There are several varieties of liver disease, some of which cause no symptoms and others of which cause life-threatening sickness. While many individuals with liver illness can eat a well-balanced diet, others may need more extensive counseling than this booklet provides. As a result, it is critical that you speak with your doctor in addition to reading this leaflet.
If you have any questions regarding your diet that are not addressed in this booklet, or if you want more assistance, please request to be referred to a state-registered dietician with competence in this area. If you have been given dietary advice in the past, you should follow it and talk to your doctor or dietitian before making any changes.
The liver’s importance in nutrition
Your stomach and intestines break down the food you ingest. The nutrients in meals are absorbed into the bloodstream and delivered to the liver through the gut. They are then either stored or further broken down, ready for your body to utilize, depending on your current requirements. When someone has a liver ailment, these processes continue, but may not be as efficient as they are in a healthy individual.
Food is composed of three primary energy sources, or calories, carbohydrate, fat, and protein. Carbohydrates and fat are the main sources of energy in the body, while protein is used for growth and repair.
Carbohydrates are found in foods such as bread, potatoes, rice, pasta, cereals, fruit, and sweets. Carbohydrates are converted to glucose in the liver. Any glucose that is not utilized for energy immediately is stored as glycogen in the liver and a small amount in the muscles. When the body requires more energy, the liver rapidly converts glycogen back to glucose. In addition to being a place to store glycogen, the liver helps keep blood glucose levels from rising or falling too high or too low.
Our diet contains fat from butter, cheese, cooking oil, animal fat, and a variety of “invisible” sources such as cookies, pastries, crisps, and cakes. Without bile, which is produced in the liver and stored in the gallbladder, fat cannot be processed.
gallbladder. Bile is secreted into the small intestine when required and functions as a detergent, dissolving fat into microscopic droplets that may be absorbed by the body. Fat may be utilized as a source of long-term energy.
Protein is found in foods such as meat, fish, eggs, cheese, nuts, and dairy products. Protein is made up of amino acids, which, once they reach the liver, serve as the building blocks for cells and tissues.
A healthy, well-balanced diet
At the moment, scientists believe that a healthy diet should be low in fat, sugar, and salt and rich in fiber. Fibre is a component of fruits, vegetables, and cereals that goes through your body undigested and aids in constipation prevention. Your diet should include an adequate amount of protein and a variety of vitamins and minerals. Healthy eating entails striking the proper balance of meals. The healthiest diet is one that is high in vegetables, fruit, legumes, and wholewheat cereals (including bread) and low in fat. Additionally, it is the ideal diet for many individuals who suffer from liver illness.
Five food groups exist:
- veggies and fruits
- Cereals, breads, potatoes, rice, and pasta
- yoghurt, milk, eggs, and cheese.
- Mutton, fish, nuts, pulses, and legumes
- foods that are rich in calories, such as fried and sweet dishes.
It is important to choose a variety of meals from the first four categories on a daily basis to ensure that you get a diverse range of nutrients. While foods in the fifth category may be beneficial for those who are underweight, they should be avoided or consumed in very tiny amounts by those who are overweight.
Our calorie or energy requirements vary according to our gender, age, weight, and degree of physical activity. A little old lady, for example, will need less nourishment than a young, vigorous man. If we consume fewer calories than our bodies need, we lose weight; if we consume too much, we gain weight. Calories may be expressed as kcal, kilocalories, kJ, or kilojoules; all of these abbreviations refer to energy.
Consuming a well-balanced diet may be challenging if you have been unwell or have lost a significant amount of weight. If this is the case, it is important to keep eating and, if necessary, get help from your doctor or dietician.
Minerals and vitamins
Our bodies require vitamins and minerals. They are required for the millions of chemical reactions that occur every day in our bodies. They allow our bodies to carry out all of the life-sustaining activities. The majority of individuals get all of the vitamins and minerals they need by eating a mix of foods from the first four food categories, while some forms of liver disease require an increased intake of vitamins.
If you are concerned that your diet is vitamin deficient, your doctor may prescribe vitamins or recommend that you purchase multivitamin pills at your local pharmacy. Individual vitamins and minerals sold on their own are not recommended unless they are prescribed by a doctor.
