Food for hepatitis b

Tips to Avoid Liver Damage From Hepatitis

What Not to Eat or Drink

Keep in mind that an unhealthy diet can contribute to liver damage. If you eat too much high-calorie greasy, fatty, or sugary food, you’ll gain weight and fat will begin to build up in your liver. A “fatty liver” can contribute to developing cirrhosis, or scarring, of the liver. Fat in your liver can also interfere with the effectiveness of drugs that target the hepatitis virus.

Avoid the following:

  • Saturated fats found in butter, sour cream, and other high-fat dairy foods, fatty cuts of meat, and fried foods
  • Sugary treats like cookies, cake, soda, and packaged baked goods
  • Foods heavily laced with salt
  • Alcohol

Many experts recommend that hepatitis patients also avoid raw or undercooked shellfish, which can harbor viruses and bacteria. You may consider limiting your consumption of processed foods as well, since they can contain chemical additives and high levels of salt.

Other Precautions

Because your liver is battling the hepatitis virus, take special precautions to protect against any disease that would increase the chances of liver damage. Wash all meats, fruits, and vegetables to remove any potentially harmful residues, and wash your hands thoroughly before and after handling food to prevent cross-contamination.

Supplements for Hepatitis

People with hepatitis should talk to their doctors about taking a multivitamin once a day, says Christine Gerbstadt, MD, RD, a doctor and a registered dietitian in Sarasota, Fla., as well as a spokesperson for the American Dietetic Association. B vitamins in particular can help spur healing.

“You really want to make sure your body has everything it needs,” Dr. Gerbstadt says.

However, you also need to make sure that you don’t take in too much of certain vitamins and minerals through the use of supplements, since some can cause liver damage. Be cautious of:

  • Iron
  • Vitamin A
  • Vitamin B3 (niacin)
  • Vitamin C
  • Vitamin D

Hepatitis patients looking for herbal remedies may consider milk thistle, available in capsules and other forms. Milk thistle may have some restorative properties, suggests Gans. Some studies have found that milk thistle can improve liver function in hepatitis and cirrhosis patients. However, you should always consult with your doctor before trying any supplement or herb, especially if you have hepatitis.

The pros and cons of drinking coffee have been wildly debated for years. However, for those with Hepatitis B and other liver diseases, the addition of a couple of cups of coffee per day to slow down the progression of liver disease, along with decreasing the risk of diabetes and heart disease just makes sense.

Dr. Melissa Palmer was a guest speaker at a previous Hepatitis B Foundation patient conference. The information from her presentation had all sorts of nutritional nuggets for those with HBV (Check out Dr. Palmer on podcast if you would like to have a listen!) She stated, based on studies, that coffee and caffeine intake has been associated with improvements in liver ALT and AST levels. There also seems to be a correlation between increased coffee consumption and warding off cirrhosis and HCC.

Just recently there are was an article that discussed the benefits of coffee for those patients with HCV, undergoing treatment with pegylated interferon (PEG) and ribavirin therapy. It claimed that drinking three or more cups of coffee a day not only reduced some of the difficult side-effects associated with treatment of PEG, but it also increased the treatment success. However, like so many of these coffee studies, it was a small study and had to be adjusted for other factors.

We all know that HBV and HCV are very different viral infections, but you have to wonder if any of the benefits of coffee that is seen in those being treated for HCV can be extrapolated to include those with HBV being treated with Pegylated interferon or antivirals. Dr. Palmer did mention that coffee did seem to have a greater impact on those with hepatitis C, although I have no idea why.

Regardless, if you’re living with HBV, you have to think about the pros and cons of adding coffee to your daily list. Since all studies seem to show an increased number of cups of coffee having a more positive impact on preventing liver disease progression, or warding off cirrhosis or potentially reducing PEG side effects or benefiting treatment, you have to consider just how much caffeine you can take. It does not appear that caffeine is the only factor involved, but rather the coffee bean itself and associated antioxidant features. This seems to be the case because tea, despite all of its benefits, does not appear to have the same protective effect on the liver.

