title: Efficacy of long-term dietary restriction of total calories, fat, iron, and protein in patients with chronic hepatitis C virus.
abstract: OBJECTIVE
  A diet restrictive in total calories, fat, iron, and protein intake reduces serum alanine aminotransferase levels in patients with long-term hepatitis C virus infection. However, whether long-term dietary therapy causes adverse effects such as malnutrition and anemia due to a shortage of energy intake is not clear. We evaluated the balance of energy intake and changes in physical and hematologic indices of nutrition after a long-term dietary therapy.
  
  
  METHODS
  Twenty-two patients with long-term hepatitis C virus infection that did not respond to or who were able or unwilling to take interferon therapy were enrolled in this study. Our prescriptions included 7 mg/d or less of iron, 30 kcal. kg(-1). d(-1) of energy, 1.1 to 1.2 g. kg(-1). d(-1) of protein, and a fat energy fraction of 20%. Patients were followed for 24 mo.
  
  
  RESULTS
  Mean body fat percentage was 24.6% at entry and was significantly reduced after the diet prescription. Mean serum ferritin decreased significantly from 376 ng/mL at entry to 141 ng/mL after 24 mo. Mean serum alanine aminotransferase levels decreased significantly from 66 to 49 IU/L. Mean levels of hemoglobin, serum albumin, and cholinesterase did not change significantly during the follow-up period.
  
  
  CONCLUSIONS
  These results suggest that restriction of energy, fat, iron, and protein intakes is safely tolerated, so its long-term use should be recommended to patients with long-term infection with hepatitis C virus.
authors.affiliation: Third Department of Internal Medicine, Mie University School of Medicine, Tsu, Japan. motoh@clin.medic.mie-u.ac.jp
authors.forename: Motoh
authors.initials: M
authors.lastname: Iwasa
authors.forename: Kazuko
authors.initials: K
authors.lastname: Iwata
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kaito
authors.forename: Jiro
authors.initials: J
authors.lastname: Ikoma
authors.forename: Mika
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Masaki
authors.initials: M
authors.lastname: Takeo
authors.forename: Makoto
authors.initials: M
authors.lastname: Kuroda
authors.forename: Naoki
authors.initials: N
authors.lastname: Fujita
authors.forename: Yoshinao
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Yukihiko
authors.initials: Y
authors.lastname: Adachi
mesh_terms: D000273:Adipose Tissue; D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001823:Body Composition; D015992:Body Mass Index; D018752:Diet, Fat-Restricted; D018753:Diet, Protein-Restricted; D002149:Energy Intake; D005260:Female; D005293:Ferritins / Q000097:blood; D019698:Hepatitis C, Chronic / Q000178:diet therapy*; D006801:Humans; D019266:Iron, Dietary / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged
chemical_list: D019266:Iron, Dietary; D005293:Ferritins; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase