Food provides you with the energy to
get through your day, and eating is
one of life’s basic pleasures.
A well-balanced diet will:
• Provide the energy to perform your daily activities
• Boost your immune system
• Help you maintain a healthy weight, and
• Reduce the risk of many diseases such as heart
disease, obesity and some cancers.
Dietary recommendations for people with hepatitis C, unless
they have advanced liver disease, are the same as for the
general population – high fibre and reduced fat. There’s
information on the internet and within the community
suggesting that people with hepatitis C need a special diet. But
there’s no research that shows that diet makes any difference
to the progression of hepatitis C, and some diets can cause
harm – whether or not you have hepatitis C.
Making healthy choices about your diet and putting these
choices into practice can provide you with a sense of well
being and empowerment.
This fact sheet provides basic information about diet and
nutrition for people who inject drugs who have hepatitis C. It
provides information on:
• Healthy eating including basic information about
different food groups
• Junk food
• Alcohol use
• Relieving gastrointestinal symptoms such as
nausea and constipation
• A shopping list for a healthy diet.
The effects of drug use on diet are under-researched. Drug
use affects the body in two distinct ways - the effect of the
substance itself and lifestyle changes, such as irregular
eating habits and poor dietary intake.
Opiate based drugs affect the gastrointestinal system
with a common problem being constipation. The symptoms
of withdrawal which can include diarrhoea, nausea, and
vomiting, may lead to nutrient deprivation. Eating regular
and balanced meals will decrease the severity of these
symptoms.
Methamphetamine was used to treat obesity in the 1950s
and 60s and affects the central nervous system. Its
effects include decreased appetite, an aversion to food
with subsequent weight loss and nutrition problems can
develop in long term users.
Anyone with advanced liver disease or nutrition
problems should seek expert advice on their dietary
needs.
There is evidence that people with hepatitis C who are
either obese or have type 2 diabetes, are at greater risk of
liver damage. Losing weight will not only make you feel
better, but it will help your liver function.
The liver performs a range of
functions:
• Helping digestion by filtering (or breaking down)
and removing toxins such as alcohol, drugs
(including medicines) and some waste products
from the body
• Manufacturing and packaging important proteins
essential to the body, including blood clotting
factors and enzymes
• Identifying and labelling proteins and other
essential nutrients so that they can be transported
to specific parts of the body where they are needed.
The liver also stores sugars and vitamins and produces the
bile salts that go to the small intestine to help break down
fats.
This fact sheet provides general dietary information and
is not intended to replace the advice of a dietician or
nutritionist.
Healthy eating
The National Health and Medical Research Council have
produced The Australian Guide to Healthy Eating. This guide
recommends including a variety of foods in your diet. These
foods are:
Bread, cereals, rice, pasta and
noodles
Eat 4 to 6 serves per day
• Cereals wheat, oat, rye, rice or barley
1 serve equals:
• Vegetables there are a variety of vegetables
available including;
2 slices of bread or one bread roll
1 cup of cooked rice or pasta
• Root vegetables; carrots, beetroot, parsnip, ginger
1 cup of cooked porridge
• Leafy green: spinach, cabbage, brussel spouts, bok
choy
One and a third cups of prepared cereal
½ a cup of muesli
• Marrow: zucchini, cucumber, eggplant, or pumpkin
Eat wholegrain bread, high fibre cereal, brown rice
and wholemeal pasta.
• Flowers: broccoli, cauliflower or lettuce
Rice, pasta and noodles have less salt and sugar than
bread or breakfast cereals and are nutritionally better.
• Onion: spring onion, garlic and leek
• Peppers and tubas: potatoes, sweet potato and
yams
Your body absorbs nutrients from different food sources in
different ways – this means that the nutritional effect can be
very different within and across the food types. Too much of
any one food can be unhealthy. The guide suggests that you
eat around 30 different foods every day – this may sound
challenging, but choosing foods that include a lot of variety
such as stir fries, salads, casseroles and multigrain breads
make it possible.
Avoid highly processed foods such as white breads or
pre-packaged foods
Foods in this group provide fibre, energy, protein, fat,
magnesium, zinc, riboflavin, niacin, folate, sodium
minerals and carbohydrates which are important for
energy, growth, and repair of the body.
Vegetables and legumes:
Eat 5 serves per day.
The aim of a good diet is to maintain variety in your diet –
don’t eat too much of any one type of food, or let one food group
dominate your diet.
