The liver processes food and chemicals in the blood and stores carbohydrates and other nutrients. It also makes bile that is excreted into the small intestine to aid in digestion. Furthermore, it helps manage fluid balance and makes proteins for the immune system and blood clotting. Various degrees of liver disease require dietary modifications. Dietary choices and the diagnosis and treatment of disease should be undertaken with the consultation of a physician or other qualified health care professional.
Degrees of Liver Disease
Liver disease is classified from stage 1 to stage 4 with the final stage being complete liver failure. Mild liver disease may need little to no dietary medications with the exception of the avoidance of liver toxins, such as chemical additives in processed foods, and stressors, such as alcohol. The more severe the liver disease, the more dietary modifications will be needed.
Sodium
Sodium is a common mineral in a typical Western diet. People with problems regulating fluid may need to limit their intake of sodium. Liver disease often causes fluid retention and swelling, particularly in the abdomen and legs. Sodium tends to promote fluid retention because water tends to follow sodium. Therefore, the more fluid is absorbed into the blood stream in the diet, the more fluid will follow and contribute to swelling, according to Vinay Kumar, M.D., author of "Robbins and Cotran Pathologic Basis of Disease."
Fluids
Since swelling is often a problem in liver disease, moderate to severe liver disease often requires fluid restriction. Excessive fluid can contribute to swelling, increase the blood pressure and put excessive strain on the heart and kidneys. If fluid is restricted, the fluid intake is often determined by a person's daily weight because daily fluctuations in weight with liver disease are often due to fluid balance.
Carbohydrates
Increased intake of carbohydrates are needed with significant liver disease. The liver serves as a reservoir for glycogen, which is the storage form of glucose, the main sugar in the blood that is important for providing energy to the body. When blood sugar drops, the liver can release glucose into the blood. If the liver stores are depleted in liver disease, a higher, more regular carbohydrate intake will help avoid low blood sugar. In addition, the calories in carbohydrates help to stave off protein wasting in the body.
Protein
As liver disease advances, protein levels need to be limited more and more. Protein is broken down into waste products, such as ammonia. The damaged liver is unable to process the excess ammonia, and this can lead to hepatic encephalopathy. This is a disorder in which ammonia and other toxins interfere with brain function, causing confusion, disorientation, memory problems, personality changes, wandering attention and decreased levels of consciousness. Protein is generally not eliminated though because it is necessary for general health and to prevent malnutrition and wasting.
Fat
A diet for a person with liver disease usually calls for a moderate amount of fat. This is because fat helps to absorb fat soluble vitamins, such as vitamins A, D, E and K. In addition, fat has relatively many calories to help provide the body with energy.
References
- "Harrison's Principles of Internal Medicine"; Anthony S. Fauci et al; 17th Ed 2008
- "Robbins and Cotran Pathologic Basis of Disease"; Vinay Kumar et al; 8th Ed 2009