What about decaffeinated coffee? I kept looking to see if it was specifically referenced, but I haven’t seen it. However, during the decaffeinating process, much of the bean is lost, and it may be treated with a chemical solvent, both which might nix the positive benefits. If you’re going to give decaffeinated coffee a try, consider a coffee with a more natural decaffeinating process. Personally, I’d have a tough time balancing the jitters and racing heart rate associated with drinking more than a cup or two of high-test coffee a day, but we’re all individuals. If you can drink coffee and sleep well at night, it seems like it can’t hurt your liver health to add a few cups to your daily regimen.

Treatment of Hepatitis B

  • Antiviral medications
    Antiviral medications inhibit the replication of the virus, and in doing so, they reduce the inflammation of your liver. Often you will need to take them for the rest of your life. In some cases, the treatment with antiviral medications will eventually be successful in removing the virus from your body. A disadvantage of some of these medications (lamivudine / adefovir) is that they will ultimately stop working in some people. If that happens, it is because the virus will have become insensitive (resistant) to the medications. With the current generation of antiviral medications (tenofovir / entecavir), there is only a very small risk of that happening, however.
  • Peginterferon
    This medication is given via injections and can have unpleasant side-effects. Peginterferon can potentially help cure you of Hepatitis B, although that only works for a minority of those who are treated with it. The 48-week course of treatment has a relatively large number of side-effects and by no means everyone is eligible for this treatment.

Hepatitis B – including symptoms, treatment and prevention

Routine monitoring (at least annually) even when there are no symptoms, can prevent severe liver disease including liver cancer.

Prevention

  • Exclusion from childcare, preschool, school or work is not necessary.
  • infected health care workers must comply with the requirements of their professional boards
  • any open sores, cuts or abrasions should be covered with waterproof dressings
  • all donated blood and organs are screened for evidence of hepatitis B infection
  • practice safer sex – use condoms consistently and correctly
  • injecting drug users should never share injecting equipment
  • if required to handle blood or body fluids, the routine use of standard precautions will reduce the risk of transmission of hepatitis B virus.

Immunisation and immunoglobulin

There is a safe and effective vaccine available for hepatitis B for infants and those at higher risk of acquiring hepatitis B infection and/or higher risk of severe disease. Completion of a full course will give protection against hepatitis B infection in more than 90% of people. See the Hepatitis B vaccine page or the High Risk Hepatitis B Immunisation Program for more information. A combination hepatitis A and B vaccine is available and should be considered for:

  • expatriates and travellers in countries where hepatitis A and hepatitis B are common
  • individuals whose occupation may put them at risk of acquiring hepatitis A and/or hepatitis B
  • individuals whose lifestyle may put them at risk of acquiring hepatitis A and hepatitis B
  • solid organ transplant recipients
  • residents and staff of facilities for people with developmental disabilities
  • patients with chronic liver disease and/or hepatitis C.

Hepatitis B vaccine and/or immunoglobulin can be given soon after exposure to make it less likely a person will develop hepatitis B. This is called post exposure prophylaxis.

Read the Get tested, get vaccinated, eliminate Hepatitis B infographic for more information.

Post exposure prophylaxis (treatment to prevent disease)

Hepatitis B immunoglobulin is a solution made from blood products containing a high level of antibodies specific to the hepatitis B virus.

Hepatitis B immunoglobulin and vaccine are also offered to non-immune people who have had close physical contact with a person known to be infected with hepatitis B in the following situations:

  • after needle sharing or needle stick injury
  • after sexual exposure.

Immunoglobulin is offered after needle stick injuries unless the source is known to be negative for hepatitis B. Immunoglobulin should be administered as soon as possible within 72 hours after a needle stick injury and within 14 days after sexual exposure.

All women are tested for hepatitis B infection during pregnancy. If a mother is found to have hepatitis B infection, her baby is given immunoglobulin and a dose of hepatitis B vaccine within 24 hours of birth. With this treatment less than 10% of infants become infected with hepatitis B.

