Nutrition in Chronic Liver Disease

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

To help prevent muscle and fat loss, you

need to eat foods high in energy and
protein.

if you are retaining fluid, you may stay the

same weight.

To increase your energy and protein

intake, include at least one food from

If not corrected, muscle and body fat loss can

result in a variety of health complications.

A high 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 the keep the body working
normally.

Some people believe that people with liver

disease need to avoid protein-rich foods to
help prevent a condition called hepatic
encephalopathy. However, this is not the
case. Hepatic encephalopathy is treated by
medications and avoiding protein will only
make you more malnourished.

each of the following columns at each

meal or snack.
Energy foods
Bread and bread
products
Breakfast cereals
Pasta and Rice,
noodles
Cakes and Biscuits
Potato, sweet potato,
corn
Butter/margarine, oil
Cream/mayonnaise
Jam, honey, golden
syrup
Sugar and sugary
products

Protein foods
Milk and milk
powder
Yoghurt
Cheese
Custard
Meat, Fish,
Chicken
Eggs
Nuts and Seeds(including pastes)
Legumes (baked
beans, lentils,
chickpeas)

Note: Some of these foods may be high in

salt. If you have been advised to follow a low
salt diet, refer to the low salt information
below.

This is a draft document from Queensland Health Dietitian/ Nutritionists

Disclaimer: http://www.health.qld.gov.au/masters/copyright.asp

Developed: March 2009

Review Date: December 2013

Further ideas to increase protein and

A number of special nutrition

energy include:

supplements may be able to help

Eating six to eight smaller meals and

increase your calorie and protein intake.

snacks throughout the day can help you

Talk to your dietitian-nutritionist about

get more nutrition than having three

these, if required.

normal sized meals. Small frequent meals

are also useful if you feel full quickly or if

Note: If you are overweight you should

your appetite has decreased.

focus on having a high protein intake and

Use fat in cooking, frying and baking; add

oils to vegies and salads

limit fatty and sweet foods. Sometimes

people with liver disease require a low fat
diet. If your doctor recommends a low fat

Add eggs, legumes, yoghurt, or low salt

diet of if you are diabetic see your

cheese to your meat dishes or salads.

dietitian for information.

Have a small meal of energy rich food

before going to bed. This has been shown

Vitamins and Minerals

to be helpful in weight management for

The changes that occur in chronic liver

people with liver disease.

disease can lead to vitamin and/or

Replace tea, coffee or water with fluids

that provide energy (such as milk, juice,
cordial or soft drink), especially if you are
on a fluid restriction.

Milk is a great base for nourishing drinks as it

is high in protein and energy. Full cream milk
contains more kilojoules than low fat milks, so
is preferable to use. Fortified soy milk (eg So
Good) is also suitable. To make your milk
higher in protein and calories, other

mineral deficiencies. Problems such as

excessive bleeding, osteoporosis,
anaemia, and night blindness can result if
vitamin and/or mineral levels 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.

ingredients may be added, such as ice-cream

and a variety of flavourings.

This is a draft document from Queensland Health Dietitian/ Nutritionists

Disclaimer: http://www.health.qld.gov.au/masters/copyright.asp

Developed: March 2009

Review Date: December 2013

Fluid and Salt

1. Do not add salt at the table or

As liver disease progresses, fluid can be

in cooking.

stored around your stomach this is

What to use instead

called ascites. If this occurs it becomes

very important to limit the amount of salt

freshly ground pepper, dry mustard

powder

(sodium) you consume.

lemon juice, lime juice, vinegar

Because salt acts like a sponge with fluid

a sprinkle of dried herbs

in your body, by reducing the amount of

chopped fresh herbs- basil, oregano,

salt you eat you can limit the amount of

mint, rosemary, thyme, parsley, chives,

fluid that stays in your body. If you have

sage, tarragon

ascites, your doctor and dietitian will

garlic, curry, chilli, onion, fresh ginger,

spring onions

recommend you follow a low salt diet.

spices- cinnamon, nutmeg, cardamom,

ginger, cumin

You may also be asked to limit the

amount of fluids you drink through the
day. This includes all beverages and

Also, try.

watery foods such as soup, ice-cream,

wet curries, fruits etc.

slowly cutting down your salt intake

over a few months to allow your taste
buds to adjust.

HINTS TO REDUCE SALT

tasting food before adding salt or salty

sauces

1. Do not add salt at the table or

in cooking

Other products such as sea salt,

vegetable salt, celery salt, lemon pepper,

2. Choose low salt foods

herb salt can still contain high levels of

3. Count your salt

sodium. Check the nutrition panel and

ingredients.

This is a draft document from Queensland Health Dietitian/ Nutritionists

Disclaimer: http://www.health.qld.gov.au/masters/copyright.asp
2013

Developed: March 2009

Review Date: December

FLAVOUR COMBINATIONS TO TRY

pork - garlic, lemon rind, coriander,

apple sauce, ginger, mustard.

beef - bay leaf, thyme, mustard, sage.

lamb - mint, ginger, currant jelly,

black pepper.

paprika, oregano, rosemary, garlic.

chicken - sage, tarragon, garlic, chilli.

fish - lemon juice, lemon pepper, lime

potato - chives, paprika, mint, parsley,

carrots - ginger, cinnamon, honey,

parsley.

juice, chives, parsley, vinegar.

tomato - basil, garlic, black pepper,

parsley, oregano.

