Recipes and diet plan

[Soso444]

What to avoid and what’s good to eat when u are getting ready and waiting for a healthy liver . My father is waiting for a liver transplant and he need to be on a very strict diet . Can anyone plz help with any do’s and don’t

[jojokarak]

Has he not been referred to a dietitian ? As most of us have different needs on the list

[Soso444 in reply to jojokarak]

No there not doing anything there just making him wait and do a lot of tests so far

[jojokarak in reply to Soso444]

That's rubbish

Avoid salt, eat protein, fresh food make any sauces you can from fresh and try and avoid red meat x

[AyrshireK]

Regular snacking with carbohydrates and proteins, a good supper before bed to prevent the long fast overnight. No long breaks without a snack during the day - little and often is key. Lots of snacks or small meals if the appetite is poor. Carbohydrate and protein (eggs are brilliant) are more important than lots of fruit and veg if you are fuelling in late stage liver disease and trying to prevent muscle wastage.

You must ask to see a liver specialist dietician or he will never regain the weight he needs if eating wrongly and not fuelling properly.

Katie

[Hidden]

Hepatologist Dr. Mellissa Palmer in her book ‘Dr. Melissa Palmer’s Guide to Hepatitis & Liver Disease’ makes the following recommendations with respect to diet for people with stable liver disease:

Most people with liver disease find that eating multiple small meals throughout the day is the best approach, as it maximizes energy levels and the ability to digest and absorb food. However, if one insists on eating three meals per day, try to follow the saying, "Eat breakfast like a king, lunch like a prince, and dinner like a pauper."

• 60 to 70 percent carbohydrates—primarily complex carbohydrates, such as pasta and whole-grain breads

• 20 to 30 percent protein—only lean animal protein and/or vegetable protein

• 10 to 20 percent polyunsaturated fat

• 8 to 12 eight-ounce glasses of water per day

• 1,000 to 1,500 milligrams of sodium per day

• Avoidance of excessive amounts of vitamins and minerals, especially vitamin A, vitamin B3, and iron

• No alcohol

• Avoidance of processed food

• Liberal consumption of fresh, organic fruits and vegetables

• Avoidance of excessive caffeine consumption—no more than one to three cups of caffeine-containing beverages per day

Mellissa Palmer recommends 60 to 70% carbs because the liver can most easily convert carbs to energy.

You asked for recipes:

I make a stew consisting of chunks of lean beef & lots of brown rice & vegetables. The rice is cooked in a pressure cooker. The beef is grilled after cutting every visible piece of fat off. After the meat is cooked I cut it into small pieces that go into the stew. The vegetables (carrots, peas, cauliflower, broccoli, corn etc.) are frozen from the supermarket & are the kind that won't fall apart in the stew. I make a liquid sauce using packet gravy (Gravox) that I add to the stew & I mix & heat the ingredients in a large pot. Through experience I've learned how much packet gravy to use to make the right consistency liquid sauce.

I store the stew (around a month's supply) in microwave safe plastic containers in my freezer. I thaw a container before I want to use it & I separate the thawed contents into 3 smaller meal sized microwave safe containers. When I want to eat some of the stew I add a little water to one of the containers, stir the contents & heat it up in the microwave for between 3 & 4 minutes. The stew tastes good & contains protein (meat), a little fat, carbs (rice) & vegetables making it a complete nutritious meal.

I also like to eat a 'Four Bean Mix' I buy from the supermarket in a can that's cheap & nutritious. I'm also partial to canned beetroot slices that I buy at the supermarket which are cheap.

I also make a milkshake with around 150 ml of skim milk to which I add some Bickford's chocolate syrup that has no artificial colours or flavours. I use a milkshake machine that thickens & doubles the volume of the milk. I swallow as many heaped tablespoons of oat bran & natural wheat bran (both available at supermarkets) that I can wash down with the milkshake. I have a lot more of the wheat bran because it's insoluble fibre (the oat bran is soluble fibre). This ensures that I get plenty of fibre. My body seems to like the milkshakes.

[vulnerable in reply to Hidden]

Edward I found your post so useful. Whilst I’m not stupid regarding food labels diet etc I am having difficulty getting my head around the high protein high calorie . Good to see common sense samples of the above fyimcyou. All food tastes bland without salt

[Hidden in reply to vulnerable]

I agree that many foods taste bland without salt. I use Diet-Rite Lite salt that I buy from the supermarket which has 50% less sodium than normal salt but tastes just like normal salt. As for high protein anyone with cirrhosis shouldn't be eating too much protein according to hepatologist Dr. Mellissa Palmer.

Quoting from her book ‘Dr. Melissa Palmer’s Guide to Hepatitis & Liver Disease’:

Since protein is such a vital component of the body, many people mistakenly believe that the more protein they consume, the better. Not only is this belief misguided, but for someone with liver damage such an approach to nutrition can actually be downright dangerous. The trouble is that a damaged liver cannot process as much protein as a healthy liver.

As far as high calorie goes you'd only eat high calorie if you have liver damage & are losing weight. In end stage liver disease if the person doesn't eat enough then the body begins breaking down muscle in a desperate attempt to stay alive and the person starts to look like skin and bone.

[vulnerable in reply to Hidden]

That’s interesting! I was at Kings last week for pre tax assessment. At the education session we were told absolutely no salt and high protein calerie diet. My dietician here at my Home Hospital had me on protein supplements

[Hidden in reply to vulnerable]

The book I quoted written by Mellissa Palmer was published in 2004 & she hasn't written an updated version since. Her book makes no mention of FibroScans for instance because they hadn't been invented when she wrote her book. Views on protein have changed since her book was published. One example is that in her book Mellissa Palmer states that too much animal protein increases the likelihood of encephalopathy. Now encephalopathy is no longer thought to be caused by eating a lot of protein in the form of meat.

The following quote from her book is critical of high protein though:

Finally, diets high in protein have been demonstrated to enhance the activity of the cytochrome P-450 enzyme system, which is responsible for drug metabolism. This enhanced activity increases the likelihood that a drug may be converted into a toxic by-product capable of causing liver injury.

Checking on the internet it does appear that extra protein is now recommended for people with liver damage whereas at the time Mellissa Palmer wrote her book the recommendation was that protein intake should be restricted so what you were told at Kings reflects the latest knowledge.

As for Mellissa Palmer's recommendation of 1000 to 1500 mg of sodium per day this is actually a tiny amount. 1500 mg is around three quarters of a teaspoon of salt so she's saying you should eat almost no salt at all which is in agreement with what you were told at Kings.

[Hidden]

Hi,

Are you in the UK? If your father is waiting for a liver transplant he should be referred to a hospital registered dietitian via his liver doctor, as there will be some special considerations that he will need to make in his diet that will be specific to his diagnosis.

Best wishes

Trust1