Useful links

  • Handling blood and other body substances
  • Hepatitis A, B, C, D and E summary
  • Avoiding sexually transmitted infections (STI)
  • Immunisation
  • When you have a notifiable condition
  • Hepatitis SA
  • Viral Hepatitis Nursing Support
  • Immunise Australia Program
  • ASHM Hepatitis B Mapping Project
  • Hepatitis Australia

Frequently asked questions

  • What is hepatitis B?
  • Who is at risk of getting hepatitis B?
  • How do you get hepatitis B?
  • What are the symptoms for hepatitis B?
  • What is acute hepatitis B?
  • What is chronic hepatitis B?
  • What happens to people with chronic hepatitis B?
  • How is hepatitis B treated?
  • Can a person spread hepatitis B and not know it?
  • How long does the hepatitis B virus survive outside the body?
  • What if I am exposed to hepatitis B, what should I do?
  • If I’ve had hepatitis B and cleared it, can I get it again?
  • What tests are there for hepatitis B?
  • How can I protect myself until I am full vaccinated?

What is hepatitis B?

Hepatitis B (also called hep B) is a virus that is found in blood and other body fluids including vaginal fluid, semen and breast milk. It is highly infectious and causes inflammation of the liver. Most adults, but not all, who become infected with hepatitis B are able to clear the virus without any problems. However most babies and young children infected with hepatitis B are unable to clear the virus and will develop a chronic hepatitis infection.

Hepatitis B is one of the most common infectious diseases in the world and is a serious public health concern. Hepatitis B is a vaccine preventable illness.

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Who is at risk of getting hepatitis B?

There are around 165 000 people living with hepatitis B in Australia. The majority belong to one or more of the following groups:

  • people who have migrated from countries where hepatitis B is endemic (especially North-East and South-East Asia, and sub-Saharan Africa)
  • Aboriginal and Torres Strait Islander people
  • people who inject drugs
  • men who have sex with men.

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How do you get hepatitis B?

Hepatitis B is most commonly spread by:

  • at birth (from mother to child) or in early childhood (from family members or other close contacts)
  • through sharing drug injecting equipment
  • through vaginal, anal or oral sex without a condom/dental dam
  • through unsterile tattooing or piercing.

There is also a chance that it can be spread through:

  • blood-to-blood contact through open wounds
  • needle stick injuries
  • sharing personal items such as toothbrushes, razor blades or nail clippers
  • blood transfusions/products (especially rare in Australia)*
  • unsterilised medical equipment (especially rare in Australia)* (screening for hepatitis B in blood supply has been in place in Australia since 1971).

You cannot get hepatitis B from:

  • hugging, kissing, another person’s tears or sneezes
  • sharing cups, plates, clothes, food, drinks, showers or toilets
  • eating food prepared by a person with hepatitis B
  • mosquito bites.

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What are the symptoms for hepatitis B?

Symptoms can take up to 6 months to appear, and are likely to make you sick for between 1 and 3 months. If you do get symptoms, these are the most common:

  • yellow skin or eyes (jaundice)
  • feeling tired
  • losing your appetite and weight loss
  • aches and pains in muscles and joint
  • dark urine and pale faeces.

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What is acute hepatitis B?

If someone has hepatitis B for less than 6 months it is called an acute infection. Most people who get hepatitis B as adults will only have an acute infection and recover from it. If you have acute hepatitis B, you might not experience any symptoms.

The older a person is when they become infected with hepatitis B, the better their chances of successfully fighting it off (‘clearing’ the virus). Around 95% of adults who contract hepatitis B will go on to have an acute infection and are then clear it naturally. On the other hand, up to 90% of babies and 30% of children who become infected will go on to have chronic hepatitis B.

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What is chronic hepatitis B?

If the infection lasts for longer than 6 months it is called chronic hepatitis B. Most people with chronic hepatitis B contracted it as babies or young children. Many people with chronic hepatitis B have no symptoms, but if they appear they are similar to the symptoms of acute hepatitis B. Chronic hepatitis B is a lifelong illness.

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What happens to people with chronic hepatitis B?

Chronic hepatitis B it is a lifelong illness. Each person’s experience of the illness will be different, and will depend on a number of factors like what stage his or her hepatitis B is currently in, lifestyle factors, and how long he or she has the virus.

However we do know that 20 to 30% of people with chronic hepatitis B will develop advanced liver disease if the virus is left untreated. Advanced liver disease can lead to complications including liver failure and liver cancer, and unfortunately, can lead to death. Treatment for hepatitis B aims to avoid these outcomes.

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How is hepatitis B treated?

Treatment aims to stop or slow as much as possible, the increase in numbers of hepatitis B viruses. This decreases the risk of serious liver disease developing later in life and makes it possible for the liver to repair some of the damage and to work better.

