Diet - liver disease

Definition 
A diet plan for people with liver disease.

Function 
This diet is intended to protect the liver (in a person with liver disease) from over work and enable it to function as efficiently as possible.

Proteins assist with tissue repair, and prevention of fatty infiltration and damage to the liver cells. In people with severely damaged livers, the proteins cannot be properly metabolized and waste products (including ammonia) that are toxic to the body can build up and affect the brain. In this case, protein may be restricted.

The increase in carbohydrate helps in providing for an adequate reserve of glycogen, which is the storage form of carbohydrate. Carbohydrates should be the major source of calories for people with liver disease.

Anemia, peripheral neuropathy, and nutritional deficiencies may be treated with medication and vitamin supplementation.

Ascites and edema may be worsened by salt intake because salt holds on to water in the body. Most people with liver disease will need to have a sodium restricted diet.

Food Sources 
The liver is involved in the metabolism of all foods. Therefore, proteins, carbohydrates, fats, vitamins, sodium (salt), and fluids may be affected by this diet.

Side Effects 
Because liver disease can affect the absorption of all types of food, major side effects include weight loss, anorexia (loss of appetite), and vitamin deficiency. Prolonged protein restriction can cause deficiencies of certain amino acids.

Recommendations 
The dietary recommendations may vary somewhat depending on how well the person’s liver is functioning. It is very important to be under the care of a health professional, otherwise malnutrition can lead to serious consequences. In general, recommendations include:

     
  • high intake of carbohydrate foods. Carbohydrates should be the major source of calories in this diet.  
  • A moderate intake of fat (as prescribed by the health care provider). The increased carbohydrate and fat help in preserving the protein in the body and prevent excessive protein breakdown.  
  • approximately 1 gram of protein per kilogram of body weight. For a 70 kilogram man (154 pounds), 70 grams of protein translates into 8 ounces of cooked protein and two 8-ounce glasses of milk on a daily basis. This does not include the protein from starches and vegetables. People with a severely damaged liver may be on strict protein restriction, and may be limited to only minimal quantities of essential amino acids (obtained through special nutritional supplements).  
  • vitamin supplementation as medically recommended, especially B-complex.  
  • sodium restriction if fluid retention is present.

SAMPLE MENU

     
  • breakfast       o 1 orange       o cooked oatmeal, with milk and sugar       o 1 slice of whole-wheat toast       o 2 teaspoons of margarine       o strawberry jam       o coffee or tea  
  • lunch       o 4 ounces of cooked lean fish, poultry, or meat       o a starch item (such as potatoes)       o a cooked vegetable       o salad       o 2 slices of whole-grain bread       o 2 teaspoons of margarine       o 1 tablespoon of jelly       o fresh fruit       o milk  
  • midafternoon snack       o milk with graham crackers  
  • dinner       o 4 ounces of cooked fish, poultry, or meat       o starch item (such as potatoes)       o a cooked vegetable       o salad       o 2 whole-grain rolls       o 2 tablespoons of margarine       o fresh fruit or dessert       o 8 ounces of milk  
  • evening snack       o high-protein milk (milk with non-fat dry milk added)

    Usually, there are no cautions against specific foods. However, many people are unable to tolerate strongly flavored vegetables, high-fat foods, fried foods, chocolate, nuts, and foods that have a lot of seasoning.

    If you have questions about your diet or your symptoms contact your physician immediately.

Johns Hopkins patient information

Last revised: December 6, 2012
by Simon D. Mitin, M.D.

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