодробна цироза се нуждаят от повече белтъци и въглехидрати. Ако не са настъпили усложнения те не се нуждаят от специална диета.

При наличие на усложнения е необходимо да се спазва по специална диета.

    * При асцит – необходимо е да се ограничи приемът на сол. Солта води до задържане на течности в организма и до влошаване на състоянието на болния. Повечето фабрични храни съдържат голямо количество сол. Затова се препоръчва следното:
          * Да не се соли допълнително храната.
          * Да не се използват пакетирани бульони.
          * Да не се използват пакетирани супи.
          * Да не се използват консервирани зеленчуци.
          * Да не се консумира пушена риба.
          * Да не се консумират колбаси.
          * Да не се консумират сирене или кашкавал.
          * Да не се консумират бутилирани сосове, като кетчуп и др.
    * При мозъчни увреждания – препоръчват се следните промени в диетата:
          * Да се яде често - на всеки 2-3 часа.
          * Да се ядът млечни продукти и пилешко месо.

Примерно дневно меню на болен с чернодробно заболяване

Закуска

    * 1 портокал
    * овесени ядки с мляко и захар
    * 1 филия пълнозърнест хляб
    * 2 чаени лъжици маргарин
    * сладко от ягоди

Обяд

    * 120 грама риба, пилешко месо или друго бедно на мазнини месо. Препоръчва се да не е пържено.
    * варени или печени картофи
    * задушени зеленчуци
    * зелена салата, но без мазнина
    * 2 филии пълнозърнест хляб
    * 2 чаени лъжици маргарин
    * 1 супена лъжица сладко
    * пресен плод
    * мляко

Следобедна закуска

    * мляко със сухари

Вечеря

    * 120 грама риба, пилешко месо или друго бедно на мазнини месо. Препоръчва се да не е пържено
    * богати на нишесте храни – картофи, ориз
    * готвени зеленчуци (да не са пържени)
    * салата без мазнини
    * 2 филии пълнозърнест хляб
    * 2 супени лъжици маргарин
    * един пресен плод
    * една чаша мляко

Как да ядем по-малко мазнини?

Закуска

Голяма част от храните съдържат мазнини, без да е очевидно това и ние ги поемаме без да отчитаме този факт. Това е причината при спазване на бедна на мазнини диета да се избягват следните храни:

    * Масло
    * Пълномаслени млека
    * Всички видове сирене и кашкавал, с изключение на фабрично обезмаслените
    * Всички видове растителна мазнина за готвене
    * Патешко и свинско месо
    * Колбаси
    * Чипсове
    * Бисквити, торти, пасти

Какво да правим при гадене?

    * Яжте храни, които харесвате и не се насилвайте да ядете такива, които не харесвате.
    * Поддържайте устата си чиста и свежа през целия ден.
    * Не гладувайте, гладът влошава вашето състояние .
    * Яжте по малко и на често - опитайте се да хапвате нещо на всеки 2 часа независимо колко малко е то.
    * Студените храни се понасят по-добре.
    * Ако винаги Ви се гади в определено време на деня, не яжте през този период.
    * Избягвайте да ядете когато сте много уморени. Първо си починете и след това се нахранете.
    * Ако готвенето влошава вашият проблем, яжте готови храни или сандвичи.
    * Пийте студени напитки през сламка.

     
Ако гаденето продължи повече от няколко дни или започнете да повръщате незабавно се консултирайте с Вашия личен лекар.
Какво да правим при загуба на апетит?

    * Яжте храни, които харесвате.
    * Яжте по малко и на често.
    * Опитайте се да хапвате нещо на всеки 2 часа независимо колко малко е то.
    * Не се насилвайте да ядете нещо което не Ви харесва.
    * Опитайте се да си почините преди и след хранене.
    * Яжте бавно, без да бързате.
    * Ако сухата храна Ви дразни, пийте повече нектари, компоти, прясно изцедени плодове.

