Keep It Simple - healthy & delicious recipes

Keep it Simple a collection of healthy & delicious recipes presented for sampling at the Community Food SA Centre

brought to you by Hepatitis SA T: 1300 437 222 / 8362 8443 - www.hepsa.asn.au - www.K3myliver.org.au

An Eat Well Recipe

Apple & Cinnamon Muffins brought to you by Hepatitis SA

These homemade muffins are just as yummy as store bought ones but are far healthier. They have no oil and a low GI. Pop them in the microwave for a few seconds to warm them up and they’ll be even more delicious.

INGREDIENTS

1/2 cup All-Bran cereal or any brand of processed bran cereal 2/3 cup low-fat milk 1/2 cup whole wheat flour 2 teaspoons baking powder 1 teaspoon allspice 1 teaspoon cinnamon 1 green apple or 1 cup tinned apple 1/2 cup unprocessed oat bran 1/4 cup sultanas 1 egg 1/4 cup honey 1 teaspoon vanilla essence

Photo by Back to the Cutting Board

METHOD

Preheat oven to 180°C Pour All-Bran into milk and let stand for 10-15 minutes. Sift flour, baking powder, allspice and cinnamon into a large bowl. Peel and dice apple or measure out tinned apple. Add apple, oat bran and raisins to flour mixture and stir to combine.

Combine slightly beaten egg, honey and vanilla in a small bowl. Pour into flour mixture and stir with wooden spoon.

Pour All-Bran mixture into the rest of the ingredients and continue stirring until well combined.

Lightly grease 12-hole muffin tin and spoon in the mixture. Bake for 15-18 minutes until lightly brown.

Serve warm or re-heat by placing in the microwave for a few seconds.

TIPS & VARIATIONS

You can find processed bran cereal and unprocessed oat bran in the cereal aisle of your supermarket.

Use this basic recipe to create any type of fruit muffins you like, simply replace some or all of the apple with other fruit.

If you’re using a whole apple grate it rather than dice it. Leave out the cinnamon & allspice and add a dash more vanilla essence. Some delicious combinations to try: Raspberry & Lemon Replace half of the apple with a handful of frozen raspberries and the zest of one lemon.

Banana Replace all of the apple with one medium banana.

Strawberry & chocolate chip Replace half of the apple with a handful of frozen strawberries and 2 Tbsps of chocolate chips.

For more recipes and information on healthy living and hepatitis, see our online publications at issuu.com/hepccsa

________________________________________________________________________________________ Fast Facts

Many people with hepatitis C experience no symptoms or symptoms may not appear until 15 years or more after initial exposure. The most common symptoms are fatigue, lethargy, nausea and discomfort around the liver.

Only 3 out of 10 people with hepatitis B have symptoms when first infected. Common symptoms include jaundice, fatigue, joint or abdominal pain, loss of appetite and flu-like illness.

For more information call our Info & Support Line on 8362 8443 or 1300 437 222 (regional callers) or visit our website at www.hepatitissa.asn.au

Hepatitis C can be cured. Hepatitis B can be clinically managed.

An Eat Well Recipe

Bircher Muesli brought to you by Hepatitis SA

This makes a fine, healthy, light breakfast because of the protein in the yoghurt and the fibre in the fruit.

INGREDIENTS Individual serve • 6 – 7 tablespoons low fat natural yoghurt • 4 tablespoons natural untoasted muesli • 1 teaspoon honey (to taste) • ½ grated granny smith apple Group serve • 500 grams low fat natural yoghurt • At least one large granny smith apple • 1 tbsp of honey or more to taste • 8-10 tbsp of untoasted muesli

Photo by snarkattack

METHOD Mix muesli into yoghurt and leave to soften overnight or as long as practical. This is not an essential step but is nice to soften the grains. Just before eating, grate the peeled and cored apple and add to the mixture along with the honey. Mix well.

TIPS Try this dish as a delicious dessert, especially to accompany a lighter dinner.

Other fruit can be used and chopped nuts can be added. Try mango, strawberries, passionfruit, almonds, pecans or macadamias.

Many thanks to Yvonne for this delicious recipe.

