ASSESSMENT OF NUTRITIONAL STATUS :-

Most of the traditional markers of nutritional status are affected by liver disease and its consequences, making assessment very difficult. Blood serum indicators of protein status, such as albumin, transferrin, prealbumin and retinal binding protein are depressed due to decreased synthesis in addition to being affected by hydration and renal dysfunction.In terms of the body measurement (anthropometric)- arm anthropometry, triceps skinfold thickness and midarm muscle circumference are most commonly used. Weight is unreliable in chronic liver disease because a patient gaining weight could imply accumulation of ascites.

Therefore, a nutritious diet is an important part of management of liver disease and should be designed to protect the liver and to enable it to function as efficiently as possible.

HEPATITIS :-

The objectives of dietary treatment in hepatitis are to aid in the regeneration of liver tissue and to prevent further liver damage. A high caloric diet daily is needed to promote weight gain and to ensure maximum protein utilization. In general 25 to 35 Kcal/kg estimated weight is prescribed.

Carbohydrate:-

An intake of 6-8 gm/kg carbohydrate ensures adequate glycogen reserves needed for the maintenance of liver function for protection against further injury to the liver and for its protein sparing action.

Protein :-
An intake of 1 ½ to 2 grams protein per kg of body weight is recommended to overcome negative nitrogen balance to promote regeneration of parenchymal cell, and to prevent fatty infiltration of the liver.

Fat :-
Diets restricted in fats are not necessary in the majority of patients with hepatitis. In fact, restricting fats all together may retard recovery if calories are thereby limited. Fats from dairy products, cooking fats are easily utilized and add palatability to the diet without large amounts of bulk. If there is anorexia, fats may cause nausea and should be limited to amounts tolerated by the patient.
Foods of liquid of soft consistency may be preferable if there is anorexia in the acute stages of illness, progressing to wider selection of foods with convalescence. The patient must be convinced of the importance of the diet in promoting recovery and preventing relapses. Anorexia is frequently a problem; hence every effort must be made to encourage the patient to eat. Foods must be well prepared and attractively served with consideration given to the individual food preferences. Judicious use of spices and condiments may help to stimulate the appetite. Small to moderate portion at mealtime with high protein between meal supplements are frequently more acceptable than larger meals. Some individuals need assistance in feeding themselves and should be allowed adequate time to eat a leisurely pace.