Diet in liver cirrhosis guidelines:
In cirrhosis, it is necessary to follow a diet that is dependent on the severity of the disease. The liver is the most important organ in systemic metabolism. The malfunction causes severe disturbances in the functioning of the body. One of the most common diseases of this organ is liver cirrhosis. The reasons for the development of this disease is primarily a large intake of alcohol, medicines and bad nutrition. Cirrhosis can also be a consequence of viral hepatitis and biliary diseases. In many cases, medicine is not able to determine the reason of the development of this disease.
Cirrhosis is the destruction of liver tumors and construction of damaged parenchyma by excessive growth of connective tissue. The effect is hindering of venous outflow, biliary drainage and disturbance in the functioning of the liver. When the disease proceeds without any complications, diet is similar to a normal diet. However, in decompensated cirrhosis occurs impaired liver function. This disease is characterized by symptoms such as edema, portal hypertension, ascites, jaundice, abnormal metabolism of certain nutrients. These symptoms must be taken into account when planning the diet, which should be individually adjusted.
The main principles of the diet in adjusted liver cirrhosis
• Provide the right amount of energy. If your weight is normal, daily intake of 35-40 kcal per kg of body weight is recommended. Caloric content of the diet should therefore be an average of 2400-2700 calories. Conversely, if the patient has very low body weight and observed symptoms of malnutrition, it is necessary to increase the food intake of calories to 44 kcal / kg body weight.
• The diet should be rich in protein. Increasing the amount of protein is needed to fill gaps in tissue proteins, plasma proteins and regenerative processes. It is recommended to consume 1.5 g protein / kg body weight per day. Please note that at least half the protein (up to 2/3) should be animal origin. Its source should be primarily meat, poultry, fish, milk, dairy products and eggs.
• Keep the amount of fat as recommended in a healthy man diet. It should therefore be at the level of 1 g / kg body weight, so from 50 to 90 g per day. The best sources of fats are primarily vegetable oils, soft margarine, butter. It is necessary to the exclude bacon, lard, bacon, tallow.
• The source of easily digestible energy should be carbohydrates, 330 to 400 g is the amount that should be provided daily. Exceeding of 400 g per day is not advisable because of the glucose intolerance possibility.
• Limit the amount of simple sugars to not more than 70 g per day. Their source is the sugar used to sweeten beverages, sugar confectionery, sweets, and even fruits.
• Vitamin A, D and K are stored in the liver. Therefore, it is important to provide the proper amount of vitamins due to the potential of their deficiencies. Among the vitamins special attention should be paid to vitamin C and vitamin B. The need for vitamin C increases to 500 or even 1000 mg per day. For comparison, demand for it in a healthy individual is about 60 mg. The demand for B vitamins are: vitamin B1 30-50 mg, 5-10 mg B2, vitamin PP to 100 mg. In the case of vitamin A intake should be at the level of 5000 IU. To cover such a large demand for vitamin A and C, plenty of fruits and vegetables rich in beta-carotene (provitamin A) and vitamin C should be included.
The source of B vitamins are brewer's yeast and cereal products.
• In cirrhosis, there are also shortages of minerals. Most concerns are calcium and zinc. Dairy products should be the source of calcium in the diet. Zinc, in turn, is present in lean meat, poultry and fish.
• It is necessary to avoid consuming these products, which may be poorly tolerated by patients. These include foods containing a large amount of fiber, cruciferous vegetables (cabbage, Brussels sprouts, cauliflower), leguminous vegetables, bulb vegetables (onion, garlic). Among the fruits contraindicated are pears and plums. Intolerance can also occur in case of coarse cereal, pastry high in fat, fish and smoked meats, canned pork fat. Avoid the chocolate and cocoa.
• All food should be prepared according to the diet easy to digest. Boiling in water, steaming not preceded by a roast, baking in the foil is recommended.
• The daily food rations shall be divided into 5-6 meals. The result is a meal of small volume, without aggravating the gastrointestinal tract.
• In cirrhosis alcoholic beverages are completely forbidden. Drinking coffee and tea, especially the strong brew should be also reduced.
The main principles of the diet in decompensated liver cirrhosis
• The amount of energy and protein should be the same as in the adjusted liver cirrhosis. However, if the failure symptoms worsen, the amount of protein should be reduced.
• It is not necessary to limit the amount of fat in the diet.
• Because of edema and ascites, it is necessary to limit the amount of sodium to about 1,200 mg per day. This is called mild controlled sodium diet. This means that you should refrain from salting the dishes and eliminate products containing large amounts of sodium, such as yellow cheese, canned, smoked foods.
• Another component of the mineral, which should be noted, is potassium, because due to the use of diuretics shortages of it can occur. To prevent this, rich in potassium plant products such as tomatoes, potatoes, bananas should be included in the diet. You should also prepare strong decoctions of vegetables, which provide a large amount of potassium.
Example - diet in liver cirrhosis:
Breakfast: Milk soup (1.5% milk), small pasta, plain bread with margarine, beef and tomato, tea with milk
Lunch: Wheat Bread with cottage cheese, fruit juice
Dinner: Cream of carrot soup, grilled cod, mashed potatoes, beets
Afternoon snack: A banana, plain yoghurt
Supper: Veal meatballs with vegetables, plain bread, tomato juice