1 serve equals:
½ a cup of cooked vegetables
½ a cup of cooked dried beans, peas or lentils
Food Groups
1 cup of salad vegetables
There are five food groups you need include in
your diet:
1 small potato
• Bread, cereals, rice, pasta and noodles
½ a cup of cooked beans, lentils, chickpeas, split peas
and canned beans
• Vegetables and legumes
• Fruit
• Milk, yoghurt and cheese
• Meat, fish, poultry, eggs, nuts, tofu and bean
curd.
Legumes are all types of beans including baked beans,
black beans, cannelini beans, chickpeas, kidney
beans, lima beans etc.
Choose a wide variety of vegetables
Frozen and canned vegetables are nutritious, often
cheaper, quick and easy to prepare, easily stored and
available everywhere.
Foods in this group are a good source of vitamins, mineral,
fibre, carbohydrates and antioxidants.
Fruit
Aim to eat 2 or more serves per day.
1 serve equals:
1 medium piece of fruit (about 150g) such as an
apple, banana, orange or pear
Meat, fish, poultry, eggs, nuts, tofu
and bean curd
Aim to eat 1 serve per day or if you are
a vegetarian, 2 or 3 serves of tofu or
bean curd per day.
1 serve equals:
2 small pieces of fruit such as apricot, peach or plum
½ a cup of mince, 2 small chops, or 2 slices of roast
meat
1 cup of canned fruit
80-120g of cooked fish fillet
1½ tablespoons of sultanas, or 4 pieces of dried fruit
such as apricot halves or mango pieces
2 small eggs
½ a cup of fruit juice
Whole fresh fruit is higher in fibre than juice.
Dried fruits are nutritious and add variety to your diet,
although they are high in sugar and can lead to tooth decay.
Canned fruit is nutritious especially if it canned in its
natural syrup and without added sugar.
Fruit is a good source of antioxidants, vitamins, and
provides fibre – particularly if you keep the skin on when
eating.
Milk, yoghurt, cheese and soy milk
Aim to eat or drink 3 serves per day.
1 serve equals:
1 cup of fresh milk
1 cup of soy milk (with calcium)
½ a cup of evaporated milk
2 slices of cheese
1 small carton of yoghurt
Dairy products provide calcium, protein, riboflavin and
vitamin B12.
One third of a cup of unsalted peanuts or almonds or
¼ of a cup of sunflower or sesame seeds
Choose a variety of meats and fish – beef, lamb, pork,
chicken, turkey, duck, rabbit, kangaroo, fish and shellfish.
This group of foods provides iron – good for carrying
oxygen in your blood and zinc – helps in the repairing of
wounds and growth.
B12 is only found in foods of an animal origin – vegans will
need to supplement their diet with vitamin B12.
Fats
People with hepatitis C do not need to exclude fats or oils
from their diets because of hepatitis C. The liver is able to
metabolise fat even when it is very damaged.
Small amounts of fat in your diet are essential for body
functioning and are a source of energy.
A diet high in saturated fats – found in fatty meat, butter,
full-cream milk products, cream, and in many takeaway
foods – can cause your body to produce cholesterol which
can contribute to developing heart disease and some
cancers.
Unsaturated fats – found in plant oils such as peanut
or sunflower oil, margarine, nuts and lean meat – are a
healthier choice.
Eat low fat varieties wherever possible (although infants
and young children should eat full fat varieties)
Packaged foods that are ‘creamed’ or ‘toasted’ often have
added fat.
Calcium enriched soy milk is a good alternative if you
can’t tolerate milk or milk products.
Fruit and vegetables (with the exception of avocado) are
virtually fat free – unless oil or fat has been added during
cooking.
Sugar
There’s no research to show that people with hepatitis C
have problems metabolising sugar.
A lot of foods contain sugar including fruit and milk.
Manufactured foods often have added sugar.
Many foods with large amounts of sugar also contain high
amounts of fat.
Sugar, sweets and lollies are very low in nutrients and fill
you up, making eating more nutritious foods difficult.
There are some foods that are
quick and easy to prepare and
eat:
• Fruit
• Salad sandwich
• Baked beans on toast
Salt
• Hamburgers or steak sandwiches made with lean meat,
with extra salad on wholemeal or wholegrain bread or a roll
with no butter
Salt intensifies flavour, colour and texture of food and a
small amount is essential for your body to function.
