My 22-year-old daughter is suffering from an attack of jaundice caused by the virus hepatitis A. Her appetite is very poor and she has become very weak. Different people are giving different dietary advice. Could you please guide me as to what foods are safe and good for her now and what foods should be strictly avoided?

Jaundice caused by hepatitis A virus is usually got from contaminated food or water. During the summer season food spoils easily and one should be very careful about eating from outside the home.

During an attack of jaundice the liver cells are damaged. The liver is the place where fat is metabolized and since it is damaged and needs to rest and recover, fat in the diet must be restricted. A small amount of fat, say 2-3 tsps per day may be permitted in seasoning of the food but apart from this all fatty foods must be strictly restricted for atleast 90 days. Cream of milk must be thoroughly removed, ice cream, ghee, cheese, butter, and desserts using these must be avoided. All pastries and rich bakery items, all Indian sweets and nuts are not permitted. Marie biscuits, arrowroot and glucose biscuits may be eaten but all rich cookies avoid. Fried foods and snack items like chips, mixture etc are to be completely avoided.

Nuts and coconut chutney and coconut curries as well as all non-veg is best avoided. As she recovers eggs may be introduced. The liver is also the place where breakdown products of protein metabolism are metabolized so we have to be careful about protein intake. However for the damaged liver cells to heal and be regenerated protein food is necessary so a moderate intake of protein is recommended. This can be skimmed milk about 3-4 cups per day in the form of milk or curd or even made into porridge or custard.

Thin dhal may be given which is not spicy. This can be cooked with various vegetables to give variety and flavor. All beans, peas and pulses must be avoided at this time. If tolerated, soft cooked eggs like scrambled eggs and pouched egg may be given.

The main focus at this time is to give plenty of carbohydrates so that energy levels are kept high and also protein food is not used for energy. Large quantities cannot be tolerated so frequent intake of smaller meals besides breakfast, lunch and dinner is advised. This can be light biscuits, bread and jam or honey and plenty of fruit like banana or even dried fruits like dates or raisins. Jelly, custards, lassi, cold milk shakes etc can also be taken in-between the meals.

Meals can be, porridge or cereal and milk, idli, is probably the only south Indian item safe to eat at this time. Rice, bread, soft chapatti or wheat kanji may be had at meals. Plenty of soft cooked vegetables like potato, carrot, and cauliflower must also be eaten, as there is a special need for vitamin B and C for recovery.

If there is a lot for vomiting the sodium and potassium may be lost. Salt can be used as needed and banana and fruits is a must to replace potassium. Vegetable soups and juices too may be had when ever possible.