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Can a person spread hepatitis B and not know it?

Yes. Many people with acute hepatitis B have no symptoms and may not even know they have hepatitis B.

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How long does the hepatitis B virus survive outside the body?

Hepatitis B virus can survive outside the body for at least 7 days. During that time, the virus can still cause infection if it enters the body of a person who is not infected.

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What if I am exposed to hepatitis B, what should I do?

You should see your GP or local health centre as soon as possible to discuss your options. You will need to have a blood test and in some cases you may start treatment immediately to stop your body becoming infected with Hepatitis B. Management may include hepatitis B immunoglobulin, an injection of plasma which contains high levels of antibodies to help prevent hepatitis B infection from developing in a person who has been exposed.

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If I’ve had hepatitis B and cleared it, can I get it again?

If your body has naturally cleared the hepatitis B virus, then you will be immune. This means you cannot get hepatitis B again.

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What tests are there for hepatitis B?

All of the tests used to diagnose hepatitis B are blood tests. Some indicate different stages of the illness or immunity. The following list shows the different tests available, and what a positive result indicates for each of them.

Test

What a positive result means

Hepatitis B surface antigen (HBsAg)

Shows the person has hepatitis B.
It can be detected during acute and chronic infection.

Hepatitis B surface antibody (HBsAb or anti-HBs)

Shows the person has developed immunity to hepatitis B.
It can be detected in people who have recovered from acute hepatitis B or been vaccinated against it.

Hepatitis B e antigen (HBeAg)

Shows the hepatitis B virus is multiplying, and that it can be more easily passed on.

Hepatitis B e antibody (HBeAb or Anti-HBe)

Shows the person’s immune system has responded to hepatitis B and in some circumstances, the virus is not actively replicating.

Hepatitis B core antibody (HBcAb or Anti-HBc)

Shows a person has had hepatitis B, either past or present infection.
(If someone has immunity through vaccination he or she will not test positive)

Hepatitis B virus DNA (HBV DNA)

Measures the amount of hepatitis B virus in the bloodstream and indicates how actively the virus is multiplying.

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How can I protect myself until I am full vaccinated?

  • practice safer sex (use a condom)
  • wash hands after touching blood or body fluids
  • wear disposable gloves if giving someone first aid, or cleaning up blood or body fluids
  • avoid sharing toothbrushes, razors, needles, syringes, personal hygiene items and grooming aids or any object that may come into contact with blood or body fluids
  • use new and sterile injecting equipment for each injection
  • cover all cuts and open sores with a waterproof dressing
  • wipe up any blood spills and then clean the area with household
    bleach
  • throw away personal items such as tissues, menstrual pads, tampons and bandages in a sealed plastic bag.

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1 – In South Australia the law requires doctors and laboratories to report some infections or diseases to SA Health. These infections or diseases are commonly referred to as ‘notifiable conditions’.

Hepatitis A

In this section:

  • What is hepatitis A?
  • How common is hepatitis A?
  • Who is more likely to get hepatitis A?
  • What are the complications of hepatitis A?
  • What are the symptoms of hepatitis A?
  • What causes hepatitis A?
  • How do doctors diagnose hepatitis A?
  • How do doctors treat hepatitis A?
  • How can I protect myself from hepatitis A infection?
  • How can I prevent spreading hepatitis A to others?
  • What should I eat and drink if I have hepatitis A?

What is hepatitis A?

Hepatitis A is a viral infection that causes liver inflammation and damage. Inflammation is swelling that occurs when tissues of the body become injured or infected. Inflammation can damage organs.

Viruses invade normal cells in your body. Many viruses cause infections that can be spread from person to person. The hepatitis A virus typically spreads through contact with food or water that has been contaminated by an infected person’s stool.

Hepatitis A is an acute or short-term infection, which means people usually get better without treatment after a few weeks. In rare cases, hepatitis A can be severe and lead to liver failure and the need for an emergency liver transplant to survive. Hepatitis A does not lead to long-term complications, such as cirrhosis, because the infection only lasts a short time.

You can take steps to protect yourself from hepatitis A, including getting the hepatitis A vaccine. If you have hepatitis A, you can take steps to prevent spreading hepatitis A to others.

How common is hepatitis A?

