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Cirrhosis of the liver is marked by severe scarring that prevents the liver from functioning normally. It can result from a number of causes with the most common in the United States being alcohol abuse and hepatitis C, reports the National Digestive Diseases Information Clearinghouse. Impaired liver function and the ensuing complications call for dietary modifications to manage these issues. Beware of any alternative, unfounded nutritional therapies that call for drastic dietary measures, particularly those that call for large amounts of herbs -- just like some drugs, some herbs can cause liver damage as well.
Working With a Registered Dietitian
Many people who suffer from cirrhosis suffer from some degree of malnutrition due to factors like lack of appetite, the liver’s reduced capability to assimilate nutrients and poorly planned diets. You should work with a registered dietitian experienced in working with cirrhosis patients. A dietitian can help you plan a nutritionally sound diet that takes into account the food restrictions based on the stage of your disease and complications you're experiencing personally as well as your food preferences. This will ensure that you're getting the calories and nutrients you require. While good nutrition is important for anyone, it becomes paramount when suffering from chronic illnesses.
- Many people who suffer from cirrhosis suffer from some degree of malnutrition due to factors like lack of appetite, the liver’s reduced capability to assimilate nutrients and poorly planned diets.
- A dietitian can help you plan a nutritionally sound diet that takes into account the food restrictions based on the stage of your disease and complications you're experiencing personally as well as your food preferences.
Diet Plans for People With Cirrhosis of the Liver
Your body requires protein for a variety of purposes, including building muscle mass. If you have cirrhosis, you need high quality protein to repair damaged tissues. When protein breaks down, however, it creates toxic byproducts like ammonia and other substances that a healthy liver can normally filter out. If you have cirrhosis, your liver cannot handle this job effectively. Toxins can build up in the bloodstream and travel to the brain, causing confusion and memory loss. Your dietitian and doctor can offer guidance on how much protein you should eat. Dr. Arthur Schoenstadt, writing for eMed TV, says research has shown cirrhosis patients seem to suffer fewer complications when eating more vegetable proteins like tofu and beans and non-meat animal proteins like eggs and dairy 1.
- Your body requires protein for a variety of purposes, including building muscle mass.
- If you have cirrhosis, you need high quality protein to repair damaged tissues.
Cirrhosis can cause a condition called ascites, which leads to fluid build up in the abdomen. Eating too much sodium will worsen ascites as it encourages your body to retain fluid. If you suffer from ascites, you will need to limit your sodium intake to about 2,000 mg daily, according to the American Dietetic Association. Reading food labels takes on supreme importance as most of the salt in your diet likely comes from commercially-prepared items like canned soup and frozen dinners. The ADA recommends choosing items that have less than 300 mg of sodium per serving. Your best bet for limiting sodium intake entails eating as many fresh, unprocessed foods as possible -- they often contain miniscule amounts of salt, so you won't have to obsessively monitoring every milligram.
- Cirrhosis can cause a condition called ascites, which leads to fluid build up in the abdomen.
- If you suffer from ascites, you will need to limit your sodium intake to about 2,000 mg daily, according to the American Dietetic Association.
Controlling Blood Sugar
Hepatic Diet Restrictions
According to the British Liver Trust, a non-profit organization that provides information and research on liver disease, some people with cirrhosis can suffer from high blood sugar, which can lead to diabetes. If you have this problem, you must choose healthier carbohydrates like whole grains, fruits and vegetables and cut back on refined carbohydrates like white bread as well as sugar-rich cookies, cakes and candies. Your dietitian and doctor will help you devise a plan for getting high-quality carbs.
Reducing Risk of Infection
Impaired liver function can increase your susceptibility to infection, meaning you should avoid foods that are more likely to contain harmful bacteria and other microbes. Do not eat raw or unpasteurized dairy products, fruit or vegetable juices, raw or undercooked meats, eggs, fish or tofu or raw sprouts. Wash all fruits and vegetables before eating them.
Cirrhosis can decrease your appetite; ascites can make it difficult to eat large meals. Eating smaller meals throughout the day rather than trying to force three large ones might help you better meet your daily calorie needs. When you feel like you can't eat a lot, opt for calorie-dense foods like full-fat dairy to maximize caloric intake. Drinking nutritional supplements can also help you meet your nutritional requirements.
- Cirrhosis can decrease your appetite; ascites can make it difficult to eat large meals.
