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Hepatitis CGuide to

Healthy Living

ContentsIntroduction 2

Diet nutrition and hepatitis C 4

Functions of the liver 6

Healthy eating guidelines 9

Healthy food shopping and preparation 20

Convenience food versus junk food 33

Fats sugars salt caffeine and food additives 35

Alcohol and hepatitis C 43

Dietary supplements 47

Relieving gastrointestinal symptoms 50

Foods and medications to avoid 53

Complementary and alternative therapies 54

Relieving stress 72

Exercise 76

Benefits of counselling 77

Glossary 79

Further reading 87

Contacts 92

copy Hepatitis Australia 2014

Hepatitis C Guide to Healthy Living published by Hepatitis Australia and funded by the Commonwealth Department of Health

Acknowledgements

We thank those individuals who contributed to this booklet by sharing their stories about the experience of living with hepatitis C We are also grateful to individual members of Hepatitis Australiarsquos Health Reference Group Community Reference Group and National Resource Network for their contributions to the development of this booklet

Disclaimer

Hepatitis Australia takes care to ensure the information provided in this booklet is accurate however it is for general information only and not intended as medical advice Hepatitis Australia encourages all readers to seek independent medical advice before making any decisions based on the information provided in this booklet

Further information

For further information about hepatitis C please visit the Hepatitis Australia Website wwwhepatitisaustraliacom or call the National Infoline 1300 437 222

Feedback

If you would like to provide feedback about the information contained in this booklet please email adminhepatitisaustraliacom

Introduction

32

can be related to hepatitis C infection and treatments We recommend that you discuss your dietary needs with your doctor who can refer you to a dietitian if you need specialist advice A dietitian is qualified to perform a nutritional assessment based on factors such as your medical history your food intake and clinical test results From this information they can help you develop an eating plan that meets your particular needs

People living with chronic illness often explore various options when making choices about their health Some people with hepatitis C choose existing medical treatments others manage their symptoms using complementary and alternative therapies Anyone who has hepatitis C and is considering alternative and complementary therapies needs to be aware that even though the products are lsquonaturalrsquo some preparations can damage the liver A complementary medicine practitioner your GP or liver specialist can advise you about this

he purpose of this booklet is to help people who are living with hepatitis C to make lifestyle changes to improve

their liver and whole body health to stay well

The general dietary advice provided is not intended to replace the advice of a dietitian who can develop a program to meet individual needs Many benefits can be gained from a healthy balanced diet although little research has been done on the effect diet and nutrition have on liver function or the level of virus present in your blood when you have hepatitis C

The booklet does not provide detailed information about the dietary requirements of vegetarians people with an intolerance of or allergy to certain foods or people with cirrhosis Dietary choices and conditions such as these might necessitate guidance from a specialist dietitian

Dietary information for people with impaired liver function is included in this booklet along with useful tips to ease gastrointestinal symptoms that

T

54

bull energytoengageinyourdailyactivities

bull the ability to maintain a healthy weight thusavoiding the health risks associated with obesity

bull reducing the riskofmanydiseases suchasheartdisease and some cancers

But food alone cannot make you healthy As the World Health Organization noted in 1986 lsquoHealth is a complete state of physical mental and social well-being and not merely the absence of disease or infirmityrsquo This means that good health is dependent on a variety of factors including physical factors such as your genes social factors such as whether you are employed and have access to secure housing and mental factors such as whether you have family and friends who support you

The lifestyle choices you make are also important for example not smoking drinking little or no alcohol and using no drugs (or only in moderation) as well as taking regular exercise can improve your ability to cope with any health problems associated with hepatitis C Making healthy choices and then putting these decisions into practice can also give you a feeling of wellbeing and empowerment

nutrition and hepatitis C

Diet

eople with hepatitis C are more susceptible to liver disease and other diseases such as coronary heart disease

and hypertension (high blood pressure)

What you eat affects your quality of life Enjoying a healthy diet can help to

bull relieve some of the symptoms related to hepatitis Cinfection and treatment such as nausea

bull boostyourimmunesystem

bull giveyourbodythenutrientsnecessarytomaintainliver health

For most people hepatitis C does not cause nutrient imbalances Liver dysfunction and liver disease such as cirrhosis can however result in malnutrition

By eating healthy foods you will be giving your body the opportunity to function at its best A well-balanced diet offers many benefits including

P

Functions

76

T

of the liver

bull identifying and labelling proteins and otheressential nutrients so that they can be transported to the parts of the body where they are needed

bull storingsugarsandvitamins

bull producingbilesaltswhichgotothesmallintestineto help break down fats

Liver function can be seriously impaired by hepatitis C so it is important to enjoy a healthy diet to give your body the support it needs

If the liver is inflamed for a lengthy period scar tissue can develop The development of this scar tissue is called lsquofibrosisrsquo Scarring can restrict blood flow through the liver and in some cases leave the liver unable to function properly You can reduce the risk of developing serious liver conditions by

bull reducingtheamountofalcoholyoudrinkExcessivealcohol consumption is the most important factor involved in the development of cirrhosis in people with hepatitis C

bull eatingadietthatislowinsaltandfatyethighinfruit vegetables whole grains and lean proteins such as lean meats soy based products and low fat dairy foods

bull maintainingahealthyweighttoreducetheriskofconditions such as diabetes and fatty liver disease which can accelerate liver disease

fter the skin the liver is the largest organ in the body It is found behind the lower ribs on the right side of the

abdomen The liverrsquos size depends on the overall size of your body but in an average-sized person it is about as big as a football

A healthy liver is brownish in colour its surface is smooth and it weighs about 1200 to 1600 grams People can often function normally with only one-third of their liver because the organ is able to compensate for areas that have been damaged

Among the liverrsquos functions are the following

bull helping the digestive process by filtering(breaking down) and removing toxins such as alcohol drugs (including medicines) and some waste products from the body

bull manufacturing and packaging proteins that areessential to body functioning including blood-clotting factors and enzymes

A

98

eating guidelinesHealthy

The Australian Guide to Healthy Eating developed the following food groups based on the nutrients they provide

bull breadcerealsricepastaandnoodles

bull vegetablesandlegumes

bull fruit

bull milkyoghurtandcheese

bull meatfishpoultryeggsandnuts

You should aim to eat a wide range of nutritious food from each of these food groups each day

Extras or other foods such as sugars and salt are not included in the core food groups because these types of food are not the best sources of essential nutrients for your body These foods should be eaten infrequently and in small amounts

Fibre is found in plant products such as wholegrain

bull avoidingdrugsandnaturaltherapiesthataretoxicto the liver as well as the misuse of prescribed drugs

bull stoppingsmoking

Most people with cirrhosis have altered nutritional requirements Nausea or changes in a personrsquos sense of taste although relatively uncommon can exacerbate the situation If you have cirrhosis seek advice from a dietitian

1110

folate sodium and carbohydrates all of which are important for energy growth and repair of the body

bull Avoid highly refined (processed) foods such aswhite breads and pastas and some pre-packaged meals Fresh foods are always preferable to processed foods

Vegetables and legumesFor vegetables and legumes (peas and beans) the recommended daily intake for women is five to seven serves and for men is five to six serves

bull Legumes are an important source of proteinparticularly for vegetarians There are many types of legumes such as adzuki beans baked beans black beans borlotti beans cannellini beans chickpeas kidney beans lentils lima beans mung beans (sprouts) pinto beans snow peas green beans soy beans dried peas

bull Choose a wide variety of vegetables rootvegetables such as carrot ginger beetroot and parsnip leafy greens such as spinach silverbeet and kale marrow-like vegetables such as zucchini squash and pumpkin cruciferous vegetables such as broccoli and cauliflower peppers such as capsicum and chillies and onions such as shallots garlic and leeks Vegetables in season are usually the best value for money

bull Frozenandcannedvegetablesareagoodalternativeto fresh vegetables They are nutritious often cheaper quick and easy to prepare easily stored and available in remote areas

bull Foods in this group are a good source of vitaminsminerals dietary fibre carbohydrates and anti-oxidants

breads cereals fruits and vegetables You need to include it in your diet to help to prevent bowel disease Fibre improves bowel function by increasing the bulk of faeces and reducing transit time in the body which results in softer larger stools and more frequent bowel action

The Australian Guide to Healthy Eating and the Australian Dietary Guidelines 2013 recommends eating a variety of foods from within each core food group The serving quantities and sizes listed in this section are an indication only For more detailed recommendations based on gender age level of physical activity body size and pregnancy and breastfeeding status see the guide

The Australian Guide to Healthy Eating and the Australian Dietary Guidelines 2013 can be found at the following link httpswww nhmrc gov auguidelinespublicationsn55

Bread cereals rice pasta and noodlesFor bread cereals rice pasta and noodles the recommended daily intake for women is three to six serves and for men four to six serves depending on level of physical activity age size and genetics

bull Eatwholegrainbreadhigh-fibrecerealbrownriceand wholemeal pasta

bull Choose rice and wholemeal pasta and noodlesbecause these products contain less salt than bread and breakfast cereal

bull When choosing breads opt for variety brownwholegrain mixed grain rye and rolls pita breads and other flat breads

bull Foods from this group provide fibre and energyprotein fat magnesium zinc riboflavin niacin

1312

add milk or milk powder to soups casseroles and sauces You can also add cheese to pancakes omelettes and vegetable dishes and use yoghurt with curries and in dips

bull If you canrsquot tolerate milk or milk productsuse calcium-enriched soy milk products as an alternative

bull If you donrsquot like any foods from this food grouptry foods such as sardines tuna salmon lentils almonds brazil nuts and dried apricots which also provide calcium although in smaller amounts

Meat fish poultry eggs and nutsFor the meat fish poultry eggs and nuts group the recommended daily intake for both men and women is two to three serves

bull Choose a varietyof leanmeats beef lambporkchicken turkey duck kangaroo and so on and fish and shellfish

bull This food group offers a good source of ironzinc and vitamin B12 Iron helps your body carry oxygen in the blood and zinc helps the healing of wounds as well as being important for growth and reproduction

bull Ifyouareavegetarianchoosefoodssuchasnutsandseeds tofu and bean curd instead These foods are good sources of iron and zinc

Vitamin B12 is found only in foods of animal origin Vegans who eat no animal products will need supplements of vitamin B12

FruitFor fruit the recommended daily intake for women and men is two serves of whole fruit per day Fruit juice is not a good alternative as it is high in sugar and low in fibre

bull Whole fruit is higher in dietary fibre than juiceDried fruits are nutritious and can add variety to your diet although they are high in sugar and excess consumption can lead to tooth decay

bull Cannedfruitespeciallyvarietiesthatarecannedinnatural juice without added sugar can be used as a nutritious replacement for fresh fruit

bull Fruits are a rich source of anti-oxidantscarbohydrates and vitamins especially vitamin C and some folate Keeping the skin on fruit whenever possible will allow you to obtain more dietary fibre

bull Eating a diet rich in fruit and vegetables mayreduce the incidence of constipation and some types of cancer

Milk yoghurt and cheeseFor the milk yoghurt and cheese group the recommended daily intake for women and men is two to four serves The group also includes calcium-enriched soy milk

bull Dairyproductsareanexcellentsourceofcalciumandalso provide protein riboflavin and vitamin B12

bull A high calcium intake when you are young canhelp protect against osteoporosis

bull Milk cheese and yoghurt are available in low-fat varieties Choose these for yourself whenever possible remember though that low-fat varieties are not suitable for infants and young children

bull If you donrsquot like drinkingmilk or eating yoghurt

1514

Food group One serve

Fruit One piece of fruit weighing about 150 grams such as an apple a banana an orange or a pearTwo small pieces of fruit (each weighing about 75 grams) such as apricots kiwi fruit or plumsOne cup (150 grams) of diced pieces or canned fruitOne-and-a-half tablespoons of sultanas or four pieces of dried fruit such as apricot halvesHalf a cup (125 millilitres) of fruit juice

Milk yoghurt cheese and calcium-enriched soy milk

One cup (250 millilitres) of fresh long-life or reconstituted dried milkOne cup (250 millilitres) of soy milk fortified with at least 100 milligrams of calcium per 100mlHalf a cup (125 millilitres) of evaporated milk Two slices (40 grams) of cheeseOne small carton (200 grams) of yoghurt

Meat fish poultry eggs nuts and legumes

65 to 100 grams of cooked meat or chicken such as half a cup of lean mince two small chops or two slices of roast meat80 to 120 grams of cooked fish filletTwo small eggsOne-third of a cup of unsalted peanuts or almonds or one-quarter of a cup of sunflower seeds or sesame seedsHalf a cup (80g) of cooked dried beans lentils chickpeas split peas and canned beans

Protein intake

Your body needs protein to repair and replace damaged tissue and cells in nearly every structure and system including the liver and the immune system People with liver problems (including cirrhosis) are often malnourished and a reduction in protein intake could be even more harmful than usual

Dietary experts recommend that protein intake be restricted only if you have cirrhosis and develop a condition called lsquohepatic encephalopathyrsquo This condition can arise when the liver is so damaged it cannot process protein properly causing substances such as ammonia to build up in the blood

Ask a medical professional dietitian or nutritionist for more advice about how much protein to include in your diet

Whatrsquos in a serve

Bread cereals rice pasta and noodles

Two slices (60 grams) of bread or one medium bread roll

One cup (180 grams) of cooked rice pasta or noodles

One cup (230 grams) of cooked porridge one-and-a-third cups (40 grams) of ready-to-eat cereal

Half a cup (65 grams) of muesli

Vegetables legumes (peas and beans)

Half a cup (75g) of cooked vegetables

Half a cup (75g) of cooked dried beans peas or lentils

One cup of salad vegetables

One potato


1716

Variety in your dietNutritional educators recommend that you have variety in your diet lsquoVarietyrsquo means choosing a mix of foods across the range of food groups and from within each food type For example

bull Cereals can be wheat oat rye rice barley and so on

bull Vegetables can be root vegetables leafy greensmarrow-like vegetables cruciferous vegetables such as broccoli and cauliflower onions peppers and tubers such as potatoes and sweet potatoes

Your body absorbs nutrients from different food sources in different ways that is the nutritional effect can vary within each food type and across the range of food types Including a variety of foods in your diet will allow you to obtain the nutrients your body needs

Nutrition Australia encourages people to aim to eat about 30 different foods each day This might sound difficult to do but if you choose foods or meals that already provide variety for example stir-fries casseroles and multigrain breads you are more likely to achieve this goal

Remember to aim for a good degree of variety in your diet by not allowing any particular type of food or food group to dominate Too much of one thing can be unhealthy

Within each of the five food groups some foods provide more of some nutrients than others If you eat a variety of foods from within each group you will probably obtain all the nutrients provided by the foods in that group for example in the vegetable group carrots and pumpkin contain much more vitamin A than do potatoes The following are examples

If you omit any of the food groups (or a significant component of the range of foods in one of the food groups) for personal medical or cultural reasons it is important to replace them with another type of food For example if you are a vegetarian you need to replace meat products with other foods high in protein and iron such as tofu

Maintain good food hygiene

Healthy eating also involves maintaining good food hygiene This means storing food at the correct temperature (the bacteria listeria can be particularly dangerous for people with liver disease) and reheating foods that are already cooked thoroughly

Never let raw meats come into contact with other foods during storage and preparation Make sure to wash your hands with soap and water before preparing food and during preparation if you handle raw meat

Keep workstations clean and use an anti-bacterial laundry soaker to sanitise dishcloths sponges and washing up brushes

1918

Eat plenty of plant foods with moderate amounts of animal foods in proportions shown in the guide small amounts of extra foods and margarines and oils

Bread cereal rice pasta noodles vegetables legumes and fruit

Milk yoghurt cheese meat fish poultry eggs

Biscuits cakes desserts pastries soft drinks lollies chocolates and high fat snack items such as crisps pies pasties sausage rolls

Drink plenty of water

For good health the guide recommends that adults drink six to eight glasses of liquid per day (but not sugary drinks) and more if engaging in physical activity and in hot weather

Plants foods Animal Foods Extra Foods

of promoting variety in your diet

Breakfast ndash wheat-based cereal milk and orange juice

Untoasted muesli with added seeds and quinoa flakes served with yoghurt fresh fruit and unsweetened juice

Lunch ndash toasted cheese and tomato sandwich on wholemeal bread using low-fat mayonnaise or tahini (sesame seed paste)

Multigrain bread sandwich with chicken (or ricotta if you are a vegetarian) tomato low-fat cheese onion capsicum mushrooms mung bean sprouts and lettuce using avocado for the spread instead of margarine and served with a low-fat fruit smoothie