For more recipes and information on healthy living and hepatitis, see our online publications at issuu.com/hepccsa

______________________________________________________________________________________

Fast Facts Hepatitis C is not the same as hepatitis B or HIV/AIDS. Infection with one of these viruses does not lead to, or protect against, infection with the other.

For more information call our Info & Support Line on 8362 8443 or 1300 437 222 (regional callers) or visit our website at www.hepatitissa.asn.au

Hepatitis C can be cured. Hepatitis B can be clinically managed.

An Eat Well Recipe

Spinach & Cherry Tomato Frittata brought to you by Hepatitis SA

Serves 4 as a light meal.

INGREDIENTS • Olive oil spray or a little margarine • 1 tbsp olive oil • 6 eggs • ½ cup milk • ½ cup reduced fat cheese • 125gms baby spinach • 6 cherry tomatoes • 1 small brown onion & a clove of garlic • fresh basil (optional) • salt & pepper to taste

Photo by jeffreyw

METHOD Pre-heat oven to 180°c. Spray or grease a 20cm square cake pan with oil. Line base and sides with baking paper.

Finely dice onion & mince garlic and sauté in the olive oil for 5 minutes or until soft and clear. Wash spinach well and dry with a salad spinner or in a clean tea towel. Halve cherry tomatoes. Turn off heat and add spinach and cherry tomatoes to the pan to just wilt and heat through. Set aside to cool a little.

Mix together the eggs & milk in a bowl and beat well. Stir in cheese and the spinach mixture. Tear up 6-8 basil leaves and add (if using). Add salt and pepper to taste. Pour into cake pan and bake for 25-30 minutes or until set.

TIPS You can check the frittata after 25 minutes by removing it from the oven and inserting a skewer into the middle, if it comes out clean and all the liquid is set then it is done. You can replace the milk with soy milk if preferred. Ham or bacon go very well in this dish for a non-vegetarian version.

For more great recipes and information on healthy living and hepatitis, visit our website www.hepatitissa.asn.au

______________________________________________________________________________________ Fast Facts In South Australia, people with hepatitis B or hepatitis C are not required by law to disclose their positive status unless they are: • a member of, or applying to join the Australian Defence Force • healthcare workers undertaking exposureprone procedures • donating blood, organs or tissues • asked when applying for life or health insurance

For more information call our Info & Support Line on 8362 8443 or 1300 437 222 (regional callers) or visit our website at www.hepatitissa.asn.au

It is illegal to discriminate against a person because she/he has, or is thought to have, hepatitis b or hepatitis C.

Hepatitis C can be cured. Hepatitis B can be clinically managed.

An Eat Well Recipe

Veggie Pita Bread Pizzas brought to you by Hepatitis SA

INGREDIENTS 4 large pita breads Small jar of pasta sauce 1 red onion 1 capsicum, red or green 4 mushrooms 1 small zucchini Handful of pitted olives (optional) 1 cup of grated low-fat cheese Fresh or dried basil and oregano Photo by sara_kate

METHOD Preheat the oven to 200°C/180°C fan-forced.

Finely slice onion, capsicum, mushrooms and zucchini.

Spread the pita breads with a large tablespoon of pasta sauce. Place sliced ingredients and olives (if using) on pitas and sprinkle with herbs. Top with ¼ cup of grated cheese per pita.

Bake for 10-15 minutes or until cheese is melted and pitas are crispy.

Serve alone or with a green salad. Serves 4.

TIPS Avoid using too much pasta sauce as this can make the pitas soggy. Many toppings work well with these pizzas. Non-vegetarians can try ham or chicken. Other great vegetable options include artichokes and eggplant. You can also use small spoonfuls of cottage cheese instead of grated cheese for a very low fat, but still delicious, version.

For more great recipes and information on healthy living and hepatitis, visit our website www.hepatitissa.asn.au

______________________________________________________________________________________ Fast Facts Hepatitis C is a blood borne virus transmitted when infected blood enters the bloodstream of another person. Hepatitis C is not classified as a sexually transmissible disease.

The hepatitis B virus is transmitted by blood to blood contact or unprotected sexual contact. A pregnant woman who has hepatitis B infection can transmit the virus to her baby.

For more information call our Info & Support Line on 8362 8443 or 1300 437 222 (regional callers) or visit our website at www.hepatitissa.asn.au

Hepatitis C can be cured. Hepatitis B can be clinically managed.