Нямам възможност да отговарям своевременно на постове и лични съобщения.
Сдружение ХепАктив - www.hepactive.org


Неактивен Радослав Русинов

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Re: Да се спазва ли диета и каква да бъде тя?
« Отговор #4 -: Февруари 06, 2007, 10:37:26 »
Успях да намеря и цялата статия Natural Approaches for Hepatitis C  :)
Articles on Hepatitis C
Писана е от Dr. Michael Wald и се състои от 18 части, в първия пост всъщност публикувах само 6 част, която се отнася за диетите.
Ето въведението към серията от публикации:
This series of articles have been written primarily for those infected with the Hepatitis C virus. It is also intended for anyone wishing to support those infected with HCV by improving and enhancing their own level of education and pro-activeness. Familiarizing oneself with the approaches and philosophies outlined in this text makes it possible for those infected, as well as the friends and family of those infected, to develop confidence in their own level of knowledge and ability to make intelligent and well thought out choices regarding healing options.

Уточнението на края поредицата също е много важно и важи за всичко, което е публикувах в горните постове:
Disclaimer: The information contained on this site is meant for educational purposes only.  It is not to be used in place of standard medical, nutrition or general health advice by a licensed health professional. The use or misuse of this information is the sole responsibility of the user. The user hereby shall hold harmless Advanced Medical of Mount Kisco, P.C. (AMMK), Dr. Michael Wald, Dr. Neil Raff and all other employees & associates of AMMK of all lawsuits and legal actions that may be taken against said health care facility.
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Неактивен irka

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Re: Да се спазва ли диета и каква да бъде тя?
« Отговор #5 -: Февруари 06, 2007, 16:31:15 »
Радо, поздравления за труда и благодаря, че го сподели с нас! :)

За съжеление не всичко разбрах, ама минуса си е мой! :-\

На мен това което са ми казали за диетата е, че всъщност такава няма. Хапваш си здравословна храна, с каквато по принцип би трябвало да се храним. Друг е въпроса доколко го правим! :) Пърженото и мазното по принцип не са за препоръчване, както сладкото и мнооого лютото.  Така че човек е хубаво да ги ограничава и без да има хепатит С. Но да ги ограничава, а не е задължително да ги изключи съвсем от менюто си! Както каза моята лекарка- то черния дроб си има нужда понякога и от мазничко, и от сладичко! Така че си мисля ако човек не се храни всеки ден с мазни храни /изброени в горните постинги/, не яде на всяко ядене адски люта храна и не набива по цял ден сладки работи, всичко ще си е о.к.!

Поне аз за себе си спазвам тези неща. Хапвам си и свинско, и пържено, и люто, и сладко, но един път седмично да ми се върже от всяко едно от изброените. И то не защото спазвам някакви правила, ами просто така си се получава, така съм се хранила винаги.

Алкохола е друго нещо вече! Ясно е, че той е забранен! :-X Но честно да си кажа аз си позволявам 1-2 чаши вино или бира. На разни поводи си позволявам и концентрат. Всъщност аз алкохол не бях близвала 3години покрай бременеене и кърмене, така че по принцип не пия. Дори виното и бирата най-много да ми се е случвало 1-2 вечери в седмицата да пия по 1-2 чаши.

Съпругът ми, откакто разбра, концентрат пие мнооого рядко. Вино и бира и той като мен отвреме навреме по малко.

Ясно е, че в момента който почнем лечение няма да си позволим и капка алкохол!

Обаче това родителите са "голяма работа"! И моите и неговите знаят за състоянието ни, но като им отидем на гости се почва - Айде малко ракийка/водка или др./ за здраве, няма да навреди, една чашка! - после обаче се сипва и още една и ....Не мога да ги разбера! :-\ Накрая все се налага да им напомняме, защо ограничаваме алкохола!

Аз зе замислих нещо друго! В момента съм на една диета /ама не заради болест а за сваляне на кг.  :-[/ та се чудя дали няма да окаже някакво влияние! Май ще трябва да се консултирам с някой! Че тя  е доста дълга  и макар че се избягват повечето храни които не са препоръчителни при Хепатита, все пак се набляга доста на белтъчините и протеините, като изключва почто до минимум въглехидратите, а също и плодовете и голяма част от зеленчуците/в тях има доста въглехидрати/.Затова и се налага да взимам допълнително витамини! Ей, сега се хвърлих в размисли! :-\



Неактивен Радослав Русинов

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Re: Да се спазва ли диета и каква да бъде тя?
« Отговор #6 -: Февруари 06, 2007, 21:41:03 »
Здравей :)