Dinner ndash lamb chops with mashed potato peas broccoli and carrots

Stir-fry using lean meat fish or tofu with a variety of vegetables ndash say broccoli capsicum zucchini cabbage garlic onion mushrooms carrot shallots snowpeas bok choy and fresh herbs ndash served on noodles

Typical day Suggestion for increased variety

21

Healthy

20

Choose the leanest mince available or ask the butcher to mince beef that has been trimmed of fat

Drain the fat from mince during or after cooking

Choose low-fat cheeses (25 per cent less fat varieties cottage cheese or ricotta) and reduced-fat or low-fat milk Donrsquot just try these once it might take a while for your taste buds to adjust Try low-fat yoghurt you can scarcely taste the difference

Use avocado chutney cottage cheese or low-fat mayonnaise instead of margarine or butter on sandwiches Instead of cream use evaporated skim milk with gelatine and chill before whipping Alternatives to sour cream are low-fat yoghurt evaporated skim milk and lemon juice

Olive oil sunflower oil safflower oil canola oil and grape-seed oil are good vegetable oils to choose

Use a non-stick fry pan and cooking spray or brush the base of the pan with oil instead of pouring oil into the pan Some non-stick fry pans donrsquot require oil at all

Choose wholemeal bread pasta flour and rice instead of white or bleached grains for extra fibre

Leave the skin on vegetables and fruits to boost the fibre content and flavour of meals

Breakfast cereals should be high in fibre and low in salt

Use breakfast cereals sparingly as a tasty nutritious snack

Tips for shoppingHealthy ways to prepare and cook your food

food shopping and preparation

Tips for healthy food shopping

Healthy ways to prepare and cook your food

Choose lean cuts of meat such as topside blade rump fillet gravy beef veal steaks pork fillet and lsquotrimrsquo lamb varieties such as lean lamb chump

Trim visible fat from meat before you cook it

Keep meat portions small (about 100 grams) and lsquobulk-uprsquo meals with vegetables and legumes brown rice or wholemeal pasta Cook vegetables lightly and steam them whenever possible to retain their nutrients

When roasting meats trim the visible fat from the meat and place the meat on a rack in a baking dish with one to two centimetres of water For extra flavour add herbs and wine to the water (Alcohol is harmless when used with heat in cooking because it evaporates)


22 23

M

Choose low-salt or lsquono added saltrsquo products by comparing food labels

Donrsquot add salt to your sandwiches or cooking

Avoid adding salt at the dinner table

Breads and cereal products are often sources of hidden salt Most processed food has a high salt content

Make your own dressings and mayonnaise using low-fat yoghurt tomato paste vinegar lemon juice ricotta mustard and fruit pulp Buy dressings labelled lsquono oilrsquo or lsquolow fatrsquo

Use low-fat or no-oil dressings in salads and sandwiches

Tips for shopping Healthy ways to prepare and cook your food

12 top foods that are good for the liverMaintaining a healthy liver is about maintaining a healthy body There is definitely an association between some conditions and liver disease such as high cholesterol high blood pressure insulin resistance abdominal obesity and diabetes It therefore makes sense to lead a lifestyle that prevents andor manages these conditions

Maintaining or improving a healthy body can be assisted by consuming the right amount of kilojoules to maintain a healthy weight having lots of fibre to keep your digestive tract healthy reducing cholesterol levels and eating only a small amount of fat Unsaturated fats from plants and fish are better for your liver Below is a list of 12 top foods for people with hepatitis C These have been taken from the lsquoLove your liverrsquo website www loveyourliver com au

Note Some people with hepatitis C may have specific dietary requirements for protein salt and fluid intake Speak to your doctor or dietitian for further guidance

22

2524

Recommended intake Oats brown rice and couscous fall into the lsquobreads and cerealsrsquo food group Also in this group are foods like wholegrain bread breakfast cereals and crackers pasta rice and noodles You should have 4 ndash 8 serves of lsquobreads and cerealsrsquo per day depending on how physically active you are 1 serve is equal to 2 slices of bread 1 cup of cooked pasta rice noodles or couscous 1 cup of cooked porridge or 1 13 cups of breakfast cereal flakes Aim for 12 ndash 1 serve of your 4 ndash 8 servesday to be oats brown rice or couscous

3 Blueberries

Other sources cranberries boysenberries straw-berries currants blackberries and cherries

Benefits Blueberries are high in plant compounds (phytonutrients) As with cranberries phytonutrients in blueberries may help prevent urinary tract infections Blueberries may also improve short-term memory promote healthy aging and lower your risk of heart disease and cancer They are a low-kilojoule source of fibre potassium and vitamin C and have been shown to have anti-inflammatory properties One cup of fresh blueberries has 350 kilojoules 3 6 grams of fibre and 14 mg of vitamin C Vitamin C helps form the connective tissue collagen keeps your capillaries and blood vessels healthy and aids in the absorption of iron

Recommended intake All fruit is healthy for you and you should aim to have two servings of fruit per day One serve is equal to one medium piece of fresh fruit 1 cup of diced fresh or 2 tablespoons of dried Of these serves aim to have 4 ndash 5 serves per week of blueberries or other sources listed above

1 Almonds

Other sources other nuts

Benefits Almonds are packed with nutrients ndash fibre riboflavin magnesium iron and calcium In fact almonds have more calcium than any other nut ndash 75mg in one serving (about 23 almonds) Like all nuts almonds provide one of the best plant sources of protein and nuts are also good for your heart as they contain unsaturated fats ndash a healthier type of fat that helps to lower blood cholesterol levels

Recommended intake Aim for 1 ndash 2 tablespoons of raw unsalted almonds (or other nuts) five times per week

2 Oats

Other sources brown rice couscous

Benefits Eating oats on a regular basis may lower cholesterol levels reduce heart disease risk and prevent type 2 diabetes It is thought that this is because oats have a high soluble fibre content a low Glycaemic Index and they are a whole grain meaning they contain many essential vitamins and minerals

2726

Benefits Soy is an extremely high quality protein that has no cholesterol or animal fat is low in saturated fat and high in fibre Soy is one of naturersquos super-foods that can reduce your risk of heart disease and stroke helps prevent osteoporosis and may help protect against certain cancers like breast prostate and bowel cancer It also helps alleviate hot flushes during menopause There has been some controversy in recent times over the relationship between soy and cancer There are now over 3000 scientific research papers on soy and there is no sound evidence which demonstrates any negative health effects in humans from consuming soy foods as part of a balanced diet

Recommended intake 1 ndash 4 servings per day such as soymilk on your cereal tofu in your evening meal andor soy ice-cream for dessert

6 Tea

Other sources green or black tea

Benefits Tea is rich in antioxidants which help protect our bodyrsquos cells against damage and mutation The overall antioxidant power of black tea is the same as green tea but green tea does have ECGC a powerful antioxidant that may inhibit the growth of cancer cells Black tea in particular may boost the immune system lower the risk of stroke and may help prevent osteoporosis

Recommended portion 1 cup per day

7 Yoghurt

Other sources milk cheese custard

Benefits Dairy foods are the best sources of calcium Calcium promotes strong bones and a healthy heart Yoghurt in particular has additional benefits of pre- and probiotics which promote a healthy digestive tract Dairy is naturally high in saturated fat and because the link between saturated fat and heart disease is clear most people in the general population should be

4 Salmon

Other sources all fish predominantly oily (salmon mackerel tuna marlin swordfish sardines herring trout) oysters clams

Benefits Omega 3 fatty acids a type of unsaturated fat lowers heart disease and stroke risk by decreasing cholesterol and triglyceride levels slowing down the growth of artery-clogging plaques and lowering blood pressure Omega 3rsquos have also been shown to help reduce inflammation associated with arthritis and may possibly help with memory loss and Alzheimerrsquos disease There is some evidence to show that it reduces depression as well In addition to being an excellent source of omega-3s fish is low in saturated fat and is a good source of protein Omega-3s are most prevalent in fatty cold-water fish Other forms of omega 3rsquos are available in fortified eggs flax seed (linseed) and walnuts

Recommended intake Aim to eat fish (fresh andor canned) 2 ndash 4 times per week

5 Soybeans

Other sources soymilk soy yoghurt soy custard soy icecream tofu soy-based meat substitutes (soy bacon soy sausages etc )

2928

9 Kidney beans

Other sources other legumes e g chickpeas cannelini beans borlotti beans baked beans three bean mix

Benefits Kidney beans and other red beans are good sources of iron magnesium phosphorus potassium copper and thiamine Other legumes such as chickpeas cannellini beans and borlotti beans are also great choices All legumes are low in fat low in kilojoules and are high in dietary fibre Red beans also contain phytonutrients that may help prevent chronic diseases such as heart disease high blood cholesterol high blood pressure and cancer Legumes although plant foods are very high in protein and thus serve as a meat-alternative for vegetarians Legumes are categorised into the vegetable group and also the meat group

Recommended intake 1 serve is 12 cup of cannedcooked legumes Aim to have 4 servings per week

10 Spinach

Other sources baby spinach silver beet turnips dark lettuce

Benefits Spinach is high in vitamins A and C and folate Itrsquos also a good source of riboflavin vitamin B-6 calcium iron and magnesium The plant compounds in spinach may boost your immune system and may help keep your hair and skin healthy

Recommended intake One serving is 12 cup of lightly steamed or 1 cup of raw Aim to have 1 serving 2 ndash 3 times per week

having reduced fat low fat or no fat varieties Also be aware that ice-cream cream and soft cheeses such as brie and camembert are relatively low in calcium and high in saturated fat

Recommended intake Aim to have 3 serves of reduced fat dairy per day 1 serve is equal to 1 cup (250mL) milk 1 tub (200g) yoghurt or 40g of hard cheese

8 Broccoli

Other sources Brussels sprouts cabbage cauliflower

Benefits Aside from having important nutrients such as calcium potassium folate and fibre broccoli contains phytonutrients mdash a group of compounds that may help prevent chronic diseases such as heart disease diabetes and some cancers Broccoli is also a good source of vitamins A and C and antioxidants that protect your bodyrsquos cells from damage These foods have also been linked with reducing the incidence of birth defects boosting the immune system and buildingmaintaining strong healthy bones

Recommended intake All vegetables are healthy and you should make an effort to eat a wide variety Aim for 5 serves of vegetables per day with only one serve being starchy vegetables (potato sweet potato corn) One serve of vegetables is equal to 12 cup of cooked 1 cup of rawsalad or 1 medium potato Of the 4 serves of non-starchy vegetables aim for one serve each day to be broccoli brussels sprouts cabbage or cauliflower

3130

11 Pumpkin

Other sources carrots squash sweet potatoes capsicum

Benefits These vegetables are high in the antioxidant beta carotene Food sources of beta carotene which is converted to vitamin A in your body may help slow the ageing process and reduce the risk of some cancers such as cancers of the lung colon bladder and breast Unlike true Vitamin A beta-carotene is not toxic to the liver if consumed in large amounts mdash excess is broken down and excreted through the kidneys Pumpkin is also a good source of fibre vitamins B6 C and E folate and potassium and like all vegetables theyrsquore fat-free and low in kilojoules

Recommended Portion Like other vegetables one serve equals 12 cup of cooked or 1 cup of rawsalad Aim for 5 serves of vegetables per day with only one serve being starchy vegetables (potato sweet potato corn) Aim for one of your 5 serves of vegetables to be pumpkin or one of the lsquoother sourcesrsquo listed above

12 Vegetable juice

Benefits Vegetable juice contains the vitamins minerals and other nutrients found in the original vegetables and it is an easy way to include vegetables in your diet Tomato juice and vegetable juices that include tomatoes are good sources of lycopene an antioxidant that may reduce the risk of heart attack prostate cancer and possibly other types of cancer Vegetables unlike fruit contain no (or very little) sugar and hence vegetable juices are a low kilojoule nutrient dense drink Carrot celery beetroot cucumber capsicum tomato and ginger can all be juiced You can also buy commercial vegetable juices however be sure to select the low-sodium varieties

Recommended intake If you regularly meet your recommended 5 serves of vegetables per day aim to have one vegetable juice drink once per week However if you struggle to eat enough vegetables use vegetable juices more often to help you meet your vitamin and mineral requirements Keep in mind however that vegetable juices do not contain the fibre from whole vegetables and hence you should make an effort to include whole vegetables in your daily diet

For more information and recipes containing these foods please see www loveyourliver com au

32 33

N ot all lsquoconvenience foodsrsquo lack nutritional value Some of the most convenient foods such as a piece of fruit

a wholemeal salad sandwich or baked beans on toast for example are healthy foods The following are other kinds of healthier convenience foods you can choose

bull hamburgersor steak sandwichesmadewith leanmeat and extra salad on wholemeal bread or a roll with little or no butter or margarine

bull grilledfish insteadof friedservedwith lemonorvinegar rather than salt

bull thickchipsratherthanthinThickonesabsorblessfat when frying Wedges are an even better choice

bull bread-based take-away foods such as sandwichesrolls and wraps Choose wholemeal bread and varieties of pita bread flat bread and rolls

bull Asian dishes that are steamed and braised andinclude plenty of vegetables rather than battered or

Conveniencefood versus

junk food

Try to add as many different vegetables to your meals as you can each day

34 35

sugars salt caffeine and food additives

Fats

FatsAlthough excessive amounts of fat in the diet can cause health problems it is important to have small amounts of fat because your body needs essential fatty acids to function properly

Fats are classified according to their chemical structure they can be saturated polyunsaturated or mono-unsaturated Most of the fat you eat should be mono-unsaturated

A diet high in saturated fats can cause your body to produce excess cholesterol which can contribute to your risk of developing heart disease and some cancers Saturated fats are mainly found in fatty meat butter full-fat milk products cream lard and many take-away and processed foods They are also found in some plant foods such as palm and coconut oils Choose meat that has been trimmed of fat and reduced-fat dairy products wherever possible

fried dishes

bull low-fatmilk drinks fruit juicemineral water andlow-fat smoothies

bull barbecuedchicken It ishealthier thandeep-friedchicken especially if you donrsquot eat the skin

bull kebabs

bull pasta with vegetable-based sauces rather thancream-based sauces

bull pizzas with low-fat toppings such as pineapplemushrooms capsicum onions olives and other vegetables with a small amount of lean ham rather than salami or other types of sausage

bull salads with lean skinless chicken or turkeysalmon or tuna Avoid high-fat dressings fried croutons and bacon

bull baked potatoes in their jackets with low-fat sourcream yoghurt or cheese and chives

bull soups make a large pot of soup with low-fatingredients refrigerate or freeze and then serve as required

bull low-fat frozen yoghurt instead of ice-cream fordessert

Many foods that are sold ready to eat such as battered fish chips hamburgers deep-fried chicken potato scallops (or potato cakes) hot dogs and meat pies are high in fat and salt and low in fibre The term lsquojunk foodrsquo does not mean the same thing as lsquoconvenience foodrsquo or lsquofast foodrsquo It usually applies to foods that are relatively low in nutrients compared with their energy (kilojoule) content Generally junk foods rely on substances such as salt or sugar and artificial colours for their appeal

36

0grams Fruit and vegetables (with the exception of avocado) are virtually fat-free unless fat or oil has been added during cooking or preparation

0grams One cup cooked pasta

1gram One slice of bread

1gram One cup of baked beans

4grams One grilled trim steak (100grams)

4grams One grilled fish fillet (100grams)

5grams One hard-boiled egg

5grams Two plain biscuits (20grams)

6grams One lamington (60grams)

7grams Three small slices of trim lamb roast

10grams Two cubes of full-fat cheese

10grams One glass full-cream milk

13grams One tablespoon of peanut butter

15grams Two scoops of full-fat ice cream

15grams One Croissant (63grams)

15grams One small doughnut (60g)

16grams One barbeque steak untrimmed (120grams)

17grams One spring roll

18grams Six chicken nuggets

19grams One tablespoon of olive oil

37

Polyunsaturated and mono-unsaturated fats are healthier choices These types of fats are found in plant oils (such as sunflower safflower olive and canola oils) polyunsaturated margarine nuts and very lean meats Olive peanut and canola oils are mostly mono-unsaturated fats

All types of fat are rich sources of energy there are about 37 kilojoules of energy in each gram of fat you eat Your body will however store excess kilojoules as body fat and this can lead to obesity Obesity is linked to an increased risk of developing type 2 diabetes high blood pressure heart disease and fatty liver

The Australian Guide to Healthy Eating suggests that you aim to have about 30 per cent of your total energy intake in the form of fat A personrsquos energy requirements vary of course according to their age size genetics state of health and level of physical activity If you would like assistance to work out how much fat is suitable for you contact a dietitian It is also important to be aware that infants and pre-school children underweight people breastfeeding women and people engaged in unusually heavy work have a greater need for fat in their diet Again talk to a dietitian