In the United States, hepatitis A has become relatively uncommon. After the hepatitis A vaccine became available in 1995, the rate of hepatitis A infections declined by 95 percent in the United States. The number of reported cases of hepatitis A fell to 1,239 in 2014, the lowest yearly number of cases reported since the disease could be tracked.1 However, the number of reported cases increased to 3,366 in 2017, almost 3 times higher, mostly due to outbreaks among people who use drugs and people experiencing homelessness.1 Early reports suggest that the numbers of cases and outbreaks of hepatitis A increased further during 2018 and continue at these higher rates in 2019.2

Hepatitis A is more common in developing countries where sanitation is poor and access to clean water is limited. Hepatitis A is more common in parts of Africa, Asia, Central and South America, and Eastern Europe than it is in the United States.

Who is more likely to get hepatitis A?

People more likely to get hepatitis A are those who

  • travel to developing countries
  • have sex with an infected person
  • are men who have sex with men
  • use illegal drugs, including drugs that are not injected
  • experience unstable housing or homelessness
  • live with or care for someone who has hepatitis A
  • live with or care for a child recently adopted from a country where hepatitis A is common

People who travel to developing countries are more likely to get hepatitis A.

What are the complications of hepatitis A?

People typically recover from hepatitis A without complications. In rare cases, hepatitis A may lead to liver failure. Liver failure due to hepatitis A is more common in adults older than age 50 and in people who have another liver disease.3

What are the symptoms of hepatitis A?

Some people have symptoms 2 to 7 weeks after they come in contact with the virus.3 People with hepatitis A typically get better without treatment after a few weeks. In some cases, symptoms can last up to 6 months. These symptoms may include

  • dark yellow urine
  • diarrhea
  • feeling tired
  • fever
  • gray- or clay-colored stools
  • joint pain
  • loss of appetite
  • nausea
  • pain in the abdomen
  • vomiting
  • yellowish eyes and skin, called jaundice

Some people infected with hepatitis A have no symptoms, including many children younger than age 6.3 Older children and adults are more likely to have symptoms.

What causes hepatitis A?

The hepatitis A virus causes this type of hepatitis and spreads through contact with an infected person’s stool. Contact can occur by

  • eating food made by an infected person who did not wash his or her hands after using the bathroom
  • drinking untreated water or eating food washed in untreated water
  • placing a finger or an object in your mouth that came into contact with an infected person’s stool
  • having close personal contact with an infected person, such as through sex or caring for someone who is ill

You cannot get hepatitis A from

  • being coughed on or sneezed on by an infected person
  • sitting next to an infected person
  • hugging an infected person

A baby cannot get hepatitis A from breast milk.4

How do doctors diagnose hepatitis A?

Doctors diagnose hepatitis A based on symptoms and a blood test. A health care professional will take a blood sample from you and send the sample to a lab. A blood test will detect antibodies to the hepatitis A virus called immunoglobulin M (IgM) antibodies and show whether you have acute hepatitis A. If the blood test finds antibodies to the hepatitis A virus that are not IgM antibodies, then you are immune to hepatitis A, due to either past hepatitis A infection or hepatitis A vaccination.

How do doctors treat hepatitis A?

Treatment includes resting, drinking plenty of liquids, and eating healthy foods to help relieve symptoms. Your doctor may also suggest medicines to help relieve symptoms.

Talk with your doctor before taking any prescription or over-the-counter medicines, vitamins or other dietary supplements, or complementary or alternative medicines—any of these could damage your liver. You should avoid alcohol until your doctor tells you that you have completely recovered from hepatitis A.

See your doctor regularly to make sure your body has fully recovered. If you have symptoms for longer than 6 months, see your doctor again.

How can I protect myself from hepatitis A infection?

You can protect yourself from hepatitis A by getting the hepatitis A vaccine. If you have not had the vaccine, you can take steps to reduce your chance of infection.

If you have had hepatitis A in the past, you cannot get hepatitis A again. You can still get other types of viral hepatitis though.

You can protect yourself from hepatitis A by getting the hepatitis A vaccine.

Hepatitis A vaccine

All children should receive the hepatitis A vaccine between 12 and 23 months of age. People who are more likely to be infected and people with chronic liver disease should also receive the vaccine.