An Eat Well Recipe

Yummy Lunchtime Wraps brought to you by the Hepatitis SA

INGREDIENTS Any type of flat bread – try: • Mountain bread • Pita bread • Tortillas Assorted fillings such as: Chicken, ham, tuna, egg, low fat dips and spreads, avocado, grated carrot, tomato, roasted vegetables, bean sprouts, lettuce.

Photo by Matej Novak

Try these delicious combinations: • Hummus and tabouli • Chicken & avocado with salad • Cheese, tomato & lettuce with mustard • Egg, low-fat mayo & lettuce • Tuna and coleslaw METHOD Lay bread out on a board & add fillings to the middle. Roll up & enjoy!

TIPS

Cut wraps into smaller portions to make them easier to eat or for kids lunch boxes.

A breakfast wrap makes for an easy to carry breakfast in a hurry. Mashed banana, sultanas & honey make a delicious breakfast filling. Or try cottage cheese and no added sugar jam.

For more recipes and information on healthy living and hepatitis, see our online publications at issuu.com/hepccsa

__________________________________________________________________________________________ Fast Facts

Globally, an estimated 71 million people have chronic hepatitis C which can result in liver disease and liver cancer. In Australia, over 180,000 people have chronic hepatitis C. Globally, 257 million people have chronic hepatitis B which can result in serious liver disease .It is a leading cause of liver cancer and death worldwide with 887,000 deaths due to hepatitis B. In Australia, over 226,000 people are living with chronic hepatitis B.

For more information call our Info & Support Line on 8362 8443 or 1300 437 222 (regional callers) or visit our website at www.hepatitissa.asn.au

Hepatitis C can be cured. Hepatitis B can be clinically managed.

An Eat Well Recipe

Healthy Chips & Dips brought to you by Hepatitis SA

Chips INGREDIENTS Any type of flat bread – try mountain bread, pita bread, tortillas.

METHOD Cut bread into wedges or squares. Lightly spray with olive oil spray (optional) and season with salt & pepper.

Use other spices such as paprika if preferred. Bake in a single layer in a pre-heated 200°c oven for 8-10 minutes or until crisp. Ovens vary, so keep a close eye on the chips while they’re baking as they can burn quite easily.

Place on a wire rack until cool. Store in an airtight container so the stay nice & crispy.

Photo by olgucz

Dips Tzatziki • • • • • • •

500g (2 cups) plain Greek-style yoghurt 1 cucumber, peeled, halved, seeded 1 large garlic clove, crushed 1 tbs finely chopped fresh chives 2 tbs olive oil 1 1/2 tbs fresh lemon juice Salt, to taste

Coarsely grate the cucumber and squeeze out excess moisture. Combine yoghurt, cucumber, garlic, chives, olive oil and lemon juice in a bowl and mix well. Season with salt.

Guacamole • • • • • • •

2 ripe avocados 1 small red onion, finely chopped 1 ripe tomato, finely chopped 2 garlic cloves, crushed 1 small fresh red chilli, deseeded, finely chopped 60mls (1/4 cup) fresh lime juice Salt & ground black pepper, to taste

Place the avocado flesh in a medium bowl and use a fork to mash until almost smooth.

Add the onion, tomato, garlic, chilli and lime juice and use a spoon to mix well. Taste and season with salt and pepper.

For more recipes and information on healthy living and hepatitis, see our online publications at issuu.com/hepccsa

________________________________________________________________________________ Fast Facts

There is no vaccine for hepatitis C. New infections can be prevented by making sure all injecting, tattooing, piercing and medical equipment is sterilised. In the community, sterile injecting equipment distributed through Clean Needle Programs helps to reduce hepatitis C infections.

The Australian blood supply has been screened for hepatitis C since 1990.

Hepatitis B infection is vaccine preventable. The vaccine is effective in 95% of the population and is provided through the National Immunisation Program.

For more information call our Info & Support Line on 8362 8443 or 1300 437 222 (regional callers) or visit our website at www.hepatitissa.asn.au

Hepatitis C can be cured. Hepatitis B can be clinically managed.

An Eat Well Recipe

Sweet Potato Wedges with Minty Yoghurt Dip brought to you by Hepatitis SA Healthy, quick and delicious, these wedges serves 4 as a snack or 2 as the main accompaniment to a meal.