The lsquofat scalersquo

lsquoHiddenrsquo fat in foods can have a big impact on the amount of fat you eat Fats found in food products can also be labelled as animal fat or oil shortening copha lard coconut oil palm oil butterfat milk solids chocolate and vegetable oil lsquoCreamedrsquo or lsquotoastedrsquo on a label can mean that fat has been added to food during preparation The following scale is a guide to how much fat is in certain foods

Food typeFat content

3938

come from sugars protein or alcohol

There are however a number of things people with hepatitis C should be aware of

bull Thirty to 70 per cent of people with hepatitis C develop some form of insulin resistance (Harrison SA Clinical Gastroenterol Hepatol 2008 6(8)864ndash76)

bull Obesityandinsulinresistanceareassociatedwithareduced sustained virological response to antiviral therapy (Poustchi H et al J Hepatol 2008 48(1)28ndash34)

bull Those eating large amounts of kilojoulescarbohydrates and lipids (fats) were found to have more severe fibrosis of the liver (Loguerico C et al Am J Gastroenterol 20081031ndash8)

bull High serum glucose in people with chronichepatitis C can trigger liver fibrosis (Ratziu V amp J Hepatol 2003 39(6)1049ndash55)

bull The accumulation of fat in the liver blocks itsability for insulin signalling This can mean there is uncontrolled glucose production in the liver ldquoSome research has shown that if you lose weight gradually you may be able to reverse early liver fibrosisrdquo (Farrell GC et al Fatty liver disease NASH and related disorders Melbourne Blackwell Publishing 2005)

SaltApart from intensifying the natural flavours colours and textures of foods salt has many purposes Your body needs small amounts of salt to function because it is an essential nutrient the body cannot make by itself When salt is eaten in excess though it can increase your risk of developing high blood pressure Try to reduce your intake of salt and processed foods that contain a lot of salt such as

21grams One cup of fried rice

21grams One plain chocolate bar (55grams)

37grams One Big Mac (205grams)

42grams One serve of spinach pie

57grams Two lamb chops untrimmed (145grams)

Note that the fat contents shown here are approximate The listing is adapted from a publication issued by Queensland Health and prepared by the Australian Dairy Corporation mdash Facts on Fat finding it reducing it and using low-fat dairy foods

SugarsHighly refined carbohydrates such as sucrose (sugar) do not contain the nutrients (vitamins minerals and so on) they had in their lsquorawrsquo state This means the body is effectively leached of the nutrients needed to break down the carbohydrate and metabolise it

Nevertheless sugar is added in small amounts to many useful processed foods and these products should not be excluded from your diet For example high-fibre breakfast cereals and foods such as canned baked beans are nutritious low in fat and high in fibre and are useful foods to include in a healthy diet Some foods such as fruit and milk naturally contain sugar

Manufactured foods often have large amounts of sugar added to them when they are being processed During digestion sugars such as sucrose and lactose and other carbohydrates such as starch break down into simple sugar These provide energy for body cells and are sometimes stored for future use Excess body fat results when a person eats more kilojoules than the body needs regardless of whether those kilojoules

Fat content Food type

4140

pressure in people who consume caffeine There is no firm evidence that tea coffee and other caffeine-containing products consumed in moderate amounts cause particular problems for people with hepatitis C

The way your body reacts to caffeine depends on many factors including your body mass general state of health and metabolism Limiting your caffeine intake to 500mg per day (or less than 200mg a day during pregnancy) is generally recommended

Approximate caffeine levels per serve include

bull Chocolatedrinksndash30to60mg

bull Instantcoffeendash60to100mg

bull Driporpercolatedcoffeendash100to150mg

bull Espressocoffeesndashsuchasespressoorlattendash90to200mg

bull Coladrinksndash35mg

bull Decaffeinatedcoffeendasharound3mg

bull Tea ndash 30 to 100mg depending on the type andstrength of the brew

bull EnergyorsportsdrinksndashsuchasRedBullorlsquoVrsquondash80to 90mg

bull Darkchocolatebarndash40to50mgper55gserve

bull Guaranandashcancontainupto100mgperonegramof guarana

bull Caffeine tablets ndash such as No-Doz ndash 100mg pertablet

Drinks that help to keep you alert (such as Red Bulltrade and Vtrade) contain about two-and-a-half times the amount of caffeine found in regular cola drinks Avoid these so-called lsquoenergyrsquo drinks if you are limiting your caffeine intake All caffeine-containing beverages should be consumed in moderation especially if you have trouble going to sleep Useful caffeine-free alternatives are decaffeinated coffee fruit teas herbal teas milkshakes fruit juice diluted with half water and plain water

processed meat bacon and sausages

The link between eating too much salt and the development of high blood pressure is difficult to quantify some people are sensitive to high intakes of salt and experience a rise in their blood pressure others experience no change For this reason the National Health and Medical Research Council recommends that adults do not exceed the upper limit of 2300 milligrams of sodium or about one teaspoon of salt a day

Monitor your salt intake by reading the nutrition panel on packaged foods salt is often called lsquosodium chloridersquo its chemical name on food labels Fruit and vegetables have low sodium content unless salt is added during processing mdash as can happen with canned vegetables and during cooking Cereals such as pasta rice rolled oats and other grains are also low in salt Breads contain higher amounts of salt about 120ndash400 milligrams per slice Fresh meat contains around 60ndash90milligrams of salt per 100 grams and processed meats such as sausages contain 900ndash1000 milligrams per 100 grams Bacon contains about twice this amount Try to reduce your intake of salt and processed foods that contain a lot of salt such as processed meat bacon and sausages

To limit or reduce your salt intake choose low-salt varieties of food and foods labelled lsquono added saltrsquo and avoid adding salt to your food when cooking

CaffeineMany people are mildly (and relatively harmlessly) addicted to caffeine Tea coffee chocolate cocoa energy drinks and some cola drinks contain caffeine

Caffeine stimulates your brain and nervous system and the physical effects vary from person to person Among these effects which are temporary and reversible are increased alertness and heartbeat and a need to urinate more often

Some studies have shown that caffeine can slightly raise blood pressure others have found lower blood

43

Alcoholand hepatitis C

42

A lcohol is a toxin It is broken down by the liver but it can stimulate the build-up of fat in the liver (steatosis) and the

development of fibrosis (scarring of the liver) The Australian Alcohol Guidelines for low-risk drinking published in 2009 by the National Health and Medical Research Council reported a higher risk of developing cirrhosis if you have hepatitis C and drink alcohol It is the single biggest risk factor for developing cirrhosis among people with hepatitis C Drinking alcohol has an effect on any personrsquos risk of developing liver disease although it is unclear how much alcohol puts you at a higher risk

It is wise to avoid alcohol but if you do choose to drink limit yourself to moderate amounts These amounts will vary according to your health and whether you have active liver disease or cirrhosis The recommendation for both women and men to drink is no more than two standard drinks a day with two alcohol-free days per week if they want to reduce their risk of being harmed by an alcohol-related injury or disease Some studies

Food additives Additives are used in foods for a specific purpose and are not considered to be food themselves For example the artificial sweetener aspartame is added to many beverages yoghurt chewing gum and other foods to keep the calorie content of the product low Some additives help maintain or improve the quality colour taste and texture of food and prevent it from spoiling

Stevia (stevia rebaudiana bertoni) is a herbal sweetener that is suitable for diabetics and for overweight people who are aiming to lose weight by avoiding sugar in their diet

The Australia New Zealand Food Authority regulates the use of food additives through the Food Standards Code The standards which are compulsory specify the quantity and type of food colours and preservatives that can be used Food additives must be listed on packaged and processed foods See the lsquoFurther Readingrsquo section for the website location

Many convenient and nutritious processed foods contain small amounts of artificial colours and preservatives but having hepatitis C is not a reason to avoid these foods If you are sensitive to particular food additives or natural chemicals that occur in food you need to avoid these whether you have hepatitis C or not It is unlikely that hepatitis C will cause you to be more sensitive to food additives such as colours or flavours

If you have an allergic reaction to a particular food or food additive you should go to a medical clinic that specialises in allergies and have the diagnosis confirmed usually by skin tests An accredited practising dietitian can provide dietary advice

4544

Medication interactionsAlcohol can interact with a range of prescribed over-the-counter medications as well as some herbal preparations Check with your doctor or phamacist

Standard drinksThe National Health and Medical Research Councilrsquos Australian Alcohol Guidelines for low risk drinking www druginfo adf org aufact-sheetsaustralian-guidelines-for-low-risk-drinking-web-fact-sheet defines a standard drink as one containing 10 grams of alcohol The following are examples

bull beermdash375mlcanlowstrength=08ofastandarddrink375mlcanmidstrength=1standarddrink375mlfullstrength=14standarddrinks

bull table wine (about 135 per cent alcohol)mdash oneglass(100mls)=1standarddrink

bull fortified wines such as sherry and port (about18 per cent alcohol) mdash one sherry glass (60 mls) =1standarddrink

bull spiritsandliqueurs(about40percentalcohol)mdashonenip(30mls)=1standarddrink

bull Premixeddrinkwithaspirit(15alcohol)375mlcan=15standarddrink

have indicated that abstinence from alcohol is strongly recommended before and during antiviral therapy and for those with cirrhosis you might decide that this is your preferred course of action

If you have any of the following conditions you should consider lowering your consumption of alcohol

Acute hepatitis CMost people donrsquot notice any symptoms during the initial or acute phase of hepatitis C mdash the first six months of infection However drinking alcohol during this time can aggravate inflammation of the liver and any symptoms you might have such as nausea and fever

CirrhosisIt is estimated that between 5 and 10 per cent of people with chronic hepatitis C will develop cirrhosis of the liver after 20 years If you have developed cirrhosis it is recommended that alcohol should be avoided completely as it will lead to increased liver damage

Fatty liverPeople with hepatitis C are prone to fatty liver which as the name suggests occurs when excess fat cells build up in the liver Drinking alcohol to excess over a long period is one of the main causes of fatty liver Other causes are insufficient exercise a diet containing too many foods and drinks that are high in fats and sugars having diabetes and having hepatitis C ndash genotype 3

47

Dietarysupplements

46

I t is possible to promote your health and boost your immune system without using dietary supplements

In fact when some nutrients such as zinc and copper are taken in excess they can suppress your bodyrsquos immune system

Vitamin and mineralsDietary supplements include fat-soluble and water-soluble vitamins and minerals To date there is only limited evidence that these supplements deliver any benefit for people with hepatitis C The body does not excrete fat-soluble vitamins and too much of them can cause damage to your liver

Vitamins A D E and K are fat-soluble vitamins that are stored in the liver If you have hepatitis C you should take fat-soluble vitamin A or beta-carotene supplements only if they are prescribed by your doctor Iron

Limiting your alcohol intakeHere are a few tips to help you limit your alcohol intake

bull Switchtolow-alcoholoralcohol-freedrinks

bull Mixyourwinewithplainmineralwater

bull Mixbeerorstoutwithlemonade

bull Avoid situationswhere there ispressure todrinkfor example drinking in rounds

bull Alternate a non-alcoholic drinkwith an alcoholicone

bull Aim to have two or three alcohol-free days eachweek

If you have trouble reducing your alcohol intake contact your doctor or your local community health centre for a referral to someone who might be able to help you You can also contact an alcohol and drug support service See the lsquoContactsrsquo section

4948

planning to use or are using a dietary supplement or alternative therapy especially if you are undergoing treatment

bull Onlyusesupplementaryvitaminsormineralsthathave been prescribed by your doctor or therapist

bull Consult a qualified herbal practitioner ornaturopath who is a member of a recognised complementary therapy or natural therapy organisation before taking any herbal preparations and ensure they know you have hepatitis C as some products are harmful to the liver

supplements or foods with added iron (such as fortified milk or juice) should also be avoided by people with hepatitis C These supplements have been shown to cause increased damage to the liver especially if alcohol is consumed regularly Always avoid excessive intakes of any dietary supplements and remember that such products will be useful only if your diet is lacking in vitamins and minerals

Other supplements or therapies Some people take guarana which is a stimulant similar to caffeine and some herbal stimulants in order to increase their energy levels rather than for nutritional purposes Although these supplements can have a short-term stimulating effect few studies have examined whether they are actually beneficial

Many people with hepatitis C use herbs such as silymarin (St Maryrsquos thistle) and traditional Chinese medicines The benefits associated with these substances have not been proven Traditional Chinese therapies are often a combination of different herbs in proportions that are tailored for each individual See lsquoComplementary and alternative therapiesrsquo for more detail

Anecdotal reports from individuals do not provide enough evidence to assess the therapeutic benefits of herbal supplements and traditional Chinese medicines

Contact a hepatitis organisation in your state or territory for further information about herbal supplements

There are three important things to remember

bull Let your doctor or dietitian know that you are

Relieving

5150

gastrointestinal symptoms

bull Make yourownginger teabygrating aone-inchpiece of ginger and placing it in a tea strainer Add boiling water cover for five minutes and then sip throughout the day

bull Dry starchy food such as toast and crackers canhelp you when you feel nauseated in the morning

bull If you cannot tolerate food odours because ofnausea avoid being in the kitchen when food is cooking or prepare meals in advance when you are feeling better

bull Coldfoodssuchassandwichessaladsfruitscoldsoups and cheese and biscuits might be useful

bull Foodshighinfatsuchasfriedfoodsandpastriescan make nausea worse Spicy or very sweet foods can also cause nausea

bull Avoidliquidsatmealtimesastheymightmakeyoufeel bloated

bull Rest after meals but donrsquot lie flat use pillows tokeep your head and shoulders slightly raised if you lie down

bull Toavoidfeelingnauseouseatmealsbeforetakingyour medication unless your doctor or pharmacist advises otherwise

bull Try not to skipmeals as an empty stomach canworsen nausea

If you are vomiting frequently sip plenty of fluids such as ginger ale lemonade or glucose drinks (diluted with fifty per cent water) to avoid dehydration If nausea or vomiting persists seek specialist advice and ask your doctor about anti-nausea medication

NauseaDuring periods of nausea citrus juices such as orange or lemon juice can add to the discomfort because the acid in them upsets your stomach Ginger peppermint spearmint fennel seed and aniseed teas can reduce nausea bloating and abdominal cramps

To maintain your energy levels and ensure your body gets the nutrition it needs try the following tips

bull Small sipsoffluidareoften toleratedbetter thansolids

bull Eatsmallermealsmoreoften

bull Soupsandbrothsareofteneasiertoeat

bull Coldcarbonatedbeveragesareoftenwelltolerated

bull Trychilledjellyicypolesorweaktea

bull Suckonglucoseorbarleysugar

53

Foodsand medications

to avoid

52

Food type Why to avoid it

Raw or undercooked shellfish

A high risk of contamination from a variety of organisms that can cause gastroenteritis or hepatitis A

Raw eggs Risk of contamination from a variety of organisms

Fats and oils An excessive intake can increase your risk of developing diet-related cardiovascular disease and becoming overweight

Medications and supplements Some prescription and over-the-counter medications have been found to be toxic to your liver

Some medications have been found to cause harmful reactions and liver problems for people with hepatitis C Always check with your doctor before taking any medications or supplements

Food type Reason for avoiding it

Loss of appetiteTry to eat small healthy meals regularly even if you donrsquot feel hungry Your loss of appetite could be related to nausea or diarrhoea Eat four to six smaller meals each day instead of three large ones Your body will still need the nutrients necessary to function so monitor what you eat and try to eat foods high in kilojoules and protein if you have lost your appetite

If you notice that you are losing weight or your symptoms are preventing you from being able to eat properly seek the advice of a doctor or a dietitian

5554

Complementaryand alternative

therapies

Why some choose complementary and alternative therapiesComplementary and alternative therapies are growing in popularity up to 50 per cent of all Australians now use them Among the reasons people with hepatitis C choose complementary and alternative therapies are the following

bull toimprovequalityoflifebyrelievingsymptomsofchronic infection andor reducing the side-effects of conventional treatment

bull totakeanactiveroleindecisionsabouttheirhealthcare

bull becauseofculturalinfluences

bull because of concerns about the perceived orreported toxicity of conventional prescription medicines

People with hepatitis C who choose complementary and alternative therapies are often aware of the limitations of conventional treatments They accept the idea that being healthy means more than just lsquothe absence of diseasersquo

The effectiveness of complementary and alternative therapies for hepatitis CThere has been only limited research into the effectiveness of complementary and alternative therapies for hepatitis C Some people with hepatitis C report good results while using complementary or alternative therapies others notice few benefits Information on the effectiveness and toxicity of complementary and alternative therapies can be found