Аз мога да кажа каква диета спазвам в момента, ако може да се нарече така.
Не пия никакъв алкохол, по никакъв начин, дори и глътка.
Това е нещото, което и лекарката ми каза "никакъв алкохол", и от нещата които съм прочел се опитвам да не пия никакъв, спрях да пия преди лечението и досега още не съм пил никакъв.
Това е единственото, което лекарката ми каза относно диетата, аз я питах за останалите неща, мазно и т.н. и тя каза, че няма нужда да се спазва такава стриктна диета.
Ограничавам се и да ям прекалено люти неща, може само леко пикантни.
И другото, което спазвам e да избягвам всякакви лекарства, особено тези базирани на ибупрофен. А в днешно време почти всички по-силни лекарства, болкоуспокояващи и т.н. са на базата на ибупрофен. Загледай рекламите по телевизията на лекарства и ще прочетеш или чуеш накрая "съдържа ибупрофен". А след като прочетох статията на www.puls.bg видях, че може би съм имал някакво право.
Цитат
Хепатит С - симптоми, диагноза, лечение - Какво е лечението?
 - избягване приема на лекарства, които са вредни за черния дроб (важно е да се отбележи, че почти всички медикаменти, широко прилагани за понижаване на температурата, болката и симптомите на настинката са токсични за черния дроб и прилагането им трябва да се избягва); не трябва да се приемат потискащи имунната система медикаменти (наричат се още имуносупресори), тъй като те намаляват естествените защитни сили на организма и улесняват размножаването на вируса; ако сте болни от хепатит се консултирайте с лекар преди започване приема на каквото и да било лекарство, тъй като чернодробното увреждане променя разграждането и от там ефекта на голям брой лекарствени вещества.
Не стига, че натоварват черния ти дроб ами и всъщност не действат, защото черния дроб не работи както трябва.
Всъщност хепатита ми го откриха след като си направих едно ударно едноседмично лечение с лекарство, базирано на ибупрофен, от което така ми се разстрои стомаха, че след като отидох на гастроентеролог той ме прегледа и се усъмни за хепатит и тогава ми го откриха. След това не можах да убедя никой лекар, че предписаното ми ибупрофеново лечение е предизвикало силна чернодробна реакция. Дори открих статия по темата, но никой не прие това като възможен вариант. Ще я сложа тук, ако ти е интересно да я прочетеш: Ibuprofen-Induced Hepatotoxicity in Patients With Chronic Hepatitis C. Тези няколко пациенти са били лекувани с ибупрофен-базирани лекарства в количества точно като при мен и стойностите на AST и ALT на единия от тях например, са скочили до 523 и 1238  ???
Но много се отклоних от темата :)
В момента никаква друга диета не спазвам и мисля, че това трябва да си е индивидуално решение. Тези статии точно дават идеи как можем да се храним така, че да не натоварваме черния дроб, но аз не мисля, че едно нормално хранене може до такава степен да натовари черния дроб, че едва ли не той да се увреди по-бързо отколкото ако човек се храни правилно.
Но както ти казваш, не знам как стоят нещата, когато спазваш някаква диета която може по някакъв начин доста да натовари черния дроб. Виждам, че препоръчват повече въглехидрати, но не знам.
Мисля, че с едно сравнително нормално хранене, без да се прекалява с нищо и без да се ограничава, човек може да се чувства съвсем нормално.
Иначе преди да започна лечението точно така се бях уплашил и след като бях изчел всички тия статийки  :D по-горе, реших да спра да ям месо. Пак изчетох сума ти неща какво трябва да се яде, когато си вегетарианец и така изкарах почти 3 месеца, като рядко се случваше инцидентно да хапна нещо с месо. Наблегнах на по-здравословните храни, рибни неща и сурови ядки и мога да кажа, че се чувствах доста добре. Но като започна лечението веднага спрях. Тогава всъщност минах през един период от 3-4 месеца дето просто ядях по 4-5 пъти на ден  :D, и ядях наистина много месо.
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Неактивен Stefan

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Re: Да се спазва ли диета и каква да бъде тя?
« Отговор #7 -: Февруари 07, 2007, 01:42:06 »
Rado, ako procheti moia post deto govorih za dietata mi i az imah sashtoto prejiviavane. spriah da iam po4ti vsiakakvi mesni i jivotinski produkti i sled niakolko dni se 4uvstvah ujasno. spored men triabva da se hapva ot vsi4ko i kakto kaza irka samo da se ogranichavat tezi po vrednite, natovarvashti hrani. po princip strogite dieti se preporachvat nai ve4e za hora v mnogo naprednal stadii na bolesta, pri koito chernia drop veche ne e zdrav.

mnogo chesto cheta i za jeliazoto, 4e triabva da se izbiagva. mai svinskoto ima pove4ko jeliazo, a sushto go ima i v niakoi vitamini, triabva pak da potarsia malko pove4ko info za tova.

