Diet Guidelines for Patients with Cirrhosis

Cirrhosis of the liver is a disease that has serious effects on the body. It often leads to loss of muscle mass and a buildup of fluid in the arms, legs, and abdomen. Loss of muscle mass is a common complication of cirrhosis and can have a negative impact on quality of life.

In order to slow and/or prevent loss of muscle mass, you need to eat enough protein, and adjust your meal and snack times. It is important to reduce long periods of fasting (not eating). The longest time period between meals is between dinner and breakfast. Snacks in the late evening may be helpful. The best snack option is a protein-rich snack.

To help prevent buildup of extra fluid, a low-sodium diet is recommended. A diet high in sodium may cause you to retain more fluids. You should also avoid added salt.

Here are some suggestions that will help you plan the nutritional management of your condition.

Protein guidelines

There is no need to limit your protein intake. Your doctor or dietitian will be able to tell you the proper amount of protein you need for your weight. It is important that you eat protein with every meal and for an evening snack (preferably around 9:30-10:00 pm). Casein, the protein found in milk products, is generally well-tolerated in people with cirrhosis.

Protein Source	Serving size	Protein per serving (grams)
Dairy
Cottage Cheese, low-fat*	120ml (½ cup)	15
Milk	240ml (1 cup)	8
Greek Yogurt	150g (5.3 oz container)	15
Yogurt	170g container (6 oz)	5
Cheese, low sodium	1 slice	8
Laban	180ml	5
Plant Based
Boiled lentils	227g (1 cup)	18
Beans (ie: navy, garbanzo, lima)	227g (1 cup)	15
Edamame (green soybeans)	113g (½ cup)	9
Soy nuts	30g (1 ounce)	11
Peanut butter/Almond butter	1 tbsp	4
Tofu/tempeh	30g (1 oz)	5
Soy milk	225g (8 oz)	6
Soy - or bean-based veggie burger	1 patty	11
Nuts (walnuts, pecans, peanuts, almonds)	30g (1ounce)	5
Hummus	2 tbsp (1 oz)	1
Falafel	5.7 cm (2.25 inch) patty	2
Quinoa	227g (1 cup)	8
Pumpkin seeds	57g (¼ cup)	9
Sunflower seeds	2 tbsp	4
Animal
Poultry	30g (1 oz)	7
Beef	30g (1 oz)	7
Lamb	30g (1 oz)	7
Venison	30g (1 oz)	8
Liver	6
Fish/seafood	30g (1 oz)	7
Egg	1 egg	6
Egg white	1 egg white	4
Egg substitute	57g (¼ cup)	6

*caution: food may be high sodium

YOUR PROTEIN PRESCRIPTION IS _______________gm/day

Sodium (salt) guidelines

Too much sodium in your diet may cause you to retain more fluids. To avoid this:

• Limit the amount of sodium you take in every day
• Do not use the salt shaker
• Use fresh foods when possible, or frozen vegetables instead of canned
• Avoid convenience foods.

Food group	Use	Do not use
Meat/ProteinAverage 50mg sodium per ounce	Lean fresh or frozen unsalted beef, veal, lamb, chicken, turkey, fish, eggs	sausage, hot dogs, luncheon meats, meat spreads, canned meats, all processed meats unless low sodium
DairyAverage 100-200mg sodium per serving	Milk, pudding, custard, yogurt, ice cream, low-sodium cheese laban	Regular cheese, labneh, laban up
StarchAverage 200-400mg sodium per serving	All breads (white, wheat, rye, pumpernickel, pita, sandwich buns), bagels, dry or hot cereals, rice, potatoes, noodles, unsalted crackers, chips, pretzels, popcorn	Salted, seasoned breadcrumbs, stuffing, rice or potato mixes, potato chips, pretzels, popcorn, tortilla chips, corn chips, all crackers (unless unsalted)
Fruits and VegetablesAverage 5-20mg sodium per serving	Fresh, frozen, canned fruits, fresh, frozen, unsalted canned vegetables	Canned vegetables, vegetable juices, sauerkraut, and beans, canned dried type beans (kidney, pinto, garbanzo)
CondimentsAverage 100mg sodium per serving	Butter, margarine, mayonnaise, lemon juice, vinegar	Salt, meat tenderizers, monosodium glutamate (MSG), pickles, olives, sauces such as steak, barbeque, teriyaki, soy, Worcestershire, relish, ketchup