Chat:Everyday Nutrition for People with Hepatitis -->可可转移

liver411

Town Hall Hosted Chat - September 4th, 2001 Everyday Nutrition for People with Hepatitis Hosted by Heidi Gennaro, RD, your Hepatitis Neighborhood Nutritionist. (Medallion Room) MODERATOR: Hello. I made it! We are having a tremendous thunderstorm here in Lake Mary, Florida tonight!! MODERATOR: Welcome. We will start at 8PM eastern time when Heidi joins us. MODERATOR: Welcome everyone. Glad you could join us tonight. The storm is finally passing and we did not lose power, as I feared we might! We'll be ready to start in about 15 minutes. MODERATOR: Hello to all just logging on. Our chat tonight is "Everyday Nutrition for People with Hepatitis" hosted by your Neighborhood Nutritionist, Heidi Gennaro, Registered Dietitian (RD). MODERATOR: You are welcome to send your nutrition questions to the MODERATOR for Heidi to answer. MODERATOR: For those who are new to our moderated chats, I will explain how it works before we begin. To send a question, just type in the text box at the bottom of your screen and click on SEND to Moderator. MODERATOR: Hello to everyone just logging on. Our speaker has arrived and we'll get started answering questions in just a few minutes. First, I will explain how our moderated chats work. MODERATOR: The format of these hosted chat rooms may be slightly different than what you have experienced before. We encourage you to submit questions Related to the Topic of the session. All questions are initially reviewed and possibly edited slightly, by the Screeners, before being sent to the Moderator, for Posting to the Host speaker for a response. If you do not see your question posted, it may have been a duplicate, not related to the selected topic for the evening, or could not be posted in the time allotted. If you enter the chat room after the speaker has begun answering questions remember you may have missed some questions and the question you submit may be a duplicate. MODERATOR: Please do NOT ask the host to DIAGNOSE or PRESCRIBE for you, or interpret your specific lab results. Questions will be held in "queue" by the Moderator in order to give the Speaker an opportunity to see and answer questions one-at-a-time or possibly group questions that are similar. The Moderator will decide which questions are selected to go to the speaker and the order in which they are sent to the speaker to be answered. Usually questions that are on TOPIC are first, and not always in the order in which they were submitted by members. We will answer as many questions as possible during our hour together! MODERATOR: So, now that you know how the chat works, it is with pleasure that I introduce once again our Neighborhood Nutritionist, Heidi Gennaro, RD. Heidi Gennaro RD: Hello everyone! Nice to be here with you all tonight... : ) MODERATOR: Heidi is a registered dietitian, and has worked with us for the past two years. Thank you Heidi! Heidi Gennaro RD: It has been a pleasure... MODERATOR: Our first question tonight is from jselkirk. jselkirk: I need to lose about 65 lbs. I am having a hard time losing weight. I'm also on Coumadin so I cannot have too many foods that have vitamin K. My total cholesterol is not anywhere high due to my liver problems, but my triglycerides are very high about 400 mg/dl and my HDL is 29mg/dl too low. I was on the treatment rebo-combo for 1 year, but I’m a non responder. I will try the peg-combo in October. I need to know what foods would help me lose the most weight? I cannot do a lot of exercise. MODERATOR: Welcome to everyone just joining us. Heidi is answering the first question of the evening. Heidi Gennaro RD: Hi jselkirk. The short answer is: check out the Aisle 1 article in the Food Market section... paying close attention to the Food Pyramid guidelines...The longer answer: more whole grains with lower fat content: low or no-fat dairy only; fruits and vegetables 5/day or more as tolerated. Easy on the fats and sweets. Most of all: DON’T DIET! Dieting doesn't work (95% failure rate). Just eat healthy... Heidi Gennaro RD: Jselkirk what are your limits on exercise? jselkirk: Jselkirk my limits are I need two knee replacements and have cervical herniated discs problems and severe injury to back, fell 2 stories and heart problems due to mitral valve surgery. Heidi Gennaro RD: Jselkirk that sounds like some real limitations. Perhaps you could ask your doctor to refer you to a Physical Therapist for some supervised, sanctioned exercise.... I say this because it would help greatly with your cause. God bless. MODERATOR: You are welcome to submit your questions now on nutrition for Heidi to answer. This is your chance to get expert information about your daily diet needs. moonlioness: Can occasionally eating beef make a person real sick? I ate a calzone one day and marinated beef tips the next day. I got so sick as though I would have to go to hospital. I was sick for 2 weeks. This has happened to me twice in one month. Heidi Gennaro RD: Moonlioness it sounds like you went through quite an ordeal! But please don't blame the beef. Unless you got a confirmed case of food poisoning...beef itself should not make you