Неактивен Радослав Русинов

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Re: Да се спазва ли диета и каква да бъде тя?
« Отговор #8 -: Февруари 07, 2007, 08:40:03 »
Да, и аз така мисля, не трябва да се прекалява с ограниченията :) Особено когато става въпрос за нещо, което не може да окаже чак толкова голямо влияние, специално при хроничен хепатит в не толкова напреднал стадий.
За желязото ще е интересно да пуснеш инфото, да прочета какво казват за него.
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Re: Да се спазва ли диета и каква да бъде тя?
« Отговор #9 -: Февруари 12, 2007, 20:49:16 »
Радо ,за ибупрофена - всички хванахме грипа и мъжа реши да се лекува ударно .С ибупрофен за смъкване на температурата - той също е с хепатит С .Вечерта беше много зле - казваше ,че му изтръпват крайниците ,че умира да викам бърза помощ .Кошмар.Аз така и не ги викнах - реших ,че достатъчно се е натровил и ако дойдат ще му сложат още нещо и ще стане по- зле .Не сгреших - оживя  ::)Е наблюдавах го де питах го през десет минути - дишаш ли ? На другия ден му взех глюкоза .За три дни се съвзе .Та този ибупрофен е супер гадост - предлагат го под формата на Нурофен - и за деца малкия ми получи тежка алергична реакция от него и се наложи урбазон .Внимавайте с него .
Хепатита си действа бавно но сигурно черния дроб полека ,полека отказва - това са моите наблюдения .
Нинка , диетите да не са много драстични само .След такава доста често започна да ме боли от дясната страна - личната каза - аа жлъчката е но аз си знам  :-\
 Благодарности  за  инфото за храненето !
Стефан ,тези неща дето ги писах за ттт.. ги изрецитира Чернев на времето .Но човек сам познава себе си най-добре .И чувства кое му понася и кое не . Между другото какво мислите за имунизациите за хепатит В в нашето положение .Мен ме е страх да си сложа такава ,като чета за смъртните случаи след нея ..
« Последна редакция: Февруари 12, 2007, 20:56:34 от ninka »

Неактивен Радослав Русинов

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Re: Да се спазва ли диета и каква да бъде тя?
« Отговор #10 -: Февруари 13, 2007, 10:17:41 »
Това, което се е случило с мъжа ти след употреба на нурофен пак показва, че може би има нещо вярно в теорията. Трябва да се внимава с тези лекарства, когато човек има увреден черен дроб. А все повече лекарства в момента са базирани на ибупрофен.
За ваксината и аз не знам, това което съм чел е че се препоръчва човек, който има хепатит C да се ваксинира срещу хепатит B, защото комбинацията от двата хепатита наведнъж е доста по-тежка и по-трудна за лекуване. В същото време ваксината може би има някои странични ефекти, но не вярвам да е чак толкова опасна. Един приятел си слага наскоро комбинирана ваксина срещу хепатит A и хепатит B, мога да го накарам да сподели тук как му се е отразило и дали е имало някакви странични ефекти.
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Неактивен Радослав Русинов

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Re: Да се спазва ли диета и каква да бъде тя?
« Отговор #11 -: Февруари 13, 2007, 11:45:30 »
Ето малко информация за ваксината от Wikipedia:
Цитат
Hepatitis B
...
Prevention
Several vaccines have been developed for the prevention of hepatitis B virus infection. These rely on the use of one of the viral proteins (hepatitis B surface antigen or HBsAg). The vaccine was originally prepared from plasma obtained from patients who had long-standing hepatitis B virus infection. However, currently, these are more often made using recombinant technology, though plasma-derived vaccines continue to be used; the two types of vaccines are equally effective and safe.