INGREDIENTS • 750gms of sweet potato • Olive oil spray • ¼ tsp ground paprika • Salt & pepper to taste and for the dip • • •

200ml low fat plain yoghurt 1 clove of garlic, crushed 2 tbsp fresh mint, shredded

Photo by dearbarbie

METHOD Pre-heat oven to 220°C. Wash the sweet potatoes and pat dry (or peel them if you prefer) and cut into long thick wedges. Lightly spray with olive oil spray. Spread wedges out onto a baking tray and bake for 40 minutes or until tender.

Mix the dip ingredients together in a bowl and refrigerate until ready to serve.

TIPS If you don’t have oil spray, put the wedges into a clean freezer bag and pour in a teaspoon or two of oil.

Stir wedges around in the bag until they’re well coated with oil.

For more recipes and information on healthy living and hepatitis, see our online publications at issuu.com/hepccsa

_____________________________________________________________________________________ Fast Facts The risk of mothers passing hepatitis C to their unborn child is very low. Breastfeeding is encouraged for women who are hepatitis C positive, as it is for women in general.

Transmission of hepatitis B from mother to baby can be prevented by vaccination and injection of immunoglobin soon after birth.

For more information call our Info & Support Line on 8362 8443 or 1300 437 222 (regional callers) or visit our website at www.hepatitissa.asn.au

Hepatitis C can be cured. Hepatitis B can be clinically managed.

An Eat Well Recipe

Fruit & Oat Biscuits brought to you by Hepatitis SA

These homemade biscuits are much yummier than store bought ones and healthier too. They’ll last for several days in an airtight container.

INGREDIENTS 1 ½ cups of muesli ¼ cup of oat bran 1 egg 2 tbsps of honey 1 tbsp of fruit juice METHOD Preheat the oven to 160°C and line 2 baking trays with baking paper. Combine the muesli and oatbran in a bowl. In another bowl, mix the egg, honey and fruit juice.

Photo by Joana Hard

Add the egg mixture to the muesli mixture and stir well until combined. Set aside for 10 minutes to let the liquid soak into the muesli.

Shape the mixture into 12 balls. If the mixture is a little runny, stir in an extra couple of tablespoons of oatbran. Place onto the lined baking trays, 3cms apart and press down with a fork.

Bake for 16-18 minutes or until the biscuits are golden brown. Set aside for 10 mins until the biscuits have cooled slightly, then transfer to a wire rack to cool completely.

TIPS You can use any type of fruit juice for this recipe. If you don’t already have some on hand simply buy one orange and squeeze it.

For more recipes and information on healthy living and hepatitis, see our online publications at issuu.com/hepccsa

_______________________________________________________________________________________________

Fast Facts The first stage of acute infection with hepatitis C is often very mild, and may go unnoticed. Around 75% of people living with hepatitis C go on to develop chronic infection and varying levels of liver damage.

It used to be thought that many people with chronic hepatitis B were “healthy carriers”. We now know that all people with chronic hepatitis B are potentially at risk for progressive liver damage, cirrhosis and liver cancer.

For more information call our Info & Support Line on 8362 8443 or 1300 437 222 (regional callers) or visit our website at www.hepatitissa.asn.au

Hepatitis C can be cured. Hepatitis B can be clinically managed.

An Eat Well Recipe

Fruit Cake

brought to you by Hepatitis SA This easy & delicious cake is a healthy alternative to traditional high fat and sugar Christmas cakes.

INGREDIENTS • 2 cups of diced dried fruit • 2 cups of orange juice • 2 cups of self-raising flour • 1 tsp margarine or oil spray

Photo by Ellie Jayne

METHOD • Combine fruit and juice in a bowl. Cover bowl with cling-wrap and leave in the fridge overnight to soak.

• Pre-heat oven to 160⁰ C with fan-forced function turned on.

• Sift the self-raising flour into the fruit mixture and stir to combine.

• Lightly grease a round or square cake tin using either margarine or an olive oil spray. Line the tin with grease proof baking paper. Pour the cake mix into the tin.

• Bake in a fan-forced oven at 160⁰ C fan forced for 1 hour.