sick. MODERATOR: Welcome everyone just joining. The topic is Everyday Nutrition for People with Hepatitis. course: What phytochemical supplements are safe to take? What is the limit in taking vitamin E and other supplements? Heidi Gennaro RD: Hi course. I would not recommend phytochemical supplements. Why? Because you can eat them in the most tasty packages! Blueberries, plump tomatoes, grapes, broccoli, whole grain sourdough bread, the list is endless!!!!!! In terms of E...I would not take more than 400IU of synthetic (most brands), or 200IU of natural. Most studies done on vitamin E keep to these doses and have found no ill effects. MODERATOR: Welcome to all just joining us. You can only see the last few lines of text. The topic is "Everyday Nutrition for People with Hepatitis". There will be a full transcript posted in Town hall in 3-5 working days. Don't forget to check your Welcome Page for news and articles about hepatitis and treatment. MODERATOR: Watch for our new chat hosts with topics on PEG Combo treatment. rcaseyjames: My ALT/SGPT was 73 at last testing -- are there foods I can eat since I can't take the treatments to help me stay as healthy as I can? Heidi Gennaro RD: Hi Rcasey. I would make my journey one of learning to become a "born-again health nut" in terms of the basics: whole grains, fruits and veggies galore. You will give your body scores of antioxidant defense weapons!! Go get'em! Check out the Food Market Aisle 1 article to learn more... MaryV: Are there any vitamins or special foods that would give me more energy? Heidi Gennaro RD: MaryV low energy, or fatigue, is a common complaint with Hepatitis. The best food weapons are 4-6 small, feedings containing ample whole-grain type foods, plant foods, and enough lower-fat protein foods to keep your blood sugar levels up over hours of time. Carbohydrates (breads, cereals, grains) give you quicker blood sugar for energy, but adding a bit of higher protein foods with them keep the blood glucose (sugar) levels up longer. Think of protein as a "blood glucose" extender. Does this make sense? MODERATOR: Welcome to all just joining us. You can only see the last few lines of text. The topic is "Everyday Nutrition for People with Hepatitis." There will be a full transcript posted in Town hall in 3-5 working days. CodeForBrains: Is it bad to drink green tea or coffee? Green Tea is said to have antioxidants but it also contains caffeine. Does the benefit of the antioxidants outweigh the fact that tea contains caffeine? Heidi Gennaro RD: Green tea and coffee contain caffeine...still a lot of controversy about it. Best to check with your doctor to see if caffeine is something you should limit. There's no evidence that it hurts a person with Hepatitis...but it can induce anxiety...a side effect of many treatment drugs, which could potentiate the side effect. No thanks! Check out the decaf types.... You can get powerful antioxidants from so many other sources.... you’d never miss out omitting green tea. : P) ronchi12: Hello Heidi, thanks for being here. What foods can I eat to gain weight or not lose what I have? Heidi Gennaro RD: Ronchi12 thank you...glad to be here with all of you good folks. : ) As long as you're not losing a significant amount of weight (greater than 5% of your body weight in a month's time), you should be able to continue to eat as you have been and relax... But if you have been seeing a gradual loss that concerns you...start keeping a food diary, at least for a week, and add up your calories using a calorie book. You may be surprised at what you find. Check the food types against the Food pyramid guidelines and improve from there first. You may need a referral to a Registered Dietitian if you start to lose below your ideal weight. Good eating! MODERATOR: We're happy to have so many of you join us tonight. If you have a nutrition question for Heidi, just type it in the text box at the bottom of your screen and click on SEND to Moderator! Electrick: Are there any foods that contain high amounts of vitamin A? Should I avoid drinking Ensure because of the vitamin A? Heidi Gennaro RD: Hi Electrick...Vitamin A is really tough to "overdose" on...you would have to really be taking some serious supplements to cause the liver damage that overdosing can bring about. I have never heard of any Vit. A toxicity from someone eating higher Vit. A foods. At ease, soldier! : ) Enjoy that Ensure..... guitardan: Heidi, what if the beef that Moonlioness had was marinated in even a little alcohol or the sauce on the calzone had alcohol, wouldn't that have made her sick? Heidi Gennaro RD: Good thinking, Guitardan... but no. Most of the alcohol in marinades evaporates in cooking. I'm stumped on this one! MODERATOR: Don't forget to join us for next week's chat "The New Combo for HCV: PEG + Ribavirin" hosted by Victor Araya, MD -- Tuesday, September 11th, at 8 PM EST. jordan1: What herbs are dangerous for the liver? Heidi Gennaro RD: You've been studying up on herbs, Jordan 1 good! Yes, the forest lurks with many dangers...A few off the top of my head that are lethal to the liver: comfrey, Ma haung, Vinca, chaparral, tonka beans.....AVOID!!! Some good websites on