weight loss before I start tx also good or bad foods i should know about

[jm58]

i have a chance to start treatment next week, but im wondering if i should weight,reason being is because im 245LBS, 5/10. iwas told that at this weight i might have a hard time responding to the tx they want to treat me with, pegint/ rib/. again i was diagnosed in 2010 october with stage 1, grade 1, geno 3 with minamal scarring,at this weight of 245. which i was carrying around with me since 2007. ive recently started my diet , ive been eating alot oatmeal ,fruits veggies ,fish chicken turkey,ect,ect, and lots of water . am i eating the right foods ,is there any certain food or beverage group i should or shouldnt be eating or drinking .(
( what about fett/alfredo and /wine.) LOL  thks jm58

[pooh55811]

Yes, I agree. I am beginning to learn more about SOC and the other Genotypes. It is interesting how different not only the Genotypes are, but also the treatment and the responses to those treatments depending on the Genotype and other factors.

I sure hope they can find a cure for 100% of people soon (no matter which Genotype they have).

[can-do-man]

Yeah one should not even try to compare triple therapy with SOC as it a whole different ballgame.

[pooh55811]

PS: One other thing I have learned when attempting to lose weight. Do not get hungry. Eat a small planned snack in between meals (nuts, veg. sticks, etc.). If a person gets hungry he/she is more likely to veer off the diet (in terms of food types) and more likely to eat too much at the next meal.

[pooh55811]

If it's any consolation, I had a BMI of 32 when I started treatment. I had recently lost 21 pounds and would have kept losing had I not been diagnosed with Hep C and pursued treatment sooner rather than later. (The Incivek and the 20 grams of fat nixed weight loss, lol.) Of course, I am Geno 1 and on triple med therapy so it is a different situation than yours.

I would have preferred to be thinner, but at 66 and Grade 2, Stage 2, I did not want to wait. Besides, at the time, I did not know weight could potentially affect treatment.) I had a pre-treatment VL of 14.4 million, high as far as I am concerned. At 4 weeks I was at <43 but detectable, and at 8 weeks I was undetectable. (Also und. at 12, 16, and 20 weeks.)

I did read that steosis could be a factor in fibrosis progression, especially if coupled with diabetes and/or insulin resistance and especially in Geno 3.

Here is a recent course from "In Practice." This is from 12-2011 so it is recent. It is pretty comprehensive (it is a continuing education course for physicians) but it is understandable to lay people, I think. This course covers a lot and I think it is very good.

http://www.clinicaloptions.com/inPractice/Hepatology/Hepatology/ch7_Hepatitis_C_Epidemiology_Pathogenesis_Diagnosis_and_Natural_History.aspx

If you really think you can lose weight, and lose a fair number of pounds, it may be a good idea to lose. I think cutting down is probably one of the most important factors in weight loss. Instead of 3 eggs and 5 pieces of bacon for breakfast, have 1 egg and 1 piece of bacon (or no bacon, lol), and some fresh fruit. Instead of an 8 ounce steak for dinner, have 3-4 ounces instead coupled with at least 2 types of fresh vegetables lightly cooked and a salad (with only a small amount of dressing on it, perhaps olive oil and vinegar and Italian spices). For dessert have some fresh raspberries of other fruit.  For snacks have some almonds, celery sticks, carrot sticks, etc. Some cut out bread and pasta and potatos completely. Personally, I do not. I just cut way down, and have a very small baked potato instead of a large one or a piece of bread instead of 2.

However, foods that I think that should be completely avoided are fast foods, junk foods, processed foods, sweets, sodas, commercial juices unless they are pure juice with no additives, foods high in transfats, high fructose corn syrup, and any foods that contains ingredients you cannot pronounce and have no idea what they are. One has to read the labels and see what is in them.

As far as desserts/sweets I think one can get accustomed to fresh fruits for desserts or sweet cravings. Mandarin oranges, strawberries, pears, etc. taste pretty sweet but do not have anywhere near the calories that sweet have and they also contain good nutrients.  

