Table 2.

Short, practical dietary advice for bedside or outpatient clinic use.

● Most of what you have heard/read on the relationship between food and the liver has limited scientific evidence to support it. Generally, healthy eating of a variety of foods is advisable to all patients.

● Virtually no food other than alcohol does actually damage the liver and/or is genuinely contraindicated in patients with chronic liver disease.

● In most patients with chronic liver disease, eating an adequate amount of calories and protein is much more important than avoiding specific types of food, so it is important that you have a good, varied diet that you enjoy.

● You should try to split your food intake into 3 main meals (breakfast, lunch and dinner) and 3 snacks (mid-morning, mid-afternoon, late evening). The late-evening snack is the most important, as it covers the long interval between dinner and breakfast.

● You should try to eat as much vegetables and fruit as you can. If you feel that this makes you feel bloated, and that it makes you eat less, please report to your doctor or dietician.

● You should try not to add too much salt to your food. It may take some time to adjust, but it usually gets easier with time. However, if you keep feeling that this makes your food unpleasant to eat, and that it makes you eat less, please report to your doctor or dietician.

● A limited proportion of patents with liver disease have a complication called hepatic encephalopathy, which may make them tolerate animal protein (meat) less well than vegetable protein (beans, peas etc) and dairy proteins. Before you make any changes to your protein intake, you should always ask your doctor or dietician. Please do not reduce your total protein intake as it is not advisable in cirrhosis.

● Some patients with liver disease have other diseases, for example diabetes or overweight/obesity, which require dietary adjustments. Please remember to tell your doctor about all your illnesses and about any dietary advice you have already received from other doctors, nurses or dieticians.