Nourishing a Strained Liver: Diet Tips for Cirrhosis Patients

This year was a milestone for me. December 24th marked three years since I was told that I had high blood pressure and may have cirrhosis, it would be four more months before that diagnosis was confirmed. After some heart rate monitoring, I was put on high blood pressure medicine. Combining the medicine with diet and exercise changes and I was able to come off the meds in about four months. As for the cirrhosis, that was to be another story all together. Once my diagnosis was confirmed, I had to start thinking about the future and what I was going to do. Sure, you may think that is an easy choice but there are so many factors and thoughts that go through a person’s mind that the decision is far from easy. 

While my past articles on cirrhosis have discussed how I have coped and what things I have implemented since my diagnosis, this article I wanted to focus a bit more on what I have learned in how your body processes food and its needs after a cirrhosis diagnosis. Today, lets talk about Nourishing a Strained Liver: Diet tips for Cirrhosis Patients.

So you have cirrhosis, now what?

Growing up, whenever I heard someone had cirrhosis, the only thing I heard after was how long they had until they died. It was a death sentence. A lot hasn’t changed but doctors are learning that there is much more that needs to be learned with cirrhosis. The first thing you hear from your doctor when you are diagnosed with cirrhosis is that it can’t be cured or reversed, at least that is what is currently believed. There are studies going on that are looking at the possibility of reversing it. 

When my doctor first told me I had cirrhosis, my mind was a whirl of thoughts that mostly ended with wondering how long I had left. The good news, that took me a while to understand, was that my MELD score showed that I was in early stages of cirrhosis, so there were still avenues open to me. My doctor is great, from the beginning she listened to my worries, talked me off of ledges (figuratively), and explained things in such detail that I started to have hope for a long life. She impressed upon me that changing my lifestyle would be the most advantageous thing I could do. So, if you just found out that you have cirrhosis, rest assured that there are options open to you. Learning about a proper cirrhosis diet will help you prevent further damage to your liver, protect you against certain conditions that are prone to happen, and give you a better quality of life. 

Exercise will become an integral part of managing cirrhosis. If you are overweight, it will help you lose those excess pounds so your liver isnt constantly working overtime. Exercise will also help with insulin resistance. If you are starting a workout regime, as part of your treatment routine, remember to start slow. High intensity workouts and powerlifting can have negative side effects on the liver, especially if you are experience portal hypertension.

Please note, I am not a doctor and the things I have learned and implemented into my life have come from many long conversations with my liver doctors, nutritionists, trainers, and vast amounts of research. What has worked for me may be different for you, please seek medical advice before implementing any dietary or exercise changes to your life.

The importance of nutrition with cirrhosis

Cirrhosis is a condition that is characterized by scarring of the liver. The more scarring that occurs, the more impaired your liver becomes. Some side effects that come from cirrhosis include fatigue, loss of appetite, weight loss, and nausea. From personal experience fatigue and nausea can be really bad, at times. The two biggest things that happen with cirrhosis is that your body can longer store glycogen. Glycogen is an important carbohydrate for providing the needed energy to the body. Typically, it is turned into fat and stored in the body, turning fat back to energy becomes harder with cirrhosis and your body often looks for easier means to obtain that energy, In turn, it will start to break down protein from muscles, instead. 

There are three things you need to consider with a diet. With cirrhosis, you will need an adequate about of calories throughout the day, you need good carbohydrates for energy needs, and you will need increased protein for muscle support. Old studies said that too much protein could be bad for cirrhosis, but it has been proven that is only a factor in advanced stages of cirrhosis or in specific types of liver issues. If you arent getting enough to eat daily and cannot meet the energy needs your body demands, it will start breaking down muscle to compensate. This will leave you under nourished and weak and will only further complicate issues. 

Keep in mind that this is a generalize recommendation and you should seek your doctors advice in relation to your specific condition. People with compensated cirrhosis (milder or beginning stages) should eat around 16-18 calories, .45-.68 grams of protein per pound of body weight per day. Here my example: I am 200 pounds and 50 years old.

200 pounds * 16 calories = 3200 calories per day

200 pounds * .45 grams of protein = 90 grams of protein daily. 

You are probably sitting there thinking that is a lot of calories in a given day and may be contrary to what most physical trainers will tell you for weight loss needs. Keep that difference in mind, you are not trying to lose weight, you are trying to nourish a body that doesn’t store energy as well as it used to or utilizes it effectively for energy production. 

That being said, you need to prioritize high and lean protein foods, using a combination of plant and animal proteins. Helpful hints, find ways of adding protein to each time you eat or snack. When you are focusing on calories and carbohydrates, you want the best options. Stay away from processed foods and sugars as the fat is bad in them and typically use processed sugars that are harder for your body to break down. In the end, they are all stored as fat and that causes your liver to work harder.  Avocados and nuts provide easier fats for your body to break down so that you do not miss out on the benefit that fats bring to a diet. 

Stop the insanity

There are things that you will need to stop, immediately, if you are diagnosed with cirrhosis. Here is the no brainer. If you have cirrhosis and you are drinking you are killing yourself much quicker. 

Put down the alcohol. I am not going any further into that, just stop. This means alcohol from any source. Here is a tidbit often overlooked. Most mouthwash contains alcohol, the thought process is that alcohol will kill bacteria. The body absorbs alcohol through the skin and is processed through the liver. So yes, even mouthwash is bad for you. Switch to alcohol free mouthwash. If you need advice on it, check out this option.