• After 1 hour, turn off the fan and reduce the temperature to 150⁰ C. • Continue to bake the cake for another hour (2 hours total cooking time).

• To check if it is ready, insert and remove a wooden skewer through the middle of the cake. If the skewer is clean the cake is ready; if there is lumpy, wet mixture on the skewer then it still needs more time.

For more recipes and information on healthy living and hepatitis, see our online publications at issuu.com/hepccsa

Fast Facts

There is no vaccine against hepatitis C, but hepatitis C can be cured. Hepatitis C treatment has close to 100% success rate. It is subsidised in Australia and is available to all adults with a Medicare Card.

There is treatment for hepatitis B but not all people with the virus need, or will benefit from, treatment.

The main goal of current hepatitis B treatment is to suppress the virus and prevent further liver damage.

For more information call our Info & Support Line on 8362 8443 or 1300 437 222 (regional callers) or visit our website at www.hepatitissa.asn.au

Hepatitis C can be cured. Hepatitis B can be clinically managed.

12 Top Foods that are Good for the Liver There is no one food or list of foods that will magically protect your liver. Maintaining a healthy liver is about maintaining a healthy body. There is definitely an association between some conditions and liver disease, such as high cholesterol, high blood pressure, insulin resistance, abdominal obesity, and diabetes. It therefore makes sense to lead a lifestyle that prevents and/or manages these conditions.

Consume the right amount of kilojoules to maintain a healthy weight, have lots of fibre to keep your digestive tract healthy and reduce cholesterol levels, and eat only a small amount of fat. Of the fat you do eat, try to have more unsaturated fats than saturated.

Below is a list of foods that stand above the rest in their food group that will help you achieve these things.

Note: If you have been diagnosed with some kind of liver disease, you may have specific dietary requirements for protein, salt and fluid intake. Speak to your doctor or dietitian.

1. Almonds Other sources: other nuts (all except coconut, which contains saturated fat).

Benefits: Almonds are packed with nutrients – fibre, riboflavin, magnesium, iron and calcium. In fact, almonds have more calcium than any other nut – 75mg in one serving (about 23 almonds). Like all nuts, almonds provide one of the best plant sources of protein. And nuts are also good for your heart as they contain unsaturated fats – a healthier type of fat that helps to lower blood cholesterol levels.

Recommended intake: Aim for 1 – 2 tablespoons of raw unsalted almonds (or other nuts) five times per week.

2. Oats Other sources: brown rice, couscous Benefits: Eating oats on a regular basis may lower cholesterol levels, reduce heart disease risk and prevent type 2 diabetes. It is thought that this is because oats have a high soluble fibre content, a low Glycaemic Index, and they are a whole grain, meaning they contain many essential vitamins and minerals.

Recommended intake: Oats, brown rice and couscous fall into the ‘breads and cereals’ food group. Also in this group are foods like wholegrain bread, breakfast cereals and crackers, pasta, rice and noodles. You should have 4 – 8 serves of ‘breads and cereals’ per day,

depending on how physically active you are. 1 serve is equal to 2 slices of bread, 1 cup of cooked pasta, rice, noodles or couscous, 1 cup of cooked porridge or 1 1/3 cups of breakfast cereal flakes. Aim for ½ - 1 serve of your 4 – 8 serves/day to be oats, brown rice or couscous.

3. Blueberries Other sources: cranberries, boysenberries, strawberries, currants, blackberries, cherries.

Benefits: Blueberries are high in plant compounds (phytonutrients). As with cranberries, phytonutrients in blueberries may help prevent urinary tract infections. Blueberries may also improve short-term memory, promote healthy aging, and lower your risk of heart disease and cancer. They are a low-kilojoule source of fibre, potassium and vitamin C, and have been shown to have anti-inflammatory properties. 1 cup of fresh blueberries has 350 kilojoules, 3.6 grams of fibre and 14 mg of vitamin C. Vitamin C helps form the connective tissue collagen, keeps your capillaries and blood vessels healthy, and aids in the absorption of iron.

Recommended intake: All fruit is healthy for you and you should aim to have two servings of fruit per day. I serve is equal to one medium piece of fresh fruit, 1 cup of diced fresh, or 2 tablespoons of dried. Of these serves, aim to have 4 – 5 serves per week as blueberries or other sources listed above.

