A swollen liver, known as hepatomegaly, can be the result of many conditions, including nonalcoholic fatty liver disease, alcoholic liver disease, hepatitis and cancer. Treatment for a swollen or enlarged liver focuses on managing the underlying cause, and a doctor needs to determine which course of treatment, including dietary changes, is best. Diet and exercise improvements along with weight loss are known to improve a common reason for swollen liver -- fatty liver disease. There are many foods that can be incorporated into the daily diet to help manage an enlarged liver.
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Diet and lifestyle changes help prevent and manage some complications associated with a swollen liver. For example, avoiding alcohol is important to prevent further damage in alcoholic liver disease, and sodium restriction is important to help manage the swelling related to advanced liver disease. Also, if the enlarged liver is caused by accumulation of fat, called fatty liver, abdominal obesity is directly associated with its development, according to a review article published in the May 2007 issue of "Epidemiological Reviews." The 2012 practice guidelines published in the "American Journal of Gastroenterology" report that weight loss can improve liver health, specifically for nonalcoholic fatty liver disease (NAFLD). In addition, abstinence from smoking and alcohol can improve overall liver health.
A July 2015 review article published in "Journal of Medicine and Life" suggests a low- to moderate-carbohydrate diet may be beneficial for those diagnosed with NAFLD, a common condition that can cause a liver to be enlarged, or swollen. As its name implies, NAFLD is fatty liver that is not caused by alcohol use, and over time this condition can cause liver scarring or liver failure. This same literature review indicated that whole-grain consumption was linked to losing abdominal fat, a mainstay of therapy to reduce a fatty liver. The focus need not be on strictly limiting carbohydrates but instead on choosing high-fiber, quality carbohydrate foods. In moderate portions, these foods are a healthful addition to the diet: -- Fruits. -- Vegetables. -- Whole-grain breads or pasta, brown rice, quinoa or oatmeal. -- Legumes such as pinto beans, kidney beans or lentils. -- Reduced-fat or nonfat milk products, such as plain yogurt.
Choosing the best types of dietary fat may also help with the management of an enlarged liver. High intakes of saturated and trans fat -- the fat found in milk and meats and hard fats such as shortening -- as well as a low intake of omega-3 fatty acids have been implicated to worsening of NAFLD. In a February 2010 review article published in "Practical Gastroenterology," supplementation with omega-3 fatty acids was linked to a reduction in fatty liver. While the majority of research investigated the benefits of omega-3 supplements, not foods, adding more omega-3 rich foods to your diet may be of benefit. The following foods provide omega-3 fatty acids: -- Fatty fish such as sardines, tuna and salmon. -- Walnuts, chia seeds and ground flaxseed. -- Flaxseed oil and canola oil. -- Soy products such as tofu or natto.
In general, protein needs do not change for someone with an enlarged liver. A December 2014 review article published in "Integrative Medicine Research" indicated that lean protein sources such as skinless poultry and fish and plant proteins such as nuts, beans and soy should be recommended for management of NAFLD. In turn, they could benefit those with an enlarged, fatty liver. The recommended protein-rich foods include: -- Lean poultry, lean meat and fish. -- Legumes such as beans and lentils. -- Eggs. -- Nuts, seeds and soy.
The Mediterranean diet is a food pattern that incorporates a variety of whole, unprocessed foods and emphasizes plant foods. Foods common in the Mediterranean diet include fruits, vegetables, whole grains, legumes, fish, wine and olive oil. Moderate intake of milk, yogurt or cheese and small amounts of meat are typically consumed. This dietary pattern, minus the wine, has been linked to improved liver function in NAFLD, according to a small study published in the July 2013 issue of "Journal of Hepatology." This study suggests the whole diet, rather than individual foods, may be an important focus.
Warnings and Precautions
A swollen or enlarged liver has many potential causes, including hepatitis, mononucleosis, cancer, toxins and genetic conditions. For most of these conditions, there may not be a specific therapeutic role of diet -- other than maintaining good nutrition and managing any complications, such as fluid retention or malnutrition. If you have an enlarged liver, your doctor will determine the underlying cause and course of treatment. Seek advice from your doctor about any diet changes that may benefit your health, and ask for a referral to a registered dietitian to set up a plan to improve your liver health, facilitate weight loss, if needed, and ensure all nutrient needs are met.
Reviewed by: Kay Peck, MPH, RD
REFERENCES & RESOURCES
- Journal of Medicine and Life: Medical Nutrition Therapy in Non-Alcoholic Fatty Liver Disease – A Review of Literature
- Practical Gastroenterology: Nutritional Recommendations for Patients With Non-Alcoholic Fatty Liver Disease: An Evidence Based Review
- Integrative Medicine Research: Practical Approaches to the Nutritional Management of Nonalcoholic Fatty Liver Disease
- Epidemiological Reviews: Abdominal Obesity and Fatty Liver
- The American Journal of Gastroenterology: The Diagnosis and Management of Non-Alcoholic Fatty Liver Disease: Practice Guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association
- Journal of Hepatology: The Mediterranean Diet Improves Hepatic Steatosis and Insulin Sensitivity in Individuals With Nonalcoholic Fatty Liver Disease
- Today's Dietitian: Nonalcoholic Fatty Liver Disease
- British Dietetic Association: Omega-3