A person with liver disease must eat a special diet. This diet is protects the liver from working too hard and helps it to function as well as possible.

Proteins normally help the body repair tissue. They also prevent fatty buildup and damage to the liver cells.

In people with severely damaged livers, proteins are not properly processed. Waste products may build up and affect the brain. Restricting the amount of protein in the diet can reduce the chance that toxic waste products will build up.

The body stores carbohydrates in the form of glycogen. Increasing carbohydrates in the diet helps preserve glycogen stores. People with liver disease may need to increase their intake of carbohydrates in proportion to protein.

Low blood count, nerve problems, and nutritional deficiencies that occur with liver disease may be treated with drugs and vitamin supplements.

Salt in the diet may worsen fluid buildup and swelling in the liver, because salt causes the body to retain water. Most people with severe liver disease must restrict the amount of sodium in their diet.

The liver is involved in the metabolism of all foods. Metabolism is the conversion of food into energy.

Changing the diet by increasing or decreasing proteins, carbohydrates, fats, and vitamins may further affect the function of the diseased liver, especially its protein and vitamin production.

Because liver disease can affect the absorption of food and the production of proteins and vitamins, your diet may influence your weight, appetite, and the amounts of vitamins in your body. Do not limit protein too much, because it can cause deficiencies of certain amino acids.

The dietary recommendations may vary, depending on how well your liver is working. It is very important to be under the care of a doctor, because malnutrition can lead to serious problems.

In general, recommendations for patients with severe liver disease may include:

• Large amounts of carbohydrate foods. Carbohydrates should be the major source of calories in this diet.
• Moderate intake of fat, as prescribed by the health care provider. The increased carbohydrates and fat help preserve the protein in the body and prevent protein breakdown.
• About 1 gram of protein per kilogram of body weight. This means that a 154-pound (70-kilogram) man should eat 70 grams of protein per day. This does not include the protein from starchy foods and vegetables. A person with a severely damaged liver may need to eat less protein than this, and may even be limited to small quantities of special nutritional supplements. Avoid limiting protein too much, however, because it can lead to malnutrition.
• Vitamin supplements, especially B-complex vitamins.
• Limit sodium (typically 1 - 2 grams per day) if you are retaining fluid.

SAMPLE MENU

• Breakfast
  • 1 orange
  • Cooked oatmeal with milk and sugar
  • 1 slice of whole-wheat toast
  • 2 teaspoons of margarine
  • Strawberry jam
  • Coffee or tea
• Lunch
  • 4 ounces of cooked lean fish, poultry, or meat
  • A starch item (such as potatoes)
  • A cooked vegetable
  • Salad
  • 2 slices of whole-grain bread
  • 2 teaspoons of margarine
  • 1 tablespoon of jelly
  • Fresh fruit
  • Milk
• Mid-afternoon snack
  • Milk with graham crackers
• Dinner
  • 4 ounces of cooked fish, poultry, or meat
  • Starch item (such as potatoes)
  • A cooked vegetable
  • Salad
  • 2 whole-grain rolls
  • 2 tablespoons of margarine
  • Fresh fruit or dessert
  • 8 ounces of milk
• Evening snack
  • Glass of milk or piece of fruit

Usually, there are no cautions against specific foods.

If you have questions about your diet or symptoms, contact your doctor.

DeLegge MH. Nutrition in gastrointestinal diseases. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2006: chap 16.