DefinitionsThe terms lsquocomplementaryrsquo and lsquoalternativersquo describe types (or modalities) of medicine that are not currently part of conventional medical practice and can be referred to as natural systems of medicine Conventional and natural systems of medicine each have their own distinct philosophy and use particular therapies to promote healing

lsquoComplementary therapyrsquo refers to a health practice used with a conventional or mainstream health care approach lsquoAlternative therapyrsquo refers to a health practice chosen instead of a conventional or mainstream health care approach Sometimes these terms are used interchangeably

5756

Itrsquos important to know that there are no complementary or alternative therapies that will cure your hepatitis C infection

Hepatitis organisations in each state and territory can support you and provide information about different therapies and access to practitioners See the lsquoContactsrsquo section

Choosing a therapyIt is important to choose a therapy that suits your needs physical mental emotional or spiritual Factors such as the location of the therapist the cost and comfort with the treatment process might influence your choice for example if you are scared of needles acupuncture might be something to avoid

Complementary and alternative therapies are based on philosophies that often entail adjustment to diet exercise and rest The therapies can vary in their emphasis on different aspects of health but there is generally a focus on strengthening your immune system reducing symptoms strengthening or protecting your liver and improving your lsquolife forcersquo or natural energy flow Such therapies might also involve taking medicines andor a program of physical support treatments

Before choosing a complementary or alternative therapy have a general check-up with your conventional doctor so you can be clear with the practitioner about your health Tell your doctor you are considering using a complementary or alternative therapy Some doctors will not be supportive of this if you feel uncomfortable with your doctorrsquos resistance to alternative and complementary therapies you might need to seek a practitioner you are happy with

Like pharmaceutical preparations complementary and alternative medicines can be potent and the prescriber

in the publications and on the websites listed in the lsquoFurther readingrsquo section of this booklet

It is important that you inform your liver specialist and GP of any complementary and alternative therapies you have recently used are using or plan to use They should also be made aware of any conventional treatments you are using

As a general rule every practitioner you see whether they practise conventional or alternative or complementary medicine needs to know about all the therapies you are using This will help them protect your health

What results can I expect from complementary and alternative therapiesBefore you start any complementary or alternative therapy think about the results you are looking for This will help you determine whether the therapy is working

bull Doyouwanttoreduceyourstress

bull Areyouseekingpainrelief

bull Are you keen to reduce the side-effects ofconventionaltreatment

bull Doyouneedmoreenergy

bull Doyouwanttoboostyourimmunesystem

bull Areyouseekingsupportfordepression

bull Do youwant to improve your generalwellbeingfor example by dealing with nausea poor appetite muscle aches headaches night sweats rashes and soon

This will help you choose your practitioner and find a therapy that suits you

5958

bull whattheyknowabouthepatitisC

bull what experience they haveworkingwith peoplewho have hepatitis C

bull aboutthetherapyanditsbenefitstoyouincluding

raquo the proposed number of treatment sessions and the length of treatment

raquo what will be required of you

raquo how the therapy might improve your health

bull whatifanyrisksareassociatedwiththetherapy

bull howthetherapyworksincombinationwithothertherapies or conventional treatments

bull whatareallthelikelycostsofthistherapy

bull iftheywillvisityouatyourhomeor inhospital ifnecessary

If possible check with other people who have received therapy from the practitioner before deciding to begin a course of treatment

Talk to your local hepatitis organisation about your approach to obtaining this information particularly if you feel uncomfortable about asking the practitioner these questions Finding out as much as possible about the practitioner and the therapy will help you feel comfortable with the decisions you make

Hepatitis organisations liver clinics and some gastroenterologists can refer people to reputable practitioners See the lsquoContactsrsquo section for services near you

needs to be fully aware of any other medications you are taking The Association of Natural Health advises that people take up natural therapies only when they have clear and accurate information about the medications they are taking

When thinking about any new treatments or changes to your existing therapy discuss the implications with both your conventional doctor and the complementary or alternative health practitioner In any event when using complementary or alternative therapies it is essential to continue to have your liver monitored by your doctor

Choosing a practitionerHealth practitioners become part of your support network and it is important that you have a positive relationship with them Your choice of practitioner might be influenced by many factors including location cost and comfort with the treatment your lifestyle your cultural background and advice you receive from family and friends

Some natural health practitioners are registered with professional bodies so choose someone who is properly qualified knows about hepatitis C and has experience working with people who have hepatitis C or other chronic liver disease In making this choice ask the therapist

bull whatqualificationsortrainingtheyhaveinrelationto particular therapies

bull whether they are a registered member of aprofessional association for that particular therapy

6160

Therapy Traditional Chinese Medicine (TCM)

Whatisit Traditional Chinese medicine involves the use of techniques designed to keep the energy or qi flowing smoothly through the bodyrsquos channels or meridians

Principle Good health is seen as a function of balance between the heart the liver the spleen the kidneys and the lungs When there is an energy imbalance between or within these organs disease can occur

Method Treatment usually consists of a combination of acupuncture herbs dietary changes massage and exercise

Benefits This form of medicine can be appealing to people who want to alleviate the side effects of pharmaceuticals such as interferon Traditional Chinese medicine treatments vary according to the patient but can be used for secondary conditions resulting from hepatitis C infection Practitioners of traditional Chinese medicine also take the emotional and psychological effects of hepatitis C into account in their treatment

Whatisit Acupuncture is an ancient system of healing developed as part of the traditional medicines of China Japan and other eastern countries

Principle The principle is to regulate the flow of qi which travels through the bodyrsquos meridians and connects acupuncture points to tissues and organs Hepatitis is characterised by stagnation in liver qi and an excess of damp heat reflecting the presence of the virus Acupuncture will be applied to stimulate energy and help clear blockages as well as to keep the liver cool and moist

Traditional Chinese Medicine (TCM)

Acupuncture

How much do these therapies costThe costs for therapies vary and you can often negotiate a fee with your practitioner Your local hepatitis organisation might be able to give you a guide to the costs involved in using local practitioners

Some health insurance companies provide rebates for services delivered by natural health practitioners registered with professional bodies but Medicare rebates are not available for most complementary and alternative therapies

Examples of complementary and alternative therapiesThe information that follows is a guide only There is little evidence to confirm the effectiveness of these therapies Anyone considering them should discuss their use with a qualified practitioner and their doctor excessive or wrongly prescribed therapies can damage the liver Further information on these and other therapies can be obtained from your local hepatitis organisation or the natural health practitioner concerned

6362

Whatisit Homeopathy is a system of medicine that treats illness with a very small amount of a drug that in a healthy person would produce symptoms of the illness being treated

Principle The therapy is based on the law of similars which put simply means lsquolike cures likersquo

Method A personrsquos case is recorded in detail so that the practitioner can analyse symptoms and known remedies in order to find a single remedy that best covers the personrsquos expressed symptoms and their mental emotional and physical state

Benefits Individual results vary but benefits can be gained in symptom control or improved health and wellbeing

Whatisit Naturopathy embraces a wide variety of therapiessuch as nutrition herbal medicine supplements and flower essences with the aim of treating the whole person and stimulating the bodyrsquos natural healing capacity

Principle The principles involved are do no harm prevention of disease rather than cure a belief in naturersquos inherent healing properties a holistic approach (treating the whole person) treating the cause (rather than the symptoms) of disease The emphasis is on restoring health rather than treating disease

Homoeopathy

Naturopathy

Method Fine needles are inserted into the skin at specific points on the body to stimulate qi unblock the meridians and restore organ function Some practitioners also use treatment modalities such as moxibustion cupping electro-stimulation massage and Chinese herbs

Benefits Individual responses vary Patients will generally feel relaxed after treatment and experience improvements in sleep digestion and energy levels

Whatisit Aromatherapy involves the use of essential oils for the purpose of influencing the mind body or spirit

Principle The principle is to awaken and strengthen the vital energies and self-healing capabilities thus having a direct effect on mind body and spirit

Method Essential oils can be massaged directly into the skin inhaled through vaporisers or added to bath water When liver function is poor care must be taken with the amount of oil used on the skin A light application in the first instance will help determine a personrsquos response

Benefits When absorbed through the skin essential oils can reach the organs to be treated through connective and lymphatic tissue and the circulatory system Some say essential oils have the capacity to affect the brain through the senses of touch and smell and consequently affect psychological and physiological processes

Aromatherapy

Acupuncture

6564

Whatisit Energy therapies are therapies that focus either on energy fields originating from within the body (biofields) or on those from other sources (electromagnetic fields) Among such therapies are reiki qigong and therapeutic touch

Principle Emphasising the health of internal organs rather than muscular strength these methods aim to open up the internal energy channels in order to achieve mental and emotional balance along with improved physical strength and vitality

Method Some forms of energy therapy use pressure or body manipulation by placing the hands in or through the biofields

Benefits For people with hepatitis C these therapies are designed to improve liver health and increase overall energy levels They also help with relaxation and this could benefit the immune system

Energy therapies

Method Treatment varies depending on the individual but may include use of herbs and other substances and dietary and lifestyle changes designed to slowly modify the internal environment and optimise health

Benefits Individual results vary Many people experience a greater sense of wellbeing after making some of the recommended dietary changes and taking the herbs and vitamins

Whatisit Systems of therapy based on manipulation andor movement of the body are used This includes chiropractic medicine osteopathy reflexology Swedish massage and Rolfing

Principle The belief is that all the bodyrsquos systems work together and disturbances in one system can affect function elsewhere in the body Practitioners focus on the relationship between body structure and function and how this affects the preservation and restoration of health

Method Procedures vary Manipulative therapy is integral to the work of chiropractors Osteopaths who place emphasis on the musculoskeletal system practise osteopathic manipulation Massage therapists manipulate the soft tissues of the body to assist with relaxation

Benefits Individual results vary Some practitioners believe the ability to relax is closely linked to the effectiveness of fighting infection

Manipulative and body based systems

Naturopathy

6766

What are they

Food supplements containing extracts of natural substances that can be taken orally to assist with body functions are often used

Principle The aim is to redress deficiencies in the diet and assist with specific nutritional needs ideally based on providing the recommended daily allowance of each substance

Method Use of vitamins and minerals is determined on an individual basis

Benefits Many vitamins and minerals often improve overall wellbeing

Whatisit Mind body interventions use a variety of techniques designed to improve the mindrsquos capacity to affect bodily functions and symptoms Among them are meditation yoga and tai chi

Principle The techniques are based on ancient disciplines that aim to promote balance between the body and the mind

Method Yoga techniques include deep breathing stretching and meditation Tai chi involves a series of slow rhythmic movements

Benefits These systems promote the benefits of relaxed mental and physical states calmness well-being and increased energy levels

Whatisit Herbalism is the oldest form of medicine it uses medicines made from plants (herbs) The biological complexity of humans is well suited to the use of treatments based on the biological complexity of plants

Principle The principle is that people have an innate ability to heal themselves and that the medicine used should support the bodyrsquos own self-healing mechanism The emphasis is on strengthening the bodyrsquos defensive system and restoring organ function rather than attacking disease

Method Herbal treatments vary A personrsquos symptoms overall health diet lifestyle and exercise will be assessed in order that a suitable herbal treatment can be prescribed Herbs can be taken as an infusion in capsules as a decoction (essence) or as a tincture (solution)

Benefits Herbal treatments can provide immediate symptomatic relief to people suffering from among other things headache cold and flu Long-term treatment strategies might alleviate the symptoms of hepatitis C infection

Vitamins and minerals

HerbalismMind-body interventions

6968

Licorice

The root of the licorice plant (Glycyrrhiza glabra) is commonly used to treat flu gastric ulcers liver disease and chronic fatigue syndrome In Chinese medicine it is often used as a remedy for jaundice and is considered a good liver detoxifier It may be taken dried powdered or decocted (boiled down) Side effects can include headache diarrhoea or dehydration Licorice can cause sodium retention so people with high blood pressure should avoid licorice root

Dandelion

Arabian physicians were writing about dandelion (Taraxacum officinale) in the 10th and 11th centuries Primarily cultivated in India the plant is said to promote the formation of bile and to act as a tonic and stimulant for the liver It may improve the function of both the liver and the kidneys Fresh dandelion juice is used (expressed from the root or leaf ) although many people also make a tea It is a good idea to discuss preparation and quantities with your naturopath

CH100

CH100 is the first herbal formulation developed in Australia that has been subjected to double-blind placebo-controlled trials for people with hepatitis C A combination of 19 different Chinese herbs demonstrated a drop in alanine aminotransferase levels at weeks 4 and 24 The ALT levels returned however to pre-treatment levels once treatment ceased The trials did not demonstrate any anti-viral action In a follow-up study of 100 people with chronic hepatitis C infection CH100 did not show the same

Herbs used for people with hepatitis CPeople with hepatitis C should take herbal medicines

only under the guidance of a qualified herbalist or

naturopath who is monitoring their progress If you are

currently taking conventional treatments talk to your

doctor about using herbs as they might cause side

effects

St Maryrsquos thistle

St Maryrsquos thistle (Silybum marianum) is the herb

most commonly used by people with hepatitis C

A favourite of naturopaths it has been used since

Roman times as a liver tonic The seeds contain silymarin

which has been found to have a therapeutic effect

for liver ailments such as cirrhosis chronic hepatitis

and fatty infiltration Studies have demonstrated that

silymarin protects the liver from the damaging effects

of alcohol and toxic chemicals and stimulates the

production of new liver cells Although the herb is used

in the treatment of hepatitis Australian research into

its specific effects for people with hepatitis C is thus

far limited

7170

Other herbs and herbal preparations

There are a variety of other herbs and herbal preparations available and their use is widespread for a range of conditions

Some herbs and combinations of herbs can be harmful to the liver and are therefore potentially dangerous for people with hepatitis C Again make sure you tell each of your treating practitioners that you have hepatitis C so they can prescribe medications herbs vitamins minerals and so on that are suitable for you

Herbs that must be avoided

The following herbs must be avoided by people with hepatitis C

bullchaparral(Larrea tridentata)

bullcomfrey(Symphytum officinale)

bullpennyroyal(Mentha pulgeum)

bullgermander(Teucrium chamaedrys)

bullJamaicanbushtea

bulljinbuhuan

bullKombuchatea

bullsassafras(Sassafras albidum)

bullsenna(Cassia angustifolia)

level of reduction in liver inflammation as the initial study although it did show significant alleviation of bodily pain depression and nausea (Mollison L et al J Gastroenterol and Hepatol 2006211184ndash8) The conclusion of the study was that CH100 was no better than placebo in the treatment of patients with chronic hepatitis C

Hep573

One hundred and eighteen people with hepatitis C were recruited into the Hep573 Study a randomised double-blind placebo-controlled clinical trial testing herbal medicines and vitamins in chronic hepatitis C in three hospitals in New South Wales There was a promising difference in ALT normalisation after six months of therapy in the silymarin plus anti-oxidant group compared with the placebo and the silymarin groups There was no change in viral load

St Johnrsquos wort

St Johnrsquos wort (Hypericum perforatum) is promoted as a treatment for bacterial and viral infections and is thought to reduce the production of mature virus in hepatitis C Clinical trials have also shown it is effective in the alleviating the symptoms of mild to moderate depression It is available as tablets a tincture or a tea Use of St Johnrsquos wort by people with hepatitis C should be discussed with a qualified herbalist since the herb is known to interact with some conventional treatments

73

Relievingstress

Reliable informationResearching in order to identify reliable information sources is the beginning of taking care of yourself The internet can be a useful tool for finding the latest information providing it comes from a credible source as are the hepatitis organisations in each state and territory See the lsquoContactsrsquo section

SupportThe support of family friends community and support groups can be valuable You can share resources experiences and tips on managing your illness

ExerciseExercise is an effective self-help antidote to fatigue and depression Start slowly and build up slowly Donrsquot overdo it

If getting out of bed becomes a chore remember that just feeling the fresh air on your face will lift your mood Start with five minutes of exercise and gradually build up to at least 20 minutes three times a week See the lsquoExercisersquo section for more details

T here are a number of ways to relieve stress anxiety and depression if you have hepatitis C whether or not you are

receiving treatment

bull Obtainreliableinformation

bull Getsupportfromyourfamilyfriendsandothers

bull Exercise

bull Usestressmanagementtechniques

bull Eatnutritiousfoods

bull Sleepforeighthoursanight

bull Balancerestandactivity

bull Decreaseyoursubstanceuse

bull Laughandplay

72

7574

Decreasing substance useSubstances such as alcohol drugs tobacco and excessive caffeine can all cause or aggravate depression or anxiety Alcohol is a depressant and can cause even greater liver damage in people with hepatitis C Tobacco and caffeine are stimulants and can produce an increase in anxiety levels

Ask your doctor or health care worker for help with ending your substance use

Laughing and recreationYou donrsquot need a doctorrsquos prescription for laughter and play Prescribe it for yourself

