Dietary alterations due to perceptions in acute viral hepatitis lead to sub-optimal calorie intake and increased length of hospitalization

Abstract

Although there are no dietary restrictions recommended in acute viral hepatitis (AVH), there is an altered food intake, probably because of perceptions and traditional nutritional practices, leading to sub-optimal intake and poorer clinical outcome. Therefore, we aimed to determine nutritional intake of AVH patients before and after disease onset and to investigate if optimal intake following nutrition education shortened the length of hospitalization (LOH). Seventy-five patients with AVH were interviewed for foods consumed and avoided because of perceptions during illness. Nutrition education was given to all patients with meal plan. In-patients were monitored for their nutritional intake until discharge. All patients were followed up after 2 weeks to assess compliance to the plan. There was a statistically significant decrease in mean calorie and protein intake in AVH patients during illness [1314 kcal (standard deviation, SD 291) and 27.5 g (SD 8.84)] when compared with that before onset of the disease [1873 kcal (SD 246) and 51.5 g (SD 8.03); P < 0.0001]. Mean LOH in patients consuming a high calorie diet [6.28 days (SD 2.91)] was significantly lower than those consuming low calories [8.36 days (SD 2.59), P = 0.024]. Two-week follow up revealed that 70% of patients modified their diet to a balanced normal diet as per the given plan. Our study showed that AVH patients consumed sub-optimal calories because of perceptions and traditional nutritional practices. Nutrition education played a major role in achieving overall nutritional goals and in decreasing the LOH.

Old dietary cultural practices leading to suboptimal nutritional intake of calories in children with acute viral hepatitis

“…8 Age wise supplementation of calories and protein is very important for the growth of child for growth and also for recovery during illness. 7,9,10 In our study, in a series of 50 children recruited, majority children were male (80%). Only 10 (20%) were female.…”

“…E. Sathiaraj et al, also showed decrease in calorie and protein in adult population in AVH compared to pre illness dietary intake. 7 These calorie and protein intake when compared two weeks after nutritional counseling to child/caregiver, there was increase in mean calorie intake centile from 54% to 88%. The mean centile intake for protein intake was also increased from 43% to 84%.…”

“…Studies in adult shown that adequate intake of fats and oils in diet makes food more tasty and improves palatability and patient calorie intake gets improved. 6,7 Even in adults there are very few studies to show the impact of these suboptimal nutritional practices. There is hardly any study in pediatric age group regarding nutritional impact of these suboptimal practices.…”

Viral hepatitis A - possible diagnostic and therapeutic problems

“…Důležitým diagnostickým parametrem je De Rittisův koeficient -poměr AST/ALT, který je zpravidla menší než 1. Obrácený poměr může být znakem fulminantně probíhajícího onemocnění [8]. Pouze 7 % našich pacientů mělo vstupně poměr > 1.…”

“…Mezi širokou a bohužel i odbornou veřejností je stále hojně rozšířen mýtus zvaný ,,jaterní" dieta, která je založena zejména na omezení tučných jídel a červeného masa. Dodržování ,,jaterní" diety vede ke snížení příjmu energie a bílkovin, což ve výsledku zpomaluje regeneraci jater [7,8]. Efekt hepatoprotektiv nebyl nikdy plně prokázán [5].…”