People with cirrhosis need more protein and calories than the average person. If your liver is not working well, you may become tired and weak. Eating enough protein and calories is important if you have cirrhosis because:
- your liver may be working harder than usual
- you may not be able to store as many nutrients as usual
The information on this page can help you get the nutrition (protein, calories, vitamins, and minerals) you need to stay strong and be able to do the things you need to do every day. It will also help you cut down on the salt (sodium) you eat.
When to Eat
Some people with cirrhosis can find eating quite challenging. Lack of hunger, fluid build-up, and nausea are just some examples of things that may impact your ability to eat. You can improve your food intact by making sure you eat:
- breakfast soon after you wake up
- every 3 to 4 hours during the day
- a snack before bed, and again if you wake in the night
Protein
Everyone needs a different amount of protein. Talk to your healthcare provider about how much is right for you. Start by eating 3 meals and 2–3 snacks each day. Have a bedtime snack every day
Protein in foods
Use the Protein in foods table below to choose:
- at least 2–3 servings of protein at each meal, and
- at least 1–2 servings of protein at each snack.
| Food | 1 serving |
|---|---|
| Milk products | |
| Milk, kefir, chocolate milk | 1 cup (250 mL) |
| Regular yogurt | 3/4 cup (175 mL) |
| Greek yogurt | 1/4 cup (60 mL) |
| Cheese * | 1 0z (30g) |
| Ricotta or cottage cheese* | 1/4 cup (60 mL) |
| Plant-based protein foods | |
| Hemp seed hearts | 2 Tbsp (30 mL) |
| Nuts and seeds, unsalted | 1/4 cup (60 mL) |
| Nut and seed butters, unsalted | 2 Tbsp (30 mL) |
| Meatless protein, vegetarian ground round | 2 Tbsp (30 mL) |
| Peas, beans, lentils, soft tofu | 1/2 cup (125 mL) |
| Hummus, soybeans (edamame) | 1/3 cup (75 mL) |
| Tempeh | 1/4 cup (60 mL) |
| Firm tofu | 1/3 cup (3.5 oz/100g) |
| Soy beverage** | 1 cup (250 mL) |
| Bread, whole grain | 1 slice |
| Animal protein foods | |
| Fish, chicken turkey, pork, beef, game meats (cooked) | 1 oz (30 g) |
| Eggs | 1 |
| Egg whites | 2 whites, 1/4 cup (60 mL) |
| Nutrition supplements | |
| Nutrition supplement drinks, bars, pudding Protein powders Protein bars, shakes |
Protein amounts vary. Read nutrition Facts tables on packages. |
Meals higher in protein
- Add beans or lentils to soups, stews, and sauces.
- Melt low salt cheese in soups, sauces, scrambled eggs, and casseroles.
- Have cereal with 1 cup of milk at breakfast.
Snacks higher in protein
- Add protein powder to hot cereal, smoothies, pudding, and homemade muffins.
- Add unsalted nuts, seeds, and wheat germ to cereals, salads, smoothies, or yogurt.
- Toast with 2 Tbsp (30 mL) peanut butter.
- A muffin with cheese
- Fruit and a container of Greek yogurt
- A smoothie: banana, milk, protein powder.
- Have a nutrition supplement drink.
Talk to your healthcare team about other ways to increase the protein in your diet.
Take a look at this handout for more information about protein and cirrhosis: Eating well with cirrhosis
Sodium (Salt)
Too much sodium can make your body hold on to extra fluid. This fluid can pool in your belly and legs. Swelling in your belly (ascites) can make you feel fuller, quicker. Eating foods with less sodium can help control ascites.
- Aim to eat less than 2000 mg of sodium a day.
- One teaspoon of salt has about 2300 mg of sodium.
- All types of salt contain the same amount of sodium, including table salt, sea salt, and Himalayan salt.
Tips to reduce sodium:
- At first, foods may taste bland. Over time, your taste buds get used to less salt.
- Don’t add salt to your food while cooking or at the table.
- Choose fresh, unprocessed, and homemade foods.
- Eat less processed, packaged, or restaurant foods.
- Limit condiments and sauces (ketchup, mustard, soy sauce, gravies, salad dressings).
- Limit pickled foods, olives, chutneys, and dips.
- To boost flavours, try adding spices, seasoning mixes with no salt added, lemon, lime, vinegar, fresh or dry herbs, garlic, or onions
Learn to read food labels
Vitamins and Supplements
People with cirrhosis can be low in some vitamins and minerals. Osteoporosis (weak bones) is common in liver disease. Getting enough vitamin D and calcium will help keep your bones strong.
- Every day, take a multivitamin and mineral pill with no iron.
- You may be asked to take calcium or vitamin D pills.
- Talk to your healthcare team about what kind of supplement is right for you
The Importance of Nutrition to Prevent and Treat Low Muscle Mass
For more information, check out these handouts!
Check back soon for more detailed videos on protein, cooking on a low sodium diet and late evening snack ideas!
Useful Links
References:
The information on this page was adapted (with permission) from the references below, by the Cirrhosis Care Alberta project team (physicians, nurse practitioners, registered nurses, registered dietitians, physiotherapists, pharmacists, and patient advisors).
This information is not intended to replace advice from your healthcare team. They know your medical situation best. Always follow your healthcare team’s advice.
References: