Salt / Sugar / diet and food recommendations and a bit of background.

[Aplaceinthesun]

I have Cirrhosis, end of November 2023 bloods taken, GP sent me to hospital to confirm what was suspected, not had a drink since the start December 2023. I was told I had Cirrhosis and nothing else, told to eat more protein and 4 smaller meals per day, no information about salt or sugar / diet in general. Discharged in less than 24 hours, told I could go home as soon as my bloods came back and my liver number had gone down, which it had. Was given Vit B tablets and that's it.

3 Months later I had a gastropathy, I've had one appointment with the clinic's registrar, and told it was all clear and that I had mild ascetics and given tablets for this. They did put a not on a letter to the GP to refer me to a dietitian, I've only just seen this and GP as usual have done nothing. Although apart from no salt more protein, I don't know what else A dietitian could tell me.

I've had a further appointment at the clinic which has been cancelled twice and told to wait for another appointment, rang to check if it is re-booked and told just have to wait.

So, I know nothing apart from Spleen and Gallbladder, one is collapsed, and one is enlarged. So, if anyone can help me with suggestions for information to look for on my medical records and or questions to ask at my next appointment would help?

I have looked at the online diet information but did not find it helpful for someone like me who has lost 5 stone and looking to lose more. Had my cholesterol and sugars checked as part of GP checking bloods for something else and they are all good, I've never been a takeaway eater and have not eaten fried food, my diet has consisted of turkey and chicken and never red meat. I eat most of the things I ate prior to weight loss, just smaller portions and have never added salt to cooking.

Also, food has turned out to be a problem, I'm not a big meat eater (nothing on the bone), I do add lentils to a chilli (always used turkey mince), and have always cooked most things from scratch, use only a splash of olive oil and have always eaten lots of fruit and veg. Before I would have had fruit for breakfast and half a tin of soup, or a salad made with turkey bacon for lunch, both of which I now know have a bit too much salt.

The thought of eating a yogurt or protein drink makes me gag and having cereal for breakfast (I don't drink milk) with a very small splash of skimmed milk always makes me want to eat half an hour later.

I know it's all part of the diet going forward, I have no problem cooking, I'd just like a few alternatives. I've found Matzo crackers are ok and an M&S tuna which is very low in salt, just need a few more ideas, rice and pasta are not a good idea due to IBS. I have no idea how much salt is maybe ok (none is best) is 2G max in a day ok?

Thanks, if you have gotten this far, feel like I've got myself into a bit of a rut.

Have a good week everyone.

[DaveQ67]

Hi,

You sound like you’re doing great in regards to healthy eating and that you have a really good handle on things. I can’t advise much on the spleen and gall bladder.

I was going to suggest yoghurts. You get excellent 25 grams per pot ones which are really nice. You do get protein powders which add to water, they come in fruit flavours and designed as a fruit juice type drink instead of milkshakes.

I use these before and after exercise, they are 20 grams of protein per scope.

Avocado, blue berries, raspberry’s are all good natural antioxidants. I have over night oats and top with honey and blueberries in the morning. Chicken salads for lunch, chicken with veg (mostly broccoli), chick peas and other legumes are great sources of protein. You can also get really creative with salads, Omelette is something I have most days although may divide opinion.

Sweet potatoes and quinoa are also good and very healthy to have with your dinner, I tend to have cubed butternut squash and toast them mixed with paprika and herbs.

Pre planning your meals I find tricky, but I tend do this on a Sunday by prepping my veg for cooking by putting them in containers in the fridge.

Although a bit of a chore at first, you get into the swing of it. I tried to stick to what I like and try make it work, or substitute for alternatives.

I found that along with exercise and eating this way, the weight came of effortlessly and I was also able to build muscle again.

[Aplaceinthesun in reply to DaveQ67]

Thank you, didn't know about the fruit drinks.

I will look at the overnight oats, I really struggle with dairy (fruit is not a problem), I eat lots of it. Honey I'm not keen on, but will give it a try, I did think it had too much sugar.

[DaveQ67 in reply to Aplaceinthesun]

I was told not to worry too much about sugar. Conflict of info is very common, not just between different doctors but with everyone I have spoken to or read about.

With the over night oats, if not splash of honey, try a sprinkle of cinnamon.

You’re doing all the right things, I would just try to take in a little bit more protein. You have to enjoy your food, so try a few different things based round what you like.

I stopped counting salt in food, I just eat clean. Nothing processed.

There’s a lot of mixed info out there, each person’s circumstances may require something different.

In regard to questions, I focused on where I’m at bloods wise and how I was feeling. Kept up living as healthy as possible and exercised. I asked what prognosis I had both at time of diagnosis and where I was at now.

At my first appointment with the liver team, I was only told do not drink! That was about it. If you’ve lost that much weight and obviously working hard . Keep doing what you’re doing.