4. Salmon Other sources: All fish, predominantly oily (salmon, mackerel, tuna, marlin, swordfish, sardines, herring, trout), oysters, clams.

Benefits: Omega 3 fatty acids, a type of unsaturated fat, lower heart disease and stroke risk by decreasing cholesterol and triglyceride levels, slowing down the growth of artery-clogging plaques, and lowering blood pressure. Omega 3’s have also been shown to help reduce inflammation associated with arthritis, and may possibly help with memory loss and Alzheimer's disease. There is some evidence to show that it reduces depression as well. In addition to being an excellent source of omega-3s, fish is low in saturated fat and is a good source of protein. Omega-3s are most prevalent in fatty, cold-water fish: Other forms of omega 3’s are available in fortified eggs, flax seed (linseed), and walnuts.

Recommended intake: Aim to eat fish (fresh and/or canned) 2 – 4 times per week.

5. Soybeans Other sources: Soymilk, soy yoghurt, soy custard, soy icecream, tofu, soy-based meat substitutes (bacon, sausages etc) Benefits: Soy is an extremely high quality protein that has no cholesterol or animal fat, is low in saturated fat and high in fibre. Soy is one of nature’s super-foods that can reduce your risk of heart disease and stroke, helps prevent osteoporosis, and may help protect against certain

cancers like breast, prostate and bowel cancer. It also helps alleviate hot flushes during menopause. There has been some controversy in recent times over the relationship between soy and cancer. There are now over 3000 scientific research papers on soy and there is no sound evidence which demonstrates any negative health effects in humans from consuming soy foods as part of a balanced diet.

Recommended intake: 1 – 4 servings per day, such as soymilk on your cereal, tofu in your evening meal and/or soy ice-cream for dessert.

6. Tea Other sources: green or black tea.

Benefits: Tea is rich in antioxidants, which help protect our body’s cells against damage and mutation. The overall antioxidant power of black tea is the same as green tea, but green tea does have ECGC, a powerful antioxidant that may inhibit the growth of cancer cells. Black tea in particular may boost the immune system, lower the risk of stroke and may prevent osteoporosis.

Recommended portion: 1 cup per day.

7. Yoghurt Other sources: milk, cheese, custard.

Benefits: Dairy foods are the best sources of calcium. Calcium promotes strong bones and a healthy heart. Yoghurt in particular has additional benefits of pre- and probiotics, which promote a healthy digestive tract. Dairy is naturally high in saturated fat, and because the link between saturated fat and heart disease is clear, most people in the general population should be having reduced fat, low fat or no fat varieties. Also, be aware that ice-cream, cream and soft cheeses such as brie and camembert are relatively low in calcium and high in saturated fat.

Recommended intake: Aim to have 3 serves of reduced fat dairy per day. 1 serve is equal to 1 cup (250mL) milk, 1 tub (200g) yoghurt or 40g of hard cheese.

8. Broccoli Other sources: Brussels sprouts, cabbage, cauliflower Benefits: Aside from having important nutrients such as calcium, potassium, folate and fibre, broccoli contains phytonutrients – a group of compounds that may help prevent chronic diseases, such as heart disease, diabetes and some cancers. Broccoli is also a good source of vitamins A and C – antioxidants that protect your body's cells from damage. These foods have

also been linked with reducing the incidence of birth defects, boosting the immune system and building/maintaining strong healthy bones.

Recommended intake: All vegetables are healthy and you should make an effort to eat a wide variety. Aim for 5 serves of vegetables per day, with only one serve being starchy vegetables (potato, sweet potato, corn). One serve of vegetables is equal to ½ cup of cooked, 1 cup of raw/salad or 1 medium potato. Of the 4 serves of non-starchy vegetables, aim for one serve each day to be broccoli, brussel sprouts, cabbage or cauliflower.

9. Kidney beans Other sources: other legumes, e.g. chickpeas, cannalini beans, borlotti beans, baked beans, three bean mix.

Benefits: Kidney beans and other red beans are good sources of iron, magnesium, phosphorus, potassium, copper and thiamin. Other legumes, such as chickpeas, cannalini beans and borlotti beans are also great choices. All legumes are low in fat, low in kilojoules and are high in dietary fibre. Red beans also contain phytonutrients that may help prevent chronic diseases, such as heart disease, high blood cholesterol, high blood pressure, and cancer. Legumes, although plant foods, are very high in protein and thus serve as a meatalternative for vegetarians. Legumes are categorised into the vegetable group and also the meat group.