Doctors give the hepatitis A vaccine in two shots. You should get the second shot 6 to 12 months after the first shot. You need to get both shots to be fully protected against the virus.

If you are traveling to a developing country where hepatitis A is common and you haven’t received the hepatitis A vaccine, talk with your doctor about how to prevent getting hepatitis A. If possible, try to get both shots of the hepatitis A vaccine before you go. If you don’t have time to get both shots, get the first shot as soon as you can. Most people gain some protection within 2 weeks of the first shot.

Reduce your chance of infection

You can reduce your chance of getting hepatitis A by washing your hands thoroughly with soap and warm water for 15 to 30 seconds

  • after using the toilet
  • after changing diapers
  • before and after handling or preparing food

When traveling in a developing country, drink bottled water. Use bottled water to brush your teeth, make ice cubes, and wash fruits and vegetables.

When traveling in a developing country, drink bottled water.

Prevent infection after contact with the virus

If you think you have come in contact with the hepatitis A virus, see your doctor right away. A dose of the hepatitis A vaccine or a medicine called hepatitis A immune globulin may protect you from getting the infection. Your doctor may recommend a vaccine dose or medicine if

  • you live with, have had sex with, or have had close contact with someone who has hepatitis A
  • you shared illegal drugs with someone who had hepatitis A
  • you ate food or drank water possibly containing the hepatitis A virus

You must get the vaccine dose or medicine shortly after coming into contact with the virus to prevent infection.

How can I prevent spreading hepatitis A to others?

If you have hepatitis A, you can reduce your chance of spreading the infection by washing your hands with warm, soapy water after using the toilet and before fixing or eating food. While you are sick, avoid close contact with others, and don’t prepare food or serve food to others. Also, tell your doctor, dentist, and other health care professionals that you have hepatitis A.

Talk with a blood donation center before you donate blood. If you had hepatitis A when you were younger than 11, you may be able to donate blood. If you had hepatitis A when you were age 11 or older, you should not donate blood.

You are most contagious—able to spread the virus to others—during the 2 weeks before you have symptoms. You may be contagious for up to 3 weeks after you develop symptoms. Children are often contagious longer than adults.5

What should I eat and drink if I have hepatitis A?

If you have hepatitis A, you should eat a balanced, healthy diet. Talk with your doctor about healthy eating. You should also avoid alcohol because it can cause more liver damage.

Healthy Liver Tips

  • Get the Hepatitis A vaccine to protect yourself from another virus that attacks the liver.
  • Avoid drinking alcohol and smoking since both will hurt your liver, which is already being injured by the hepatitis B virus.
  • Talk to your provider before starting any herbal remedies or vitamin supplements because some could interfere with your prescribed hepatitis B drugs or even damage your liver. Read more.
  • Check with your pharmacist about any over-the-counter drugs (e.g. acetaminophen, paracetamol) or non-hepatitis B prescription drugs before taking them to make sure they are safe for your liver since many of these drugs are processed through your liver.
  • Avoid inhaling fumes from paint, paint thinners, glue, household cleaning products, nail polish removers, and other potentially toxic chemicals that could damage your liver.
  • Eat a healthy diet of fruit, whole grains, fish and lean meats, and lot of vegetables. “Cruciferous vegetables” in particular — cabbage, broccoli, cauliflower — have been shown to help protect the liver against environmental chemicals.
  • Limit foods and drinks with added sugars including sodas, fruit juices, desserts, packaged snacks and other foods that contain added sugar.
  • Limit foods containing saturated fats including fatty cuts of meat and foods fried in oil.
  • Avoid eating raw or undercooked shellfish (e.g. clams, mussels, oysters, scallops) because they could be contaminated with a bacteria called Vibrio vulnificus, which is very toxic to the liver and could cause a lot of damage.
  • Check for signs of mold on nuts, maize, corn, groundnut, sorghum, and millet before using these foods. Mold is more likely to be a problem if food is stored in damp conditions and not properly sealed. If there is mold, then the food could be contaminated by “aflatoxins,” which are a known risk factor for liver cancer.
  • Reduce your stress levels by eating healthy foods, exercising regularly, and getting plenty of rest.
  • Keep in mind everything you eat, drink, breathe, or absorb through the skin is eventually filtered by the liver. So protect your liver and your health.

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