[Clock01 in reply to DaveQ67]

Being told not to worry about sugar is very odd Dave. There is a lot of disagreement about it but over the last 10 years proper research (ie not funded by the sugar lobby) has shown that it's eating sugar that messes our metabolic health up. Best wishes.

[DaveQ67 in reply to Clock01]

I didn’t know that Thanks.

I was told initially salt is a no go. Never had emphases put on sugar. I’ve never had much of a sweet tooth anyway but was unaware.

The advice I got was purely what I was told from a young age. In January it was purely just stay away from alcohol.

Just another account of the information differences experienced in the last year. I used to hammer google constantly to get the “right info” I spent half my time chopping and changing diet, then getting annoyed I’d went down the wrong road for a couple of weeks after reading something else.

I now stay off google completely. I got a Cirrhosis diet recipe book, it had fried steak in it !!! Kind of makes my point.

[Clock01 in reply to DaveQ67]

It's been a big revoluton really Dave. I have diabetes T2 as well and 10ish years ago it was still all, eat lots of bread and carbs but that has thankfully changed a bit now.

I've not found much good modern info about livers and diet tbh. It worries me because of the sort of advice you have been told. I suspect - I'm not medical, but I suspect there will soon be a sort of 'revolution' in diet and livers because it has appened in heart and diabetes care. Totally away from the old 'good plate' pyramid with carbs all along the bottom. Generally, seems that now best advice seems to be, as you are, to eat a good Mediterranean Diet as you know (though there are many varieties!). As you are cut out UPF - anything with a bar-code, in the centre isles of a supermarket and a long list of ingredients that you don't recognise as a food (especially emulsifiers). As you are already doing, eat a variety of the most colourful fruit and veg you can (you know, berries etc to keep the fruit sugars down.) It's the fibre that comes with real fruit that makes some lower sugar fruits OK I think.

Coffee also seems to be good for livers - any sort I think.

I miss a Liver food guru! For Diabetes, which I think will be proven to be highly connected to the food related liver problems. two gurus are either Canadian nephrologist Dr Jason Fung or UK GP Dr David Unwin. Possibly also Dr Tim Spector at Zoe.

Also, in Diabetes T2, fasting / intermittent fasting is very useful. Yet with liver, people still seem to be told to graze - eat every few hours, no attention paid to sugar as you say. Again that was the old (incorrect) info given to T2 Diabetics for years until they found this diet could reverse T2 diabetes.

Sorry to go on, my pet subject! And so much easier to read about than to do very often.

I wish I could find a 'liver nutrition guru' I mean someone who has really studied liver + nutrition in the light of these changes of advice in other areas.

One of the doctors I mentioned, Jason Fung, I found this short video from him: youtube.com/watch?v=_oBkdms...(Not working as expected?)

[DaveQ67 in reply to Clock01]

That’s great info thanks.

I’ve kinda now adopted a fairly low carb high protein and veg diet. I went down the route of how I was feeling, looking, exercise performance wise. I just cannot do the eat often and small portions. My daily life doesn’t lend to that.

I do intermittent fasting but mostly because I’m not hungry in the morning.

Mediterranean diet seems the most recommended so I eat fairly close to that. I was In really bad shape at diagnosis, with everything moving the right way and dropping nearly 5 stone. I’m looking at it as something is working.

Hopefully there is progress in the diet front, I just got the feeling when being walked through it in hospital it was going to the old faithful sensible eating route

[Clock01 in reply to DaveQ67]

It's been really useful to me replying Dave. I'm a classic 'Do as I say, not what I do!' person unfortunately.

I found this research from 2023 basically confirming that little research is being done so, yes, it's likely to be same old, same old dietary advice.

You have done fabulously well losing that much weight. You must feel better for it. Could I be cheeky and ask where you were / at what stage when you started? But only if you don't mind saying of course.

Very best wishes, keep doing what is working! 😀

ncbi.nlm.nih.gov/pmc/articl...

[DaveQ67 in reply to Clock01]

No probs.

Health wise I was decompensated cirrhosis. A couple of pound over17 stone. I’m now sitting 12 and a half stone.

feeling very fit and worked hard on growing muscle again. I’ve been of the mind set that if benefiting in the body, hopefully my liver is following suit. There’s been positive progress so I’ll keep chipping away.

I spent about 4-5 months chopping and changing diet/ training. Actually going full circle back to this eating plan. Hopefully further improvement will come. But……. It took me a while to wreck my body, It will take longer to get back again!

[Clock01 in reply to DaveQ67]

That is a great attitude. Well done on really good achievements. 👍😀

[Nerico in reply to Aplaceinthesun]

Go traditional Scottish and make porridge with water, it's just as nice.