Recommended intake: 1 serve is ½ cup of canned/cooked legumes. Aim to have 4 servings per week.

10.Spinach Other sources: baby spinach, silver beet, turnips, dark lettuce Benefits: Spinach is high in vitamins A and C and folate. It's also a good source of riboflavin, vitamin B-6, calcium, iron and magnesium. The plant compounds in spinach may boost your immune system and may help keep your hair and skin healthy.

Recommended intake: 1 serving is ½ cup of lightly steamed or 1 cup of raw. Aim to have 1 serving 2 – 3 times per week.

11. Pumpkin Other sources: carrots, squash, sweet potatoes, capsicum Benefits: These vegetables are high in the antioxidant beta carotene. Food sources of beta carotene, which are converted to vitamin A in your body, may help slow the aging process and reduce the risk of some cancers, such as lung, colon, bladder and breast. Unlike true Vitamin A, beta-carotene is not toxic to the liver if consumed in large amounts – excesses are

broken down and excreted through the kidneys. Pumpkin is also a good source of fibre, vitamins B6, C and E, folate and potassium. And like all vegetables, they're fat-free and low in kilojoules.

Recommended Portion: Like other vegetables, one serve equals ½ cup of cooked or 1 cup of raw/salad. Aim for 5 serves of vegetables per day, with only one serve being starchy vegetables (potato, sweet potato, corn). Aim for one of your 5 serves of vegetables to be pumpkin or one of the ‘other sources’ listed above.

12.Vegetable juice Benefits: Vegetable juice contains the vitamins, minerals and other nutrients found in the original vegetables and it is an easy way to include vegetables in your diet. Tomato juice and vegetable juices that include tomatoes are good sources of lycopene, an antioxidant that may reduce the risk of heart attack, prostate cancer and possibly other types of cancer.

Vegetables, unlike fruit, contain no (or very little) sugar and hence vegetable juices are a low kilojoule, nutrient dense drink. Carrot, celery, beetroot, cucumber, capsicum, tomato, and ginger can all be juiced. You can also buy commercial vegetable juices; however be sure to select the low-sodium varieties.

Recommended intake: If you regularly meet your recommended 5 serves of vegetables per day, aim to have one vegetable juice drink once per week. However, if you struggle to eat enough vegetables, use vegetable juices more often to help you meet your vitamin and mineral requirements. Keep in mind, however, that vegetable juices do not contain the fibre from whole vegetables, and hence you should make an effort to include vegetables in your daily diet.

----------------------------Our thanks to Hepatitis Australia and Dr Jill Benson for this factsheet.

For more information, call Hepatitis SA on 1800 437 222.

12 Foods/substances that are Bad for the Liver 1. Alcohol Alcohol is metabolised (processed) in the liver by enzymes. However, this is bad for liver cells and leads to liver fibrosis and cirrhosis. The energy from alcohol is then either used as a fuel or stored in liver cells as fat. The storage of lots of fat in the liver can lead to ‘fatty liver disease’ and other complications. Alcohol consumption is by far the most common cause of fatty liver disease and even as little as one glass of wine or beer a day may contribute to this condition in some people.

2. Cigarette smoking Cigarette smoking may change certain enzymes in the liver, thereby making smokers more likely to get damage to their liver from some medications. Smoking may also decrease the liver’s ability to get rid of dangerous substances, and it may affect the dose of medication required to treat a particular liver disease. Research has shown that cigarettes are associated with a possible increased risk of liver cancer.

3. Marijuana If you have Hepatitis C, you should try and limit how much Marijuana you use. Cannabis (marijuana) may decrease the effectiveness of hepatitis medications. Smoking marijuana on a daily basis has also been significantly associated with worsening of fibrosis in people with hepatitis C.

4. Illicit drugs All drugs can put stress on your liver and can bring on a range of health problems.

Injecting unsafely increases your chance of developing infections and contracting diseases such as hepatitis. It has been suggested that amphetamines (or speed) can damage the liver, while cocaine and ecstasy have been known to cause liver toxicity and liver failure. Hallucinogenic mushrooms also contain many chemicals that the liver cannot tolerate. Heroin and morphine are not in themselves toxic to the liver, but the substances that they are mixed with can be.