2. Choose low salt foods

Most sodium (75%) comes from processed foods. When shopping, buy fresh, unprocessed,
or frozen foods. Also choose foods labelled low salt or no added salt.
Some foods labelled reduced salt can still contain high levels of sodium. Check the nutrition
panel a sodium (Na) content less than 150 mg per 100gm serve is desirable.
FOOD
Bread &
Cereals
Often high in
salt

Lower Salt - CHOOSE

salt reduced bread
fresh and dried pasta
salt reduced and low salt crackers
and biscuits eg Ryvita, Vitaweat,
rice and corn cakes
rolled oats, porridge
Weetbix, Sustain, muesli, Just
Right, puffed wheat, oat or wheat
bran
rice
plain flour & cornflour

This is a draft document from Queensland Health Dietitian/ Nutritionists

Disclaimer: http://www.health.qld.gov.au/masters/copyright.asp
2013

High Salt - AVOID

savoury crackers
sweet biscuits & shortbread
croissants, pastry, cakes, scones,
muffins
savoury breads, bread, bread
rolls (products based on self
raising flour are high in salt)
packet rice & pasta with
flavouring, instant noodles
breakfast cereals with more than
150 mg sodium per serve eg
Cornflakes, Rice Bubbles, Bran
Flakes
tinned spaghetti

Developed: March 2009

Review Date: December

FOOD
Fruit

Vegetables

Milk, yoghurt
and cheese

Meat , Fish,
Chicken,
Eggs

Lower Salt - CHOOSE

fresh fruit
dried fruit, tinned fruit
fruit juices
all fresh and frozen vegetables
legumes (lentils, chickpeas, soup
mix, soybeans, kidney beans),
canned bean mix
no added salt canned vegetables
milk all types
yoghurt
custard, dairy desserts, icecream
cottage, ricotta or continental
(quark) cheese
fresh, unprocessed meat (lamb,
beef, veal, pork), chicken, turkey,
fish and seafood
eggs
no added salt tinned seafood eg
tuna in springwater

High Salt - AVOID

olives
canned plums

Fats

Drinks,
Snacks &
Extras

unsalted butter, oil and avocado

no added salt (e.g. Becel, Sundew)
or reduced salt (Goldn Canola,
Flora) margarines
no added salt peanut butter
Drink water!

cordial, softdrink
home made, unsalted soups
Milo, tea, coffee
unsalted nuts & seeds
jam, honey, syrup
unsalted popcorn
plain chocolate
plain lollies

This is a draft document from Queensland Health Dietitian/ Nutritionists

Disclaimer: http://www.health.qld.gov.au/masters/copyright.asp
2013

pickled and
canned vegetables
tomato or vegetable juice
baked beans or reduced salt
baked beans
cheese : cheddar, cream, brie,
camembert, feta, parmesan
cheese spreads
reduced salt cheeses (still high in
salt)
cured, smoked, canned or salted
meat eg corned beef, ham,
bacon, sausages, salami, brawn,
pate, frankfurts
meat pies, sausage rolls, fish
fingers, crumbed or battered fish,
hamburgers, BBQ chicken, pizza,
chicken nuggets, Chinese food
tinned fish in brine or tomato
sauce, anchovies
butter
margarine
peanut butter

sports drinks
soup, Bonox
tomato juice, vegetable juice
clear aspirin or panadol
effervescent drinks e.g. alkaseltzer, Eno and vitamins e.g.
Berocca
dips, olives, marinated & pickled
foods
most sauces - tomato sauce,
tartare sauce, BBQ sauce,
teriyaki , soy sauce (even
reduced salt), Worcestershire
sauce, cheese sauce
gravox, gravy, stock cubes
vegemite, meat & fish paste
salted nuts and snacks
crisps, pretzels
mustard, pickles, relish
Developed: March 2009
Review Date: December

3. Count your salt

Check the nutrition information panel for an accurate measure of sodium per serve in a
particular food, and aim to have less than 2000mg of sodium each day. In some cases,
a limit of 1400mg daily may be needed. Any food with more than 150mg sodium per
100 gm serve should be limited.

The table below provides a general guide.

FOOD

mg sodium FOOD

mg sodium

bread, 1 slice

150

fresh, dried, canned fruit

crumpet, 1

290

fresh or frozen veg,

10

average serve
porridge, muesli, weetbix,

0 - 80

(low salt) small bowl

Cornflakes, Nutrigrain

tinned vegetables (peas,

150

corn, etc ) cup

200 - 320

potato crisps 50g packet

450

rice or pasta 1 cup

salted nuts 50g

210

2-3 crackers

100

unsalted nuts 50g

2 sweet biscuits

100 - 150

baked beans cup

570

piece of cake/ scone

150 - 200

tinned fish in brine 100g

300 - 400

sports drink 500mL

200

chicken, fresh 100g

60

cup of soup, 1

650

ham, 2 thin slices 60g

950

tomato sauce, 20mL

200

bacon, 1 rasher, 20g

650

mayonnaise/dressing 20ml 250

egg, 1 large

70

sausage roll, average 80g

600

cheese, 1 slice 30g

200

meat pie, 1

900

cottage/ ricotta 30g

60

chicken nuggets 6

630

glass of milk

100

hamburger, average

1000

small tub yoghurt

120

sausage, 1 thick

650

butter/marg 1 teaspoon

60

pizza, medium

1200

2-3 pinches salt (1gram)

1500

1 scone

200

Berocca, 1 tablet

285

(high salt) small bowl

This is a draft document from Queensland Health Dietitian/ Nutritionists

Disclaimer: http://www.health.qld.gov.au/masters/copyright.asp
2013

Developed: March 2009

Review Date: December

SUGGESTED MEALPLAN
BREAKFAST

MORNING TEA

LUNCH

AFTERNOON TEA

DINNER

SUPPER

Things I can do to improve my management of chronic liver disease:

1.

2.

3.

For information contact your Dietitian or Nutritionist:

This is a draft document from Queensland Health Dietitian/ Nutritionists

Disclaimer: http://www.health.qld.gov.au/masters/copyright.asp
2013

Developed: March 2009

Review Date: December