[Hidden]

Why don't you try making some home made banana bread? You could have this for a breakfast choice. I regularly make 2 of these each week. Healthy ingredients, not that much sugar, very filling. PM me for my recipe. I eat clean 90% of the time with everything cooked from scratch, but it's nigh on impossible to not have any amount of processed at some point. I also use small amount of salt during cooking process, but not added at the table. I've lost over 2 st in 11 months and eat for England!

[Breakfastbabe]

I think the diet part is really hard and everyone is different. Advice is conflicting. My husband has cirrhosis and was told keep up the carbohydrates. He pointed out he is diabetic but he was told not to worry and to be fair his blood sugars have been fine. But he was getting terrible pain in his feet. So we sought advice and he was told to leave out all carbs including bread, pasta, bananas, and rice and just have protein and veg. He has just cut out the biscuits and snacks and kept in the bread etc but I worry he'll keep losing weight though his feet are a bit better. We asked doctor about protein and he said 4 eggs a day! I think it is a balancing act and a bit trial and error. I hope you find a balance that suits you and that you enjoy. Take care.

[Jothedancer]

I know exactly where you're coming from! When I had my news I was astounded that there didn't seem to be anything to check up on!

My cirrhosis occurred from taking Ibuprofen for spinal pain, for over 50 years, so I don't have a lot of trust in doctors anyway!

I think what you should be doing is CLEAN food, meaning NO preservatives, nothing factory made. Good advice I found was the first aisle in a supermarket is the only aisle we don't have to check for ingredients, it is all CLEAN!

Plenty of spring water, nothing that is going to make your liver over work!

No bacon, no sausage, no tinned food, no pies, no quick snacks!

At the end of the day it is relatively easy!

EGGS are our life saver. Eggs have everything we need. Olive Oil, no other oil whatsoever. I was seriously ill for 2 weeks before I worked that out!! I always have boiled eggs in my fridge! We have to think how we can help our liver!!

I live in a home and they can't do everything for me, food wise. I can't have roast potatoes, chips, any thing that has to use oil to cook!

Olive oil can't be heated enough to cook in, so we have to think of alternate ways! My daughter in law made me some very welcome chips by baking a potato, cutting it into chips and gently frying in olive oil!! Delicious!!!

I wish you all the very best in your research but I think I've covered the basic facts! xxx

[Readlots]

Nuts! Peanut butter on rice cakes or a bowl of nuts to graze on. Got for protein and you can have little and often

[Aplaceinthesun]

Thank you all for your suggestions and help, I've been out and bought 2 new griddle pans, one for chicken / turkey and one for veg, going to look at making something with oats.

Wishing you all well.

[McEwan1962]

hi

Everyone is different and there is a lot of conflicting information out there.

Have you had any information other than you have cirrhosis? So I really think you need to get back to the GP and/or hospital and get a clear diagnosis and results of any tests you had and what they mean going forward. So push for that appointment. Write down what you want to know. It can be very confusing with all the jargon.

If you have been given diuretics for ascites, you should have had follow up as they can in some cases cause kidney problems. They did for me.

Losing weight and eating healthy is important, however depending on how poorly your liver is can impact on your diet. I was malnourished and had to have a lot of protein, very little salt and to eat what I fancied, though I avoided processed food. I have a friend who’s a dietitian which was very helpful and it might be beneficial for you to see one to get a clear idea of the do’ s and don’t as I said we are all different.

Not sure if that is helpful. I hope you stay well. Lesley

[SanFranciscoGirl]

Hello Everyone! Since I was diagnosed with alcohol fatty liver disease one year ago, I know that I had to make major lifestyle changes or, quite frankly, this disease called alcoholism was going to take me out prematurely.

So my journey began and, FOR ME, I know this must be the way I have chosen to live for the rest of my life: 1) No alcohol (no exceptions), 2) Daily walking at least 1 hour when I can, 3) “CLEAN” eating (no ultra processed food, processed sugar, bread, rice, potatoes, all sweets, etc.) The only carbs I eat are from berries & cruciferous vegetables. And for protein, I like eggs, chicken, nuts, & fish. My ‘good’ fats include avocado oil, olive oil, and coconut oil. Intermittent fasting works for me, too, but that is certainly not for everyone. I also take a few vitamins & other supplements. (I will have a piece of birthday cake & ice cream every now & then.) 😃

I’m only sharing this because I feel the best I have felt in decades! Lost a few pounds without even trying. My labs are within ‘range’ again. I really have to discipline myself and it is SO dang hard sometimes! And imagining that I finally have some control in my life.

I do have many other issues in my life that I’m working on, so unfortunately life is NO WAY perfect! I pray for everyone suffering and I thank you for every one for sharing here. You have all inspired and keep me going. And I thank the BLT, too, for all you do. God bless everyone! 🙏🏼🕊️🕯️