Nutrition
Liver disease
Malnutrition is present in most people with cirrhosis and is frequently missed. Eating little and often is the core of the plan.
What you are aiming for
- Prevent muscle loss — the strongest predictor of outcome in cirrhosis
- Provide enough energy and protein, contrary to outdated advice to restrict protein
- Control sodium if there is ascites or oedema
- Avoid alcohol completely
Build meals around
- Protein at every meal: eggs, fish, chicken, dairy, beans, tofu
- A late evening snack with carbohydrate and protein — this reduces overnight muscle breakdown
- Small frequent meals: three meals plus two to three snacks
- Soft, easy-to-eat foods when appetite is poor
- Vegetables and fruit for micronutrients, as tolerated
Limit or avoid
- Alcohol — entirely, at any stage
- Salt if you have ascites: no added salt, no stock cubes, no processed meat
- Raw shellfish, which carries serious infection risk in cirrhosis
- Very large single meals, which are poorly tolerated
Meal timing
- Never go more than four to six hours without eating during the day.
- Always take a bedtime snack — it is one of the best-evidenced interventions in cirrhosis.
- Eat something within an hour of waking.
Portions
- Small plates, eaten more often, beat three large meals.
- Aim for a protein source roughly the size of your palm at each main meal, unless told otherwise.
A sample day
- BreakfastEggs on toast; milk
- Mid-morningYoghurt with banana
- LunchChicken and vegetable stew with rice, no added salt
- AfternoonPeanut butter sandwich
- DinnerFish, potatoes, greens
- BedtimeMilk with cereal, or bread with cheese — do not skip this
Common myths
“People with liver disease should avoid protein.”
Protein restriction is outdated and harmful. Even with encephalopathy, protein is usually maintained.
“Liver 'detox' supplements help.”
Many supplements are hepatotoxic. Check everything, including herbal teas, with your team.
Treatment-related challenges
- Ascites makes you feel full quickly — eat small, energy-dense meals.
- Nausea and taste changes are common; cold foods often go down more easily.
- Encephalopathy affects appetite and safety around cooking — supervision may be needed.
See a registered dietitian if
- · Any cirrhosis diagnosis warrants at least one dietetic assessment
- · Unintentional weight or muscle loss
- · Ascites needing sodium restriction
Afya Companion offers education and self-help support. It does not diagnose, treat or replace care from your doctor, nurse, psychologist or dietitian. If something in your health changes, speak to your care team.