Find fun things to participate in as they will improve your mood and help you get rid of negative thoughts Laughter can release you from the burdens of hepatitis C

Stress managementToo much stress takes its toll Include some stress management techniques for example yoga meditation visualisation and exercise in your daily routine

Healthy eatingEating well will help with fatigue levels Try a low-fat high-fibre diet and include a variety of fruits vegetables and whole grains This might involve a bit of planning but it will be worth it Some suggestions are made in the lsquoHealthy eating guidelinesrsquo section

SleepingThe body needs seven to nine hours sleep a night Inadequate or poor quality sleep can lead to daytime tiredness Talk to your doctor if sleeplessness continues to contribute to your fatigue

Balancing rest and activityRest provides fuel for the body Schedule a daily rest period Consider resting as a preventive measure and try to plan things so you can rest before you become too tired Pace yourself take breaks plan ahead and delegate responsibilities

76

Exercise

77

Benefitsof counselling

CExercise will help keep your immune system and liver working well thus decreasing the risk and possible

development of fatty liver diabetes depression stress and anxiety

The right amount of exerciseStart gently and slowly build up to exercising daily for at least 30 minutes Do more if you can but donrsquot do so much that you begin to feel tired and run down Check with your doctor or health care worker if you are not sure what type of exercise you should do

Walking jogging riding a bike playing football doing yoga tai chi qigong pilates dancing gardening or any other pleasurable activity will help relieve stress and decrease your level of anxiety or depression

Exercise can help by distracting you from your daily worries lifting your mood helping you get a good nightrsquos sleep and giving you more social contact

The aim is to find a balance of activities that revitalise you during the day and promote sound sleep at night

ounselling can assist you to connect to your unique life story and make sense of the past It can also leave

you with increased energy feeling happier and more fulfilled and help you manage long-term once you have been tested positive for hepatitis C

Counselling can assist you

bull overcome your personal traumas dilemmas orissues that are troubling you

bull helpyoutocreatewaystothinkmoreclearly

bull makebetterdecisions

bull feelbetteraboutyourself

bull helpyouachieveyourdesiredoutcomes

bull managestressandmeetlifersquoschallenges

bull gainaclearerunderstandingofhowyourchoiceshave an impact on your life

78 79

Glossary

Acute hepatitis C Newly acquired hepatitis C virus infection The acute phase of infection can last from two to six months and will become a chronic hepatitis C infection if the body does not clear the virus

Additives Substances added to foods and beverages during production to improve taste and appearance extend storage life or improve nutritional value

Alcohol Ethanol or ethyl alcohol produced by yeast fermentation of sugars or starch

ALT or Alanine Aminotransferase ALT is a liver enzyme that can leak into the bloodstream when liver cells are inflamed or damaged

Beta-carotene A precursor form of vitamin A found in fruit and vegetables and functions as an antioxidant

Biofields Relating to the fields of energy in the body in the practice of energy therapies such as qigong

Caffeine Natural stimulant found in coffee tea and cocoa and added to some drinks Excessive amounts of caffeine can cause insomnia nervousness upset stomach frequent urination and irritability The effects are usually temporary and reversible

Counsellors

bull understand your motivations desires wants andactions

bull understandwhylsquopeopledothethingstheydorsquo

Counselling is

bull confidential

bull supportive

bull non-threatening

bull non-judgemental

8180

Connective tissue Tissue that supports and binds other body tissue and parts

Decoction The product of simmering herbs for a long time

Digestion The mixing and breaking down of food by juices and enzymes in the stomach pancreas liver and intestine which allows the nutrients to be absorbed into the bloodstream Carbohydrates are converted into glucose and fructose protein into amino acids and fat into glycerol and fatty acids

Double-blind placebo-controlled trial An experimental drug study in which both the person administering the substance and the recipient of the substance are unaware of whether it is the substance or a placebo (an inactive substance)

Fats Oily or waxy substances made up of fatty acids and glycerol Also called lipids

Fatty acids Can be saturated mono-unsaturated or polyunsaturated depending on the number and type of chemical bonds Most foods contain a mixture of all three types

Fibre dietary Parts of food that are not digested or are only partly digested by humans Fibre creates bulky faeces relieves constipation and helps reduce the incidence of bowel cancer and haemorrhoids Some fibre delays food absorption and lowers cholesterol

Fibrosis Scar formation in the liver resulting from the repair of damaged tissue

Folate A B-Group vitamin that is necessary for the growth and reproduction of all body cells

Free radicals Substances that damage cell membranes and DNA and impair the immune system The body produces free radicals when oxygen is used and

Calcium Essential mineral that builds and maintains bones and teeth regulates heart rhythm assists in blood clotting and helps maintain proper nerve and muscle function

Carbohydrates Starch sugars and some components of fibre Sugars are the simplest form of carbohydrate starches are complex carbohydrates that are broken down into sugars during digestion Carbohydrates are the most important fuel of the body and should make up 40ndash50 per cent of energy intake They are found in plant foods mdash grains vegetables fruit beans mdash and sugars and honey

Cholesterol Found almost exclusively in foods of animal origin and continuously produced by the liver and other parts of the body Cholesterol facilitates the absorption and transport of fatty acids and assists with the production of vitamin D at the surface of the skin and the production of hormones including sex hormones High cholesterol levels can suggest there is too much saturated fat in the diet which may be associated with a higher risk of developing cardiovascular disease

Chronic fatigue syndrome An ongoing condition in which the person lacks energy and feels weak or exhausted after performing simple tasks

Chronic hepatitis Any form of liver inflammation lasting more than six months and causing continuous damage to liver cells

Cirrhosis The stage of liver disease where severe scarring has replaced much of the liver tissue This severe scarring depending on how extensive it is can seriously affect the functioning of the liver

8382

Magnesium A mineral found in many enzymes Together with calcium sodium and potassium it controls muscle contraction and nerve functioning Magnesium occurs widely in foods nuts vegetables flour and bread are the main sources

Manipulation Use of the hands in therapeutic or diagnostic procedures or in various treatments in physical therapy and osteopathy

Meridians A term used in traditional Chinese medicine Refers to the energy channels in the human body

Metabolism The total of all chemical processes that result in growth generation of energy and elimination of wastes and assists the distribution of nutrients

Minerals Elements required in small amounts for regulation of the bodyrsquos metabolism and the formation of body structure Minerals especially calcium potassium phosphorus sodium iron magnesium sulphur chlorine and the trace minerals iodine fluorine zinc chromium copper and selenium are needed for health and growth

Modalities Forms of treatment

Moxibustion A term used in the practice of acupuncture Refers to the warming of an acupuncture point

Musculoskeletal system The muscles bones joints and related structures such as the tendons and connective tissue that function in the movement of parts of the body

Nutrients Essential food factors required for health and growth mdash for example protein carbohydrates fats vitamins minerals and water Apart from breast milk no single food contains all the nutrients needed to maintain life and ensure growth

in the environment they can form as a result of smog smoke and pollution

Glucose A simple sugar that is the building block of starch and a constituent of carbohydrate Starch is broken down into glucose and absorbed into the bloodstream to create blood glucose (blood sugar) a fuel for the brain and muscles

Glycerol An alcohol that is a component of fats It is soluble in ethyl alcohol and water

Hepatotoxic Potentially destructive of liver cells

Infusion The result of steeping or boiling a substance such as a herb in order to extract its medicinal properties

Iron Mineral needed to produce haemoglobin the substance that carries oxygen in blood Iron gives blood its red colouring and is needed to provide muscle protein Although it occurs in many foods only 10 per cent is absorbed by the body from lean meat and 1 to 5 per cent from vegetables and grains Women adolescents and athletes have higher iron requirements

Junk food Although difficult to define the term usually applies to processed foods that are high in kilojoules and provide limited or no nutrients

Lactose Milk sugar constituting 4 to 5 per cent of milk Only one-seventh as sweet as table sugar

Legumes A plant group that includes dried beans (soy lima borlotti navy and kidney) peas lentils and chick peas

Lipids See Fats

Lymphatic system Refers to a system of the body that consists of a vast network of tubes transporting fluid originating in many organs and tissues of the body

8584

Sugar Although lsquosugarrsquo is usually taken to mean table sugar or sucrose there are several sugars of nutritional importance such as fructose (fruit sugar) glucose lactose (milk sugar) and maltose Fructose ranks as the sweetest followed by sucrose glucose maltose and lactose A moderate sugar intake is best for a well-balanced diet

Tinctures A solution of a medicinal substance in alcohol

Toxicity The degree to which a substance is poisonous

Vapouriser A device for making condensed steam or mist

Vegetarian diet A diet containing plant foods plus dairy foods (lacto-vegetarian) eggs and dairy foods (ovo-lacto-vegetarian) or no animal meat or by-products (vegan) Vegetarian diets can also be beneficial because they are generally high in fibre

Vitamins Organic substances necessary for life Vitamins regulate our bodyrsquos metabolism through enzyme systems Found in minute quantities in most foods

Vitamin A Occurs as retinol and beta-carotene Essential for vision growth and healthy mucous membranes of the mouth and respiratory and urinary tracts Excess intakes of vitamin A are stored in the body and can be harmful

Vitamin B group (or complex) Eight vitamins that function similarly They occur together in cereal grains vegetables lean meats and milk and are soluble in water

Vitamin B1 Thiamin Acts to release energy from carbohydrates and maintain the nervous system

Placebo A substance designed to appear identical to the drug or treatment actually being tested but lacking the active chemical

Polyunsaturated fats Fats with two or more unsaturated or incomplete chemical bonds in their structure Two types occur omega-3 fats found in abundance in fish and seafood and omega-6 fats found in common oils (sunflower safflower maize cottonseed) and polyunsaturated margarines

Potassium An element needed for normal cell function Works with sodium to regulate the bodyrsquos waste balance and normalise heart rhythms

Preservatives A substance that has the ability to slow the spoilage of food Chemical preservatives include sorbic and propionic acids sulphur dioxide sodium metabisulphites nitrates and nitrites and sodium benzoate

Protein Essential nutrient required for growth maintenance and renewal of body tissue Protein is a constituent of all living cells and is continuously turned over Usually 10ndash15 per cent of the total kilojoules eaten come from protein found in eggs meat fish milk grains beans and nuts

Saturated fat A type of fat that can increase the risk of heart disease Saturated fats are found in large quantities in butter lard and dripping They are also found in meat vegetable fats and hydrogenated vegetable oils

Starch (complex carbohydrate) The storage carbohydrate of plant foods such as vegetables legumes grains nuts and fruit

Steatosis The build-up of fat in the liver

86

Furtherreading

WebsitesHepatitis Australia does not endorse these websites they are listed here because they could provide useful information

Guide to Low Risk Drinking httpwww health wa gov audocregReportsRiskAlcoholAustralian_alcohol_guide pdf

The Australian Dietary GuidelinesAustralian Guidelines for low risk drinking httpwww druginfo adf org aufact-sheetsaustralian-guidelines-for-low-risk-drinking-web-fact-sheet

Gastronetwww gastro net au

Healthy Active Websitewww healthyactive gov au

Vitamin B2 Riboflavin Required for healthy skin nails hair and eyes Forms part of several enzymes involved in energy metabolism

Vitamin B6 Pyridoxine A group of three related substances that is essential for protein and amino acid metabolism

Vitamin B12 Cyanocobalamin Found almost entirely in animal foods and likely to be present at borderline level in long-term strict vegetarians Required for the formation of red blood cells and for the body to be able to use protein fat and carbohydrate

Vitamin C Ascorbic acid Essential vitamin that plays a primary role in the formation of collagen a cementing material in bones teeth blood vessels and connective tissue It is required for wound healing and increases the bodyrsquos absorption of iron

Vitamin D Cholecalciferol Formed in the skin by ultraviolet light vitamin D enables calcium to be absorbed into bones

Zinc Essential mineral of many enzyme systems helping to metabolise carbohydrate and protein as well as speeding up the healing of cuts and sores and maintaining eyesight

87

89

The Australian Natural Therapists Associationwww anta com au

The Australian Complementary Health Associationwww diversity org au

The Association of Massage Therapists Australiawww aamt com au

Good Health Magazine wwwhealthninemsncomauarticleaspxid=370230

The National Institute of Complementary Medicinewww nicm edu au

88

Love Your Liver Websitewww loveyourliver com au

The Complementary Healthcare Council of Australiawww chc org au

Food Standards Australia New Zealandwww foodstandards gov au

Food labellingwww foodstandards gov aufoodmattersfoodlabelling

Practical food tips and informationwww foodwatch com au

Nutrition Australiawww nutritionaustralia org

Australian Acupuncture and Chinese Medicine Association www acupuncture org au

Australian Homoeopathic Associationwww homeopathyoz org

Australian Traditional Medicine Society www atms com au

The Australian Naturopathic Networkwww ann com au

The Association of Traditional Health Practitionerswww traditionalmedicine net au

The National Herbalists Association of Australiawww nhaa org au

9190

What Food is that and How Healthy is it Rogers Jo Adelaide Griffin Press

The Encyclopedia of Healing Foods ndash Murray M Pizzorno J Pizzoron L New York Atria Books 2005

Recipe booksCooking for Few ndash National Heart Foundation

Healthy Food for Families ndash Australian Nutrition Foundation

Recipes for Good Health ideas for controlling weight diabetes cholesterol and high blood pressure The Australian Dairy Corporation in association with Diabetes Australia

Nutrition for Life ndash Catherine Saxelby Reed Books

Health amp Energy Cookbook ndash Rosemary Stanton Murdoch Books

Food for Sport ndash Karen Inge and Peter Brukner William Heinemann

The Taste of Fitness ndash Helen OrsquoConnor and Donna Hay Australian Nutrition Foundation QLD

A Real Hep Cookbook ndash Ramona L Jones and Vona L Stanfield

Books and articlesDietary Management of Hepatic Encephalopathy ndash Seymour S amp Whelan K

Eating for Health an easy guide to shopping and cooking low-fat meals ndash Canberra National Heart Foundation

Eating for Peak Performance ndash Rosemary Stanton Allen amp Unwin

Effectiveness of Complementary and Self-help Treatments for Depression MJA 176 (10) 84-95 (supplement)

Food ndash Whatrsquos in It A-Z of food and nutrition ndash Catherine Saxelby Reed Books

Guide to Healthy Eating ndash National Heart Foundation

Healthy Vegetarian Eating ndash Rosemary Stanton

Hepatitis C Choices distinctive viewpoints on choices for your hepatitis C Journey Hepatitis C Caring Ambassadors Program 2002

Hepatitis C Handbook ndash Matthew Dolan

Complementary Therapies ndash Fact sheet Sydney Hepatitis C Council of New South Wales 2002

Hep C Review ndash Sydney Hepatitis C New South Wales

Choices complementary therapies and hepatitis C ndash Fact sheet Melbourne Hepatitis Victoria (Inc) 2000

Complementary and alternative medicine an educational attitudinal and research challenge ndash Lewith G MJA 172102ndash03

Complementary therapies have they become accepted in general practice Pirotta MV CohenMM Kotsirilos V Farish SJ MJA 172105ndash9

The Art of Sensible Dieting ndash Stanton Rosemary Ellysd Press

92 939393

Hepatitis AustraliaHepatitis Australia was incorporated in 1997 as the peak community organisation to promote national action on matters of importance to people affected by hepatitis C Our mission is to provide leadership and advocacy on viral hepatitis and support partnerships for action to ensure the needs of Australians affected by or at risk of viral hepatitis are met Our members are the eight state and territory hepatitis organisations

National Infoline 1300 437 222 (HEP ABC)E adminhepatitisaustralia comW www hepatitisaustralia com

Infoline 1300 HEP ABCFor more information on hepatitis C please contact the national infoline 1300 HEP ABC (1300 437 222) The national infoline diverts to information and support lines at your local state or territory hepatitis organisations

State and territory hepatitis organisationsHepatitis organisations developed in states and territories in the early to mid-1990s emerging from hepatitis C patient support groups The organisations generally define their core business as providing information and support services to people affected by hepatitis (primarily hepatitis C) and to support the reduction of hepatitis C transmission

Contacts

How to contact a dietitianbull Checkwithyourlocalhospitalorhealthserviceto

see if there is a dietetic service provided through the public system and if you can attend as an outpatient

bull Your local doctor will be able to refer you to adietitian

bull The Dietitians Association of Australia providesa list of accredited dietitians working in private practice in each state mdash see www daa asn au

bull Make sure that the dietitian you see is anaccredited practising dietitian

9594

Northern Territory AIDS and Hepatitis Council

T 08 8944 7777 E infontahc org auW www ntahc org au

Other national contactsAustralian Injecting and Illicit Drug Usersrsquo League

AIVL is the peak organisation representing state and territory peer-based drug user groups

