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Printed at: 02:57:53 / 03-03-2021

Eating Well with Liver Disease

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The importance of good nutrition
When you are unwell with liver disease, your body has a higher demand for energy and protein. This is because the liver plays a major role in storing and releasing energy and protein, and when it is not working well these functions do not work properly either.

Good nutrition can help overcome symptoms of liver disease and prevent complications by:
 Slowing down muscle wasting
 Helping wounds heal more quickly
 Helping prevent and fight infections

This diet sheet is based on general dietary advice for people with liver disease. Certain aspects may change depending on your doctor’s/dietitian’s specific advice. If you have any questions or concerns regarding your diet with liver disease, then please consult your doctor or dietitian.

Starchy Carbohydrate Foods
It is important to have regular meals and snacks which contain starchy carbohydrate, ideally every 2-3 hours during the day. Starchy carbohydrate containing foods include bread; potato; cereals & cereal bars; pasta; noodles; rice; and biscuits or crackers.

Carbohydrate bedtime snack
It is important to have a bedtime snack containing 50g of carbohydrate as it is a long time until breakfast.

Protein
Your body needs more protein than usual when your liver is not working properly. Protein can help prevent muscle wastage and oedema. A good source of protein should be included with at least 3-4 meals or snacks a day. This could be meat, poultry, fish, cheese, eggs, pulses such as beans, peas and lentils, or meat alternatives such as soya, tofu, beans, seeds and nuts.

Fruit and Vegetables
Make sure you include fruit and vegetables in your diet, which are important for vitamins, minerals and fibre. A small glass of fruit juice or fruit smoothie a day may be included if you are unable to eat enough fruit and vegetables.

Fluids
It is important to drink around 6-8 cups of fluid a day to help prevent constipation and dehydration, unless you have been given a fluid restriction by your doctor. Avoiding caffeinated drinks is important as the liver usually breaks down caffeine. Choose decaffeinated tea and coffee or fruity/herbal teas, or chose milky drinks if your appetite is poor. The most important lifestyle change you can make to prevent further damage to your liver is to stop drinking alcohol.

Fluid Retention – ascites and oedema
Ascites is the collection of fluid around your middle and oedema is the collection of fluid in your feet, ankles and legs. This can cause your weight to change greatly, and can mask the fact that you are losing muscle or fat. Reducing salt in the diet can help reduce fluid retention. In order to reduce salt in the diet, it is recommended no salt is added at the table and it is used sparingly in cooking. Three quarters of the salt in our diet is already in the foods we eat. The table below lists high salt foods to avoid and suitable alternatives.

If you have a poor appetite
– Aim to eat every 2-3 hours and include some starchy carbohydrate in all meals/snacks.
– Use one pint of full cream milk a day, have at least two milky drinks a day.
– Avoid filling up on drinks which contain little nourishment i.e. tea, coffee, packet soups.
– Avoid “diet” or “light” products; always go for full-fat products.

Fortify Your Foods
– Add grated cheese, butter/spread, cream to potatoes, soups, sauces, vegetables.
– Add extra sugar/ honey to breakfast cereals, milk puddings, yoghurts.
– To make enriched milk add 4 tablespoons of milk powder (e.g. Marvel® or supermarket own brand) into 1 pint of full cream milk. Use this milk in drinks, to make sauces, on cereals.
– If you are struggling to eat enough, your dietitian will be able to suggest suitable supplement drinks to have in between your meals. You can also buy Meritene® or Complan® milkshakes, smoothies and soups from supermarkets or chemists, which are a good source of protein and energy.

Suggested Meal Plan

Breakfast

2 Eggs on toast with mushrooms and tomatoes OR
2 Slices of peanut butter on toast with a banana OR
Cereal with fruit/dried fruit and enriched milk.

Mid-Morning

Milk shake (i.e. enriched milk, with 1 scoop of ice-cream and 1 small banana/ 10 strawberries) OR
2 toasted crumpets/malt loaf with butter OR
3 biscuits and a glass of milk

Lunch

Sandwich with meat, fish, eggs or cheese and salad OR
Jacket potato with tuna, minced meat, beans or cheese and salad

Dessert

Yoghurt OR rice pudding OR fruit with cream

Mid Afternoon

A piece of cake/chocolate bar OR
Hot chocolate, Ovaltine ®/ Horlicks ® made with milk.

Evening meals

Meat or fish with potatoes and vegetables OR
Lasagne or pasta with mince meat and vegetables OR
Meat/ fish/ lentil and vegetable curry with rice

Dessert

Ice cream and fruit crumble, sponge pudding and custard/ ice cream

Bedtime snack

Containing 50g carbohydrates, as suggested above.

Useful Websites: www.britishlivertrust.org.uk