Alcohol
Heavy alcohol consumption is harmful to the liver. By converting alcohol to less hazardous molecules, the liver shields the body from its destructive consequences. Some people with liver disorders may drink within prescribed limits, while others should abstain from alcohol entirely. Recent research on alcohol and liver damage reveals the following:
- If you drink too much alcohol and damage your liver, you should stop.
- You should avoid alcohol if you have chronic liver disease caused by hepatitis B or C, or even if you are a healthy carrier of hepatitis B.
- If you have minor liver illness from another source, there is presently no evidence that you cannot drink within the suggested limits if your doctor agrees. However, the majority of physicians would urge caution.
Some individuals have developed an intolerance to alcohol and are unable to enjoy a drink, while others can indulge in a small amount on exceptional occasions. Sensible drinking recommendations will differ among individuals, even if they have the same liver illness. This is because their condition may be more severe or take a different shape. Additionally, it is dependent on the kind and stage of liver disease, as well as your overall health. This might also be because physicians have divergent perspectives.
If you are unsure if drinking is safe for you, you should see your doctor.
Frequently Encountered Digestive Issues (FEDI)
Some individuals have difficulty consuming a balanced diet, particularly if they have recently been very unwell. Two prevalent
This is due to a lack of appetite and sickness. However, it is essential to eat healthfully. The following suggestions may be beneficial:
Appetite Loss
- Consume modest, regular meals—little and often.
- Nutritious snacks may be preferable to a single large meal.
- Make an attempt to consume something every two hours, however tiny it may be.
- Tempt yourself with meals that you like.
- Avoid coercing yourself into eating foods you dislike.
- Attempt to unwind before and after meals.
- Take your time eating. Chew well. Inhale slowly.
- If you’re not in the mood for solid meals, consider a healthy beverage.
Homemade milkshakes and brands such as Build Up, Complan, and Recovery are all examples of nourishing beverages. These are great ideas, but you should talk to your doctor or dietitian to make sure they’re right for you.
A healthy homemade milkshake may be produced using semi-skimmed milk, honey, bananas, or pureed fruit, and a small amount of Build Up or Complan. You may get the aforementioned products at most pharmacies and drink them between meals, particularly if you are consuming modest portions. If you have been sick and aren’t getting enough food, your doctor may give you some ready-made nutrients.
Nausea
- If some odors make you queasy, take a breath of fresh air before eating.
- Maintain a healthy mouth by cleaning your teeth, gargling with mouthwash, or sucking mints.
- Avoid being overly hungry; hunger exacerbates nausea.
- Attempt to consume something every two hours.
- Cold appetizers may be tolerated better than a heated main course.
- Is there a pattern emerging? Are you always ill at the same time of day?
- Consider eating at alternate times.
- Avoid eating when you are really weary; instead, rest and relax.
- If cooking exacerbates the issue, opt for prepared meals or sandwiches, which may be just as nutritious.
- Consider carefully drinking cold beverages via a straw.
If you have nausea for more than a few days or start vomiting, you need to see a doctor.
Specific Nutrient Recommendations
The following advice may assist with a few of the most prevalent diet-related complications associated with liver disease. The information provided is not complete. You may have other concerns or questions regarding your specific situation, and the best person to speak with is your doctor or dietitian. If you have already been told to follow a certain diet, it is important to see your doctor before making any changes.
Acute Viral Hepatitis
Individuals with acute viral hepatitis who are otherwise healthy should attempt to maintain a regular diet. Due to the increased protein and energy requirements of people with acute hepatitis, they may benefit from a high-protein, high-calorie diet.
However, if you get nausea and vomiting, which makes it hard to eat, the ideas from the previous paragraph might help.
Hepatitis chronica
People with chronic hepatitis, which is when the disease lasts more than six months and sometimes comes back, can usually eat a well-balanced diet and don’t need to change their diets.
