REPOST: INFO: Nutrition for people with Cirrhosis

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Nutrition for people with Cirrhosis

At

this stage the diet is generally high in complex carbohydrates (breads,

cereals, grains, legumes, dried beans and peas, pasta, rice). These foods are

important because they provide our bodies fuel source called blood glucose

(also referred to as " blood sugar " ). During cirrhosis, individuals

frequently experience low blood sugar (hypoglycemia) or high blood sugar

(hyperglycemia). Your body is better able to maintain a healthy, sustained

level of energy from complex carbohydrates ( " starches " ) rather than from

simple carbohydrates ( " sugars " ).

Think

of your body as an automobile. Your body's " gasoline " is blood

glucose. Sugars found in candy, fruits, sweet pastries, and milk products

supply the body with " gasoline " , but your body uses it quickly. The

result is that your energy level usually rises and then falls too quickly with

sugars than it would with complex carbohydrates, especially those with higher

fiber content. This is not to say that simple sugar foods cannot be eaten, only

in smaller proportion to complex carbohydrates and in more controlled portions.

You

will also continue to need adequate, but not excessive protein in your diet

(see When you discover you're Hepatitis C positive). Protein is needed for

repair and maintenance of blood and body tissues, including liver tissue.

Persons with cirrhosis tend to better tolerate the protein from dairy and plant

sources than from meat sources, and therefore may benefit from a more

vegetarian type diet. Daily protein needs in grams will vary according to your

nutritional state. Your R.D. can give you more specific guidelines on this

according to your body weight and the status of your disease.

Persons

with cirrhosis often begin to experience difficulty digesting and absorbing fat

in the diet. The result is steatorrhea, (the presence of undigested fat in the

stool), and thereby may require dietary fat modification. Fatty liver is also a

condition that can occur which is the accumulation of fat in the liver. In

either of these cases, reducing the fat to 25% of total calories (about 40-70

grams of fat daily) is recommended. Use of a special prescription type of fat

called MCT oil is sometimes necessary. MCT (medium-chain triglycerides) does

not require bile for absorption into the blood stream, so is advantageous when

the liver can no longer produce adequate bile for digestion and absorption of

dietary fat (lipid). MCT can be used in place of other fats in cooking and some

recipes and is also available in certain types of liquid nutritional drinks.

Therapeutic

nutritional drinks now contain a mixture of MCT and other fats (called

structured lipids). Using MCT alone can produce undesirable gastrointestinal

complaints and is not indicated for the diabetic or significantly starved

person. Structured lipids also have been found to enhance the immune system

over other types of fats. Also, if MCT is the exclusive fat used in the diet,

supplementation with the essential fatty acid called linoleic acid is required

to prevent a dietary deficiency.

Vitamin

deficiencies can occur during this stage of the disease. Fat-soluble vitamins

A, D, E, and K may need to be taken in their water-soluble form by prescription

from your doctor. Deficiencies of the minerals zinc, calcium, and magnesium can

also occur during cirrhosis and may require supplementation. It is important

that you do not take vitamins or minerals not prescribed by your doctor as

toxicity can occur with overdosing. Sodium typically needs to be restricted

with cirrhosis. Unfortunately for many salt lovers, this means learning to

enjoy the taste of foods without salt. Since the taste for salt is acquired, it

can also be lost, (usually taking 4-6 weeks of " biting the bullet "

until you finally come to enjoy the many tastes of food, spices, and herbs

without the salt shaker!) Beware: many foods are high in sodium because of

what's added in processing. Processed meats, cheeses, frozen dinners, canned

soups and vegetables, snack chips and crackers can pack over 1000 milligrams of

sodium per serving. Considering that the person with cirrhosis must usually

limit sodium to 2,500 milligrams per day, these foods leave little room for

other necessary, more healthy foods in the diet. Remember that sodium acts like

a " sponge " in the body and can cause your body to hold on to more

fluid, predisposing you to abdominal fluid retention seen in cirrhosis called

ascites.

Copyright 1998 Trustees of Dartmouth College

Protein and Hepatitis C

Proteins

are the major building blocks that the body uses to make body components such

as muscles, hair, nails, skin, and blood. Proteins also make up important parts

of the immune system called antibodies, which help fight off disease. Since

protein is such a vital component of the body, many people mistakenly believe

that the more protein they consume, the better. Not only is this belief

misguided, but for someone with liver damage such an approach to nutrition can

actually be downright dangerous. The trouble is that a damaged liver cannot

process as much healthy liver. And, when a damaged liver gets unduly overloaded

with protein, encephalopathy ( a state of mental confusion that can lead to

coma) may occur. Finally, diets high in protein have been demonstrated to

enhance the activity of the cytochrome P450 enzyme system, which is responsible

for drug metabolism. This enhanced activity increases the likelihood that a

drug may be converted into a toxic byproduct capable of causing liver injury.

Protein

intake must be adjusted in accordance with a person's body weight and the

degree of liver damage present. Approximately 0.8 grams of protein per kilogram

(2.2 pounds) of body weight is recommended in the diet each day for someone

with stable liver disease. People with unstable liver disease or decompensated

cirrhosis need to lower the percentage of protein content in their diets so

that it falls between approximately 10 to 15 %. And, they need to eat only

vegetable sources of protein. A diet high in animal protein ( which typically

contains a lot of ammonia) may precipitate an episode of encephalopathy among

these people. Vegetarian diets, on the other hand, have a low ammonia content

and have been shown to be much less likely than animal protein diets to induce

encephalopathy. It is important to keep in mind that some popular weight-loss

diets involve the consumption of a very high animal protein content. People

with cirrhosis are advised to avoid any such diets.

Source:

http://www.liverdisease.com/nutritionalguidelines.html