Many countries now routinely vaccinate infants against hepatitis B. Babies born to HBeAg positive mothers are strongly recommended to be vaccinated and injected with immune globulin immediately after birth, so as to prevent transmission of infection. In many areas, vaccination against hepatitis B is also required for all health-care workers. Some college campus housing units now require proof of vaccination as a prerequisite. Booster doses are not needed for low-risk general population. Some recommend such doses every five to ten years for health-care workers, though the evidence supporting such doses is quite limited.

The vaccine is highly effective. In endemic countries with high rates of hepatitis B infection, vaccination of newborns has not only reduced the risk of infection, but has also led to marked reduction in liver cancer. This was reported in Taiwan where the implementation of a nationwide hepatitis B vaccination program in 1984 was associated with a decline in the incidence of childhood hepatocellular carcinoma.[8] In that sense, this vaccine can be thought of as an anti-cancer vaccine.

Patients with HIV appear to have inferior antibody responses to hepatitis B vaccination.[9]
...
От нещата, които споменават, ваксината е много ефективна и се използва за ваксинация на новородени. Не мисля, че ако има сериозна опасност ще позволят тя да се слага на новородени.
На страницата на Хепасист също има доста инфо: Ваксини срещу хепатит B
Сега говорих с приятеля, който си е слагал ваксината, не е имал никакви проблеми.
Нямам възможност да отговарям своевременно на постове и лични съобщения.
Сдружение ХепАктив - www.hepactive.org


Неактивен Радослав Русинов

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Re: Да се спазва ли диета и каква да бъде тя?
« Отговор #12 -: Февруари 15, 2007, 18:07:48 »
Нинка,
Ето информация от приятеля, който си е слагал ваксина против хепатит B.
Ваксината е комбинирана срещу хепатит A и хепатит B.
Тя е на GlaxoSmithKline (GSK) и се казва Twinrix.
Малко повече инфо за нея: Twinrix - Key Features
Слага се три пъти - първа инжекция, на 3-ия месец втора и на 7-ия трета инжекция.
Цената била около 180 лв.
Дано не звучи като реклама, предполагам има и други производители, но аз цитирам за неговия конкретен случай какъв продукт е ползвал.
 
Нямам възможност да отговарям своевременно на постове и лични съобщения.
Сдружение ХепАктив - www.hepactive.org


Неактивен tanq

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Re: Да се спазва ли диета и каква да бъде тя?
« Отговор #13 -: Април 27, 2007, 13:39:52 »
Ne vidqh nqkoi da spomenavq kafeto i kakaoto, a tova be6e parvoto koeto mi kazaha za dietata: nikakvo kafe, nikakvo kakao i osven tova nikakvi qdki. Ne znam za6to i qdki ne moje, moje bi za6toto imat pove4e maznini.
Az li4no spazvam mnogo stroga dieta, no pri men e razli4no, za6toto sam s hep B. Nablqgam na plodove i zelen4uci, mle4ni hrani (niskomasleni), pile6ko meso. Znam 4e trqbva da se nablqga na vaglehidratnata hrana, da ne se li6ava6 ot hlqb. Dobre e da se zamesti bqlata zahar s nerafinirana (kafqva)

I ne6to mnogo vajno: NE zamestvaite beliqt hlqb s rajen ili palnozarnest, za6toto po4ti vsi4ko koeto se predlaga na balgarskiq pazar pod tova ime, vsa6tnost si e bql hlqb s vsevazmojni znaini i neznaini ocvetiteli, koito sa kraino vredni za 4erniq drob.

Неактивен Stefan

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Re: Да се спазва ли диета и каква да бъде тя?
« Отговор #14 -: Април 28, 2007, 19:55:09 »
tanq,

az koeto sum chel iadkite po skoro se preporachvat otkolkoto obratnoto. v tiah ima maznini koito sa mnogo po polezni otkolkoto tezi v mesata, a na nas maznini ni triabvat za da razgrajdame opredeleni vitamini. neznam kak e pri hepatiti b , no pri hepatit c ne se preporachva stroga deieta ako ne ti e naprednala bolestta. samo se kazva da se izbiagvat opredeleni tejki hrani, parjeno ili nai obshto kazano da se hranim zdravoslovno. za kafeto sushto se spori, az znam 4e to te obezvodniava, a dokato si nalechenie ti triabvat pove4e technosti. kakto i da e, az izbiagvam coffein , nikakuv alkohol i po malko preraboteni hrani, vsi4ko ostanalo gledam da si hapvam shtoto inache shte se stopia :)

pozdravi

 


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