Occasional loss of appetite, nausea, and vomiting occur. However, these symptoms constitute a nutritional concern when they persist for more than a few days, at which point you should visit your doctor. Certain individuals prescribed steroids for autoimmune hepatitis may notice an increase in appetite and gradual weight gain. Even if this occurs, it is important to maintain a varied and well-balanced diet. However, you should make an effort to limit calorie-dense meals, which include sugar, sweets, cakes, biscuits, butter, margarine, oil, and cream.
If weight gain is a problem, your doctor might suggest that you get help from a dietician.
Primary Biliary Cirrhosis (PBC) and Primary Sclerosing Cholangitis are two types of biliary cirrhosis (PSC).
Numerous individuals with primary biliary cirrhosis (PBC) or primary sclerosing cholangitis (PSC) do not require dietary changes. Others have a hard time tolerating fatty foods.
Chips, full-fat milk, and cheese are all examples of such products.
They may develop steatorrhoea, a kind of diarrhoea characterized by thick, pale feces that are difficult to flush away. It may cause nausea and an uncomfortable stomach sensation. If this happens, it may be important to alter your diet’s fat content. Individuals differ in their tolerance for fat, and not everyone will need to follow a rigorous low-fat diet. Most people can figure out how much fat they can handle by trying and failing.
If you are cutting fat in your diet but do not need to lose weight, supplement with calories from snacks such as toast, crackers, crumpets, or tea cakes between meals.
How to consume less fat
- Fat in the diet does not just refer to the visible fat found on meat and fatty foods; it also refers to the following: butter, margarine, lard, and dripping. Use low-fat spreads.
- full cream milk and cream (half-and-half)fat versions may be used).
- -12 fat milk has more calcium, which is beneficial for your bones.
- all types of cheese, with the exception of low-fat cottage cheese. Normal cheese in small quantities may be tolerated.
- Various types of cooking oils, such as olive oil, sunflower oil, and vegetable oil
- Duck and pig belly are examples of fatty meats.
- Small quantities of meat items such as sausages and pies may be tolerated.
- Instead of chips, crisps, and nuts, try oven chips.
- Biscuits, cakes, and other pastries Alternatives to tea cakes and scones that are low in fat
- There are numerous processed foods.
Fat offers calories and fat-soluble vitamins A, D, E, and K, as well as important fatty acids. Therefore, someone who reduces fat in their diet should increase carbohydrate intake, such as starch and sugar (for example, bread and honey).
Additionally, certain individuals may need monthly injections of fat-soluble vitamins.
Others are administered medium-chain triglycerides (MCTs), which are more easily digestible fats. Your doctor or dietitian will tell you how to use and when to use these.
People who have PBC seem to be more likely to have heartburn, acid reflux, and a bad taste in their mouth.
These are all possible signs that stomach acid is getting into your gullet and making you feel bad.
With any of these diseases, it is beneficial to consume small amounts of food often.
It’s a good idea to develop the habit of keeping food with you at all times in case you’re hungry. It should be a carbohydrate-containing meal whenever possible.
If symptoms linger, try the following:
- Avoid large dinners at night.
- Before bedtime and immediately after meals, an antacid
- Elevate your bed’s head by four or five inches.
Several tips for cooking with minimal fat:
- Try grilling, baking, boiling, steaming, or casserole meats instead of frying.
- Fresh herbs, spices, lemon juice, and mustard can be used to replace lost flavor.Remove any visible fat from the meat and skin the poultry;
- Skim fat from soups and casseroles.
Cirrhosis:
Cirrhosis patients often need extra protein and energy and should have a well-balanced diet. This could be done by having snacks in between meals to give you more calories and protein.
The injured liver may be unable to store glycogen, the short-term energy source.
Consuming meals on a regular basis, say every two to three hours, may assist.
Many patients with cirrhosis do not develop problems, and so they may not need a particular diet. Some people may need to change their diet if they start to have symptoms like fluid retention, which is called ascites and oedema, or mental slowness or confusion, which can be called encephalopathy.
Retention of Fluid:
Cirrhosis patients may retain substantial amounts of fluid in their abdomens (ascites), resulting in swelling of the feet and legs (oedema). This can be done with diuretics and by cutting back on salt and water in the diet.
