Dietician

[GrandmaDylan]

I have cirrhosis and an enlarged spleen with varices. I am also a type 2 diabetic and about 2 stone overweight. In January this year I decided to go low carb, highish fat and protein. I lost two and a half stone in about 3 months and was able to stop injecting insulin. I usually have a large bowl of porridge for breakfast ( carbs I know but it fills me up and I enjoy it) and quite often go without lunch and then eat dinner..always low carb. I do eat fruit although I shouldn't because of the diabetes. I know that I have lost muscle mass as I find it difficult to stand up from sitting and sometimes I struggle to lift things with my arms. I also have fibromyalgia which causes muscle pain and I'd put it down to that. I feel that I need to see a dietician as I can't eat too many carbs as it makes my blood sugar go sky high but I've read that people with cirrhosis shouldn't eat a lot of protein. The recommendations are to eat 3 meals a day plus 3 to 4 snacks between meals and to eat something before bed. The problem also is that low calorie meals are usually high in carbs. Any ideas people? Deb

[Hidden]

It used to be that a lot of protein was not recommended for people with cirrhosis because it was thought that a high protein diet promotes encephalopathy but that has been proven not to be the case & lots of protein is now recommended to help maintain muscle mass. Walking each day might be a good exercise to start with to build up your leg muscles. My legs are strong from walking on a treadmill each day that is set to an incline so I'm simulating walking up a hill. When I go to shopping centres I see other people my age shuffling while I can walk like I did when I was young. I listen to music through cordless headphones as I exercise & the music helps to distract me from the discomfort of exercising.

Dr. Melissa Palmer's Guide To Hepatitis and Liver Disease:

"Weight-bearing exercises build up both bones and muscles. For many reasons, it is important for all people with liver disease to incorporate weight-bearing exercises into their daily exercise routines. First, because they are prone to osteoporosis, people with liver disease need good strong bones. Weight training is the best way to fight against this, as stronger muscles equal stronger bones.

Second, in advanced stages of liver disease, the body is forced to recruit muscle as a source of energy, and people are at risk of developing severe muscle wasting and greatly diminished strength. However, if a person has a reserve of muscle built up on her body, it will take a much longer time for this complication of liver disease to develop. Third, people who have too much fat on their bodies are at risk of worsening their underlying liver condition by developing nonalcoholic fatty liver disease (NAFLD). Weight training reduces the amount of fat on the body and increases muscle mass. Therefore, the chance of developing NAFLD will be reduced. Finally, since muscle weighs more than fat, weight training is the perfect means of gaining lean healthy weight for those people who are underweight.

One exception to weight training should be mentioned. People with cirrhosis complicated by esophageal varices should avoid weight training. This is because wall tension in the esophagus may drastically increase with weight training, which puts this group at increased risk for esophageal variceal rupture and hemorrhage."

[Hidden in reply to Hidden]

Brilliantly explained 💪👀👍

[BSA-3 in reply to Hidden]

And I concur, young Ms. Laura ! 😁

[Hidden in reply to BSA-3]

😆xx

[LAJ123]

Good morning,

Sounds like you've put in a lot of thought and effort into getting well with paying attention to your diet.

hopefully when you see your specialist in November, you'll also see a dietician. This should be a good opportunity to get the advice you need for following a good healthy diet specifically for your diagnosis.

Edward1952 has given quite a comprehensive reply and makes a lot of sense. You are right about the recommendation of three meals a day with snacks between and that is what got me fit enough for transplant.

With your diabetes, I would be concerned that you are missing out the midday meal. You might discuss this with your Diabetic Nurse Specialist. With my cirrhosis I also had diabetes with insulin four times daily, so meals and timing was a constant balancing act (post transplant my blood sugars are now within the non-diabetic range).

In the meantime, keep healthy and I hope all goes well in November.

Jim

For anyone unsure about diet and liver disease, the British Liver Trust have information on their website.

britishlivertrust.org.uk/li...

[Isabelle2]

I would certainly ask to see a dietician. The hosp and gp will be happy you are trying to eat sensibly.

[GrandmaDylan]

Thanks for all your excellent advice. I will definitely ask for a referral to a dietician. Before I was diagnosed with cirrhosis I saw the diabetic nurses at my medical practice

Unfortunately they had totally opposite views. One was old school and insisted that I eat carbs with every meal the other was really on board with low carb. In fact she'd lost 2 stone doing low carb. The only thing I'm really not sure about is to really do low carb you need to do highish fat and high protein. The diet the blt advise is low fat and recommend eating carbs including bread , rice and pasta which drive up my blood sugar. I'll carry on doing the low carb until I see a dietician. I'll try to eat something at lunchtime even if it's just an Apple. Deb