DIET AND NUTRITION
Everything that enters the body must pass through the liver to be processed before it can be absorbed into the blood stream. The liver filters out the harmful substances and produces all the nutrients that your body needs in order to function at optimal capacity. Although the liver has a great ability to repair damage that is inflicted on it, with certain conditions like cirrhosis or chronic hepatitis, the liver can no longer function at its best.
In such a situation, diet plays a major role in controlling the damage that has already been done. Nutritional deficiencies are common among liver patients. If you suffer from some kind of liver disease it is advisable to be in touch with your dietician about the specific needs in your diet. Most people with liver disease find that eating several small meals a day helps. The liver can process these amounts more efficiently and it also maximises their energy levels.
How do I maintain my calorie needs?
Maintaining the nutritional status for your body can lower your risk of complications. It is your dietician who will monitor your calorie needs. Often people with liver disease have higher calorie needs. This can be anywhere between 30-45 cal/kg.
How much protein should I be having?
The body’s protein needs tend to increase when a person has some form of liver disease. But this does not mean that you can consume as much meat, fish or poultry as your heart desires. Again your dietician will be your best guide. A very high intake of protein can increase the amount of ammonia in your blood. This can lead to a condition called hepatic encephalopathy (mental confusion).
Are fats okay in my diet if I have liver disease?
Fats are important for the body but as everyone knows too much fat is never a good idea. Your dietician will guide you about the amount of fat that is in the correct proportion for you. To cut down on the amount of fat in your diet, you should grill, bake, boil, steam or casserole your meals instead of frying. Trim visible fat off meat and remove skin from poultry. Be aware of hidden fats in your food.
What about Carbohydrates?
Carbohydrates are the body’s energy supply. A healthy liver makes glycogen from carbohydrates. The glycogen is then broken down and used when the body needs energy. All carbohydrates – simple or complex are broken down into glucose to produce the energy molecule Known as ATP(adenosinetriphosphate).
People with liver disease should have a diet which consists of approximately 60-70% carbohydrates. Legumes, whole grains, vegetables, brown rice etc. are good sources of complex carbohydrates.
Salt/Sodium in my diet
Salt is an important ingredient to look out for in the diet of people with liver disease. Sodium (Na) is present in common salt which we use in cooking and on the table. Sodium occurs in nature only in combination with chloride. Our body requires less than 500mg of salt per day but most of us consume a lot more. While this over consumption is mostly harmless in a healthy individual, it can have negative consequences for someone with advanced liver disease. Liver disease patients often suffer from a condition called ascites (accumulation of fluid in the abdomen). Ascites must not be neglected as it can lead to a condition called SBP-subacute bacterial peritonitis. Such patients must be on a severely salt restricted diet. Even a gram of sodium consumed can result in 200ml of fluid build -up. It is therefore, important to read the labels on food packaging to monitor the salt content. Often condiments/spices such as dill pepper, vinegar, basil etc. can be used as salt substitutes to enhance the flavour of food.
Iron in the diet
Iron in the diet is another important ingredient to look out for in people with liver disease. Excessive iron in the body of a liver patient can be extremely dangerous. Although iron is an essential component of haemoglobin which is responsible for delivering oxygen to red blood cells, in excess iron can be toxic to the liver. If you are a liver patient, your doctor will continually monitor your iron levels. Do not take iron supplements without your doctor’s knowledge if you are feeling fatigued or weak. Even herbal medications, known to be good for the liver like dandelion or milk thistle may have concentrations of iron. Avoid foods high in iron content like red meats, and cereals enriched with iron.
Is Calcium good for me?
Calcium is very important for your bone health especially in pre liver patients. People with liver disease can have high rates of osteodystrophy. This can lead to weak and porous bones which is not a good sign when patients are recovering post transplant. Calcium also plays an important role in blood clotting and muscle contraction. Again it is your doctor and dietician who will monitor your calcium intake because excessive calcium will impede iron absorption and can even cause severe constipation, fatigue and kidney stones. Alcohol is known to be directly toxic to bone cells and it can impede calcium absorption. Good sources of calcium include most leafy green vegetables, tofu, canned sardines with bones and salmon with bones.