T 02 6279 1600W www aivl org au

Haemophilia Foundation Australia

Haemophilia Foundation Australia is the peak organisation representing state and territory haemophilia foundations

T 03 9885 7800E hfausthaemophilia org au W www haemophilia org au

Hep C Australasia

W www hepcaustralasia org

Telephone Interpreter Service National

TIS National can provide telephone and on-site interpreters for non-English speakers

T 131 450

Australian Acupuncture and Chinese Medicine Association

T 07 3324 2599T 1300 725 334 (for national practitioner referral service)W www acupuncture org au

Hepatitis ACT

T 02 6230 6344 E infohepatitisact com auW www hepatitisact com au

Hepatitis NSW

T 02 9332 1853 E hnswhep org auW www hep org au

Hepatitis SA

T 08 8362 8443 (office)E adminhepatitissa asn auW www hepsa asn au

Hepatitis Victoria

T 03 9380 4644 E www hepvic org auW www hepvic org au

Hepatitis Queensland

T 07 3846 0020 E infohepqld asn auW www hepqld asn au

Hepatitis WA

T 08 9227 9800 E infohepatitiswa com auW www hepatitiswa com au

Tasmanian Council on AIDS Hepatitis and Related Diseases

T 03 6234 1242 E mailtascahrd org auW www tascahrd org au

9796

Notes

Hepatitis Australia ResourcesHepatitis Australia produces the following booklets that are available for download at www hepatitisaustralia com

bull WomenampHepatitisC

bull LivingwithCirrhosis

bull MyChoiceMyRightsdisclosure anti-discrimination and health complaints information for people with hepatitis C

bull HepatitisCtreatitbeatit

bull HepatitisCguidetohealthyliving

bull HepatitisBWhatyouneedtoknow in English Arabic Vietnamese Chinese httpwww hepatitisaustralia comcommunity-resources

Australian Homoeopathic Association

T 02 9719 2793W www homeopathyoz org

Australian Natural Therapists Association

T 1800 817 577W www anta com au

Australian Traditional Medicine Society

T 02 9809 6800W www atms com au

National Herbalists Association of Australia

T 02 8765 0071W www nhaa org au

Association of Massage Therapists Australia

T 1300 138 872W www aamt com au

Notes

Infoline 1300 437 222

ContentsIntroduction 2

Diet nutrition and hepatitis C 4

Functions of the liver 6

Healthy eating guidelines 9

Healthy food shopping and preparation 20

Convenience food versus junk food 33

Fats sugars salt caffeine and food additives 35

Alcohol and hepatitis C 43

Dietary supplements 47

Relieving gastrointestinal symptoms 50

Foods and medications to avoid 53

Complementary and alternative therapies 54

Relieving stress 72

Exercise 76

Benefits of counselling 77

Glossary 79

Further reading 87

Contacts 92

copy Hepatitis Australia 2014

Hepatitis C Guide to Healthy Living published by Hepatitis Australia and funded by the Commonwealth Department of Health

Acknowledgements

We thank those individuals who contributed to this booklet by sharing their stories about the experience of living with hepatitis C We are also grateful to individual members of Hepatitis Australiarsquos Health Reference Group Community Reference Group and National Resource Network for their contributions to the development of this booklet

Disclaimer

Hepatitis Australia takes care to ensure the information provided in this booklet is accurate however it is for general information only and not intended as medical advice Hepatitis Australia encourages all readers to seek independent medical advice before making any decisions based on the information provided in this booklet

Further information

For further information about hepatitis C please visit the Hepatitis Australia Website wwwhepatitisaustraliacom or call the National Infoline 1300 437 222

Feedback

If you would like to provide feedback about the information contained in this booklet please email adminhepatitisaustraliacom