• Grilled fish instead of fried – use vinegar or lemon
instead of salt
Excess salt will increase your risk of high blood pressure.
• Thick chips are better than thin chips
The National Health and Medical Research Council
recommend that adults have an upper limit of 1 teaspoon
of salt per day.
• Takeaway foods such as sandwiches, rolls and pizzas
with a thick base and thin toppings – wholemeal is better if
you can get it
Fruit, vegetables and cereals have low salt content, while
bread and meat contain salt.
• Asian dishes that are steamed are better than fried
Caffeine
• Barbequed rather than deep friend chicken is better, and
not eating the skin is better still
Caffeine is found in tea, coffee, chocolate, cocoa and some
cola drinks.
• Kebabs
Caffeine stimulates your brain and nervous system.
There is no specific research showing that caffeine causes
particular problems for people with hepatitis C.
It is recommended that caffeine intake should not exceed
about 600ml per day – this is the equivalent of about 6
cups of coffee or tea. Remember though, that the amount
of caffeine in a coffee or tea is dependant on how strong,
fresh and the type of coffee or tea.
Food additives
There’s no evidence that people with hepatitis C should
avoid food additives such as artificial sweeteners.
Junk food
Not all junk food is bad although foods such as battered
fish, chips, hamburgers, deep-fried chicken, potato
cakes, hot dogs and meat pies are high in fat and salt
and low in fibre.
• Pasta with vegetable rather than cream sauces
• Pizzas with low fat toppings – use lean ham rather than
salami or pepperoni
• Salads
• Baked potatoes
• Soups
• Low fat yoghurt or ice cream.
Alcohol
Alcohol is recognised as the most important factor in
people with hepatitis C developing cirrhosis and can
reduce hepatitis C treatment success rates. Alcohol is a
toxin that is broken down by the liver and stimulates the
build up of fat in the liver, and the development of fibrosis
(or scarring of the liver). Controlling your alcohol intake and
drinking in moderation are effective health maintenance
strategies for people with hepatitis C.
If you choose to drink, limit the amount of alcohol you drink.
It is recommended that men with chronic hepatitis limit
alcohol to no more than 4 standard drinks per day and
women to 2 standard drinks per day. Both men and women
should have 2 to 3 alcohol free days per week. If you have
cirrhosis, it is recommended that you don’t drink at all.
There are ways you can limit your
alcohol use:
Foods that are high in fat or are spicy or sweet can cause
nausea.
Avoid drinks at meal times.
Try not to skip meals because an empty stomach can make
nausea worse.
• finish each drink before having the next drink
If you are vomiting frequently – sip plenty of fluids such
as water, herbal teas or plain mineral water to avoid
dehydration.
• mix your drink with plain mineral water
Constipation
• switch to low alcohol or alcohol free drinks
• avoid situations where there maybe pressure
to drink
One challenge for people using opiate based drugs is
constipation and prevention is the best cure.
• alternate a non-alcoholic drink with an
alcoholic one.
Using laxatives every-so-often is okay, but long term use
can cause problems.
Gastrointestinal symptoms
Nausea, loss of appetite and constipation are sometimes
experienced by people who inject drugs who have hepatitis
C. Sometimes these symptoms relate to the drug use itself or
withdrawal, at other times it can relate to your body’s response
to having hepatitis C or being treated for hepatitis C. The
following are suggestions for relieving common symptoms.
Drink a glass of warm water every morning before eating
any food.
Drink plenty of water during the day – warm water if you
can deal with it.
Exercise will help.
Eating the following will help:
Nausea
Yogurt which is full of live bacteria.
Ginger, peppermint, spearmint, fennel seed and aniseed
teas can help reduce bloating and abdominal cramps - make
ginger tea by grating a one-inch piece of ginger and adding
hot water.
Potassium - found in almonds, fruit, especially bananas
and paw paw, green leafy vegetables such as spinach
Bran, wholemeal bread, brown rice, wheat germ are all
helpful - sprinkling bran or wheat germ on your cereal.
Added acid in your stomach can add to discomfort – avoid
orange or lemon or other citrus.
Fresh carrots chopped up can be good.
Small sips of fluid are often easier to consume than solids.
If you can, pooh before you use opiates.
Eat smaller meals more often.
Don’t strain too hard when having a pooh, as it can cause
piles (haemorrhoids).
Soups and broths can be easier to eat.
Toast or crackers can be good if you are nauseous in the
morning.
