Diet in Decompensated Liver Disease

Patients with liver cirrhosis have either malnutrition or several micronutrient deficiencies due to multiple mechanisms, including poor nutritional intake, poor absorption, and increased losses. Diet plays a major role in the development and progression of liver disease.

Eating a well-balanced diet, can help to prevent the development of a catabolic phase with muscle loss.

Along with protein, a well-balanced diet with sufficient fats, calories, and carbohydrates can help to regenerate new liver cells in the damaged liver.

In most of the liver diseases, nourishment becomes a vital part of treatment.

What can we do to?      

  1. Eating a well-balanced diet: Cirrhosis leads to malnutrition and loss of muscle. The best defence against this development is to maintain a healthy diet, with a variety of foods from all food groups: grains, fruits, vegetables, meat and beans, milk, sugar and oil.
  • Small and frequent meals: Cirrhosis can reduce your hunger; ascites can allow it to be almost impossible to consume big meals.
  • Eating smaller meals through the day (every 2-3 hours once) instead of attempting three big meals will help you satisfy your daily calorie/protein needs.
  • Choose for calorie-dense, high protein snacks, in between the meal

Examples for such snacks are:

  • Nuts
  • Sundal
  • Yoghurt/Curd
  • Panner/tofu
  • Chicken/lentil stew
  • Egg(in any form)
  • High protein diet: Cirrhotic patients need good quality of proteins.

                         Protein rich foods are:

  • Chicken/ Fish / Egg White
  • Low-fat milk and dairy  products(like: curd, cheese, paneer etc)
  • Nuts and seeds
  • Pulses and legumes

** Vegetarian proteins and dairy products (including egg) are high in BCAA (branched chain amino acid) and are better tolerated than non-vegetarian proteins in cirrhotic patients.

  • Limit your fat intake: A high-fat diet  will be difficult to digest and patients will feel heavy after a fatty meal and will prevent the more important proteins to be consumed.
  •  High fiber diet: Fiber-rich meals with a lower content of simple carbohydrates, helps your liver work at an optimal level. Fruits, vegetables, whole grain breads, rice and cereals can take care of your body’s fiber needs.
  • Adding probiotic in your diet: In liver cirrhotic patients there will be an imbalance in bacterial gut flora which contributes significantly to ammonia production, resulting in varying degrees of encephalopathy. Adding probiotic drink (yakult) and curd is always beneficial to keep your gut healthy.
  • Salt restriction is a must:

If you have fluid build-up in your legs (oedema) or abdomen (ascites), reducing the amount of salt in your diet can help control this.

  • Aim for no more than 2-3g of salt (Sodium Chloride) per day
  • Black pepper, lemon, ginger, garlic, onions and herbs can be used as an alternative.
  • Avoid foods rich in sodium.
  • Examples for such snacks to avoid are:
  • Salted snacks (chips, biscuits, savouries)
  • Pickles, papad, ajinomoto
  • Packed and canned food / processed food
  • Ready to eat food/snacks
  • Bakery items
  • Restrict your fluid intake, if needed (as prescribed by your Doctor): Restriction of fluid is an important factor in your nutritional therapy in certain conditions. Please ask your doctor regarding your daily fluid intake.
  • Be physically active: Exercise as much as you can. Ask your Doctor/physiotherapist for optimum exercises. Keep yourself active and try to do your daily courses by your own, whenever possible.

A “liver-adapted” diet is just as important as medication.