Patient education: Diet for adults with cirrhosis (The Basics)

What is cirrhosis? — Cirrhosis is a type of liver disease that affects how well the liver works.

The liver is a big organ in the upper right side of the belly (figure 1). It does many things to help a person stay healthy, including:

●Regulating levels of most chemicals in the blood

●Producing bile, which helps break down fats during digestion

●Removing waste products from the blood

If the liver is damaged or scarred, it might not work properly.

Why do I need a special diet if I have cirrhosis? — If the liver is not working properly, the body might not be able to process nutrients from food normally. Harmful substances can build up in the blood, and the body can store extra fluid in the belly. Problems with nutrition are common in people who have cirrhosis.

No specific diet works for everyone. The best diet for you will give you the nutrition your body needs and help you manage your symptoms. In general, you want to decrease the amount of work the liver has to do and prevent further liver damage.

Talk to your doctor about your diet. Your doctor, nurse, or a dietitian (food expert) can help make sure that you are getting the nutrients your body needs. They can also help you with meal planning.

What can I eat and drink if I have cirrhosis? — It is important to get enough calories and protein in your diet each day. Below are some examples of foods to choose from.

●Grains – Whole-wheat and whole-grain breads, tortillas, pastas, and cereals. Brown rice, quinoa, kasha, barley, and popcorn. Cereals like oatmeal, bran flakes, and shredded wheat.

●Fruits and vegetables – Most fruits and vegetables, whether fresh, frozen, or canned. If canned, low-sodium and salt-free vegetables and fruits without added sugar. Plain frozen vegetables (to avoid added fat and sodium), fruit juice, and vegetable juice.

●Dairy – Low-fat and fat-free foods like milk, hard cheeses like cheddar and mozzarella, yogurt, kefir, ice cream, sherbet, and soy milk.

●Meats and proteins – Lean, tender meats, chicken, and fish. Eggs, nut butters, and tofu. Dried beans, lentils, seeds, and nuts (all good sources of protein).

●Fats and oils – Healthy, unsaturated fats like canola, olive, corn, and sunflower oils. Choose oils more often than solid fats. Other healthy fats are found in avocados, tofu, and soy milk. For other foods, choose fat-free or low-fat products when possible.

Choose low-sodium or salt-free products whenever you can. This is especially important for foods like broths, soups, and sauces.

What foods and drinks should I avoid if I have cirrhosis? — Avoid alcohol as it can cause more liver damage. You might also need to limit the amount of fat or sodium (salt) in your diet. Below are some examples of foods to avoid or limit.

●Grains to avoid or limit – Doughnuts, croissants, pastries, cookies, biscuits, chips, and buttered popcorn.

●Fruits and vegetables to avoid or limit – Commercially prepared potatoes and vegetable mixes. Those prepared with cheese, butter, or cream sauces. Tomato sauce and pickles. Salted, canned vegetables and processed fruits with added sugar.

●Dairy products to avoid or limit – Whole and 2 percent milk, whole-milk yogurt and ice cream, cream, half-and-half, full-fat cheese, cream cheese, full-fat sour cream, and cottage cheese.

●Meats and proteins to avoid or limit – Undercooked meats, fish, and shellfish. High-fat meats like ribs, T-bone steak, non-lean ground beef, bacon, sausage, salami, bologna, corned beef, hot dogs, organ meats, poultry with skin, and fried meats. Canned beans.

●Fats and oils to avoid or limit – Unhealthy fats like butter and lard. Vegetable, peanut, and coconut oils.

●Condiments and snacks to avoid or limit – Salted and canned peas, beans, and olives. Salted snack foods like chips, pretzels, or crackers. Ketchup, soy sauce, salad dressing, and steak sauce.

What else should I know? — Other tips to consider include:

●Eat smaller meals more often, including a snack before bed.

●Use seasonings instead of salt to flavor food. Try salt-free seasoning, pepper, herbs, spices, vinegar, lemon juice, and lime juice.

●Check your weight each morning, and write down the number in a notebook. This will tell you if you are building up too much fluid. Weigh yourself in the morning after you have urinated. You can weigh yourself with clothes on or off, but do the same each day. Put your scale on a hard surface, not on carpet. Your doctor will tell you when you should call based on how much weight you gain in a day or over a week. Take your notebook to your doctor on your next visit.

●Read food labels carefully (figure 2). They show you how much is in a serving. The amount is given as a percentage of the total amount you need each day. Food labels also tell you how much sodium is in a serving. Reading labels helps you make healthy food choices.

●Your doctor might suggest that you take a multivitamin each day.

More on this topic

Patient education: Cirrhosis (The Basics)
Patient education: Low-sodium diet (The Basics)

Patient education: Cirrhosis (Beyond the Basics)
Patient education: Low-sodium diet (Beyond the Basics)