As such, if you have this condition, what you eat and drink each day is especially important. Many foods to avoid with cirrhosis contain protein, sodium, and sugar that require your liver to work harder—a demand it may no longer be able to meet.

This article explains how a cirrhosis diet plan may be crafted with the help of your healthcare team members, such as a registered dietitian. This will ensure that you’re adequately nourished and avoiding choices that can worsen your condition and otherwise impact your health.

Benefits

The liver has more than 500 functions, making it one of the most vital organs. If your liver is damaged from cirrhosis, it is not able to efficiently perform one of its most important tasks: helping your body get nutrition from the food you eat.

A cirrhosis diet can help provide adequate nutrition, reduce the amount of work your liver needs to do, thwart related complications, and prevent further liver damage. Research has shown that people with liver disease who aren’t adequately nourished are more likely to experience complications from cirrhosis, including death.

Authors of a 2018 article in the Journal of Clinical Gastroenterology say that “dietary management of cirrhosis is not a one-size-fits-all approach.” A cirrhosis diet should be started early in treatment to improve the prognosis and outcomes.

Unfortunately, existing scarring from cirrhosis cannot be reversed. Diet, then, is a key way to take charge of your future if you have liver cirrhosis.

How It Works

Your cirrhosis diet will need to be tailored based on your overall health and individual needs, but there are some general dietary guidelines that often shape this eating plan:

Avoiding alcohol: Any amount is considered unsafe for anyone with cirrhosis, as it’s a potential cause of more liver damage—even liver failure. Drinking can also contribute to malnutrition and other health concerns. Limiting fats: The body digests fats using bile, a yellow-green fluid made in the liver. When the liver is damaged, the production and supply of bile may be affected, leading to digestive symptoms.  A liver that isn’t working well has a hard time processing a high-fat meal. (Healthy fats can be included in moderation. ) Avoiding raw or undercooked meat/seafood: People with liver damage from cirrhosis have impaired immune function, meaning bacteria and viruses that these foods can harbor can lead to a potentially serious infection.

In addition to changing the content of your diet, you may need to change the quantity of the food you eat. Having liver disease can increase your risk for malnourishment, so you may need to eat more calories in a day to meet the increased energy demands on your body due to your condition.

If you have liver disease, know that the recommendations for protein intake vary. The influence of protein on liver disease is somewhat controversial and still being studied.

You’ll need to consult with your healthcare provider or a dietitian to determine the exact amount of protein recommended for you. The calories from protein will be an essential component of a varied and nutritious diet, and protein is key to preventing muscle atrophy (thinning).

Duration

If you are at risk for liver disease, your healthcare provider may want you to follow a cirrhosis diet even if you don’t feel sick. Someone in the early stages of liver disease (compensated phase) usually doesn’t have any symptoms.

Signs of liver disease may take years to show up, and they do so only once damage to the liver has become severe (decompensated phase). Since changing how you eat can only help to prevent additional liver damage, but can’t heal what’s already occurred, you will likely need to be on a cirrhosis diet plan for a long time. 

What to Eat

If you’re following a cirrhosis diet, there are some foods and beverages you’ll need to strictly avoid. However, you’ll have your choice of many nutritious and tasty foods, including fresh produce, whole grains, and plant-based protein.

Fruits and vegetables: Choose fresh produce when possible, as canned varieties usually have sodium and sugar. Add fruit to cereal or oats for extra nutrition, fiber, and a little natural sweetness. Fiber-rich fruits like apples make a healthy and satisfying snack on their own. 

Dairy: Full-fat dairy products will likely be too hard for your body to digest. Stick to low-fat Greek yogurt, small portions of low-sodium hard cheese, and fortified dairy-free milk alternatives like almond or soy.

Rich, milk-based desserts like pudding, custard, and ice cream should be limited. You may need to avoid them completely on a cirrhosis diet if you have significant trouble processing fat and sugar.

Grains: Choose whole-grain bread, pasta, brown rice, and cereal instead of those made with refined white flour. Granola and granola bars may be approved for quick snacks as long as they’re low in sugar and sodium.

Protein: Red meat isn’t approved for a cirrhosis diet, nor is any kind of processed lunch meat or sausage. Small servings of lean poultry without the skin, some types of fresh-caught fish (such as salmon), and eggs or egg whites may be suitable.

Desserts: Packaged cake, cookie, brownie, biscuit, pancake, and waffle mixes can be high in sugar and salt, so it’s best to avoid them. In general, you’ll want to avoid pastries, doughnuts, and muffins, unless you can make your own low-fat, low-sugar, and low-salt versions.

Beverages: You cannot drink alcohol if you have liver cirrhosis, but you’ll have plenty of other options. Water is the most hydrating choice, but if you are on a low-sodium diet, you’ll want to check the labels on bottled water as some contain sodium. Milk and juice should only be consumed if pasteurized.

While some research has suggested coffee (but not other caffeine-containing beverages) could have benefits for people with liver disease due to alcohol use, most medical professionals advise that patients with cirrhosis avoid caffeinated beverages, including coffee, tea, and soft drinks.

