Low Salt Diet in Cirrhosis and Liver Disease: Advise to Patients and Family

In those patients with liver disease and cirrhosis, maintaining a diet low in salt (also knows as sodium) can be difficult at times. With all the eating out that America does, this processed food is overloaded with salt and sodium. Thus, it is nearly impossible to maintain a diet low in sodium. Usually, the target goal is to consume less than 2,000 mg per day.

A list of common foods and their sodium content is posted below. Remember to read labels, and determine the “serving size”.

Common Food Sodium Content

I have posted a new video on our YouTube page  giving you all some suggestions on maintaining this low salt diet. Send me your comments.

Dr. Joe Galati

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Grazoprevir and Elbasvir: New Hepatitis C Treatment Options with High Cure Rates

Wrapping up presentations at this years annual Liver Meetings in Boston, Dr. Eric Lawitz presented data on 2 new antiviral agents to treat chronic hepatitis C. This study looked at the more tough to treat populations.

These two drugs use in cirrhotic patients and those prior null responder to Peg-intron and ribavirin had between a 91-100% SVR.

The full article is posted in this weeks Lancet Journal.

Throughout the meeting, very encouraging data was presented about the very high cure rates we are seeing in hepatitis C. With no less than 6 new drugs being developed, in the months ahead, we will all see the slow evolution of these therapies, selecting specific drug combinations tailored to unique patient features, such as HCV genotype, prior response to therapy, presence or absence of cirrhosis, renal failure (with or without dialysis), HIV status, and whether the patient has had a liver transplant.

As with all of these therapies, cost will be factored into the course of treatment.

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Liver Transplant with Donors Over 80 Years Old Do Well

Liver Transplant with Donors Over 80 Years Old Do Well

A research paper presented this morning at the AASLD Liver Meeting indicates that liver donors 80 years of age and older do just as well as those receiving a liver transplant from a donor less than 80 years old.

Considering the large number of patients awaiting liver transplant, and the associated limited number of suitable donors, resulting in unacceptable wait-list deaths, serious consideration should be given to accepting older donors, especially those over 80 years old.

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Olysio and Sovaldi Now Approved for Hepatitis C

As the treatments for chronic hepatitis C continue to expand, and provide a superior cure rate, the FDA has approved the combination of both Sovaldi(sofosbuvir) and Olysio (simeprevir) for treating HCV. We have been using this combination, but it was not officially approved, causing some insurance related issues for some patients.

Here is one of many press releases.

All this means is a superior cure rate, and help for those who suffer from chronic liver disease.

Call us for an appointment for treatment consideration.

 

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Harvoni: Points to Consider

Harvoni, the newly FDA approved drug for chronic hepatitis C, is indicated for genotype 1 patients only. All others, at this time, are not approved. Additional new drugs are in the process of receiving FDA approval for the other genotypes.

While there is no official indication for treating post-liver transplant patients, many experienced physicians will evaluate post liver transplant patients with recurrent hepatitis C.

For patients interested in being treated, it is important that your old records from prior treatments are available. We would need to be aware of your prior response to treatment.

In conversations with patients the past couple of weeks, they are amazed that there is no use of interferon and ribavirin, which was always a concern because of the numerous serious side effects. With Harvoni, side effects include fatigue, headache, nausea, diarrhea, and insomnia. Most of these occur between 3-14% of the times.

Overall, this remains an exciting time for everyone with HCV, realizing that a cute is within reach.

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New Hepatitis C Drug Harvoni FDA Approved: Information for Patients

More information on the new Gilead drug Harvoni for patients with hepatitis C.

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New Hepatitis C Drug is FDA Approved: Harvoni (Combo Lepidasvir and Sofosbuvir)

Yet another hepatitis C drug has been approved by the FDA, a great day for those who suffer from hepatitis C. A combination of Ledipasvir and Sofosbuvir, this new drug, called Harvoni, is the latest entry by Gilead, leading the way in curing hepatitis C.

For patients interested in therapy, contact our office during business hours for details on being evaluated. Call 713-794-0700 and ask for Lexa. Dr. Galati prepared an introductory video explaining the latest FDA approval.

 

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The Great Mayonnaise Deception and Marketing Trickery

The Great Mayonnaise Deception and Marketing Trickery

Can Mayonnaise Really Be Healthy?

