Old dietary cultural practices leading to suboptimal nutritional intake of calories in children with acute viral hepatitis
DOI:
https://doi.org/10.18203/2349-3291.ijcp20202541Keywords:
Acute Viral Hepatitis, Hepatitis A virus, Children, DietAbstract
Background: Acute viral hepatitis (AVH) is one of the common infections in developing nation. Hepatotrophic virus causes AVH and most of the time it has self-limiting course. HAV is most common cause of AVH. Suboptimal dietary cultural practices are common in our nation. This study was done to know the impact of suboptimal dietary practices done in AVH.
Methods: Observational study conducted with 50 children with AVH. Dietary assessment was done at three point of time. First During AVH, second, pre illness and then two weeks after nutritional counselling. Data of dietary modification done by parents/caregiver during AVH recorded. History of herbal medicine taken for treatment of AVH enquired.
Results: HAV positive was (72%), HEV positivity was in 8 (16%) cases, hepatitis B was positive in 4 (8%) children and dual infection HAV+HEV was detected in 2 (4%) children. Many parents did dietary modification due to AVH and also by some local treating physicians, 18 (36%) patients were also on herbal medication for treatment of AVH. During AVH the mean calorie and protein requirement decreased from 96% to 54% and 92% to 43% respectively. Two weeks after nutritional counseling the mean calorie and protein intake increased from 54% to 88% and 43% to 84% respectively. This change in calorie and protein was statistically significant (p<0.01) Non-vegetarian diet preference was restarted in many of them after nutritional counseling.
Conclusions: This observational study revealed that suboptimal dietary cultural practices are prevalent in India. Majority of children were on bland diet and receiving inadequate proteins and calories.
References
Aggarwal R. Hepatitis E and pregnancy. Indian J Gastroenterol. 2007;26:3-5.
Arora NK, Nanda SK, Gulati S, Ansari IH, Chawla MK, Gupta SD, et al. Acute viral hepatitis types E, A, and B singly and in combination in acute liver failure in children in north India. J Med Virol. 1996 Mar;48(3):215-21.
Poddar U, Thapa BR, Prasad A, Singh K. Changing spectrum of sporadic acute viral hepatitis in Indian children. J Tropic Pediatr. 2002 Aug 1;48(4):210-3.
Regev A, Schiff ER. Clinical features of hepatitis. In: Thomas HC, Lemon S, Zuckerman J, eds. Viral Hepatitis. 3rd ed. Malden, MA: Blackwell Publishing; 2005:32-49.
Leone NC, Ratner F, Diefnbach WCL. Clinical evaluation of a high protein, high carbohydrate, restricted fat diet in the treatment of viral hepatitis. Ann N Y Acad Sci. 1954; 57:948-61.
Antia EP, Abraham P. Viral hepatitis. In: Galanter M, ed. Clinical Dietetics and Nutrition, 4th edn. New Delhi: Oxford University Press; 2005:298-304.
Sathiaraj E, Chutke M, Mahurkar S, Nagaraja Rao P, Nageshwar Reddy D. Dietary alterations due to perceptions in acute viral hepatitis lead to sub‐optimal calorie intake and increased length of hospitalization. J Viral Hepatitis. 2010 May;17(5):367-71.
Janghel V, Patel P, Chandel SS. Plants used for the treatment of icterus (jaundice) in Central India: A review. Annals of hepatology. 2019 May 26.
Schaffner F. Treatment of viral hepatits. Can Med Accos J. 1972;106:505-7.
Iber FL, Mendeloff AL. Prevention and treatment of viral hepatitis. Arch Intern Med. 1962;109:110.
Sudhamsu KC, Sharma D, Poudya N, Basnet BK. Acute viral hepatitis in Pediatric age Groups. J Nepal Med Assoc. 2014;52(193):687-91.
Benjamin, Sayeed M, Khaga M, Nahid KL, Rukunuzzaman, Mazumder W, et al. Acute hepatitis in Children: Experience at a tertiary hospital at Bangladesh. Pak Pediatr J. 2019;43(4):265-9.
Stanfield PS, Hui YH. Nutrition and diet therapy. In: Self instructional Modules. American Dietetic Association. 4th edn. Boston: Jones & Bartlett Publishers; 2003:242.