If you are sensitive to food smells – avoid being in the
kitchen when cooking, or use a fan to move the air around
and cook when you a feeling less nauseous.
Cold foods such as sandwiches, salads, fruits, cold soups and
cheese and biscuits can be useful.
If there are any unusual changes in your bowel habits
or faecal appearance - bulky, pale faeces the colour of
porridge or clay with a fatty consistency and a gross smell
are associated with gall bladder, liver, or pancreatic disease
– contact your local general practitioner or drug user
organisation.
The good food
shopping list
Underneath is a shopping list of foods
that when eaten in a balanced way
will provide the nutrients that will
get you through your day and more.
If you’re setting up your kitchen or
pantry, don’t get too ambitious and
think that you have to buy everything
all at once.
Making a menu of what you’re going
or want to eat over the next few days
will help in reducing the number of
things that you will need to buy and
stop you buying food that will just rot
because you haven’t used it. When
making up menus, there are millions
of websites and recipe books to
inspire you.
Cupboard:
Eggs
Peanut butter
Honey
Jam
Vegemite
Salt, pepper, herbs and spices
Rice
Rolled oats for porridge
Muesli
Spaghetti
Noodles
Legumes – chick peas, lentils, lima
beans, split peas
Olive oil
Vegetable oil
Canned tomatoes
Canned tuna, salmon or sardines
Baked beans
Bread – wholemeal/wholegrain
Canned fruit
Dried fruit
Nuts – peanuts, sesame seeds
Sugar
Coffee, tea
– including
herbal teas
Canned soup
Zucchini
Cauliflower
Bok choy
Spinach
Vegetables:
Lettuce
– these will last for a couple of weeks:
Eggplant
Onions
Avocado
Potato
Fresh tomatoes
Sweet potato
Celery
Garlic
Cucumber
Ginger
Pumpkin
Other fridge foods:
Cheese
Fridge:
Fresh fruit
– all year round:
Apples
Bananas
Oranges
Grapes
Fresh fruit
– in season:
Peaches
Apricots
Mango
Paw paw
Pineapple
Vegetables:
– these will last a few days in the
fridge:
Broccoli
Beans
Carrots
Cabbage
Beetroot
Parsnip
Milk or soy milk (with added
calcium)
Yoghurt
Bean curd
Tofu
Butter or margarine
Homous
Freezer:
Peas and other frozen vegetables
Meat or fish – although these are best
eaten fresh
Further information:
Nutrition Australia
www.nutritionaustralia.org
Practical food tips and
information:
www.foodwatch.com.au
Vegetarian diet inform ation and
recipes:
www.vital-health.com.au
AIVL NATIONAL MEMBER
ORGANISATIONS DIRECTORY
NAME
ADDRESS
POSTAL
PHONE
FAX
E-MAIL/ WEB
CAHMA
Canberra Alliance for Harm
Minimisation Advocacy
Room G05
New Griffin Centre
Civic, Canberra
ACT 2601
PO Box 5078
Braddon
ACT 2612
(02) 6262 5299
(02) 6262 8381
NAP
Network Against Prohibition
48 Narrow Rd
The Narrows, NT
0820
PO Box 701
PARAP NT
0804
(08) 8941 9921
No fax
[email protected]
www.napnt.org
PO Box 278
Darlinghurst
NSW 1300
(02) 8354 7300
1800 644 413
(02) 8354 7350
[email protected]
64 Fullarton Rd
Norwood
SA 5067
PO Box 907
Kent Town
SA 5071
(08) 8334 1699
(08) 8363 1046
[email protected]
128 Peel Street
North Melbourne
VIC 3051
Po Box 12720
Abeckett St
VIC 8006
(03) 9329 1500
(03) 9329 1501
damonbrogan@vivaids.
org.au
WASUA
WA Substance Users Assoc.
440-444 William St
Northbridge
WA 6003
PO Box 290
Maylands
WA 6931
(08) 9227 7866
(08) 9227 7855
QUIHN Brisbane
Headquarters
89-101 Gipps St
Fortitude Valley,
QLD 4006
PO Box 383
Miami Qld 4220
(07) 3620 8111
(07) 3854 1070
NUAA
NSW Users & AIDS Assoc.
SAVIVE
SA Voice of IV Education
VIVAIDS
Victorian Drug User Group
345 Crown St
Surry Hills
NSW 2010
[email protected]
www.cahma.org.au
[email protected]
[email protected]
www.quihn.org.au