herbs:www.herbalgram.com andwww.herbs.com. You'll find valid scientific information without the hype. Check them out. Also check outwww.quackwatch.com. MODERATOR: Welcome to all just joining us. You can only see the last few lines of text. The topic is "Everyday Nutrition for People with Hepatitis". There will be a full transcript posted in Town hall in 3-5 working days. savannaman: Are multivitamin supplements, excluding Fe, helpful? Also, what about things such as alpha lipoic acid, CoQ10, and SAMe? Heidi Gennaro RD: Savannaman a low potency multivitamin w/ minerals daily is always a good idea. Heck, my diet isn't always a "dietitian's dream" every single day! This helps fill in the gaps when I'm careless. As far as the others.... SAM-e may be beneficial with arthritis suffers.... but it's expensive. CoQ10 may have some benefits in Parkinsons... Alpha lipoic may be a great help in reducing cardiovascular diseases...but as with other supplements, they all tend to be costly. I would stick to the benefits of a healthy diet rich in plant foods...and I do! tammotsie: What should I add to my diet during treatment? Heidi Gennaro RD: Tammotsie as long as you are not undernourished, you should not have to add anything. Just pay close attention to what you are eating in terms of the Food Pyramid guidelines. Bon Appetit'! carlamac: I'm entering late - and apologize if my q is a duplicate. I'm on Peg/combo - any special nutritional needs that I should be aware of? These first 2 weeks on Peg I've not eaten well - mostly I eat anything that feels good or will stay down… i.e. ice cream! Heidi Gennaro RD: Carlamac not really. The biggest thing on any drug treatment is to watch for the side effects that may affect your eating: fatigue, nausea, stomach upset, diarrhea. Check out the Food Market section, Aisle 4 for more. : ) OLDTIFF: MY MD LIKES SOY PROTEIN............I DID FIND SLIM FAST HAS IT IN JUICE DRINK...BUT DON'T GET MUCH SOY I DON'T THINK...WHAT DO YOU THINK OF IT? Heidi Gennaro RD: Soy protein's a winner, Oldtiff. New labeling usually lists the amount of soy protein in soy foods and beverages. Find a good food co-op or large grocery store with a wide selection of soy drinks. I've tried some really great ones that add fruit flavors! Soy is brimming with powerful antioxidants that have been shown to protect against many common diseases: particularly cancer and heart disease. MODERATOR: Our time is going quickly as always. we have 5 minutes left in our chat and then Heidi will have to say goodnight and so will we. If your question does not get answered, feel free to post it on the ASK-the-NURSE Message Board. Also, be sure to check the Library Articles and the TRANSCRIPT ARCHIVES for the text of past chats which may hold answers to your questions. MaryV: Heidi, I take 3 Milkthistle tabs 180 mg blessed thistle & 175 mg milkthistle dried extract per day. The only drugs I am on are Spironolactone 3 times per day and Prevacid 1 per day. Is this too much Milkthistle, it is 80 % silymarin? Thank you. female63: Do you think milk thistle is a good supplement for hep C patients? Heidi Gennaro RD: Hello, MaryV. No, this is not too much milkthistle if it is 180 + 175mg of the active compound SILYMARIN. Studies done on silymarin (active ingredient in milkthistle is touted to help the liver) have used 200-400mg silymarin per day. Heidi Gennaro RD: Milkthistle is the one herb I would take if I were carrying HepC myself. It has a good research base showing regeneration of new liver cells and protection against toxic damage...however, IT IS NOT A CURE FOR HEP C: ( But yes, if you find a reputable supplement that contains what it says it does (milkthistle with at least 80% silymarin), then go for it. Heidi Gennaro RD: See consumerlab.com for reputable supplements... MODERATOR: Our last question tonight is about shellfish. Then Heidi will make a closing and say goodnight. Thank you for all your great questions tonight! harmonyNme: Are shellfish harmful to folks with hep-c? MODERATOR: Thank you all for joining us tonight, and a special thank you to our host, Heidi Gennaro, RD, our Neighborhood Nutritionist! Heidi is answering our last question. Heidi Gennaro RD: No, shellfish are not harmful. BUT, never eat raw fish or shellfish...they can contain hepatotoxic (liver toxic) pathogens that could put your already compromised liver into a tailspin. See the archives for an article I did in Newstrition monthly on this very subject! OLDTIFF: HEIDI THANK YOU SO MUCH FOR COMING TO SHARE WITH US..........I LEARN SOMETHING EVERY TIME..........THANK YOU SO MUCH........... MaryV: Heidi, Thank you for all your information. MODERATOR: Don't forget to join us for next week's chat "The New Combo for HCV: PEG + Ribavirin" hosted by Victor Araya, MD – Tuesday, September 11th, at 8 PM EST. Heidi Gennaro RD: Good night, folks...and may God bless each of you richly. Never give up your quest for truth and knowledge! MODERATOR: Don't forget to join each other in the Encouragement Room! Goodnight. 1a2b: Thank you Heidi. ronchi12: TY Heidi flowergirl: Thank you for coming and answering our questions Heidi. MODERATOR: Goodnight Everyone. See you online next week.