5. Some herbs/herbal remedies Some herbs have been shown to be bad for the liver. For example: barberry, black cohosh, chaparral, Chinese ginseng, comfrey, creosote bush, germander, gordoloba yerba tea, greasewood, greater celandine, false pennyroyal, Jamaican bush tea, Jin Bu Huan, Kombucha tea, misteltoe, Sho-saiko-to, pennyroyal oil (squawmint oil), Last updated July 2016

sassafras, senna, skullcap and valerian combined, white chameleon. Please note that this list is not exhaustive – there may be other substances that are toxic to your liver not included here.

6. Large doses of Vitamin A. Because 50 – 80% of the body’s total Vitamin A is stored in the liver, large doses of Vitamin A can cause liver damage. An upper Level of intake has been set for population sub-groups. This is the highest average daily intake of Vitamin A that is thought to be safe. As intake increases above the upper level of intake, the potential risk of adverse effects increases. The upper levels are listed below. Those with high alcohol intake, preexisting liver disease, high cholesterol or severe protein malnutrition may be more likely to have problems with an excess intake of vitamin A and of the safe level of vitamin A intake may be less than that for the general population.

Age

Upper level of intake

Infants 0-12 months

600 µg/day

Children and adolescents 1-3 yr

600 µg/day

4-8 yr

900 µg/day

9-13 yr

1,700 µg/day

14-18 yr

2,800 µg/day

Adults 19+ yr Men

3,000 µg/day

Women

3,000 µg/day

Pregnancy 14-18 yr

2,800 µg/day

19-50 yr

3,000 µg/day

Lactation 14-18 yr

2,800 µg/day

19-50 yr

3,000 µg/day

Last updated July 2016

7. Some prescription medications Some prescription medications can damage the liver because the liver plays a major role in metabolising them. For example paracetamol/codeine , corticosteroids, tetracycline, and carbon tetrachloride. Be sure to take your medicatons as directed by your doctor to avoid unnecessary damage to your liver.

8. Some over the counter medications Some over-the-counter medications, for example paracetamol (in large doses), codeine, aspirin (in large doses), ibuprofen and diclofenac can damage the liver. Be sure to take these medications only as directed on the packaging.

9. High fat intake Eating fatty foods by itself does not cause fatty liver. The liver plays an important role in the metabolism (processing) and storage of fats. If something goes wrong in this process, fat can build up in the liver. Insulin resistance, which is associated with obesity, is the most important contributor to the change in the normal process. Dietary fats are extremely energy dense and can easily contribute to weight gain. For this reason, a high intake of fat should be avoided.

10.

High intake of saturated fats

High blood fats (hyperlipidaemia) and high blood cholesterol (hypercholesterolaemia) often accompany and may contribute to fatty liver disease. It is important to get these blood levels under control, by making the major proportion of fats in your diet unsaturated – i.e. either poly- or monounsaturated fats. Saturated fats have been shown to increase fat and cholesterolin the blood and should therefore be avoided.

11. High calorie intake/being overweight Obesity is the most common cause of non-alcoholic fatty liver disease. Consuming too many total kilojoules (from fat, carbohydrate or protein) will cause weight gain. Being overweight is associated with high levels of blood fats, insulin resistance and diabetes, all of which are factors in fatty liver disease.

12.

High salt intake

A diet high in salt can increase your blood pressure, which can contribute to fatty liver disease. Try to limit your salt intake and use medication if required to get your blood pressure under control.

Last updated July 2016

13. Other factors that are bad for the liver:   

Starvation/protein malnutrition Rapid weight loss Diabetes

-----------------------------

Our thanks to Hepatitis Australia and Dr Jill Benson for this factsheet.

For more information, call Hepatitis SA on 1800 437 222.

Last updated July 2016

This small collection of recipes was developed for food sampling at the Community Food SA centre. They are intended to be simple, economical alternatives to popular snacks or treats while taking account of recommendations for liver health, especially the reducing fats in our diets.

8 https://hepsa.asn.au

@HepatitisSA

@hep_sa & @K3myliver