For full disclosure, I prefer mayo over mustard. Growing up, we were a mayo leaning household. Blame my parents.

Sitting having lunch today, as I reached for my favorite mayonnaise, my eye focuses on the bottom of the bottle, with somewhat of a surprising health claim: my favorite “real” mayonnaise actually will supply me with omega-3 fatty acids. Are these the same omega-3’s we are all looking to consume in fresh fish and nuts? Omega-3 fatty acids are the talk of the nutrition world, and seem to help us prevent or treat just about every ailment from halitosis (bad breath for the novice followers of our blog) to dementia. Wow. I always knew my parents were forward thinking for recommending mayo over yellow mustard. They had our health and well being on their mind decades earlier than most.

So with that said, and the apparent availability of omega-3’s in mayo, is that really a good thing? Here is my take on this nutritional dilemma:

1. It’s all about marketing: we are conditioned to react to statements that proclaim a health benefit. Do not be fooled. Michael Pollan states it very nicely in this quote: “…Only the big food manufacturers have the wherewithal to secure FDA-approved health claims for their products and then trumpet them to the world. Generally, it is the products of modern food science that make the boldest health claims, and these are often founded on incomplete and often bad science. ”
Michael Pollan, Food Rules: An Eater’s Manual

2. I would suggest you get your omega 3-fatty acids in their natural source, not a manufactured product. Eat fish, nuts, and vegetables, not food in a squeeze bottle.

3. For a good understanding of omega-3’s, look at this review from the Harvard School of Public Health.

4. Lastly, with all of this hype and health claims, one may walk away with the notion that “eating mayonnaise may actually be good for me”. This of course is the wrong message and an unexpected consequence of all this-or maybe exactly what the marketing department at Hellman’s wants. From a nutrition stand point, 100% of the calories comes from fat. See the nutritional breakdown here. Mayo is basically egg fat and oil. A serving of mayo is equal to the fat found in 4 chocolate chip cookies. Hmmm.maybe not so healthful.

Omega-3: Really?

 

 

Having a thin smear of mayo every blue moon won’t kill you, or clog your arteries. The impression that mayo is a healthful food, and we should eat more, is a false claim. For fairness, the makers of Hellman’s Real Mayonnaise do not tell you to eat more of their mayo for the omega-3 benefit-they simply state the fact of what’s in their product. We are all conditioned from elsewhere that these are things we need in our diet. They are simply riding on the food and nutrition benefit wave of omega-3 fatty acids.

Ham and Mayo?

 

 

 

 

 

 

 

Tell me what you think.

 

 

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Alcoholic Liver Disease: What You Need to Know-The Basics

Our latest video covers the basic aspects of alcohol related liver disease, and the complications of excessive alcohol intake. In general, there are three areas of concern:

1. The development of alcoholic fatty liver disease

2. The development of acute alcoholic hepatitis

3. Alcoholic cirrhosis

The major point to understanding is that all alcoholic drinks (servings) have about the same amount of alcohol in them. Thus, 1-beer, 1-glass of wine, and 1-serving of spirit (i.e. vodka, rum, gin, etc) all have approximately 10-12 grams of alcohol in them. Alcohol is alcohol, regardless of the volume, color, or taste.

The other key point to remember, is that the amount of alcohol daily is different for men and women. For women, one serving/day is the limit; two for men. Period. Above this, you run the risk of complications.

View our latest video.

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Childhood Obesity: A Close Up Look

Which that said, my estimate is that 35% of these young women are overweight or obese. This is consistent with the national trend.

One of the players had a very obvious “spare tire” that was visually obvious with every swing. The gravity if this adipose tissue flung forward with the twist of her swing. With each peak, I thought to myself, “this poor kid will be diabetic by age 30 if nothing is done.”

Surrounded by fast-food advertisements, junk snacks, and sugar charged drinks, this teenage generation is doomed. It has been stated repeatedly this this generation-our children-will not live as long as their parents.

So what to do? An action plan? Start with the following:
A. Look at your kids weight: take action if your child is overweight
B. Thin out you food closets of processes foods.
C. Learn to cook and feed your family real good
D. Teach your kids

This weekend I am attending a girls high school golf tournament. The girls participating are generally 15 to 17 years old. With the players dressed in skirts, shorts, and golf shirts, you can get a sense of their underlying physique.

the merits of regular, vigorous exercise.

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