We all know that over consumption of salt can lead to heart issues but did you know that it can also cause liver problems? Salt raises blood pressure and creates hypertension. This will affect all aspects of your body. I linked an article in the beginning of this that goes into detail about portal hypertension. The short version is to remove salt from your diet. Yes, that is harder than you can imagine since all processed food contains HUGE amounts of salt and it is even naturally occurring in foods. The best way to start is looking for no added salt. That also means you have to say no to chips, crackers, pretzels, and microwave popcorn. Good news, you can still have popcorn, just make it yourself and use salt alternatives. 

In reducing sodium, you also need to think about the condiments and foods you use. Processed meats are bad for you, period. They are even worse if you have cirrhosis. Say not te hot dogs, sausage, deli meats, and bacon. Condiments like soy sauce, teriyaki sauce, steak sauce, and even ketchup are high in sodium and need to be removed. Making your own ketchup is rather easy. If you are looking for do it yourself options, let me know in the comments below and I will put together an article on recipes that work for a cirrhosis diet. 

Lastly, undercooked foods can become a death sentence for you. This was a hard one for me. I love a medium to rare steak and sushi, these can be seriously problematic for me now. If they are not handled properly and develop some food borne pathogens, it can kill me. These little bugs will send your liver into overtime trying to fight them off. Your liver is already strained just doing its daily thing, why add more to it. 

Life is a veritable smorgasbord, -orgasbord, -orgasbord

By now, you are probably feeling a bit depressed over all the things you see you have to give up. That is because our bodies have become used to all the bad crap we ingest. I was there with you. I had already started a lifestyle change due to high blood pressure. So, removing salty snacks was already in the works. Next, it was advised to eat healthier, maybe look at the Mediterranean diet and/or become more vegetarian. Since cirrhosis was already a possibility and was awaiting further testing to verify, I decided to start becoming a pescatarian. If you aren’t familiar, a pescatarian focuses their diet on plant-based food first, and compensates for many other needs from fish, seafood, eggs, and dairy. After my diagnosis, I learned I needed to boost my protein levels. I remember standing in the canned tuna aisle, with Karl, wondering how in the hell I was going to get my protein levels up with being a pescatarian. It was overwhelming. 

I downloaded an app called Lose It! This app has the ability to input your own recipes, as well as track foods you buy. The app gives you detailed information on micro and macro nutrients. This allowed me to see where sodium, carbohydrate, protein, calories, and more levels were at. Adding things like plant based protein powders to recipes boosted what I was getting from foods. Soon, with Karl’s patience, I learned that being vegetarian would allow me to still get the needed protein levels while living healthier.

You need to focus on nutrient-dense foods for your diets. That means fruits, vegetables, nuts, seeds, and legumes are your new best friends. Nuts are a good combo food, they give you good calories, healthy fats, antioxidants, vitamin E, and other beneficial plant compounds. Cruciferous vegetables are high in fiber which is needed in helping process sugars and lower the amount of them circulating in your bloodstream. 

Studies are increasing that show the benefits of drinks like coffee and tea and how they are helpful to the liver. Keep in mind tha caffeine can have effects on blood pressure, so if you are in a state of high blood pressure you may want to consider decaf instead. Same benefits with less jitters. Water will become your new best friend. It is key in keeping hydrated but also a must in removing toxins from the body. 

Since salt is bad, learn to play with spices. These will help balance out flavors in your meals and not leave you missing salt. If you still need the salt flavor, there are plenty of great salt substitutes out there. 

Is it time to eat yet?

As a kid, we were all told that we need to eat three well rounded meals, in a day. We were also told that we should limit snacking between meals and keep our calories at a minimum. This is a mindset that you need to remove from your day to day regime. It is also the hardest one for me to follow. At fifty, I have spent my entire life eating three to four meals a day. Most of my life, I didn’t do breakfast. That meant that I only ate twice a day, let’s not discuss how that is bad for anyone.

Now that I have been diagnosed with cirrhosis, I have had to relearn when to eat. Instead of focusing on three meals a day, break that up even smaller .Think about five small meals instead of just three bigger ones. If it helps, you should be eating about every two hours, while you are awake. This will ensure that there is enough energy and food going into your body to compensate for fatigue and muscle building. Also, more frequent and smaller meals means your liver has a better chance of breaking down and using what you are eating instead of storing it as fat.

This has been my biggest hurdle. Portioning can help with this. Also, it is crucial that you employ a snack before bedtime. At night, your body isnt eating and will go into the catabolic phase. What this means is that since you are not eating, your body needs to find energy sources from other places, this often results in your body breaking down fats and muscle. Since the liver is stressed, its ability to break down fats becomes impaired and as such it just deposits them into the body. This comes from the liver not being able to produce adequate amounts of bile, which is key in fat digestion. In turn, your liver will break down protein which is the primary component of muscle. Long story short, eating a small snack before bed will increase sugar in your bloodstream and give your liver something to work with. This is also why eating every two hours should become your normal operating procedure. 

Bringing it all home

Being diagnosed with cirrhosis may seem like the end of the world but it’s not. With some small changes and additions, you will be able to live out a healthy life with minimal impact in your day to day. Remember that you need to increase the amount of protein and calories you intake to keep you moving and provide the needed energy. You need to stop unhealthy habits like too much salt, alcohol, and overly processed food. Add in nutrient dense, fiber, and protein rich foods to your diet. Exercise will help you maintain your weight and muscle growth so that you can stay healthy and active for longer.

Did you find anything in this article helpful? If so, comment below and let me know what it was. If you would like to see some of the recipes I have used in increasing protein and living a healthier lifestyle, let me know and I will work on that article, also. There is so much to be learned about proper eating habits for cirrhotic patients and I love sharing what knowledge I have. Just remember, this is from my journey. Seek out medical help if you are planning on making any changes to your health and daily routines. Learn what will work for you and your body. This will ensure that you, too, have a long and healthy life in front of you.