N
&D
utrition
ietetics
Patient Information
Eating Well with Liver Disease
Introduction
When your liver is not working well or when you have liver disease, your body
has a higher demand for energy and protein. This is because the liver plays a
major role in storing and releasing energy and protein and when it is not
working properly these functions do not work properly either.
Approximately 80-100% of people with liver disease suffer from malnutrition
(weight loss and muscle wasting) due to a number of reasons. These can be;
loss of appetite, nausea and vomiting, feeling full early.
Good nutrition can help overcome symptoms of liver disease by:
 Stopping your muscles from wasting
 Helping wounds heal more quickly
 Helping prevent infections and further complications.
This diet sheet is based on general dietary advice for people with liver disease.
Certain aspects may change depending on your doctor’s/dietitian’s specific
advice.
It is important to have foods which are high in starchy carbohydrate and
protein to help prevent malnutrition.
Starchy Carbohydrate
It is important to have regular meals and snacks which contain starchy
carbohydrate every 2-3 hours, (see below for examples of starchy
carbohydrate).
The liver normally stores some glucose from the starchy carbohydrate we eat
and this glucose is released for energy when we need it i.e. in between meals
and during a long fast overnight. This store is then replaced when we eat
again. If your liver is not working properly, the liver cannot replace this store
and so your body has to find an alternative energy source, this is usually
muscle stores. Eating every 2 hours when you are awake will help prevent this
happening and prevent muscle wastage
Starchy Carbohydrate includes;
Bread, potato, cereals, pasta and noodles, rice, crumpets, crackers.
Produced By: Dietetics
Reviewed By:
Version No: DIET/PI/26
Date Produced: 08/2009
Reviewed:
Review Date: 08/2012
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Eating Well with Liver Disease
Bedtime Snacks
It is important to have a bedtime snack containing 50g of carbohydrate as it is
a long time until breakfast. Suitable examples include;
300mls of milk and 3 biscuits
5 plain or chocolate biscuits
2 slices of toast and jam
Cereal with milk and banana
1 large slice of fruit cake or plain cake/ 2 large slices of Swiss roll
3 crumpets/ pikelets
2 scones
A bagel with jam/honey
Protein
Your body needs more protein than usual when your liver is not working
properly.
A good source of protein should be included with at least 3-4 meals or snacks
a day. This could be meat and poultry, fish, cheese, eggs, pulses such as
beans, peas, lentils, meat alternatives i.e. soya, tofu.
The following principles may help you to increase oral intake;




Aim to have 6 small meals/ snacks a day which contain some starchy
carbohydrate and protein.
Use one pint of full cream milk a day, have at least two milky drinks a
day.
Avoid filling up on drinks which contain little nourishment i.e. tea, coffee,
packet soups.
Avoid “diet or light” products, always go for full fat products.
Enrich your foods:



Add grated cheese, butter/ spread, cream to potatoes, soups, sauces,
vegetables.
Add extra sugar/ honey to breakfast cereals, milk puddings, yoghurts.
Add 4 tablespoons of milk powder into 1 pint of full cream milk, (use this
milk in drinks, to make sauces, on cereals)
Produced By: Dietetics
Reviewed By:
Version No: DIET/PI/26
Date Produced: 08/2009
Reviewed:
Review Date: 08/2012
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Eating Well with Liver Disease
Suggested Meal Plan
Breakfast –
2 Eggs on toast OR
2 Slices of peanut butter on toast OR
Cereal with enriched milk
Mid-Morning –
Milk shake (i.e. enriched milk, with 1 scoop of ice-cream
and 1 small banana/ 10 strawberries/ 2tbsp drinking
chocolate) OR
2 toasted crumpets with butter OR malted loaf OR
3 biscuits and a glass of milk
Lunch –
Sandwich with meat, fish, eggs or cheese OR
Jacket potato with tuna, minced meat, beans, cheese
Dessert; Yoghurt OR rice pudding OR mousse
Mid Afternoon –
A piece of cake OR
Chocolate bar OR
Milky drink i.e. hot chocolate, malted milk drink i.e.
Ovaltine/ Horlicks made with all milk
Evening meals –
Meat or fish with potatoes OR
Lasagne or pasta with mince meat OR
Meat/ fish/ lentil curry with rice
Dessert; Ice cream and crumble or sponge pudding and
custard/ ice cream
Bedtime snack –
As suggested above.
It is also important to include fruit and vegetables in your diet, which are
important for vitamins, minerals and fibre. A glass of fruit juice or fruit smoothie
a day may help if you are unable to eat enough fruit and vegetables.
If you are struggling to eat enough, your dietitian will be able to suggest
suitable supplement drinks to have in between your meals. You can also buy
Build up/ Complan drinks from supermarkets or chemists.
Produced By: Dietetics
Reviewed By:
Version No: DIET/PI/26
Date Produced: 08/2009
Reviewed:
Review Date: 08/2012
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Eating Well with Liver Disease
Fluid Retention
Ascites, Oedema and Weight
Ascites is the collection of fluid around your middle and oedema is the
collection of fluid in your feet, ankles and legs. This can cause your weight to
change greatly with fluid gain. Loss of muscle and fat is often hidden by the
ascites and oedema.
Reducing salt in the diet can help reduce fluid retention
In order to reduce salt in the diet, it is recommended no salt is added at the
table and it is used sparingly in cooking. Three quarters of the salt in our diet is
naturally already in the foods we eat, see below for ideas on reducing your salt
intake;
Salty foods to avoid/ have less of
Soups ;
Tinned and packet soups
Snacks;
Cheese *
salted savoury biscuits or snacks, i.e.
Ritz, TUC, crisps or salted nuts
Vegetable;
Tinned unless labelled no added salt
Standard ready meals
Meats & Fish
Bacon, gammon, sausages, burgers,
tinned meats and tinned fish try to keep
to a minimum
Other
Meat or yeast extract e.g. marmite,
stock cubes.
Suitable Alternative
Home made soup using a small
amount of stock
Cream crackers, ryvitas, crisp
bread, rice cakes, unsalted crisps
or nuts.
Fresh or frozen vegetables
Choose healthy eating versions or
ones labelled “low salt”
All fresh and frozen meat and fish
Other food flavourings
Black pepper, mustard, lemon
juice, garlic, spices, herbs, cider
vinegar, natural yoghurt
* Although cheese is a good source of energy and protein, it is relatively high
in salt and so it is recommended you limit it to 100g (small match box size) a
week if you have ascites or oedema.
Useful Websites:
www.britishlivertrust.org.uk
www.salt.gov.uk
Produced By: Dietetics
Reviewed By:
Version No: DIET/PI/26
Date Produced: 08/2009
Reviewed:
Review Date: 08/2012
©Milton Keynes Hospital NHS Foundation Trust
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www.mkhospital.nhs.uk