Nutrition and Dietetics - LUHFT-wide

 

Introduction

 

When your liver is not working well, your body needs extra calories and protein.  This is because your liver may not be able to digest or store enough energy to fuel your body between meals.

People with liver disease are sometimes not able to eat enough because of symptoms like:

  • Feeling full quickly, especially if you have ascites (fluid around your middle)
  • Feeling sick or vomiting
  • General loss of appetite

If you do not eat enough, you may notice that you begin to lose weight, your muscles become weaker, and you are less able to fight infection. 

Other symptoms of liver disease like ascites (fluid around your middle) or encephalopathy (confusion) might get worse.

If you have a poor appetite or have lost weight, then changing your diet can help.  Signs that you have lost weight include your clothes, jewellery or watch becoming too loose. 

You may also notice that you lose muscle from your arms, legs or across your chest.

How can I increase my appetite?

  • Try to eat small, frequent meals or snacks during the day.  This leaflet will give you ideas to do this.
  • Have your main meal at the time of the day when you feel most well.
  • Keep some easy to prepare meals at home, such as tinned soups, baked beans, instant puddings, instant mash or long-life milk.
  • Use ready meals or convenience foods.  These can be high in salt but if your appetite is poor or you are losing weight, the amount of salt you eat is not as important.

Increasing calories and protein

  • Try to eat protein foods at least three times a day.  These can include meat, fish, eggs, cheese, Quorn, tofu, nuts (unsalted), beans or lentils.
  • Try to use one-two pints of full cream (blue top) milk a day.  Try adding this to cereal, drinks, puddings and soups.
  • Include high energy food whenever you can, such as jam, honey, sweets, chocolate, cakes or biscuits. If you have diabetes, your Dietitian can support you finding alternatives.
  • Try to add extra calories to foods that you are already eating, such as:
    • Cheese, butter and cream to mashed potato
    • Using full fat yogurts
    • Serve vegetables with butter, cheese or parsley sauce

Snacks

Regular meals or snacks make sure that your body always has enough energy available and can help stop you losing weight.  Try eating a snack every two – three hours.  You should always try to eat a bedtime snack. 

Snack ideas can include:

  • Crackers or digestive biscuits with cheese, cream cheese or jam
  • Toast, muffins, crumpets or scones with butter and jam
  • 3 biscuits or a small cake or chocolate bar with a glass of full cream milk
  • Unsalted nuts, breakfast cereal or full fat yogurt

Breakfast Ideas

  • Cereal with full cream or fortified milk (see later)
  • Toast, crumpet or teacakes with plenty of butter and jam
  • Scrambled egg, bacon, sausage or beans on toast
  • Glass of full cream or fortified milk with biscuits
  • Full cream yoghurt, add honey to sweeten

Light Meal Ideas

  • Toast with eggs, beans, cheese, spaghetti, sardines, bacon or sausage.
  • Sandwiches with cheese, ham, egg mayonnaise, pate or meat paste.
  • Cheese or meat omelette eaten with bread and butter.
  • Jacket potato with cheese, tuna mayonnaise, beans or coleslaw.
  • Tinned macaroni cheese, ravioli, stew, casserole or pies with mashed potato.
  • Creamy soups with extra milk or cheese, eaten with bread and butter or toast.
  • Toasties filled with cheese, ham or tomato.
  • Boil in the bag fish with mashed potato, try adding grated cheese for extra calories.
  • Frozen ready meals like fish and chips, cottage pie, lasagne or curry.

Pudding Ideas

  • Milky puddings, such as rice pudding, semolina or sago.  Try adding extra jam or honey.
  • Individual desserts such as trifle, mousse, ice creams or full cream yogurts.
  • Cake, fruit pie or sponge pudding with custard, ice cream or cream.
  • Tinned fruit with custard, ice cream or cream.

Nourishing Drinks

If you are struggling to eat enough then having drinks that are high in calories and protein can be helpful.

Try some of the following ideas:

  • Fortified milk: add four tablespoons of dried milk powder (e.g. Marvel, Five Pints) to a pint of full cream milk.  Keep this refrigerated and use as ordinary milk in hot drinks or on cereal.
  • Milkshakes, smoothies or yogurt drinks with added ice cream.
  • Hot chocolate or malted drinks (e.g. Horlicks or Ovaltine) made with full cream or fortified milk.
  • Milky coffee or Cup a Soups made with milk.
  • Ice cream soda (made by adding ice cream to a fizzy drink).

If you are still struggling with your appetite or continue to lose weight, please ask your GP or consultant to refer you to a dietitian.

If you have diabetes, then some of the foods suggested in this leaflet may increase your blood sugar levels. 

If your appetite is poor and you are losing weight then you should try to eat well, including snacks.  Try choosing higher fat instead of sugary snacks. 

Feedback

Your feedback is important to us and helps us influence care in the future.

Following your discharge from hospital or attendance at your outpatient appointment you will receive a text asking if you would recommend our service to others. Please take the time to text back, you will not be charged for the text and can opt out at any point. Your co-operation is greatly appreciated.

Further information

Aintree Dietitians: 0151 529 3473

Text phone number:  18001 0151 529 3473

Royal Dietitians: 0151 706 2120

Text phone number:  18001 0151 706 2120

Author: Therapies, Nutrition and Dietetics

Review date: May 2029

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