Liver disease can lead to malnourishment, in which case your healthcare provider might want you to eat more calories. If you don’t feel up to eating larger meals to increase your caloric intake, try eating small, frequent meals and snacks throughout the day.

Some people with liver disease find they wake up in the night. They may stay awake for long stretches and end up taking naps during the day. If you are awake in the middle of the night, research has shown that having a late-night snack (especially those that have been specially formulated for this purpose) can be helpful for people with cirrhosis.

If your sleep schedule is interrupted, be sure that you are planning your meals around when you are awake, whether it’s during the day or at night. Try not to go longer than a couple of hours without a meal or snack. 

Cooking Tips

Try grilling or boiling veggies and preparing them without oil or butter.

If you’re reducing your sodium intake as part of a cirrhosis diet, try using fresh herbs and spices instead of table salt. If you’re used to adding salt to your food and find it difficult to break the habit, your healthcare provider may allow you to use a salt substitute.

When cooking meat, start by choosing lean cuts. Skinless poultry is a healthier option than red meat.

You may be allowed to have small portions of beef on occasion depending on how it’s prepared. For example, grilling meat instead of frying with oil or butter reduces the fat content and prevents it from becoming too greasy for a cirrhosis diet. 

In addition to avoiding raw or partially cooked meat and seafood, practice proper food handling and safety practices to further reduce your risk of foodborne infections.

Modifications

You may need to adapt your diet if you develop complications from cirrhosis, such as ascites, hypoglycemia, and encephalopathy. If you develop one or more of these conditions, your healthcare provider may recommend additional changes to your diet, including limiting salt, sugar, and protein.

Ascites 

Ascites is the accumulation of large amounts of fluid in the abdomen. Healthcare providers usually require a strict no-salt diet for people who have cirrhosis with ascites, as sodium can make the condition worse.

Prepackaged and convenience food items are often high in sodium or contain added salt. If you’re not routinely checking the nutrition labels, you may not be aware of how much sodium you’re consuming. 

When you’re doing your grocery shopping, a good rule of thumb is to focus on what you can buy along the perimeter of the store—fresh produce, lean meats, and low-fat dairy—which are low-sodium choices. Avoid the packaged snacks, cereals, and sodas found in the middle aisles. 

Encephalopathy 

As the body digests protein, it creates a byproduct called ammonia. When the liver is functioning properly, this is cleared without issue. But a damaged liver can’t handle a normal amount of protein, let alone any extra.

The more protein it tries to digest, the more ammonia can build up. At high levels, it becomes toxic to the brain and can cause memory problems, dementia-like symptoms, and a serious complication called encephalopathy. 

If you have cirrhosis, focus on including plant-based protein sources in your diet instead of meat. Your healthcare provider may give you a specific limit of how much protein you can have per meal or per day.

Hypoglycemia 

Hypoglycemia, or low blood sugar, is another common problem when you have cirrhosis. When your liver is healthy it stores energy from the complex carbohydrates you eat in an easily accessible form called glycogen.

If you have cirrhosis, your liver isn’t able to store enough energy in this chemical form. As a result, people with liver disease may experience episodes of low blood sugar.

Research has shown that eating high-fiber meals with a low glycemic index can help manage hypoglycemia in people with cirrhosis.

Considerations

It’s important to stick with your cirrhosis diet to prevent further liver damage. You can do this by following some general principles to help set yourself up for success.

General nutrition is important and healthy foods are part of a cirrhosis diet. Your healthcare provider may have you take vitamins or nutritional supplements, though, because your condition makes it harder to stay nourished. That’s especially true if you have nausea or gastrointestinal (GI) symptoms.

Changes in your diet are critical, so you’ll want to approach the cirrhosis diet as a positive lifestyle decision to promote your health. That means reading labels for fat, sugar, and salt at the grocery store so that you’ll know you’re making the best possible choices. Specific situations may include:

Selecting gluten-free bread, pasta, and crackers if you also have celiac disease Limiting pastas made from beans and legumes that are high in protein for a cirrhosis diet Reducing protein from nuts, seeds, and tofu if you follow a plant-based diet

Fresh produce, dried beans, and other ingredients you need to make healthy cirrhosis diet recipes can be affordable with careful planning and shopping. It will help you to make the most of your budget while avoiding foods that are bad for cirrhosis.

Keep in mind that your cirrhosis diet plan includes meals when you eat out, too. Don’t hesitate to ask about your menu options when dining at restaurants.

Your success in sticking to a cirrhosis diet plan also will depend on support from family members and friends. This is especially true if you may need help with meal prep and planning due to advanced liver disease.

While your healthcare team is the primary source for information about your cirrhosis diet, you may wish to consider a support group for people with liver disease in your area. You can also look online for message boards, social media hashtags, or blogs where patients share stories, experiences, and maybe even a few cirrhosis diet menu ideas.

A Word From Verywell

If you have cirrhosis, staying adequately nourished can be challenging. You may need to eat more or less of certain foods to ensure your body is getting the energy it needs.

It’s also important that you pay close attention to your diet so you can avoid more damage to your liver. For example, you’ll need to avoid alcohol, high-fat foods, and raw or partially cooked shellfish.

While changing the way you eat can’t fix a liver that is already diseased, it can improve your quality of life and help to prevent complications.