Managing Symptoms


Healthy Diet

Healhty Diet for Intrahepatic Cholestasis of Pregnancy (ICP)

The American Liver Foundation recommends eating a healthy diet that makes it easier for the liver to do its jobs and can help repair some liver damage. The Perinatal Research Group on ICP in Argentina for the Clinical Practice Guideline recommend a healthy diet as part of the treatment. Although currently there is no research into Intrahepatic Cholestasis of Pregnancy and diet there is some evidence to suggest that it may help women that experience ICP to follow a healthy eating plan. Please keep in mind there is no way to prevent or cure and once you are diagnosed there is no reversing ICP with a healthy diet.

A healthy diet should not replace any treatment and management plan that may have been implemented by the healthcare provider such as the medicine Ursodeoxycholic acid (UDCA or Urso) and early delivery by 37 weeks.

Food is powerful for good health and during pregnancy even more important to eat healthy. Women with Cholestasis of Pregnancy notice less itchy symptoms following a nutritious diet of real food that is whole, fresh and unprocessed.

Please consult with your Healthcare provider if you were diagnosed with gestational diabetes as they may have already given you dietary advice and your healthcare provider will need to review and approve this information.

*Please consult with your doctor before implementing any diet changes*

Whole Fruits & Vegetables

Whole fruits and vegetables contain nutrients your body needs including vitamins, minerals and fiber. Fresh fruit and vegetables are the best options.

  • Preferably organic produce free of pesticides to reduce the amount of toxins.
  • Limit the Dirty Dozen, Go with the Clean Fifteen as noted below as a guide.
  • If packaged, read the label to be sure there is no added sugar.
  • If canned, make sure it’s in its own juices (not a sugary substitute)
  • Frozen, canned (in BPA-free cans), dehydrated, and dried are good options if fresh fruit is not available.

Whole vegetables : carrot, beets as well as the leafy part of beets, cucumber, broccoli, radish, squash, mushroom, celery, asparagus, zucchini, brussel sprouts, cauliflower, pumpkin, mushroom, sweet potato, butternut squash, tomato, eggplant, potatoes, yams, avocado, olives, red and green peppers, garlic and onion.

Leafy greens : spinach, kale, romaine lettuce, chard, collards, swiss chard, cabbage, watercress and iceberg lettuce.

Whole fruits : banana, mango, watermelon, apple, cantaloupes, peach, strawberry, avocado, coconut, blackberries, raspberries, cranberries, blueberries, pears, orange, cherries, nectarines, papaya, grapes, pineapple, raisins and other dried fruits.


Organic

Dirty Dozen
The following “Dirty Dozen Plus” have the highest pesticide load, making them the most important to buy organic versions – or to grow them organically:

  • Apples
  • Strawberries
  • Grapes
  • Celery
  • Peaches
  • Spinach
  • Sweet Bell Peppers
  • Nectarines (imported)
  • Cucumbers
  • Cherry tomatoes
  • Snap peas (Imported)
  • Potatoes
  • Blueberries
  • Hot Peppers
  • Also: Green beans and kale are moving up on the most sprayed list as well.

Clean Fifteen
The following “Clean 15” foods have the lowest pesticide load, and consequently are the safest conventionally grown crops to consume from the standpoint of pesticide contamination:

  • Avocados
  • Sweet corn
  • Pineapples
  • Cabbage
  • Sweet peas (frozen)
  • Onions
  • Asparagus
  • Mangoes(imported)
  • Papayas
  • Kiwi
  • Eggplant
  • Grapefruit
  • Cantaloupe
  • Cauliflower
  • Sweet Potatoes

Protein

  • Protein from diverse sources preferably organic (hormone/antibiotic/steroid free) skinless chicken and turkey and other meats from animals such as grass-fed organic meats, and cage free eggs (free range), and wild caught fish..
  • Fresh fish such as wild salmon, tilapia, mackerel, flounder, sardines, and herring (fish must not be
    fried). Other seafood include shrimp, oysters, scallops, fresh sea vegetables, cod liver oil, and linseed oil. Note if pregnant do not eat raw seafood.

Beans/Legumes

  • Dried beans or legumes are best and tetra-pak or BPA-free canned beans preferred. Legumes that are protein rich include kidney beans, black beans, chickpeas, snap beans, lima beans, lentils, pinto beans, fava beans, snow peas, navy beans, and pigeon peas.

Healthy Fats

  • Healthy fat from nut sources, almond, walnut, pecan, and macadamia.
  • Healthy fat from seed sources, flaxseeds, pumpkin seeds, chia seeds, hemp seeds and walnuts.
  • Healthy oils such as extra virgin olive oil, and seed oils include olive, coconut oil, sesame seed oil, and grapeseed oil.

Whole Grains

  • Whole grains such as brown rice, wild rice, barley, buckwheat, millet, oats, farro, quinoa, bulgur, spelt, amaranth and barley.
  • Breads such as whole-grains, multi-grain, stone ground, pita, sourdough and pasta made from whole-grains, rice crackers, and pita bread.

Avoid these options

  • Large amounts of sugar, especially refined sugars, artificial sugars and artificial sweeteners, high fructose corn syrup found in sodas & many other products.
  • White flour and limit processed packaged foods or preservatives.
  • Soy and others that may include such as chips, cracker etc.
  • Avoid processed meats like deli meats, bacon, hot dogs and sausage.
  • Dairy products to reduce or avoid include full fat milk, cream and full fat cheeses such as cheddar.

Better options

  • Natural options such as honey, stevia, maple-syrup.
  • Eat fresh raw fruits, sun-dried fruits & berries such as goji berries or mulberry berries, fruit sorbet, smoothies and honey. Choose dark chocolate with at least 85% cocoa, preferably organic that is low in sugar. Try a smoothie with fruits and vegetables such as mango, spinach or kale, banana and just add water or coconut water.
  • Apple Cider Vinegar such as Braggs 1 Tablespoon in cup of apple juice or with lemon juice & water.
  • Water-soluble prenatal vitamins (there are many on the market such as Vegan Prenatal) or Vitamin Code raw prenatal from Garden of Life.
  • Milk Thistle and Dandelion as a complement or supplement.

Other Tips

  • Drink eight to twelve glasses of water daily as this helps to cleanse the liver. Add fresh squeezed lemon juice.
  • Squeeze a half or whole lemon in a cup of warm water and drink it. Lemon is very good for the liver to detoxify it.
  • Choose organic grass-fed pasture raised milk, butter and yogurt. Non-Dairy Milk substitutions with good source of calcium include almond milk, coconut milk or rice milk.
  • Use the Fooducate free app. to browse Fooducate’s extensive database to find the healthiest food options.

Important Health Claims

  • Certified Organic or non-GMO: product is made without genetically modified ingredients.
  • 100% Organic means the entire product is organic..
  • Labeling as Natural means nothing.
  • Organic means 90% of the product is organic.
  • Includes Organic means 70% of the ingredients are organic.

References:
American Liver Foundation
Kenneth F. Trofatter, Jr., MD, PhD Healthline Blog
Dr. Mark Hyman, MD