Chronic liver disease can occur for a number of reasons such as cirrhosis, hepatitis, diabetes or malnutrition. Most commonly, it results from alcohol abuse. The condition arises when gradual damage is done to the liver tissues over time. Nutrition plays an important role in the management of symptoms and prevention of further deterioration. This article provides general information about the nutritional management of chronic liver disease. This aims to provide general information and is not a substitute for thorough clinical management by health professional.
Chronic liver disease will often lead to loss of muscle and fat. Sometimes this can be difficult to notice as fluid retention can maintain weight and disguise muscle and fat losses. It is important to ensure adequate protein and energy intake to ensure other health complications do not arise from malnutrition.
Protein plays a very important role as it assists in maintaining muscle mass and body tissue – this includes the liver. Protein also plays many other important roles in the body. It is a common belief that people with liver disease should avoid protein rich diets to prevent hepatic encephalopathy (which leads to altered mental state e.g. confusion, forgetfulness). This is incorrect information and should be ignored. A low protein diet will only increase the risk of malnutrition.
Energy (kilojoules / calories)
It is important to eat foods that are high in energy – particularly if your appetite is smaller than usual and you are unable to eat usual amounts. Energy will also prevent muscle and fat losses.
Tips to increase protein / energy intake
- Try eating six or more smaller meals over the day opposed to three larger meals. This can be useful if your appetite is decreased. You will likely get a lot more nutrition in by grazing on small amounts frequently.
- Don’t be afraid to use fats and oils. Normally we are advised to steer clear of these ingredients but when we are at risk of losing weight and becoming malnourished, it is of higher importance that we prevent the weight loss, and fats and oils are great energy boosters!
- Eat a small, energy dense meal or snack close to going to bed.
- Have milk, juice or cordial as part of your daily fluid intake – this will get more energy and/or protein into your day.
- If you are really struggling to maintain muscle/ fat stores – consult a dietitian for advice on nutrition supplements.
There are some exceptions however. Those who are overweight or have diabetes may have slightly different guidelines to follow in terms of energy/ fat/ sugar intake. Again, it is best to consult a dietitian and doctor. A high protein intake will still be important.
Many individuals with chronic liver disease will be advised to follow a low salt diet. Why? As liver disease progresses fluid tends to build up around the stomach – this is called ascites. When this happens it is extremely important that salt in the diet is limited. This is because salt leads to water retention in our bodies. Cutting back on the salt in your diet can therefore limit the amount of fluid stored.
Some individuals will also be told to limit their fluid intake each day. A medical doctor will determine if this is necessary.
Vitamins and minerals
Sometimes chronic liver disease can result in vitamin or mineral deficiencies for a number of reasons. Ensure you eat a balanced diet with lots of variety – this will help meet nutrient requirements and ensure further complications don’t result. Do not take any supplements unless advised to do so by your doctor.
Contact us for results focused nutritional advice
This article was written by our dietitian Belinda Elwin who is a Dietitians Association of Australia member, and Accredited Practicing Dietitian and Nutritionist. If you have questions about healthy eating, make an appointment. We‘ll provide you with a simple and effective routine targeted to your concerns. Contact us today!