I agree with OH, fresh organic foods are best.

I think you should discuss it with your doctor and see what he/she thinks.
There might be several factors involved:
rate of progression
job
insurance (and will you still have it at a later date)

(PS: I am not implying you eat 3 eggs and 5 pieces of bacon or a half pound of steak. Those were just over all examples of what I mean by cutting down.)

[Advocate1955]

Frijole:  Thanks for the information and the link.  I did know that people with a higher BMI can have quicker liver disease progression and that going through therapy can be tougher because of the added burden on the liver.  I did not know that having a higher BMI was a predictor for not attaining SVR.  I like learning new things.

jm58:  Thanks for your good wishes.  My husband was a partial responder to his first two treatments, became UND at week 8 on triple tx with Inc, stayed UND at week 12, but lab results at week 16 or so showed VL<12.  So, we are anxiously doing another VL this Wednesday, praying that it is not a viral breakthrough, but mentally/emotionally preparing for that.

can-do-man:  My husband was on 1400 mg. per day of Riba while undergoing consensus interferon (daily infergen)/riba treatment.  His doctor said that 1200 mg. per day would be the regular dose for him, but with the consensus interferon treatment she wanted to be more aggressive.  It was rough!

Advocate1955

[jm58]

      will do bud thxs

[can-do-man]

I would make sure your on the correct amount of ribavirin so you have the best odds possible......... Good luck to you.

[can-do-man]

Many previous studies have found that body weight or BMI predicts treatment outcomes, with heavier people being less likely to achieve SVR. While obesity and related metabolic problems are known to have an effect on hepatitis C and liver health in general, poorer treatment response among heavier patients may also indicate that they did not receive enough ribavirin to do the job.

http://www.hivandhepatitis.com/hep_c/news/2011/0125_2010_b.html

[jm58]

GREAT NEWS  on your husband finnaly responding to treatment . i wish the best for him you and all of us fighting this disease. thanks for your reply

[frijole]

advocate - BMI over 30 is a negative predictor on SOC -- which is what it sounds like jm58 will be on with geno 3.  also, geno 3s have a high probability of steatosis (fatty liver) which also compound the problem. Therefore it is a good plan to try to lose some weight before treatment.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1856395/

However, what is the relevance of steatosis in chronic hepatitis C? It seems that in certain populations, steatosis may be associated with fibrosis progression and this may be genotype specific. The mechanisms underlying this association are unknown; neither is it clear whether this holds true for all patients or only a subgroup. Indeed, after antiviral treatment, virus related steatosis disappears whereas the host associated steatosis remains unaffected.

...Non‐alcoholic fatty liver disease (NAFLD) represents a spectrum from simple steatosis at one end to severe inflammation with extensive fibrosis or cirrhosis at the other. Hepatic steatosis without inflammation is thought to have a good prognosis but non‐alcoholic steatohepatitis (NASH) can progress to cirrhosis in a significant proportion of cases.

As a side note, BMI does not seem to be as big an issue with the new PIs. but I don't think you can take them.
frijole

[jm58]

i just read your profile and im very happy to see things are looking up for you . thxs for your reply , stay healthy and god bless

[Advocate1955]

I had not heard before that being heavy changes how a patient will respond to treatment, per se.  What I have heard is that being heavy, in general, makes it more difficult for one's liver to do it's job, not just on treatment but also off treatment. I think this is due to the additional fat stored in the liver, making the liver have to work extra hard to filter the toxins.  So, in the ideal world, one would lose weight prior to or in between treatments, to support the health of one's liver.  I would suggest talking to your doctor next week prior to starting treatment so he/she can guide you.  My guess is that if your prescriptions are already ordered and your insurance is already approved, your doctor will want you to start next week.
Advocate1955

[orphanedhawk]

No wine, no alcohol. None, nada.
Alcohol will make your illness worse.

In your condition you could delay beginning tx for at least 6 months while you lose weight although really, this is something you should discuss with your doctor.

You liver filters everything so the ideal best diet is one with organically grown fresh food, few or no additives or processed food.