Why diet is important when you have liver disease?
Staying nutritionally well
If you have a liver condition, there are some special considerations you may need to make in your diet to stay nutritionally well and to help to manage your condition. Some of these are specific to certain liver diseases, others relate to how advanced your liver disease is.
If you are experiencing symptoms such as loss of appetite, nausea, low energy levels, fluid retention in the legs or accumulation of fluid in the abdomen (ascites), you will need to follow a more specialised diet. These, and other problems associated with advanced liver disease, require specialist dietary advice from a registered dietitian.
It is important that you talk to your doctor as well as reading this information. Your consultant will be able to refer you to a registered dietitian. If you have already been given dietary advice you should not make changes without first talking to your consultant or dietitian.
Your liver and the food you eat
You need food to power your body, giving it energy and the material it needs to grow and repair itself. When you eat food, it is broken down in your stomach and intestine (gut) and three main nutrients are extracted:
These nutrients are then absorbed into the bloodstream and carried to your liver. Here they are either stored, or changed in such a way that your body can use them at once.
At the same time your liver is also working to detoxify substances which may harm your body such as alcohol; chemicals used in pest control, which may be present on unwashed fruit and vegetables; medicines; other drugs and some of the waste products produced in the body. If you have a liver problem, then your liver may not be able to do these jobs as efficiently as it should.
A well-balanced diet
To eat healthily you need to get the right balance between different foods. For most people, a well-balanced diet is one that is low in fat, sugar and salt, and high in fibre. Your diet should also contain enough protein and a wide range of vitamins and minerals.
It is important to remember that your body’s nutritional needs may vary depending on the type and severity of your condition. Particularly, if you are unwell and losing weight you may need to vary your diet from the recommendations below. Please refer to the ‘Coping with eating difficulties’ section for more advice in those circumstances.
Read more here: A Well Balanced Diet
Keeping to a healthy weight
Some liver diseases are linked to obesity; 90% of morbidly obese individuals are thought to have fatty livers. Obesity can also speed the damage associated with other conditions such as alcoholic liver disease and can decrease the effectiveness of treatments for hepatitis C .
It is important to maintain a healthy weight; to do this you need to balance the amount of food you eat with the energy you need. If you eat fewer calories than your body needs (especially if you are physically active) you will lose weight. If you eat more than you need, your weight will increase.Read more
Your Dietary Needs
It is important to remember that your diet needs to meet your personal nutritional needs and circumstances.
In normal circumstances, it is important to eat a well-balanced diet, with plenty of fruit and vegetables and only a small amount of fat and sugar.Learn more
Coping with eating difficulties
Some people find eating a well-balanced diet difficult, especially if they have been seriously ill. Two common reasons for this are:
- loss of appetite
- feeling sick (nausea).
However, it is important to eat as well as possible. Follow the link below for some tips.Read more
Complementary and Alternative Medicines
There is a great deal of information available on diet on the internet with many people offering dietary advice.
If you have liver disease, it is important to seek advice from your doctor and ask to be referred to a dietitian before taking any complementary medicines or dietary supplements.Learn more
Coffee and the liver
A British Liver Trust report (published June 2016) ‘Coffee and the liver – the potential health benefits’ confirms coffee is good for liver health. It is the first time that the entire body of current research and evidence has been reviewed and compiled into a single report.
The report provides evidence that:
- Regularly drinking moderate amounts of coffee may prevent liver cancer – the World Health Organisation has recently confirmed this reduced risk after reviewing more than 1,000 studies in humans
- Coffee also lowers the risk of other liver conditions including fibrosis (scar tissue that builds up within the liver) and cirrhosis
- Drinking coffee can slow the progression of liver disease in some patients
- Beneficial effects have been found however the coffee is prepared – filtered, instant and espresso
Cirrhosis and advanced liver disease
The damage present in cirrhosis stops the liver working properly and affects its ability to store and release glycogen, a chemical which is used to provide energy when you need it. When this happens, the body uses its own muscle tissue to provide energy between meals. This can lead to malnutrition, muscle wasting and weakness. Around two in ten (20%) people with compensated cirrhosis and six to nine people out of ten (60 – 90%) with decompensated cirrhosis, will become malnourished as their disease progresses.
Find out more: Cirrhosis and advanced liver disease
Looking after yourself - FAQs
Can I drink alcohol?
If you have alcohol-related liver disease, it is important that you stop drinking and remain abstinent life-long.
Alcohol can accelerate the rate of liver damage in those with hepatitis C and can limit the effectiveness of anti-viral treatment32. It can also accelerate the rate of liver damage in those with NASH33, therefore, it is recommended to avoid alcohol in these circumstances.
Alcoholic drinks are often high in calories and if you are overweight, cutting these out will help to reduce your calorie intake.
Many people with liver disease avoid alcohol as they find they do not tolerate it well. If you do choose to drink, it is important to stick within the recommended guidelines.
The Department of Health recommends adult men and women should drink no more than 14 units of alcohol in a week. These units should be spread over the week:
- men and women should not regularly drink more than 14 units per week
- everyone should have at least two consecutive alcohol free days every week.
If you are unsure whether you should drink, talk to your doctor. For more information on how alcohol affects your liver and calculating units, please refer to our Alcohol and liver disease publication.
What is a ‘fad’ diet and should I try one?
Fad diets are usually weight loss diets that promise you can lose weight quickly. These diets often focus on short term solutions and can be bad for your health. Fad diets usually involve one or more of the following:
- ‘Crash’ dieting, this can involve reducing your calorie intake considerably and can lead to other health conditions, such as gallstones. You may lose some weight in the short term but side effects often include: feeling very unwell, an inability to function properly, dizziness and eating disorders.
- Some diets may involve you cutting certain foods or food groups out completely such as wheat, meat, fish, dairy products or carbohydrates this can lead to your body being deficient in certain vitamins and nutrients.
If you need to lose weight, it is better to lose weight steadily, maintain weight loss and to be healthy. Refer to ‘A well-balanced diet’ section for further information.
I have read about diets which ‘detox’ your liver – should I try one?
There are many different suggested diets that recommend certain foods to help your liver ‘detox’ or with ‘liver cleansing’. However, there is no evidence that toxins build up in the liver and some of these diets can be dangerous for people with liver disease. A healthy balanced diet (see ‘A well-balanced diet’ section) is the best way to look after your liver.
Will drinking green tea or coffee help my liver?
Some studies have suggested that coffee has a beneficial effect on the liver and may help to reduce the risk of liver cancer in those with cirrhosis. For those with liver damage who enjoy coffee, there is no need to stop drinking it34,35. The way in which coffee may affect the liver is still being investigated.
Green tea has also been suggested to have a protective effect on the liver, due to its anti-oxidant properties36,37. Again, further research is required to confirm this.
As with everything, it is important to moderate your consumption and vary your fluids.
Should I take dietary supplements?
Dietary supplements are not an alternative to eating a well-balanced diet. Your body needs a wide range of vitamins and minerals to be able to function correctly, and the best way to get these is to eat a variety of foods5. You should always consult your doctor or dietitian before considering a supplement.