Liver diet - for what diseases? What to eat, what to avoid, sample menu

The liver is an organ that performs many important functions in the body. Responsible for, among others: for proper metabolism of nutrients. As a result of various diseases, both acute and chronic, it may be damaged and its functioning impaired. Sometimes the severity of the changes is so intense that it even leads to its failure. One of the factors supporting the work of this organ is appropriate nutrition. Correct eating habits can protect the liver against the development of certain diseases, as well as alleviate existing ones. So how should a diet be composed in case of a diseased liver? 

What is the role of the liver in the body?  The most important information about the principles of nutrition during a diet for liver disease.What is the role of the liver in the body? The most important information about the principles of nutrition during a diet for liver disease.

What is the liver diet?

The liver diet is the common name for a diet used in liver diseases. However, this is not the correct term. In the diet nomenclature, the recommended diet for liver diseases is an easily digestible diet with limited fat. It is a modified form of basic nutrition, depending on the patient’s health and nutritional status, liver function, co-occurring diseases, metabolic disorders, as well as individual tolerance of individual food products.

Due to various liver diseases, nutritional recommendations differ in individual diseases. Sometimes it will be enough to make only minor modifications to the diet, but in more severe cases, dietary restrictions will be more severe. However, the diet with impaired liver function should always be balanced to meet the person’s energy and nutritional needs, and the products included in the menu must not worsen the disease symptoms.


Read also: Easily digestible diet – rules, recommended products, what to avoid, sample menu


Principles of the liver diet

Indications for the use of the liver diet: acute and chronic hepatitis, alcoholic liver disease, non-alcoholic fatty liver disease, liver cirrhosis. Find out what you should eat for specific diseases.

Acute and chronic hepatitis

Acute hepatitis is caused by hepatotropic viruses ( AB , C , D and  E ). The disease progresses very quickly. Chronic hepatitis is a disease that lasts more than half a year and may also be caused by viruses, but also by metabolic, toxic and immunological factors. In both cases, inflammatory and necrotic changes develop in the liver. In order not to additionally burden the diseased organ, an easily digestible diet with limited fat is recommended for inflammatory liver diseases.

Meals should be eaten more often (5-6 times a day), but in smaller portions. It is recommended to eliminate hard-to-digest, fried products from the diet, containing large amounts of saturated fatty acids and dietary fiber . Hot spices are also not recommended. Fat should come from easily digestible sources (e.g. olive oil, vegetable oils, butter, low-fat dairy products). Preferred culinary techniques are: boiling in water or steaming, baking in foil, stewing without frying. Due to its hepatotoxic effect, it is advisable to stop drinking alcohol during the course of the disease, as well as for the next 6 months after the symptoms disappear.

Alcoholic liver disease

The liver is the organ where ethyl alcohol is metabolized. It is the main cause of liver disease in developed countries. Damage to this organ caused by excessive consumption of alcoholic beverages may occur in several stages, which are often not separated from each other. These include alcoholic fatty liver disease, alcoholic hepatitis and alcoholic cirrhosis.

It has been observed that this disease occurs more and more often in young women, in whom it also has a more dynamic course. In addition, the risk of disease increases as a result of drinking alcohol on an empty stomach, binge drinking, smoking , obesity and other coexisting liver diseases. Total alcohol abstinence is recommended for all people with these diseases. Nutritional treatment of alcoholic liver disease is aimed at preventing protein-energy malnutrition and supporting the functioning of this organ. It is advisable to follow an easily digestible diet with limited fat. Vitamin and mineral supplementation with ingredients that may be deficient is also recommended. These include primarily: vitamin A , B vitamins , zinc and  magnesium .

Nonalcoholic fatty liver disease (NAFLD)

It is characterized by changes in the liver similar to those occurring in alcoholic liver disease. However, it is diagnosed in people who do not abuse alcohol. It is the most common chronic disease of this organ. It usually develops in people who follow a high-energy diet, rich in products that are a source of saturated fatty acids and simple sugars, and lead an inactive lifestyle. Its risk factors include obesity, type II diabetes , and lipid disorders . It is diagnosed more often in men.

