Because the liver plays a vital role in digestion and nutrient absorption, individuals with cirrhosis are at risk of malnutrition. Dietary changes can help reduce this risk.
Liver cirrhosis is the medical term for scarring of the liver due to long-term liver disease. This scarring stops the liver from functioning properly, which affects how the body digests food.
This article discusses the best foods and mealtimes for people with cirrhosis. We also discuss some foods that people with cirrhosis may want to avoid in order to help prevent cirrhosis complications.
The British Liver Trust (BLT) suggests that people with cirrhosis eat little and often, ideally every 2 to 3 hours. This pattern of eating helps prevent the body from breaking down proteins in muscles to use as energy.
Individuals with cirrhosis should also avoid fasting. This may mean eating a snack before bedtime, and soon after waking. The BLT recommends snacking on foods that are high in starchy carbohydrates, such as:
- cereal
- oatmeal
- shortbread
Usually, the liver stores a carbohydrate known as glycogen, and then releases into the bloodstream between meals to ensure the body has a regular supply of energy.
As the BLT explains, cirrhosis means that the liver is less effective at storing glycogen. As a result, individuals with cirrhosis need to consume more calories and protein to help maintain their energy levels.
Some high protein foods that may be beneficial for people with cirrhosis include:
According to the American Association for the Study of Liver Disease (AASLD), adults with cirrhosis who are clinically stable should aim to consume between 1.2 grams (g) and 1.5 g of protein per kilogram (kg) of body weight per day.
The AASLD adds that adults with cirrhosis who are critically ill should aim to consume between 1.2 g and 2.0 g of protein per kg body weight per day.
The AASLD explains that individuals with cirrhosis are susceptible to certain vitamin and mineral deficiencies, depending on the cause of their liver disease. Consuming fruits and vegetables that are high in these micronutrients could help to prevent them.
People with alcohol-related liver disease are more likely to be deficient in:
Some people may develop cirrhosis as a result of cholestatic liver disease (CLD), which occurs due to a blockage or reduction in the flow of bile from the liver.
People with this type of liver disease are more likely to be deficient in fat-soluble vitamins, such as:
- vitamin A
- vitamin E
- vitamin D
The table below lists some of the above vitamins and minerals alongside some plant-based foods that provide a source of these micronutrients, according to the National Institutes of Health (NIH):
| Micronutrient | Fruit and/or vegetable sources |
|---|---|
| green, leafy vegetables broccoli sweet potatoes carrots winter squash cantaloupe mangoes apricot | |
| nuts seeds vegetable oils green, leafy vegetables | |
| mushrooms, particularly UV-treated mushrooms | |
| asparagus brussels sprouts dark green leafy vegetables peas beans nuts oranges | |
| black beans acorn squash orange juice | |
| pumpkin seeds lentils | |
| brazil nuts spaghetti baked beans |
A person should talk with a doctor before making any significant dietary changes to ensure that it is safe for them to do so.
The liver plays a key role in regulating the balance of water and sodium in the body. Cirrhosis can interfere with the liver’s ability to properly regulate this balance, and this may lead to uncomfortable fluid retention, also known as “ascites“.
According to the American College of Gastroenterology (ACG), signs and symptoms of ascites may include:
- abdominal distension
- abdominal pain or discomfort
- shortness of breath
- swollen ankles
- weight gain
People with ascites may need to limit salt to below 2 g per day. Others can limit their intake by following a “no added salt” diet. This means not adding salt to homemade food and avoiding foods very high in salt, such as cured meats and foods stored in brine.
According to the BLT, foods and beverages containing more than 1.5 g of salt per 100 g (or 0.6 g of sodium) are high in salt, so people with cirrhosis should avoid these.
According to the
- Foods that can cause infections: Cirrhosis can impair immune functioning, making individuals more susceptible to infection. As such, people with cirrhosis should avoid foods that increase the risk of severe viral and bacterial infections. These include:
- raw or undercooked meats
- raw or undercooked fish or shellfish
- unpasteurized milk and milk products
- Foods that are high in sodium: These can lead to uncomfortable fluid retention. The BLT recommends that people with cirrhosis avoid foods and beverages containing more than 1.5 g of salt per 100 g, or 0.6 g of sodium. People should also be aware that some medications and bottled water also contain sodium.
- Alcohol: Continuing to drink alcohol can worsen existing liver damage.
Below are some answers to frequently asked questions about liver cirrhosis and diet.
How can I prevent complications of cirrhosis through diet?
Some of the most important dietary changes to make in order to prevent cirrhosis complications are:
- completely avoiding alcohol
- avoiding raw or undercooked meats, fish, or dairy products
- limiting salty foods, particularly if a person has abdominal swelling
- eating frequently, ideally every 2 to 3 hours, including before bed and after waking up
- getting enough calories, protein, and nutrient-rich foods to prevent deficiencies.
Should I take supplements if I have cirrhosis?
People with cirrhosis may need to take supplements if they are deficient in one or more nutrients. However, a person should not take a supplement unless their doctor tells them that it is safe to do so.
As the BLT explains, some supplements can negatively affect liver function, especially in people with existing liver disease. Certain supplements may also interact with other medications or supplements a person is taking.
Medical experts typically recommend that individuals with cirrhosis eat little and often, avoid fasting, and increase their protein intake.
They may also recommend avoiding certain foods and beverages, such as alcohol, undercooked or unpasteurized animal products, and foods that are high in sodium.
Cirrhosis can increase the risk of certain nutrient deficiencies. In such cases, doctors may recommend a supplement to help treat the deficiency and prevent complications.
However, a person should not take a supplement unless a doctor says it is safe for them to do so. Some supplements can worsen liver disease, and some may also interact with other medications or supplements a person is taking.
