World-wide, over 170 million people have been infected with hepatitis C. In the United States, approximately 1 in every 60 people has an active hep C infection. Although hepatitis C is often spoken of as a death sentence, only about 20% of people who are infected with the virus develop cirrhosis of the liver, and only about 10% of people who have the infection develop liver cancer and die, and dietary interventions can increase the chances of staying in the 80% of people who avoid the worst-term complications of the infection.

Put in simple terms, the best way to avoid the nausea, vomiting, blood clotting deficiencies, emaciation, delirium, and death that can result from hepatitis C is to avoid giving your liver too much to do.

That means no alcohol, and no street drugs. It's essential to avoid exposure to liver-toxic chemicals, and it's best to work with your doctor so you can avoid certain medications. And it's best to avoid a phenomenon called insulin resistance.

We typically associate insulin with the pancreas, which manufacturers it, but no organ in the body devotes more of its energy to responding to insulin than the liver. One of the main tasks of the liver is to store energy in the form of glycogen. The liver manufacturers glycogen from a combination of glucose and water, the transport of glucose into the liver accomplished with the help of insulin. The harder it is for the liver to use insulin, the more likely is to accumulate free radical damage that leads to fiber formation, scarring, cirrhosis, and cancer.

And there's no better way to avoid insulin resistance than by simply eating fewer calories.

Australian researchers recruited 23 people infected with hepatitis C who were also overweight. Every volunteer for the study had some degree of fibrosis (interconnecting tissues within the liver that interfere with circulation), cirrhosis (“lumps” that form when damaged tissue is regenerated), steatosis (fatty liver), and inflammation. Some of the volunteers had previously been treated with interferon and some had not. All of the volunteers displayed evidence of insulin resistance, the inability of the liver and other tissues in the body to receive glucose from the bloodstream with the help of insulin.

All the volunteers were put on a 90-day reduced calorie diet, average food consumption lowered from 2,740 to 1,620 calories per day, with the diet adjusted to provide 50% of calories from protein, 30% from carbohydrate, and 20% from fat. In other words, the volunteers were not asked to follow a truly low-fat diet, no were they forbidden to eat either starchy foods or protein foods. Participants in the study were asked to gradually increase their exercise to 30 minutes per day.

At the end of the 90 days, most of the participants had lost about 10 pounds (4-5 kilos) body mass. They had lower levels of ALT and AST, the enzymes used to measure liver cell destruction. They showed evidence of less fibrosis and less cirrhosis. But most importantly, not a single volunteer among the 19 who finished the study continued to show biological markers of tissue destruction in the liver. The attack on the hepatitis virus by the immune system, which is what actually causes the destruction of the liver, completely stopped.

The Australian research team believes that any woman who has hepatitis C who has a waistline greater than 32 inches (80 cm) and any man who has hepatitis C who has a waistline greater than 37 inches (94 cm) can benefit by reducing calorie consumption and losing weight. Exercise isn't the critical component of the hepatitis C treatment program. Calorie-reduction is.
Drastic weight loss is not necessary to improve liver function. Losing as little as 2.5% of body weight (for a person who weighs 220 pounds/100 kilos, just 5-1/2 pounds/2.5 kilos) is enough. And one of the easiest ways to lose body mass is with the paleo diet.

The paleo diet removes the sugar and starch that sends blood sugar levels soaring and drives insulin resistance. The pancreas does not have to release as much insulin every time you eat, so your liver does not have to protect itself from a flood of incoming sugar needing to be stored by becoming ever more resistant to the effects of insulin.

If you happen to be of African descent, there is one more thing you can do to stop the progression of hepatitis C: Make sure you get enough vitamin D. This is possible with a supplement that costs as little as $3 for a bottle of 60 tablets. It isn't necessary to take a megadose of vitamin D, just to prevent vitamin D deficiency. Especially in men who have black skin, avoiding vitamin D deficiency significantly reduces liver inflammation, fibrosis, cirrhosis, and chronic liver changes in hepatitis C.

If you are on antiviral treatment for hepatitis C, it is always best to work out your diet with a nutritional specialist before you start interferon treatment. A combination of high-protein (in this case, at least 50% protein) diet and careful monitoring and restriction of carb calories can help prevent the loss of muscle tone that is so common when hepatitis C is treated with interferon.

Studies in Japan have found that people who have hepatitis C are more likely to have normal AST levels (that is, their “liver enzymes” are more likely to be normal) when they eat more fish than meat, and when they consume less than 25 grams of cooking oil per day. Whether these results generalize to other races and ethnic groups is not known, but fish seems to be a good choice for any weight-reducing, insulin-resistance reducing hepatitis C diet. Simply follow your paleo diet and choose fish whenever possible.

There is also a group of supplements that help relieve insulin resistance: the antioxidant R-lipoic acid, the amino acid L-carnitine, and the B vitamin biotin. The mitochondria in every cell can use these products to protect themselves against the release of free radicals of oxygen when they burn glucose. Since the process of burning sugar releases fewer the of the DNA-damaging free radicals of oxygen, the cell can become more responsive to insulin, less insulin-resistant.

The key to success with these supplements is making sure you use all three. Just one of them won't really change insulin resistance. “Alpha-lipoic acid” contains about 45% of the desired R-lipoic acid, and despite what you may have heard, the S-lipoic acid in the cheaper supplements won't actually damage your cells. You just have to take about twice as much “alpha-lipoic” acid as “R-lipoic” acid, 200 mg a day rather than 100 mg a day. Take at least 100 mg of both biotin and L-carnitine along with it. Larger amounts may be helpful but are not essential to obtaining benefits.