Introduction

32








T

54







Diet









P

Functions

76

T

of the liver















A

98





bull fruit









1110
















1312



















1514







Protein intake














One potato


1716













1918
















21

Healthy

20




















22 23

M











22

2524


3 Blueberries




1 Almonds




2 Oats



2726



6 Tea




7 Yoghurt



4 Salmon




5 Soybeans


2928

9 Kidney beans




10 Spinach






8 Broccoli




3130

11 Pumpkin




12 Vegetable juice




32 33









junk food


34 35


Fats




fried dishes



bull kebabs








36





















37







3938



















4140























43


42









4544













47

Dietarysupplements

46













4948











Relieving

5150




















53


to avoid

52











5554


therapies










5756



















5958




















6160









Acupuncture




6362







Homoeopathy

Naturopathy







Aromatherapy

Acupuncture

6564





Energy therapies








Naturopathy

6766

What are they















6968

Licorice


Dandelion


CH100







effects














far limited

7170










bullJamaicanbushtea

bulljinbuhuan

bullKombuchatea




Hep573


St Johnrsquos wort


73

Relievingstress






receiving treatment



bull Exercise






bull Laughandplay

72

7574









76

Exercise

77


















78 79

Glossary








Counsellors



Counselling is

bull confidential

bull supportive



8180

















8382



















Lipids See Fats


8584


















86

Furtherreading












87

89






88













9190


























92 939393





Contacts






9594









Hep C Australasia




T 131 450



Hepatitis ACT


Hepatitis NSW


Hepatitis SA


Hepatitis Victoria




Hepatitis WA




9796

Notes


















Notes

Infoline 1300 437 222

Introduction

32








T

54







Diet









P

Functions

76

T

of the liver















A

98





bull fruit









1110
















1312



















1514







Protein intake














One potato


1716













1918
















21

Healthy

20




















22 23

M











22

2524


3 Blueberries




1 Almonds




2 Oats



2726



6 Tea




7 Yoghurt



4 Salmon




5 Soybeans


2928

9 Kidney beans




10 Spinach






8 Broccoli




3130

11 Pumpkin




12 Vegetable juice




32 33









junk food


34 35


Fats




fried dishes



bull kebabs








36





















37







3938



















4140























43


42









4544













47

Dietarysupplements

46













4948











Relieving

5150




















53


to avoid

52











5554


therapies










5756



















5958




















6160









Acupuncture




6362







Homoeopathy

Naturopathy







Aromatherapy

Acupuncture

6564





Energy therapies








Naturopathy

6766

What are they















6968

Licorice


Dandelion


CH100







effects














far limited

7170










bullJamaicanbushtea

bulljinbuhuan

bullKombuchatea




Hep573


St Johnrsquos wort


73

Relievingstress






receiving treatment



bull Exercise






bull Laughandplay

72

7574









76

Exercise

77


















78 79

Glossary








Counsellors



Counselling is

bull confidential

bull supportive



8180

















8382



















Lipids See Fats


8584


















86

Furtherreading












87

89






88













9190


























92 939393





Contacts






9594









Hep C Australasia




T 131 450



Hepatitis ACT


Hepatitis NSW


Hepatitis SA


Hepatitis Victoria




Hepatitis WA




9796

Notes


















Notes

Infoline 1300 437 222

54







Diet









P

Functions

76

T

of the liver















A

98





bull fruit









1110
















1312



















1514







Protein intake














One potato


1716













1918
















21

Healthy

20




















22 23

M











22

2524


3 Blueberries




1 Almonds




2 Oats



2726



6 Tea




7 Yoghurt



4 Salmon




5 Soybeans


2928

9 Kidney beans




10 Spinach






8 Broccoli




3130

11 Pumpkin




12 Vegetable juice




32 33









junk food


34 35


Fats




fried dishes



bull kebabs








36





















37







3938



















4140























43


42









4544













47

Dietarysupplements

46













4948











Relieving

5150




















53


to avoid

52











5554


therapies










5756



















5958




















6160









Acupuncture




6362







Homoeopathy

Naturopathy







Aromatherapy

Acupuncture

6564





Energy therapies








Naturopathy

6766

What are they















6968

Licorice


Dandelion


CH100







effects














far limited

7170










bullJamaicanbushtea

bulljinbuhuan

bullKombuchatea




Hep573


St Johnrsquos wort


73

Relievingstress






receiving treatment



bull Exercise






bull Laughandplay

72

7574









76

Exercise

77


















78 79

Glossary








Counsellors



Counselling is

bull confidential

bull supportive



8180

















8382



















Lipids See Fats


8584


















86

Furtherreading












87

89






88













9190


























92 939393





Contacts






9594









Hep C Australasia




T 131 450



Hepatitis ACT


Hepatitis NSW


Hepatitis SA


Hepatitis Victoria




Hepatitis WA




9796

Notes


















Notes

Infoline 1300 437 222

Functions

76

T

of the liver















A

98





bull fruit









1110
















1312



















1514







Protein intake














One potato


1716













1918
















21

Healthy

20




















22 23

M











22

2524


3 Blueberries




1 Almonds




2 Oats



2726



6 Tea




7 Yoghurt



4 Salmon




5 Soybeans


2928

9 Kidney beans




10 Spinach






8 Broccoli




3130

11 Pumpkin




12 Vegetable juice




32 33









junk food


34 35


Fats




fried dishes



bull kebabs








36





















37







3938



















4140























43


42









4544













47

Dietarysupplements

46













4948











Relieving

5150




















53


to avoid

52











5554


therapies










5756



















5958




















6160









Acupuncture




6362







Homoeopathy

Naturopathy







Aromatherapy

Acupuncture

6564





Energy therapies








Naturopathy

6766

What are they















6968

Licorice


Dandelion


CH100







effects














far limited

7170










bullJamaicanbushtea

bulljinbuhuan

bullKombuchatea




Hep573


St Johnrsquos wort


73

Relievingstress






receiving treatment



bull Exercise






bull Laughandplay

72

7574









76

Exercise

77


















78 79

Glossary








Counsellors



Counselling is

bull confidential

bull supportive



8180

















8382



















Lipids See Fats


8584


















86

Furtherreading












87

89






88













9190


























92 939393





Contacts






9594









Hep C Australasia




T 131 450



Hepatitis ACT


Hepatitis NSW


Hepatitis SA


Hepatitis Victoria




Hepatitis WA




9796

Notes


















Notes

Infoline 1300 437 222

98





bull fruit









1110
















1312



















1514







Protein intake














One potato


1716













1918
















21

Healthy

20




















22 23

M











22

2524


3 Blueberries




1 Almonds




2 Oats



2726



6 Tea




7 Yoghurt



4 Salmon




5 Soybeans


2928

9 Kidney beans




10 Spinach






8 Broccoli




3130

11 Pumpkin




12 Vegetable juice




32 33









junk food


34 35


Fats




fried dishes



bull kebabs








36





















37







3938



















4140























43


42









4544













47

Dietarysupplements

46













4948











Relieving

5150




















53


to avoid

52











5554


therapies










5756



















5958




















6160









Acupuncture




6362







Homoeopathy

Naturopathy







Aromatherapy

Acupuncture

6564





Energy therapies








Naturopathy

6766

What are they















6968

Licorice


Dandelion


CH100







effects














far limited

7170










bullJamaicanbushtea

bulljinbuhuan

bullKombuchatea




Hep573


St Johnrsquos wort


73

Relievingstress






receiving treatment



bull Exercise






bull Laughandplay

72

7574









76

Exercise

77


















78 79

Glossary








Counsellors



Counselling is

bull confidential

bull supportive



8180

















8382



















Lipids See Fats


8584


















86

Furtherreading












87

89






88













9190


























92 939393





Contacts






9594









Hep C Australasia




T 131 450



Hepatitis ACT


Hepatitis NSW


Hepatitis SA


Hepatitis Victoria




Hepatitis WA




9796

Notes


















Notes

Infoline 1300 437 222

1110
















1312



















1514







Protein intake














One potato


1716













1918
















21

Healthy

20




















22 23

M











22

2524


3 Blueberries




1 Almonds




2 Oats



2726



6 Tea




7 Yoghurt



4 Salmon




5 Soybeans


2928

9 Kidney beans




10 Spinach






8 Broccoli




3130

11 Pumpkin




12 Vegetable juice




32 33









junk food


34 35


Fats




fried dishes



bull kebabs








36





















37







3938



















4140























43


42









4544













47

Dietarysupplements

46













4948











Relieving

5150




















53


to avoid

52











5554


therapies










5756



















5958




















6160









Acupuncture




6362







Homoeopathy

Naturopathy







Aromatherapy

Acupuncture

6564





Energy therapies








Naturopathy

6766

What are they















6968

Licorice


Dandelion


CH100







effects














far limited

7170










bullJamaicanbushtea

bulljinbuhuan

bullKombuchatea




Hep573


St Johnrsquos wort


73

Relievingstress






receiving treatment



bull Exercise






bull Laughandplay

72

7574









76

Exercise

77


















78 79

Glossary








Counsellors



Counselling is

bull confidential

bull supportive



8180

















8382



















Lipids See Fats


8584


















86

Furtherreading












87

89






88













9190


























92 939393





Contacts






9594









Hep C Australasia




T 131 450



Hepatitis ACT


Hepatitis NSW


Hepatitis SA


Hepatitis Victoria




Hepatitis WA




9796

Notes


















Notes

Infoline 1300 437 222

1312



















1514







Protein intake














One potato


1716













1918
















21

Healthy

20




















22 23

M











22

2524


3 Blueberries




1 Almonds




2 Oats



2726



6 Tea




7 Yoghurt



4 Salmon




5 Soybeans


2928

9 Kidney beans




10 Spinach






8 Broccoli




3130

11 Pumpkin




12 Vegetable juice




32 33









junk food


34 35


Fats




fried dishes



bull kebabs








36





















37







3938



















4140























43


42









4544













47

Dietarysupplements

46













4948











Relieving

5150




















53


to avoid

52











5554


therapies










5756



















5958




















6160









Acupuncture




6362







Homoeopathy

Naturopathy







Aromatherapy

Acupuncture

6564





Energy therapies








Naturopathy

6766

What are they















6968

Licorice


Dandelion


CH100







effects














far limited

7170










bullJamaicanbushtea

bulljinbuhuan

bullKombuchatea




Hep573


St Johnrsquos wort


73

Relievingstress






receiving treatment



bull Exercise






bull Laughandplay

72

7574









76

Exercise

77


















78 79

Glossary








Counsellors



Counselling is

bull confidential

bull supportive



8180

















8382



















Lipids See Fats


8584


















86

Furtherreading












87

89






88













9190


























92 939393





Contacts






9594









Hep C Australasia




T 131 450



Hepatitis ACT


Hepatitis NSW


Hepatitis SA


Hepatitis Victoria




Hepatitis WA




9796

Notes


















Notes

Infoline 1300 437 222

1514







Protein intake














One potato


1716













1918
















21

Healthy

20




















22 23

M











22

2524


3 Blueberries




1 Almonds




2 Oats



2726



6 Tea




7 Yoghurt



4 Salmon




5 Soybeans


2928

9 Kidney beans




10 Spinach






8 Broccoli




3130

11 Pumpkin




12 Vegetable juice




32 33









junk food


34 35


Fats




fried dishes



bull kebabs








36





















37







3938



















4140























43


42









4544













47

Dietarysupplements

46













4948











Relieving

5150




















53


to avoid

52











5554


therapies










5756



















5958




















6160









Acupuncture




6362







Homoeopathy

Naturopathy







Aromatherapy

Acupuncture

6564





Energy therapies








Naturopathy

6766

What are they















6968

Licorice


Dandelion


CH100







effects














far limited

7170










bullJamaicanbushtea

bulljinbuhuan

bullKombuchatea




Hep573


St Johnrsquos wort


73

Relievingstress






receiving treatment



bull Exercise






bull Laughandplay

72

7574









76

Exercise

77


















78 79

Glossary








Counsellors



Counselling is

bull confidential

bull supportive



8180

















8382



















Lipids See Fats


8584


















86

Furtherreading












87

89






88













9190


























92 939393





Contacts






9594









Hep C Australasia




T 131 450



Hepatitis ACT


Hepatitis NSW


Hepatitis SA


Hepatitis Victoria




Hepatitis WA




9796

Notes


















Notes

Infoline 1300 437 222

1716













1918
















21

Healthy

20




















22 23

M











22

2524


3 Blueberries




1 Almonds




2 Oats



2726



6 Tea




7 Yoghurt



4 Salmon




5 Soybeans


2928

9 Kidney beans




10 Spinach






8 Broccoli




3130

11 Pumpkin




12 Vegetable juice




32 33









junk food


34 35


Fats




fried dishes



bull kebabs








36





















37







3938



















4140























43


42









4544













47

Dietarysupplements

46













4948











Relieving

5150




















53


to avoid

52











5554


therapies










5756



















5958




















6160









Acupuncture




6362







Homoeopathy

Naturopathy







Aromatherapy

Acupuncture

6564





Energy therapies








Naturopathy

6766

What are they















6968

Licorice


Dandelion


CH100







effects














far limited

7170










bullJamaicanbushtea

bulljinbuhuan

bullKombuchatea




Hep573


St Johnrsquos wort


73

Relievingstress






receiving treatment



bull Exercise






bull Laughandplay

72

7574









76

Exercise

77


















78 79

Glossary








Counsellors



Counselling is

bull confidential

bull supportive



8180

















8382



















Lipids See Fats


8584


















86

Furtherreading












87

89






88













9190


























92 939393





Contacts






9594









Hep C Australasia




T 131 450



Hepatitis ACT


Hepatitis NSW


Hepatitis SA


Hepatitis Victoria




Hepatitis WA




9796

Notes


















Notes

Infoline 1300 437 222

1918
















21

Healthy

20




















22 23

M











22

2524


3 Blueberries




1 Almonds




2 Oats



2726



6 Tea




7 Yoghurt



4 Salmon




5 Soybeans


2928

9 Kidney beans




10 Spinach






8 Broccoli




3130

11 Pumpkin




12 Vegetable juice




32 33









junk food


34 35


Fats




fried dishes



bull kebabs








36





















37







3938



















4140























43


42









4544













47

Dietarysupplements

46













4948











Relieving

5150




















53


to avoid

52











5554


therapies










5756



















5958




















6160









Acupuncture




6362







Homoeopathy

Naturopathy







Aromatherapy

Acupuncture

6564





Energy therapies








Naturopathy

6766

What are they















6968

Licorice


Dandelion


CH100







effects














far limited

7170










bullJamaicanbushtea

bulljinbuhuan

bullKombuchatea




Hep573


St Johnrsquos wort


73

Relievingstress






receiving treatment



bull Exercise






bull Laughandplay

72

7574









76

Exercise

77


















78 79

Glossary








Counsellors



Counselling is

bull confidential

bull supportive



8180

















8382



















Lipids See Fats


8584


















86

Furtherreading












87

89






88













9190


























92 939393





Contacts






9594









Hep C Australasia




T 131 450



Hepatitis ACT


Hepatitis NSW


Hepatitis SA


Hepatitis Victoria




Hepatitis WA




9796

Notes


















Notes

Infoline 1300 437 222

21

Healthy

20




















22 23

M











22

2524


3 Blueberries




1 Almonds




2 Oats



2726



6 Tea




7 Yoghurt



4 Salmon




5 Soybeans


2928

9 Kidney beans




10 Spinach






8 Broccoli




3130

11 Pumpkin




12 Vegetable juice




32 33









junk food


34 35


Fats




fried dishes



bull kebabs








36





















37







3938



















4140























43


42









4544













47

Dietarysupplements

46













4948











Relieving

5150




















53


to avoid

52











5554


therapies










5756



















5958




















6160









Acupuncture




6362







Homoeopathy

Naturopathy







Aromatherapy

Acupuncture

6564





Energy therapies








Naturopathy

6766

What are they















6968

Licorice


Dandelion


CH100







effects














far limited

7170










bullJamaicanbushtea

bulljinbuhuan

bullKombuchatea




Hep573


St Johnrsquos wort


73

Relievingstress






receiving treatment



bull Exercise






bull Laughandplay

72

7574









76

Exercise

77


















78 79

Glossary








Counsellors



Counselling is

bull confidential

bull supportive



8180

















8382



















Lipids See Fats


8584


















86

Furtherreading












87

89






88













9190


























92 939393





Contacts






9594









Hep C Australasia




T 131 450



Hepatitis ACT


Hepatitis NSW


Hepatitis SA


Hepatitis Victoria




Hepatitis WA




9796

Notes


















Notes

Infoline 1300 437 222

22 23

M











22

2524


3 Blueberries




1 Almonds




2 Oats



2726



6 Tea




7 Yoghurt



4 Salmon




5 Soybeans


2928

9 Kidney beans




10 Spinach






8 Broccoli




3130

11 Pumpkin




12 Vegetable juice




32 33









junk food


34 35


Fats




fried dishes



bull kebabs








36





















37







3938



















4140























43


42









4544













47

Dietarysupplements

46













4948











Relieving

5150




















53


to avoid

52











5554


therapies










5756



















5958




















6160









Acupuncture




6362







Homoeopathy

Naturopathy







Aromatherapy

Acupuncture

6564





Energy therapies








Naturopathy

6766

What are they















6968

Licorice


Dandelion


CH100







effects














far limited

7170










bullJamaicanbushtea

bulljinbuhuan

bullKombuchatea




Hep573


St Johnrsquos wort


73

Relievingstress






receiving treatment



bull Exercise






bull Laughandplay

72

7574









76

Exercise

77


















78 79

Glossary








Counsellors



Counselling is

bull confidential

bull supportive



8180

















8382



















Lipids See Fats


8584


















86

Furtherreading












87

89






88













9190


























92 939393





Contacts






9594









Hep C Australasia




T 131 450



Hepatitis ACT


Hepatitis NSW


Hepatitis SA


Hepatitis Victoria




Hepatitis WA




9796

Notes


















Notes

Infoline 1300 437 222

2524


3 Blueberries




1 Almonds




2 Oats



2726



6 Tea




7 Yoghurt



4 Salmon




5 Soybeans


2928

9 Kidney beans




10 Spinach






8 Broccoli




3130

11 Pumpkin




12 Vegetable juice




32 33









junk food


34 35


Fats




fried dishes



bull kebabs








36





















37







3938



















4140























43


42









4544













47

Dietarysupplements

46













4948











Relieving

5150




















53


to avoid

52











5554


therapies










5756



















5958




















6160









Acupuncture




6362







Homoeopathy

Naturopathy







Aromatherapy

Acupuncture

6564





Energy therapies








Naturopathy

6766

What are they















6968

Licorice


Dandelion


CH100







effects














far limited

7170










bullJamaicanbushtea

bulljinbuhuan

bullKombuchatea




Hep573


St Johnrsquos wort


73

Relievingstress






receiving treatment



bull Exercise






bull Laughandplay

72

7574









76

Exercise

77


















78 79

Glossary








Counsellors



Counselling is

bull confidential

bull supportive



8180

















8382



















Lipids See Fats


8584


















86

Furtherreading












87

89






88













9190


























92 939393





Contacts






9594









Hep C Australasia




T 131 450



Hepatitis ACT


Hepatitis NSW


Hepatitis SA


Hepatitis Victoria




Hepatitis WA




9796

Notes


















Notes

Infoline 1300 437 222

2726



6 Tea




7 Yoghurt



4 Salmon




5 Soybeans


2928

9 Kidney beans




10 Spinach






8 Broccoli




3130

11 Pumpkin




12 Vegetable juice




32 33









junk food


34 35


Fats




fried dishes



bull kebabs








36





















37







3938



















4140























43


42









4544













47

Dietarysupplements

46













4948











Relieving

5150




















53


to avoid

52











5554


therapies










5756



















5958




















6160









Acupuncture




6362







Homoeopathy

Naturopathy







Aromatherapy

Acupuncture

6564





Energy therapies








Naturopathy

6766

What are they















6968

Licorice


Dandelion


CH100







effects














far limited

7170










bullJamaicanbushtea

bulljinbuhuan

bullKombuchatea




Hep573


St Johnrsquos wort


73

Relievingstress






receiving treatment



bull Exercise






bull Laughandplay

72

7574









76

Exercise

77


















78 79

Glossary








Counsellors



Counselling is

bull confidential

bull supportive



8180

















8382



















Lipids See Fats


8584


















86

Furtherreading












87

89






88













9190


























92 939393





Contacts






9594









Hep C Australasia




T 131 450



Hepatitis ACT


Hepatitis NSW


Hepatitis SA


Hepatitis Victoria




Hepatitis WA




9796

Notes


















Notes

Infoline 1300 437 222

2928

9 Kidney beans




10 Spinach






8 Broccoli




3130

11 Pumpkin




12 Vegetable juice




32 33









junk food


34 35


Fats




fried dishes



bull kebabs








36





















37







3938



















4140























43


42









4544













47

Dietarysupplements

46













4948











Relieving

5150




















53


to avoid

52











5554


therapies










5756



















5958




















6160









Acupuncture




6362







Homoeopathy

Naturopathy







Aromatherapy

Acupuncture

6564





Energy therapies








Naturopathy

6766

What are they















6968

Licorice


Dandelion


CH100







effects














far limited

7170










bullJamaicanbushtea

bulljinbuhuan

bullKombuchatea




Hep573


St Johnrsquos wort


73

Relievingstress






receiving treatment



bull Exercise






bull Laughandplay

72

7574









76

Exercise

77


















78 79

Glossary








Counsellors



Counselling is

bull confidential

bull supportive



8180

















8382



















Lipids See Fats


8584


















86

Furtherreading












87

89






88













9190


























92 939393





Contacts






9594









Hep C Australasia




T 131 450



Hepatitis ACT


Hepatitis NSW


Hepatitis SA


Hepatitis Victoria




Hepatitis WA




9796

Notes


















Notes

Infoline 1300 437 222

3130

11 Pumpkin




12 Vegetable juice




32 33









junk food


34 35


Fats




fried dishes



bull kebabs








36





















37







3938



















4140























43


42









4544













47

Dietarysupplements

46













4948











Relieving

5150




















53


to avoid

52











5554


therapies










5756



















5958




















6160









Acupuncture




6362







Homoeopathy

Naturopathy







Aromatherapy

Acupuncture

6564





Energy therapies








Naturopathy

6766

What are they















6968

Licorice


Dandelion


CH100







effects














far limited

7170










bullJamaicanbushtea

bulljinbuhuan

bullKombuchatea




Hep573


St Johnrsquos wort


73

Relievingstress






receiving treatment



bull Exercise






bull Laughandplay

72

7574









76

Exercise

77


















78 79

Glossary








Counsellors



Counselling is

bull confidential

bull supportive



8180

















8382



















Lipids See Fats


8584


















86

Furtherreading












87

89






88













