Dietary management of chronic liver disease

According to Medline (2015), the dietary management of
chronic liver disease includes:

i.
Eat large amount of carbohydrate foods.
Carbohydrates should be the major source of calories in this diet.

ii.
Eat a moderate intake of fat, as prescribed by
the provider. The increased carbohydrates and fat help prevent protein
breakdown in the liver.

iii.
Have about 1gram of protein per kilogram of body
weight. This means that a 154 pound (70kg) man should eat 70 gram of protein
per day. This does not include the protein from starchy foods and vegetables. A
person with a badly damaged liver may need to eat less protein. Talk to your
provider about your protein need.

iv.
Take vitamin supplements, especially B. complex
vitamins.

v.
Reduce the amount of salt you consume (typically
less than 1500 milligrams per day) if you are retaining fluid. Salt in the diet
may worsen fluid build up and swelling in the liver.

According to Queensland Health Dietitian/Nutritionist (2013)
the following are to be considered in the dietary management of chronic liver
disease

ii.
Weight loss

Chronic liver disease is
often associated with muscle and body fat loss. This may be difficult to detect
because of fluid retention. For example, you may be losing muscle, but if you
are retaining fluid you may stay the same weight. If not corrected, muscle and
body fat loss can result in variety of health complications.

A protein diet is important
for people with chronic liver disease as the protein is used to maintain
muscles and body tissues(including the liver) and to keep the body working
normally.

Table :1.

	Energy food	Protein food
a	Bread and bread products	Milk and milk powder
b	Breakfast cereals	yoghurt
c	Pasta and rice, noodles	Cheese
d	Cakes and biscuits	Custard
e	Potato, sweet potato, corn	Meat, fish, chicken
f	Butter /margarine, oil	Eggs
g	Cream/mayonnaise	Nuts and seeds (including pastes)
j	Jam, honey, golden syrup	Legumes-(baked beans, lentils,)
i	Sugar and sugary products.

(Source: Queensland Health Dietitian, 2015)

ii. Fluid and salt

As liver disease progresses, fluid can be stored
around your stomach. This is called ascites. If this occurs it becomes very
important to limit the amount of salt (sodium) you consume. If you have
ascites, your doctor and dietitian will recommend you follow a low salt diet.

You may also be asked to limit the amount of fluids
you drink through the day. For example all beverage and watery foods such as
soup, ice-cream, “wet” curries, fruits etc.

iii. Vitamins
and minerals

The changes that occur in chronic liver disease can
lead to vitamin and mineral deficiencies. Problems such as excessive bleeding,
osteoporosis, anaemia, and night blindness can result if vitamin and/or
minerals level are too low.

Eating a variety of foods can help to avoid
deficiencies. However your doctor may still recommend a vitamin and mineral
supplement if required. Avoid taking any supplements or following diets not
recommended by your doctor or dietitian.

Table 2.

Food	Liver salt-choose	High salt – Avoid
Bread and cereals	Salt reduced bread	Savory cracker
	Fresh and dried pasta	Sweet biscuit and short bread.
	Salt reduced and low salt
Often high in salt	Crackers and biscuits example vitawheat, rice and corn cakes	Croissants, pastry, cakes, scones, muffin.
	Rolled oats, porridge	Savory breads, bread, bread rolls
	Weetbix, sustain, muesli, just righ, puffed wheat oat or wheat bran.	Packet rice and pasta with flavoring, instant noodles
	Rice Plain flour and corn flour	Breakfast cereals with more than 150 mg sodium per serve example cornflakes, rice bubbles, branflakes. Tinned spaghetti