Non-pharmacological treatment mainly involves changing eating habits and increasing physical activity. Weight reduction is extremely important, but it should be achieved gradually (loss of about 0.5 kg/week). A low-fat diet is recommended for feeding people with this disease. Its source should especially be products rich in unsaturated fatty acids, such as olive oil, vegetable oils, seeds and nuts. However, you should avoid fatty and fried foods and products, fast food and highly processed products. If there are no contraindications, there is no need to eliminate dietary fiber from the diet. Consuming it will help you achieve your ideal body weight faster and will have a positive effect on balancing your blood glucose levels .

The diet should include vegetables and fruits, whole grain products and legumes, and low-fat dairy products. However, products with a high glycemic index and those that are a source of fructose (especially sweet carbonated drinks, highly processed products, sweets, honey, jams, fruit yogurts, breakfast cereals) will have a negative impact. Fructose is also contained in fruits, but due to their beneficial properties, this group of products should not be limited. It is also recommended to stop drinking alcohol.

Food products should include, among others:  steamed.  If you have serious liver problems, consult your doctor.Food products should include, among others: steamed. If you have serious liver problems, consult your doctor.

Cirrhosis

The disease is characterized by damage to the liver parenchyma, which leads to degeneration of liver cells and, as a result, to their necrosis and connective tissue hyperplasia. These changes are irreversible and disturb the functioning of the organ. Most often, liver cirrhosis is caused by alcohol abuse or other toxins (e.g. drugs, poisonous mushrooms), as well as viral hepatitis.

The problem with this disease is malnutrition, which occurs in up to half of the patients. There are many reasons for this state of affairs. One of them is loss of appetite, caused by, among others, gastrointestinal problems ( flatulence , nausea , constipation , quick feeling of satiety), as well as side effects of medications. Moreover, malnutrition may be the result of accelerated metabolism, digestive and absorption disorders, impaired liver function or ascites. Choosing the right diet depends primarily on the stage of the disease.

The diet of people in the compensated phase of the disease should usually not differ significantly from that of healthy people. The patient’s nutritional status should be constantly monitored due to the high risk of protein-energy malnutrition. It is extremely important to provide the right amount of calories and protein. Moreover, due to reduced appetite, when preparing an eating plan, the patient’s dietary preferences should be taken into account, attention should be paid to the aesthetics of the prepared dishes, and their sensory properties should be taken into account.

The patient should eat 5-6 small meals a day. Of particular importance is the meal consumed before bed, which aims to protect muscles against breakdown. The basis of the diet should be products that are a source of complex carbohydrates (unless there are contraindications), including: whole grain cereal products, vegetables, fruit and legume seeds. You should control your intake of simple sugars. It is recommended that protein be supplied mainly from high-quality, wholesome animal products (meat and cold cuts, low-fat dairy products, eggs). Easily digestible fats are preferred: olive oil, butter, vegetable oils.

An increased risk of deficiency of influenza B vitamins and vitamin C, selenium and zinc has been observed in patients, therefore, after consulting a doctor, supplementation may be considered. Alcohol, strong coffee and tea, hard-to-digest products that cause flatulence, foods high in saturated fatty acids (bacon, lard, bacon, fast food), spicy spices, and fried foods should be eliminated from the diet. If there are no complications, it is advisable to drink about 2 liters of fluids a day, the source of which should primarily be still mineral water and weak tea.

For people with decompensated liver cirrhosis, it is recommended to eat 5-6 small meals. Due to the frequent serious complications (e.g. ascites, glycemic disorders, hepatic encephalopathy, esophageal varices) and problems with consuming the appropriate amount of food, individualized nutritional counseling is of particular importance. The diet cannot include products that will worsen the patient’s health or worsen pain. In some cases, oral feeding is very difficult or even impossible. In such a case, after consulting a doctor and a dietitian, you should consider enriching your diet with oral food supplements that may be better tolerated by the patient. However, sometimes it is necessary to introduce intra- or parenteral nutrition. 

Liver diet – what to avoid?

The diet of people with diseases of this organ should be adapted to each patient individually. In patients who do not have any signs of organ failure, the dietary recommendations are very similar to those of healthy people. Diet modification involves introducing easily digestible products and limiting the consumption of food rich in saturated fatty acids. 

A dietitian will help you choose the right nutrition model for liver diseases.A dietitian will help you choose the right nutrition model for liver diseases.