9190


























92 939393





Contacts






9594









Hep C Australasia




T 131 450



Hepatitis ACT


Hepatitis NSW


Hepatitis SA


Hepatitis Victoria




Hepatitis WA




9796

Notes


















Notes

Infoline 1300 437 222

32 33









junk food


34 35


Fats




fried dishes



bull kebabs








36





















37







3938



















4140























43


42









4544













47

Dietarysupplements

46













4948











Relieving

5150




















53


to avoid

52











5554


therapies










5756



















5958




















6160









Acupuncture




6362







Homoeopathy

Naturopathy







Aromatherapy

Acupuncture

6564





Energy therapies








Naturopathy

6766

What are they















6968

Licorice


Dandelion


CH100







effects














far limited

7170










bullJamaicanbushtea

bulljinbuhuan

bullKombuchatea




Hep573


St Johnrsquos wort


73

Relievingstress






receiving treatment



bull Exercise






bull Laughandplay

72

7574









76

Exercise

77


















78 79

Glossary








Counsellors



Counselling is

bull confidential

bull supportive



8180

















8382



















Lipids See Fats


8584


















86

Furtherreading












87

89






88













9190


























92 939393





Contacts






9594









Hep C Australasia




T 131 450



Hepatitis ACT


Hepatitis NSW


Hepatitis SA


Hepatitis Victoria




Hepatitis WA




9796

Notes


















Notes

Infoline 1300 437 222

34 35


Fats




fried dishes



bull kebabs








36





















37







3938



















4140























43


42









4544













47

Dietarysupplements

46













4948











Relieving

5150




















53


to avoid

52











5554


therapies










5756



















5958




















6160









Acupuncture




6362







Homoeopathy

Naturopathy







Aromatherapy

Acupuncture

6564





Energy therapies








Naturopathy

6766

What are they















6968

Licorice


Dandelion


CH100







effects














far limited

7170










bullJamaicanbushtea

bulljinbuhuan

bullKombuchatea




Hep573


St Johnrsquos wort


73

Relievingstress






receiving treatment



bull Exercise






bull Laughandplay

72

7574









76

Exercise

77


















78 79

Glossary








Counsellors



Counselling is

bull confidential

bull supportive



8180

















8382



















Lipids See Fats


8584


















86

Furtherreading












87

89






88













9190


























92 939393





Contacts






9594









Hep C Australasia




T 131 450



Hepatitis ACT


Hepatitis NSW


Hepatitis SA


Hepatitis Victoria




Hepatitis WA




9796

Notes


















Notes

Infoline 1300 437 222

36





















37







3938



















4140























43


42









4544













47

Dietarysupplements

46













4948











Relieving

5150




















53


to avoid

52











5554


therapies










5756



















5958




















6160









Acupuncture




6362







Homoeopathy

Naturopathy







Aromatherapy

Acupuncture

6564





Energy therapies








Naturopathy

6766

What are they















6968

Licorice


Dandelion


CH100







effects














far limited

7170










bullJamaicanbushtea

bulljinbuhuan

bullKombuchatea




Hep573


St Johnrsquos wort


73

Relievingstress






receiving treatment



bull Exercise






bull Laughandplay

72

7574









76

Exercise

77


















78 79

Glossary








Counsellors



Counselling is

bull confidential

bull supportive



8180

















8382



















Lipids See Fats


8584


















86

Furtherreading












87

89






88













9190


























92 939393





Contacts






9594









Hep C Australasia




T 131 450



Hepatitis ACT


Hepatitis NSW


Hepatitis SA


Hepatitis Victoria




Hepatitis WA




9796

Notes


















Notes

Infoline 1300 437 222

3938



















4140























43


42









4544













47

Dietarysupplements

46













4948











Relieving

5150




















53


to avoid

52











5554


therapies










5756



















5958




















6160









Acupuncture




6362







Homoeopathy

Naturopathy







Aromatherapy

Acupuncture

6564





Energy therapies








Naturopathy

6766

What are they















6968

Licorice


Dandelion


CH100







effects














far limited

7170










bullJamaicanbushtea

bulljinbuhuan

bullKombuchatea




Hep573


St Johnrsquos wort


73

Relievingstress






receiving treatment



bull Exercise






bull Laughandplay

72

7574









76

Exercise

77


















78 79

Glossary








Counsellors



Counselling is

bull confidential

bull supportive



8180

















8382



















Lipids See Fats


8584


















86

Furtherreading












87

89






88













9190


























92 939393





Contacts






9594









Hep C Australasia




T 131 450



Hepatitis ACT


Hepatitis NSW


Hepatitis SA


Hepatitis Victoria




Hepatitis WA




9796

Notes


















Notes

Infoline 1300 437 222

4140























43


42









4544













47

Dietarysupplements

46













4948











Relieving

5150




















53


to avoid

52











5554


therapies










5756



















5958




















6160









Acupuncture




6362







Homoeopathy

Naturopathy







Aromatherapy

Acupuncture

6564





Energy therapies








Naturopathy

6766

What are they















6968

Licorice


Dandelion


CH100







effects














far limited

7170










bullJamaicanbushtea

bulljinbuhuan

bullKombuchatea




Hep573


St Johnrsquos wort


73

Relievingstress






receiving treatment



bull Exercise






bull Laughandplay

72

7574









76

Exercise

77


















78 79

Glossary








Counsellors



Counselling is

bull confidential

bull supportive



8180

















8382



















Lipids See Fats


8584


















86

Furtherreading












87

89






88













9190


























92 939393





Contacts






9594









Hep C Australasia




T 131 450



Hepatitis ACT


Hepatitis NSW


Hepatitis SA


Hepatitis Victoria




Hepatitis WA




9796

Notes


















Notes

Infoline 1300 437 222

43


42









4544













47

Dietarysupplements

46













4948











Relieving

5150




















53


to avoid

52











5554


therapies










5756



















5958




















6160









Acupuncture




6362







Homoeopathy

Naturopathy







Aromatherapy

Acupuncture

6564





Energy therapies








Naturopathy

6766

What are they















6968

Licorice


Dandelion


CH100







effects














far limited

7170










bullJamaicanbushtea

bulljinbuhuan

bullKombuchatea




Hep573


St Johnrsquos wort


73

Relievingstress






receiving treatment



bull Exercise






bull Laughandplay

72

7574









76

Exercise

77


















78 79

Glossary








Counsellors



Counselling is

bull confidential

bull supportive



8180

















8382



















Lipids See Fats


8584


















86

Furtherreading












87

89






88













9190


























92 939393





Contacts






9594









Hep C Australasia




T 131 450



Hepatitis ACT


Hepatitis NSW


Hepatitis SA


Hepatitis Victoria




Hepatitis WA




9796

Notes


















Notes

Infoline 1300 437 222

4544













47

Dietarysupplements

46













4948











Relieving

5150




















53


to avoid

52











5554


therapies










5756



















5958




















6160









Acupuncture




6362







Homoeopathy

Naturopathy







Aromatherapy

Acupuncture

6564





Energy therapies








Naturopathy

6766

What are they















6968

Licorice


Dandelion


CH100







effects














far limited

7170










bullJamaicanbushtea

bulljinbuhuan

bullKombuchatea




Hep573


St Johnrsquos wort


73

Relievingstress






receiving treatment



bull Exercise






bull Laughandplay

72

7574









76

Exercise

77


















78 79

Glossary








Counsellors



Counselling is

bull confidential

bull supportive



8180

















8382



















Lipids See Fats


8584


















86

Furtherreading












87

89






88













9190


























92 939393





Contacts






9594









Hep C Australasia




T 131 450



Hepatitis ACT


Hepatitis NSW


Hepatitis SA


Hepatitis Victoria




Hepatitis WA




9796

Notes


















Notes

Infoline 1300 437 222

47

Dietarysupplements

46













4948











Relieving

5150




















53


to avoid

52











5554


therapies










5756



















5958




















6160









Acupuncture




6362







Homoeopathy

Naturopathy







Aromatherapy

Acupuncture

6564





Energy therapies








Naturopathy

6766

What are they















6968

Licorice


Dandelion


CH100







effects














far limited

7170










bullJamaicanbushtea

bulljinbuhuan

bullKombuchatea




Hep573


St Johnrsquos wort


73

Relievingstress






receiving treatment



bull Exercise






bull Laughandplay

72

7574









76

Exercise

77


















78 79

Glossary








Counsellors



Counselling is

bull confidential

bull supportive



8180

















8382



















Lipids See Fats


8584


















86

Furtherreading












87

89






88













9190


























92 939393





Contacts






9594









Hep C Australasia




T 131 450



Hepatitis ACT


Hepatitis NSW


Hepatitis SA


Hepatitis Victoria




Hepatitis WA




9796

Notes


















Notes

Infoline 1300 437 222

4948











Relieving

5150




















53


to avoid

52











5554


therapies










5756



















5958




















6160









Acupuncture




6362







Homoeopathy

Naturopathy







Aromatherapy

Acupuncture

6564





Energy therapies








Naturopathy

6766

What are they















6968

Licorice


Dandelion


CH100







effects














far limited

7170










bullJamaicanbushtea

bulljinbuhuan

bullKombuchatea




Hep573


St Johnrsquos wort


73

Relievingstress






receiving treatment



bull Exercise






bull Laughandplay

72

7574









76

Exercise

77


















78 79

Glossary








Counsellors



Counselling is

bull confidential

bull supportive



8180

















8382



















Lipids See Fats


8584


















86

Furtherreading












87

89






88













9190


























92 939393





Contacts






9594









Hep C Australasia




T 131 450



Hepatitis ACT


Hepatitis NSW


Hepatitis SA


Hepatitis Victoria




Hepatitis WA




9796

Notes


















Notes

Infoline 1300 437 222

Relieving

5150




















53


to avoid

52











5554


therapies










5756



















5958




















6160









Acupuncture




6362







Homoeopathy

Naturopathy







Aromatherapy

Acupuncture

6564





Energy therapies








Naturopathy

6766

What are they















6968

Licorice


Dandelion


CH100







effects














far limited

7170










bullJamaicanbushtea

bulljinbuhuan

bullKombuchatea




Hep573


St Johnrsquos wort


73

Relievingstress






receiving treatment



bull Exercise






bull Laughandplay

72

7574









76

Exercise

77


















78 79

Glossary








Counsellors



Counselling is

bull confidential

bull supportive



8180

















8382



















Lipids See Fats


8584


















86

Furtherreading












87

89






88













9190


























92 939393





Contacts






9594









Hep C Australasia




T 131 450



Hepatitis ACT


Hepatitis NSW


Hepatitis SA


Hepatitis Victoria




Hepatitis WA




9796

Notes


















Notes

Infoline 1300 437 222

53


to avoid

52











5554


therapies










5756



















5958




















6160









Acupuncture




6362







Homoeopathy

Naturopathy







Aromatherapy

Acupuncture

6564





Energy therapies








Naturopathy

6766

What are they















6968

Licorice


Dandelion


CH100







effects














far limited

7170










bullJamaicanbushtea

bulljinbuhuan

bullKombuchatea




Hep573


St Johnrsquos wort


73

Relievingstress






receiving treatment



bull Exercise






bull Laughandplay

72

7574









76

Exercise

77


















78 79

Glossary








Counsellors



Counselling is

bull confidential

bull supportive



8180

















8382



















Lipids See Fats


8584


















86

Furtherreading












87

89






88













9190


























92 939393





Contacts






9594









Hep C Australasia




T 131 450



Hepatitis ACT


Hepatitis NSW


Hepatitis SA


Hepatitis Victoria




Hepatitis WA




9796

Notes


















Notes

Infoline 1300 437 222

5554


therapies










5756



















5958




















6160









Acupuncture




6362







Homoeopathy

Naturopathy







Aromatherapy

Acupuncture

6564





Energy therapies








Naturopathy

6766

What are they















6968

Licorice


Dandelion


CH100







effects














far limited

7170










bullJamaicanbushtea

bulljinbuhuan

bullKombuchatea




Hep573


St Johnrsquos wort


73

Relievingstress






receiving treatment



bull Exercise






bull Laughandplay

72

7574









76

Exercise

77


















78 79

Glossary








Counsellors



Counselling is

bull confidential

bull supportive



8180

















8382



















Lipids See Fats


8584


















86

Furtherreading












87

89






88













9190


























92 939393





Contacts






9594









Hep C Australasia




T 131 450



Hepatitis ACT


Hepatitis NSW


Hepatitis SA


Hepatitis Victoria




Hepatitis WA




9796

Notes


















Notes

Infoline 1300 437 222

5756



















5958




















6160









Acupuncture




6362







Homoeopathy

Naturopathy







Aromatherapy

Acupuncture

6564





Energy therapies








Naturopathy

6766

What are they















6968

Licorice


Dandelion


CH100







effects














far limited

7170










bullJamaicanbushtea

bulljinbuhuan

bullKombuchatea




Hep573


St Johnrsquos wort


73

Relievingstress






receiving treatment



bull Exercise






bull Laughandplay

72

7574









76

Exercise

77


















78 79

Glossary








Counsellors



Counselling is

bull confidential

bull supportive



8180

















8382



















Lipids See Fats


8584


















86

Furtherreading












87

89






88













9190


























92 939393





Contacts






9594









Hep C Australasia




T 131 450



Hepatitis ACT


Hepatitis NSW


Hepatitis SA


Hepatitis Victoria




Hepatitis WA




9796

Notes


















Notes

Infoline 1300 437 222

5958




















6160









Acupuncture




6362







Homoeopathy

Naturopathy







Aromatherapy

Acupuncture

6564





Energy therapies








Naturopathy

6766

What are they















6968

Licorice


Dandelion


CH100







effects














far limited

7170










bullJamaicanbushtea

bulljinbuhuan

bullKombuchatea




Hep573


St Johnrsquos wort


73

Relievingstress






receiving treatment



bull Exercise






bull Laughandplay

72

7574









76

Exercise

77


















78 79

Glossary








Counsellors



Counselling is

bull confidential

bull supportive



8180

















8382



















Lipids See Fats


8584


















86

Furtherreading












87

89






88













9190


























92 939393





Contacts






9594









Hep C Australasia




T 131 450



Hepatitis ACT


Hepatitis NSW


Hepatitis SA


Hepatitis Victoria




Hepatitis WA




9796

Notes


















Notes

Infoline 1300 437 222

6160









Acupuncture




6362







Homoeopathy

Naturopathy







Aromatherapy

Acupuncture

6564





Energy therapies








Naturopathy

6766

What are they















6968

Licorice


Dandelion


CH100







effects














far limited

7170










bullJamaicanbushtea

bulljinbuhuan

bullKombuchatea




Hep573


St Johnrsquos wort


73

Relievingstress






receiving treatment



bull Exercise






bull Laughandplay

72

7574









76

Exercise

77


















78 79

Glossary








Counsellors



Counselling is

bull confidential

bull supportive



8180

















8382



















Lipids See Fats


8584


















86

Furtherreading












87

89






88













9190


























92 939393





Contacts






9594









Hep C Australasia




T 131 450



Hepatitis ACT


Hepatitis NSW


Hepatitis SA


Hepatitis Victoria




Hepatitis WA




9796

Notes


















Notes

Infoline 1300 437 222

6362







Homoeopathy

Naturopathy







Aromatherapy

Acupuncture

6564





Energy therapies








Naturopathy

6766

What are they















6968

Licorice


Dandelion


CH100







effects














far limited

7170










bullJamaicanbushtea

bulljinbuhuan

bullKombuchatea




Hep573


St Johnrsquos wort


73

Relievingstress






receiving treatment



bull Exercise






bull Laughandplay

72

7574









76

Exercise

77


















78 79

Glossary








Counsellors



Counselling is

bull confidential

bull supportive



8180

















8382



















Lipids See Fats


8584


















86

Furtherreading












87

89






88













9190


























92 939393





Contacts






9594









Hep C Australasia




T 131 450



Hepatitis ACT


Hepatitis NSW


Hepatitis SA


Hepatitis Victoria




Hepatitis WA




9796

Notes


















Notes

Infoline 1300 437 222

6564





Energy therapies








Naturopathy

6766

What are they















6968

Licorice


Dandelion


CH100







effects














far limited

7170










bullJamaicanbushtea

bulljinbuhuan

bullKombuchatea




Hep573


St Johnrsquos wort


73

Relievingstress






receiving treatment



bull Exercise






bull Laughandplay

72

7574









76

Exercise

77


















78 79

Glossary








Counsellors



Counselling is

bull confidential

bull supportive



8180

















8382



















Lipids See Fats


8584


















86

Furtherreading












87

89






88













9190


























92 939393





Contacts






9594









Hep C Australasia




T 131 450



Hepatitis ACT


Hepatitis NSW


Hepatitis SA


Hepatitis Victoria




Hepatitis WA




9796

Notes


















Notes

Infoline 1300 437 222

6766

What are they















6968

Licorice


Dandelion


CH100







effects














far limited

7170










bullJamaicanbushtea

bulljinbuhuan

bullKombuchatea




Hep573


St Johnrsquos wort


73

Relievingstress






receiving treatment



bull Exercise






bull Laughandplay

72

7574









76

Exercise

77


















78 79

Glossary








Counsellors



Counselling is

bull confidential

bull supportive



8180

















8382



















Lipids See Fats


8584


















86

Furtherreading












87

89






88













9190


























92 939393





Contacts






9594









Hep C Australasia




T 131 450



Hepatitis ACT


Hepatitis NSW


Hepatitis SA


Hepatitis Victoria




Hepatitis WA




9796

Notes


















Notes

Infoline 1300 437 222

6968

Licorice


Dandelion


CH100







effects














far limited

7170










bullJamaicanbushtea

bulljinbuhuan

bullKombuchatea




Hep573


St Johnrsquos wort


73

Relievingstress






receiving treatment



bull Exercise






bull Laughandplay

72

7574









76

Exercise

77


















78 79

Glossary








Counsellors



Counselling is

bull confidential

bull supportive



8180

















8382



















Lipids See Fats


8584


















86

Furtherreading












87

89






88













9190


























92 939393





Contacts






9594









Hep C Australasia




T 131 450



Hepatitis ACT


Hepatitis NSW


Hepatitis SA


Hepatitis Victoria




Hepatitis WA




9796

Notes


















Notes

Infoline 1300 437 222

7170










bullJamaicanbushtea

bulljinbuhuan

bullKombuchatea




Hep573


St Johnrsquos wort


73

Relievingstress






receiving treatment



bull Exercise






bull Laughandplay

72

7574









76

Exercise

77


















78 79

Glossary








Counsellors



Counselling is

bull confidential

bull supportive



8180

















8382



















Lipids See Fats


8584


















86

Furtherreading












87

89






88













9190


























92 939393





Contacts






9594









Hep C Australasia




T 131 450



Hepatitis ACT


Hepatitis NSW


Hepatitis SA


Hepatitis Victoria




Hepatitis WA




9796

Notes


















Notes

Infoline 1300 437 222

73

Relievingstress






receiving treatment



bull Exercise






bull Laughandplay

72

7574









76

Exercise

77


















78 79

Glossary








Counsellors



Counselling is

bull confidential

bull supportive



8180

















8382



















Lipids See Fats


8584


















86

Furtherreading












87

89






88













9190


























92 939393





Contacts






9594









Hep C Australasia




T 131 450



Hepatitis ACT


Hepatitis NSW


Hepatitis SA


Hepatitis Victoria




Hepatitis WA




9796

Notes


















Notes

Infoline 1300 437 222

7574









76

Exercise

77


















78 79

Glossary








Counsellors



Counselling is

bull confidential

bull supportive



8180

















8382



















Lipids See Fats


8584


















86

Furtherreading












87

89






88













9190


























92 939393





Contacts






9594









Hep C Australasia




T 131 450



Hepatitis ACT


Hepatitis NSW


Hepatitis SA


Hepatitis Victoria




Hepatitis WA




9796

Notes


















Notes

Infoline 1300 437 222

76

Exercise

77


















78 79

Glossary








Counsellors



Counselling is

bull confidential

bull supportive



8180

















8382



















Lipids See Fats


8584


















86

Furtherreading












87

89






88













9190


























92 939393





Contacts






9594









Hep C Australasia




T 131 450



Hepatitis ACT


Hepatitis NSW


Hepatitis SA


Hepatitis Victoria




Hepatitis WA




9796

Notes


















Notes

Infoline 1300 437 222

78 79

Glossary








Counsellors



Counselling is

bull confidential

bull supportive



8180

















8382



















Lipids See Fats


8584


















86

Furtherreading












87

89






88













9190


























92 939393





Contacts






9594









Hep C Australasia




T 131 450



Hepatitis ACT


Hepatitis NSW


Hepatitis SA


Hepatitis Victoria




Hepatitis WA




9796

Notes


















Notes

Infoline 1300 437 222

8180

















8382



















Lipids See Fats


8584


















86

Furtherreading












87

89






88













9190


























92 939393





Contacts






9594









Hep C Australasia




T 131 450



Hepatitis ACT


Hepatitis NSW


Hepatitis SA


Hepatitis Victoria




Hepatitis WA




9796

Notes


















Notes

Infoline 1300 437 222

8382



















Lipids See Fats


8584


















86

Furtherreading












87

89






88













9190


























92 939393





Contacts






9594









Hep C Australasia




T 131 450



Hepatitis ACT


Hepatitis NSW


Hepatitis SA


Hepatitis Victoria




Hepatitis WA




9796

Notes


















Notes

Infoline 1300 437 222

8584


















86

Furtherreading












87

89






88













9190


























92 939393





Contacts






9594









Hep C Australasia




T 131 450



Hepatitis ACT


Hepatitis NSW


Hepatitis SA


Hepatitis Victoria




Hepatitis WA




9796

Notes


















Notes

Infoline 1300 437 222

86

Furtherreading












87

89






88













9190


























92 939393





Contacts






9594









Hep C Australasia




T 131 450



Hepatitis ACT


Hepatitis NSW


Hepatitis SA


Hepatitis Victoria




Hepatitis WA




9796

Notes


















Notes

Infoline 1300 437 222

89






88













9190


























92 939393





Contacts






9594









Hep C Australasia




T 131 450



Hepatitis ACT


Hepatitis NSW


Hepatitis SA


Hepatitis Victoria




Hepatitis WA




9796

Notes


















Notes

Infoline 1300 437 222

9190


























92 939393





Contacts






9594









Hep C Australasia




T 131 450



Hepatitis ACT


Hepatitis NSW


Hepatitis SA


Hepatitis Victoria




Hepatitis WA




9796

Notes


















Notes

Infoline 1300 437 222

92 939393





Contacts






9594









Hep C Australasia




T 131 450



Hepatitis ACT


Hepatitis NSW


Hepatitis SA


Hepatitis Victoria




Hepatitis WA




9796

Notes


















Notes

Infoline 1300 437 222

9594









Hep C Australasia




T 131 450



Hepatitis ACT


Hepatitis NSW


Hepatitis SA


Hepatitis Victoria




Hepatitis WA




9796

Notes


















Notes

Infoline 1300 437 222

9796

Notes


















Notes

Infoline 1300 437 222

Notes

Infoline 1300 437 222

Infoline 1300 437 222

Hepatitis Chepatitisact.com.au/wp-content/uploads/2014/10/6-Guide-to.pdf · Some people with...

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Transcript of Hepatitis Chepatitisact.com.au/wp-content/uploads/2014/10/6-Guide-to.pdf · Some people with...