Observed annually on 28 July, World Hepatitis Day aims to raise awareness about hepatitis types A, B, C, D, and E. The 2025 theme, “Hepatitis: Let’s Break It Down,” calls for dismantling stigma, improving access to vaccination, testing, and timely treatment: integration vital to eliminating hepatitis worldwide by 2030.

Hepatitis refers to inflammation of the liver, most commonly caused by viral infections. It can also result from toxins, certain medications, heavy alcohol use, or autoimmune diseases. Depending on the type and cause, hepatitis can be acute (short-term) or chronic (long-term), and may range from mild illness to severe liver damage, including cirrhosis or liver cancer.

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Common Symptoms of Hepatitis:

• Fatigue
• Nausea or vomiting
• Abdominal pain (especially near the liver)
• Loss of appetite
• Jaundice (yellowing of the skin and eyes)
• Dark urine
• Pale stool
• Fever and joint pain (more common in hepatitis B)

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According to the World Health Organisation 2025 report, the development of chronic infection varies significantly with age. Infection acquired in infancy and early childhood (before the age of 5 years) leads to chronic hepatitis in about 95 per cent of cases. In contrast, infection acquired in adulthood results in chronic hepatitis in less than 5 per cent of cases. This highlights why strengthening and prioritising infant and childhood vaccination is crucial for prevention.

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Why Nutrition Matters for Hepatitis

Liver inflammation can happen due to viral infections like hepatitis B or C, metabolic issues like MASLD (Metabolic dysfunction–Associated Steatotic Liver Disease) or MASH (Metabolic dysfunction–Associated Steatohepatitis), or from alcohol use. These newer terms (MASLD and MASH) replace NAFLD and NASH to highlight that the real issue is often a metabolic problem, not just avoiding alcohol. When the liver is inflamed, it can lead to poor nutrition and a condition called sarcopenia, which means loss of muscle strength and size. This makes recovery harder. But with the right diet, liver health can improve, complications can be reduced, and overall well-being gets a boost.

Core Principles of Liver‑Friendly Nutrition

1. Adequate Calories & Protein

• Adults with cirrhosis or alcoholic hepatitis benefit from early nutritional support, oral or enteral feeds within 48 hours reduces in-hospital mortality by approximately 30 per cent, according to a 2025  study published by the American College of Gastroenterology.
• The same study also stated that incorporating a late‑evening snack should be incorporated in patients with cirrhosis to improve BMI, lean mass, and reduce ascites (Ascites is the medical term for the abnormal buildup of fluid in the abdomen. It often causes visible abdominal swelling and discomfort.)
• Frequent small meals and a late‑evening carbohydrate snack (~200 kcal between 7–10 pm) help maintain nitrogen balance and muscle mass 
• Avoid protein restriction, even in hepatic encephalopathy. Instead, emphasise vegetable protein and consider branched‐chain amino acid (BCAA) supplementation to improve cognition and reduce mortality.

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2. Lean, Plant‑Based Proteins

Include fish, poultry, legumes, tofu, nuts, and low-fat dairy while limiting red and fatty meats and processed meats to reduce iron load and oxidative stress, especially important in hepatitis C and metabolic steatohepatitis, according to the Hepatitis B Foundation.

3. Whole Grains, Fruits & Vegetables

The American College of Gastroenterology highlights that a diet rich in whole grains, fruits, and vegetables, particularly cruciferous varieties, supports liver function by enhancing detoxification pathways. These foods provide fibre, antioxidants, and key micronutrients essential for overall liver health

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4. Healthy Fats Only

Choose plant oils (olive, rapeseed), nuts, and seeds. Limit saturated and trans fats found in fried and ultra-processed foods, which exacerbate hepatic steatosis.

5. Micronutrients & Supplements

• Vitamin D: Commonly deficient in chronic liver disease. Supplementation may improve immunity and Child‑Pugh classification in cirrhosis 
• Zinc: Replace when low, especially in encephalopathy or mucosal symptoms 
• Vitamin E (800 IU/day): Beneficial in selected patients with metabolic steatohepatitis (MASH) without cirrhosis

6. Coffee in Moderation

According to the World Journal of Hepatology, drinking 2 or more cups of coffee a day is linked to slower liver fibrosis and a lower risk of liver cancer in people with chronic hepatitis B and C.

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Type-Specific Nutritional Considerations

Hepatitis B (HBV)

• Eat whole grains, fruits, vegetables, lean proteins, legumes, low-fat dairy, fish, nuts and seeds 
• Avoid sugary drinks, processed foods, deep-fried fats, red meats, and undercooked shellfish 
• Maintain hydration and small, frequent meals if you have an acute infection (with manifesting symptoms)

Hepatitis C (HCV) & MASLD / MASH

• Focus on low-fat, low-cholesterol diets to reduce steatosis and liver inflammation 
• Mediterranean-style dietary patterns, moderate carbohydrate reduction, and exercise are effective in reversing inflammation and reducing liver fat, even without weight loss
• As per a 2025 article by the Physicians Committee for Responsible Medicine and Unbound Medicine, In people with Hepatitis C, liver damage can worsen due to excess iron and the oxidative stress it causes. Along with phlebotomy (removing blood to reduce iron), following a low-iron diet can help lower the risk of liver cancer. Foods high in iron include red meat, poultry, fish, shellfish, organ meats, and eggs 

Alcohol‑Associated Hepatitis & Cirrhosis

• Alcohol avoidance is non-negotiable.
• Early malnutrition screening followed by nutrition therapy improves outcomes and reduces complications such as ascites, infection, and mortality.
• Avoiding high-sodium foods is essential to prevent or manage fluid retention and ascites, especially when cirrhosis is present. 

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