General recommendations for an easily digestible diet with limited fat:

  1. Patients are recommended to eat 5-6 small meals a day. 
  2. Dishes should be eaten without rushing, in a calm atmosphere. 
  3. Prepared dishes should be sensory attractive due to the often co-occurring loss of appetite. When designing a menu, the individual preferences of people using a liver diet should be taken into account.
  4. The basis of the diet should be permitted vegetables, fruits and cereal products. Dietary fiber should be limited only in people who do not tolerate it well. If insulin resistance is present , it is necessary to choose products with a low glycemic index. 
  5. Limiting the consumption of products that stay in the stomach for a long time and cause constipation, flatulence or pain (e.g. food with a high content of saturated fatty acids, fast food, spicy spices, cruciferous vegetables). If the consumption of legumes does not aggravate the pain, they can be included in the eating plan. 
  6. The amount of fat in the diet should be determined individually for each patient. Its source should primarily be easily digestible products, from which it is better tolerated. These include: olive oil, vegetable oils, butter, soft margarines. Bacon, lard and lard should be eliminated.
  7. Due to the high risk of malnutrition in case of diseases, it is necessary to ensure an adequate supply of high-quality protein. It should come from lean meat and fish, eggs and low-fat dairy products (milk, cottage cheese, yogurt, kefir). 
  8. Preferred culinary techniques are: boiling in water, steaming, baking in foil, stewing without frying. You should limit frying, grilling, smoking and stewing and frying. 
  9. Ensure adequate fluid intake. Their source should primarily be mineral water, weak tea, and cereal coffee with milk. 
  10. It is recommended to refrain from drinking alcohol, which has a damaging effect on the liver. 

Diet for a diseased liver – sample menu

Liver diet – nutrition plan
BreakfastSandwiches made of graham bread spread with cottage cheese and dill, served with peeled tomatoes, cereal coffee with milk. 
2nd breakfastCream of carrot soup with coconut milk.
LunchCod baked in foil with fresh herbs, jasmine rice, broccoli, mineral water with lemon.
 
Tea
 
Natural yogurt with berry puree, weak tea.
DinnerCouscous salad with chicken, roasted vegetables and parsley, mineral water. 

Related topics: 

  • Physical activity and human health
  • Alcoholism – treatment and effects of addiction

Source:

  1. Dziewiatowska J., Guzek M., Adrych K., Malgorzewicz S. “Causes of malnutrition, assessment of nutritional status and nutritional recommendations in liver cirrhosis.” Metabolic Disorders Forum 2016, 7, 1, 16-23.
  2. Hartleb M., Wunsch E., Milkiewicz P., Drzewoski J., Olszanecka-Glinianowicz M., Mach T., Gutkowski K., Raszeja-Wyszomirska J., Jabłkowski M., Cichoż-Lach H., Stachowska E. , Socha P., Okopień B., Krawczyk M., Kajor M., Drobnik J., Lewiński A., Wójcicki M., Januszewicz A., Strojek K.: Management of patients with non-alcoholic fatty liver disease. Recommendations of the Polish NAFLD Expert Group 2019. Med. Practical, 2019; 10: 47–74
  3. Włodarek D., Lange E., Kozłowska L., Głąbska D. “Dietoterapia” PZWL 2015 211-223
  4. Bischoff SC, Bernal W., Dasarathy S., Merli M., Plank LD, Schütz T., Plauth M. “ESPEN practical guideline: Clinical nutrition in liver disease” Clinical Nutrition 39 (2020), 3533-3562
  5. Jaczewska-Schuetz J. “Nutritional recommendations for patients with compensated cirrhosis.” Practical medicine for patients. (Accessed on May 26, 2022)
  6. Jaczewska-Schuetz J. “Nutritional recommendations in acute and chronic hepatitis” Practical medicine for patients. (Accessed on May 26, 2022)
  7. Wnęk D. “Diet in non-alcoholic fatty liver disease.” Practical medicine for patients. (Accessed on May 26, 2022). 
The presented medical information should not be treated as guidelines for medical treatment for each patient. The medical procedure, including the scope and frequency of diagnostic tests and/or therapeutic procedures, is decided individually by the doctor, in accordance with medical indications, which he determines after reviewing the patient’s condition. The doctor makes the decision in consultation with the patient. If the patient wants to perform tests that are not covered by medical indications, the patient has the option of having them performed for a fee.
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