The chemical formula for common salt is sodium chloride (NaCl). Reduced salt consumption may aid in fluid retention management. If further information is necessary, your dietitian can assist you.
Your taste receptors get more sensitive to salt as you consume less; it’s simple to stop adding salt to meals by yourself, but the majority of sodium we consume is added by manufacturers.
It’s sometimes difficult to determine which meals are high in sodium since they may not taste salty. Different types of liver units recommend different amounts of salt restriction, and it’s important to talk to your doctor or dietitian about how much salt to cut back on.
A dietician will help you figure out what foods to eat and how to make recipes and menus that are just right for you.
A few foods to avoid on a no-added-salt diet include the following:
- Unless a small quantity is used in cooking, all the salt is applied at the table.
- Bouillon cubes, stock cubes, and gravy grains
- Soups in packets and tins
- Can veggies, such as baked beans,
- smoked and canned fish products, such as salmon, tuna, and pilchards.
- smoked and cured meats, such as ham, bacon, and sausages.
- EXCEPT FOR COTTON CHEESE AND CREAM CHEESE,
- sauces in a bottle: ketchup, Worcestershire, and Tabasco.
Bovril, Marmite, and yeast extracts in general.
To assist in masking the absence of salt, the following flavorings may be used:
- PEPPER, NITROGEN-FRESHLY GROUND
- on fish and meat, lemon juice.
- For lamb, try redcurrant jelly, apricots, rosemary, or garlic.
- Pork in apple or gooseberry sauce.
- With mixed veggies, ginger, garlic, and spring onions,
- salads and vegetables with olive oil and vinegar.
- Mashed potatoes with mustard powder or nutmeg
- alternative homemade gravy sauces, such as onion sauce made with milk and garlic
Certain individuals may also be asked to restrict their fluid intake while in the hospital. This is only done with the help of a doctor, and the patient’s fluid intake is gradually increased until he or she goes home.
Brain Effects:
Cirrhosis patients may have impaired memory and focus, as well as confusion, disorientation, and coma. T h I s c o n d I t I o n k n o w n a s h e p a t i c encephalopathyIt is believed to be caused by toxic substances formed during the breakdown of protein in the diet. They get into the bloodstream because the liver isn’t able to get rid of them properly.
Historically, therapy consisted of a low-protein diet. Restriction of protein is now recognized as unnecessary and harmful, as it contributes to malnutrition and weakness. Except in certain rare circumstances, low-protein diets are not recommended for critically ill patients in hospitals. Certain dietary adjustments, on the other hand, may be beneficial if you have encephalitis. Once again, these should be addressed with your physician prior to beginning.
- Instead of a single large main meal, eat three or four small meals throughout the day.
- Protein sources include eggs, cheese, pork, fish, and poultry.
- Consume only one type of protein at a time.
- Consider lentils, kidney beans, chick peas, and other pulses as vegetarian alternatives to meat.
- Fill up on more starchy foods like potatoes, rice, pasta, and cereals.
- Breakfast cereals, when served with milk, can be a convenient snack.
Hyperglycaemia:
Some people with cirrhosis have high blood sugar levels, or hyperglycemia, and may need to follow a diabetic-style diet.
This entails consuming a balanced diet but abstaining from foods high in sugar, such as jams, cakes, pastries, chocolate, puddings, ice cream, and sweets. Individuals with hyperglycemia have unique requirements and will want personalized counsel from a dietitian.
Take pleasure in your food:
You may find it beneficial to discuss diet and food issues with other individuals who share your liver ailment. It’s an excellent way to share cooking tips, recipes, and menus. However, it is critical to understand that dietary supplements are not a panacea.
Restrictions and special needs vary by individual, and even if you share a sickness with another person, your requirements may be different.
In addition, if you have been sick, you may not be able to eat your normal meals.
Thus, taking an interest in your diet is a very practical way to care for yourself when unwell, and eating healthily can only be beneficial. There may be times when you want to eat foods that are unhealthy but very tasty.
It is important to enjoy your food and communicate any concerns you may have with your physician or dietitian.
