Proteins normally help the body repair tissue. They also prevent fatty buildup and damage to the liver cells.

In people with badly damaged livers, proteins are not properly processed. Waste products may build up and affect the brain.

Dietary changes for liver disease may involve:

• Reducing the amount of animal protein you eat. This will help limit the buildup of toxic waste products.
• Increasing your intake of carbohydrates to be in proportion with the amount of protein you eat.
• Eating fruits and vegetables and lean protein such as legumes, poultry, and fish. Avoid uncooked shellfish due to the risk of hepatitis A.
• Taking vitamins and medicines prescribed by your health care provider for low blood count, nerve problems, or nutritional problems from liver disease.
• Limiting your salt intake. Salt in the diet may worsen fluid buildup and swelling in the liver.

Liver disease can affect the absorption of food and the production of proteins and vitamins. Therefore, your diet may influence your weight, appetite, and the amounts of vitamins in your body. DO NOT limit protein too much, because it can result in a lack of certain amino acids.

The changes you will need to make will depend on how well your liver is working. Talk to your provider about the kind of diet that is best for you so that you get the right amount of nutrition.

General recommendations for people with severe liver disease include:

• Eat large amounts of carbohydrate foods. Carbohydrates should be the major source of calories in this diet.
• Eat a moderate intake of fat, as prescribed by the provider. The increased carbohydrates and fat help prevent protein breakdown in the liver.
• Have about 1.2 to 1.5 grams of protein per kilogram of body weight. This means that a 154-pound (70-kilogram) man should eat 84 to 105 grams of protein per day. Look for non-meat protein sources such as beans, tofu, and dairy products when you can. Talk to your provider about your protein needs.
• Take vitamin supplements, especially B-complex vitamins.
• Many people with liver disease are deficient in vitamin D. Ask your provider if you should take vitamin D supplements.
• Limit the amount of sodium you eat to 2000 milligrams per day or less to reduce fluid retention.

SAMPLE MENU

Breakfast

• 1 orange
• Cooked oatmeal with milk and sugar
• 1 slice of whole-wheat toast
• Strawberry jam
• Coffee or tea

Mid-morning snack

• 4 to 8 ounces (240 milliliters) of milk or piece of fruit
  

Lunch

• 4 ounces (110 grams) of cooked lean fish, poultry, or meat
• A starch item (such as potatoes)
• A cooked vegetable
• Salad
• 2 slices of whole-grain bread
• 1 tablespoon (20 grams) of jelly
• Fresh fruit
• 8 ounces of milk

Mid-afternoon snack

• 4 to 8 ounces of milk with graham crackers

Dinner

• 4 ounces (110 grams) of cooked fish, poultry, or meat
• Starch item (such as potatoes)
• A cooked vegetable
• Salad
• 2 whole-grain rolls
• Fresh fruit or dessert
• 8 ounces of milk

Evening snack

• 4 to 8 ounces of milk or piece of fruit

Most of the time, you do not have to avoid specific foods.

Talk to your provider if you have questions about your diet or symptoms.

Dasarathy S. Nutrition and the liver. In: Sanyal AJ, Boyter TD, Lindor KD, Terrault NA, eds. Zakim and Boyer's Hepatology. 7th ed. Philadelphia, PA: Elsevier; 2018:chap 55.

European Association for Study of the Liver. EASL clinical practice guidelines on nutrition in chronic liver disease. J Hepatol. 2019:70(1):172-193. PMID: 30144956 pubmed.ncbi.nlm.nih.gov/30144956/.

Högenauer C, Hammer HF. Maldigestion and malabsorption. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 104.

US Department of Veterans Affairs. Eating tips for people with cirrhosis. www.hepatitis.va.gov/cirrhosis/patient/diet.asp#top. Updated December 6, 2019. Accessed May 30, 2023.

Updated by: Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.