Cirrhosis is scarring of the liver cells from liver disease. Cirrhosis can develop from alcoholism or hepatitis. You can develop muscle wasting, diabetes, vitamin deficiencies and digestion problems with fat because of the damage to your liver cells. These deficiencies are present with cirrhosis because of poor food intake, metabolism changes, malabsorption and digestive problems.
Carbohydrates
Carbohydrate intakes must be adjusted depending the severity of cirrhosis. You can develop insulin resistance and high circulating blood glucose levels, according to nutrition experts Maurice Shils and colleagues published in "Modern Nutrition in Health and Disease." Complex carbohydrates, such as whole grain and wheat products, fruits with the skin, vegetables, brown rice, quinoa and barley help control blood sugar levels with cirrhosis. Complex carbohydrates digest slowly and raise glucose levels evenly to lower your insulin requirement with meals. This helps your liver process the digested carbohydrates without becoming overwhelmed because of the scar tissue that has developed from liver disease.
Protein
Protein needs and tolerances vary among people who have liver cirrhosis. According to Shils and colleagues, protein requirements for people with liver cirrhosis is similar to protein needs of average people 0.74 g/kg of body weight compared to 0.8 g/kg of body weight. The biggest challenge with providing adequate protein intakes for cirrhosis is meeting the body's demand for repair and growth while preventing toxins from building up in the blood and damaging your brain.
Fat Intake
Fat can accumulate in your liver with cirrhosis. The damage to the liver cells decreases the function of your liver causing fat from food to clog those damaged cells and lead to fatty liver. If cirrhosis develops from alcohol use, fat accumulation is faster. Switching to medium chain triglycerides or fats found in coconut oil, palm kernel oil and butter can ease the burden on the liver processing fats. Medium chain fats bypass the liver and can be used as an energy source. According to the University of Michigan Health System, medium chain triglycerides can be used by cirrhotic patients, but they should not be the main source of fat in the diet and eaten every day. There is still some concern that medium chain triglycerides from coconut and palm kernel oils can promote high cholesterol levels because they are saturated, or solid like animal fats, which promote high cholesterol levels.
Fat-Soluble Vitamins
You run the risk of developing deficiencies with fat-soluble vitamins A, D and K with liver cirrhosis. Your pancreas not only has problems with producing too much insulin, but enzymes to help digest fats can be compromised and limit absorption of fat-soluble vitamins. Shils and colleagues recommend an intake of 5,000 units of vitamin A, 40 to 120 micrograms of vitamin D and 10 mg per day of vitamin K to correct and prevent further deficiencies. Vitamin E supplementation hasn't proven to be beneficial in adults with cirrhosis and in most cases, vitamin E levels were normal and don't necessitate supplementation, according to Shils and colleagues.
Water-Soluble Vitamins
Water-soluble vitamins, such as folic acid, B vitamins and vitamin C are deficient in persons with advanced liver damage and long-term malnutrition. Eating a mixed diet of fruit, vegetables and other complex carbohydrates provides a daily intake of water-soluble vitamins.
References
- University of Michigan Health System: Medium Chain Triglycerides
- "Modern Nutrition in Health and Disease"; Maurice Shils, James Olson, Moshe Shike, A Catherine Ross;