- Eating smaller meals throughout the day rather than trying to force three large ones might help you better meet your daily calorie needs.
Diet Plans for People With Cirrhosis of the Liver
Hepatic Diet Restrictions
Diet for Alcoholic Liver Disease
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Hepatomegaly and Fatty Liver
Can Protein Cause Your Skin to Turn Yellow?
Atkins Diet and Liver Problems
Sodium and Liver Damage
Red Meat & Its Effect on the Liver
Diet Restrictions With Jaundice
- eMedTV; Cirrhosis Diet;Arthur Schoenstadt, MD; June 2009
- University of Maryland Medical Center; Cirrhosis; Steven D. Ehrlich, NMD; September 2009
- Bhatia SN, Underhill GH, Zaret KS, Fox IJ. Cell and tissue engineering for liver disease. Sci Transl Med. 2014;6(245):245sr2. doi:10.1126/scitranslmed.3005975
- Bémeur C, Butterworth RF. Nutrition in the Management of Cirrhosis and its Neurological Complications. Journal of Clinical and Experimental Hepatology. 2014;4(2):141-150. doi:10.1016/j.jceh.2013.05.008
- Yao C, Fung J, Chu N, Tan V. Dietary Interventions in Liver Cirrhosis. J Clin Gastroenterol. 2018;52(8):663-673. doi:10.1097/mcg.0000000000001071
- National Institute of Diabetes and Digestive and Kidney Diseases. Eating, Diet, & Nutrition for Cirrhosis. Published March 2018.
- Purnak T, Yilmaz Y. Liver disease and malnutrition. Best Practice & Research Clinical Gastroenterology. 2013;27(4):619-629. doi:10.1016/j.bpg.2013.06.018
- Barnard, Neal D., editor. Cirrhosis. Nutrition Guide for Clinicians, 3rd ed., Physicians Committee for Responsible Medicine, 2017.
- McClain CJ. Nutrition in Patients With Cirrhosis. Gastroenterology & hepatology. 2016;12(8):507-510.
- Angeli P, Bernardi M, Villanueva C, et al. EASL Clinical Practice Guidelines for the management of patients with decompensated cirrhosis. Journal of Hepatology. 2018;69(2):406-460. doi:10.1016/j.jhep.2018.03.024
- Ioannou GN, Morrow OB, Connole ML, Lee SP. Association between dietary nutrient composition and the incidence of cirrhosis or liver cancer in the united states population. Hepatology. 2009;50(1):175-184. doi:10.1002/hep.22941
- U.S. Department of Veterans Affairs. Eating tips for people with cirrhosis.
- Nakaya Y, Okita K, Suzuki K, et al. BCAA-enriched snack improves nutritional state of cirrhosis. Nutrition. 2007;23(2):113-120. doi:10.1016/j.nut.2006.10.008
- Suk KT, Baik SK, Yoon JH, et al. Revision and update on clinical practice guideline for liver cirrhosis. Korean J Hepatol. 2012;18(1):1-21. doi:10.3350/kjhep.2012.18.1.1
- Volk M. Liver cirrhosis: a toolkit for patients. University of Michigan Health System. Updated October 25, 2011.
- Runyon, B. Management of Adult Patients with Ascites Due to Cirrhosis. American Association for the Study of Liver Diseases (AASLD). Updated 2012.
- Runyon BA. Management of adult patients with ascites due to cirrhosis: Update 2012. American Association for the Study of Liver Diseases. 2012.
- Barkoukis H, Fiedler KM, Lerner E. A combined high-fiber, low-glycemic index diet normalizes glucose tolerance and reduces hyperglycemia and hyperinsulinemia in adults with hepatic cirrhosis. J Am Diet Assoc. 2002;102(10):1503-7. doi:10.1016/S0002-8223(02)90334-2
- National Institute of Health. LiverTox: Vitamin A. Updated July 1, 2019.
- Manguso F, D’Ambra G, Menchise A, Sollazzo R, D’Agostino L. Effects of an appropriate oral diet on the nutritional status of patients with HCV-related liver cirrhosis: A prospective study. Clinical Nutrition. 2005;24(5):751-759. doi:10.1016/j.clnu.2005.02.010. doi:10.1016/j.clnu.2005.02.010
Kelli Cooper has been a writer since 2009, specializing in health and fitness. She holds a Bachelor of Arts in political science from Rutgers University and is a certified personal trainer with the American Council on Exercise.