Diet taboos for hepatitis B and Xiao Sanyang

Absolutely no alcohol, no moldy food, and no long-term intake of processed foods high in sugar, fat, and additives. Most of the other widely circulated "taboos" such as "can't eat mutton, can't eat seafood, and can't touch spicy food" have no clear clinical basis. Whether or not to eat taboos depends entirely on the individual's physical condition. There is no need to blindly follow the trend and go hungry.

Two years ago, I met a young man who worked as an Internet operator in the outpatient clinic. He was diagnosed with Xiao Sanyang at the age of 29. At that time, his liver function was normal and his viral load was negative. The doctor specifically told him that he did not need to take medicine and that he would just need to be reviewed regularly. As a result, he felt that he was young and had nothing to do. He drank two or three bottles of cold beer with his colleagues every week during team building, and sometimes drank functional drinks mixed with wine to catch up on projects. Only eight months later, he checked again and found that the transaminase had quadrupled and the viral load had reached the fifth power of 10, so he had to start antiviral treatment immediately. Many elders still have a misunderstanding, thinking that "drinking less red wine will soften blood vessels, and drinking a little will be fine." But now the global liver disease guidelines are unified: for hepatitis B virus carriers, there is no "safe intake" of alcohol, whether it is white wine or red wine , fruit wine, even alcohol-containing sparkling water and fermented glutinous rice, as long as it contains ethanol, the acetaldehyde produced by metabolism will directly damage the liver cells that already carry the virus. The originally peaceful virus is likely to be activated due to damage to the liver cells, so there is no need to take this risk.

In fact, what is more likely to be ignored than wine is the "semi-bad food" that is reluctant to throw away at home. Last month, the community liver friends association did a science popularization. An aunt in her 60s said that she usually pays attention to everything, does not drink alcohol, and does not stay up late. How come she found small nodules on her liver? Later, when I asked more carefully, I found out that she had been accustomed to sparing all her life. She would dig out the bad apples if they had mold spots and continue to eat them. The nuts that had been stored in Kaifeng for more than three months were a bit bitter and she was reluctant to throw them away. She put them in when cooking porridge. We must know that aflatoxin is a clear first-class liver carcinogen. The liver cells of people with Xiaosanyang are inherently more prone to genetic mutations than healthy people. Even a small amount of aflatoxin can cause cancer risks several times higher than that of healthy people. In addition to moldy fruits, bitter nuts, self-pressed oil that has been stored for more than a year, and fungus that have been soaked for several days, it is best not to touch these invisible mines.

There is really the most controversy about "you can't eat fat food". Patients often drag me and ask me as soon as they are diagnosed with Xiaosanyang: Will mutton, seafood, and peppers not be touched in the future? Every time I have to argue with them for a long time: If your liver function is stable all year round, your viral load is negative, you are not allergic to seafood, and you don’t have stomachache when you eat spicy food, then you can eat what you should. High-quality protein is originally the raw material for liver cell repair. Don't dare to eat this or touch that. On the contrary, it is easy to become malnourished, your immunity is reduced, and the virus is easy to cause chaos. The most exaggerated patient I have ever seen was that he had not eaten a bite of meat for half a year after being diagnosed with Xiaosanyang. He only ate green vegetables and white porridge every day. During the reexamination, his albumin was so low that he was so weak that he could not even climb stairs. On the contrary, his condition was far worse than that of patients who ate normally. Of course, this does not mean that everyone has no taboos. If you have progressed to the stage of liver cirrhosis, or even had hepatic encephalopathy before, you must control your high protein intake to avoid encephalopathy caused by elevated blood ammonia. ； If you have esophageal and gastric varices, you should eat less food that is too hard, too spicy, or highly irritating. Otherwise, it is easy to scratch blood vessels and cause gastrointestinal bleeding. This depends on the situation and cannot be generalized.

There is another pitfall that many people have not noticed, that is, don’t blindly eat those processed foods and health products that are said to “protect the liver.” Many people think that my liver is not good, so it’s always right to drink more honey water, liver-protecting tea, and take some liver-protecting tablets, right? Not necessarily. There used to be a little girl who drank two large glasses of honey water every day in order to protect her liver. After drinking it for half a year, she was diagnosed with fatty liver disease and high transaminase. This is because there is too much fructose in the honey, which the liver cannot metabolize and turns into fat and accumulates in the liver. Instead, it forms a double blow with the hepatitis B virus. The progression of cirrhosis will be much faster than a single liver disease. There are also those liver-protecting traditional Chinese medicines and health-preserving teas with unknown ingredients. Many of them contain hepatotoxic ingredients, which may cause drug-induced liver damage. If you really want to take any supplements, ask your doctor first.

In fact, to put it bluntly, Xiao Sanyang’s diet really doesn’t have that many problems. The core principle is not to put extra burden on the liver. You can eat as healthy as you usually want. Eat more fresh vegetables and fruits, high-quality protein, and less things that cause trouble to the liver. On the contrary, many people stare at what they can't eat and what they can't eat every day, and are so anxious that they can't sleep well. The damage to the liver is much greater than eating two spicy bites. If you really want to protect your liver, biannual liver function, viral load, and color ultrasound review are more effective than any dietary restrictions.