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Why is the liver so important in nutrition?

The liver has many functions, with nutrition being one of the key roles.  One of the most important functions of the liver is to break down food and convert it to energy when it is needed.  Some of this excess energy is stored in the liver as glycogen.  The liver releases glycogen to ensure the body has a constant supply of energy, especially in between meals. The liver also functions to produce bile to break down fat into tiny droplets that the body can absorb, the manufacturing of proteins to provide building blocks for cell and tissue growth and repair, and the storage of vitamins

Liver Disease and Nutrition

Liver disease and malnutrition

If the liver is damaged, metabolism can be affected and patients can quickly become malnourished.  Not all patients will become malnourished, this can depend on the type and severity of your condition and the treatment you are receiving.

It is important to monitor your weight.  Malnutrition is associated with a deficiency of nutrients which causes an adverse effect on your body, function and outcome.

Signs of malnutrition?

  • Unexpected weight loss
  • Loss of appetite
  • Loss of muscle bulk (especially in the face, upper arms, chest) and reduced muscle strength

How can liver disease cause malnutrition?

Liver disease can increase your energy needs and you need to eat more than you normally would to prevent weight loss.  The side effects of liver disease or treatments you are receiving may make you feel unwell and not want to eat.

Ascites and nutrition

If you have ascites (fluid in the tummy), you may find you get full up quickly and are unable to eat as much. If this is happening, healthy eating recommendations would need to be relaxed in favour of eating foods high in energy, fat and protein to maintain your weight.

For more information and dietary advice for ascites please read our leaflet on liver disease and nutrition linked above.


The aims of good nutrition are to:

  • Provide a balance of nutrients to prevent nutritional deficiencies
  • Avoid weight loss (unless specified by your clinician)
  • Maintain your muscle, strength and mobility
  • Provide you with energy for daily activities and socialising
  • Support you through your treatment and maximise your quality of life

Combining good nutrition with exercise is key to maximising your health and well-being.

Tips for a healthy balanced diet

It is important to remember that your body’s nutritional needs vary depending on the type and severity of your condition. There may be enough healthy cells in your liver to perform all of its functions adequately and if your weight is in a healthy range and you are not losing weight, it is important to try to follow a balanced diet. If you have been told to lose weight, then it is important to do so slowly and safely.

The Eatwell plate shows a pictorial version of a balanced diet and the proportions of each food group you should eat.

The Eatwell plate is divided up into five food groups:

  1. Potatoes, bread, rice, pasta and other starchy carbohydrates
  2. Fruit and vegetables
  3. Dairy and alternatives, such as milk, yoghurt, eggs and cheese
  4. Beans, pulses, fish, eggs, meat and other proteins
  5. High calorie foods, such as high fat and sugary foods

A balanced diet

1. Potatoes, bread, rice, pasta and other starchy carbohydrates include one of these foods with every meal.  Try to include wholegrain or wholemeal varieties as this will increase the fibre in your diet.


5. High calorie foods, such as high fat and sugary foods - should only be eaten in very small quantities unless you need to gain weight.  Try to avoid frying foods where possible and reduce cake, biscuit, pastries and sweet consumption.  Choose diet, low or reduced fat/sugar options where possible.  However if you need to gain weight, eating more of these foods is beneficial and ensure you avoid diet options.



2. Fruit and vegetables – aim for 5 portions a day, (see figure below for portion sizes).  These can be fresh, frozen or tinned.  Try to incorporate a variety of colours.  Fruit and vegetables are a good source of vitamins and minerals and fibre.  If your appetite and food intake are poor, try not to fill yourself up with these foods.  If you are struggling to manage 5 portions, you could consider taking a general multivitamin tablet.

3. Dairy and alternatives, such as milk, yoghurt, eggs and cheese - are good source of calcium and important for strong bones, aim to consume three portions each day, e.g. 200mls glass of milk, a yoghurt or 30g of cheese.  Choose lower fat options, such as semi skimmed milk, reduced fat spread and low fat yoghurts if excess weight is a problem.  Ensure soya/oat/rice milks are fortified with calcium.


4. Beans, pulses, fish, eggs, meat and other proteins – important for tissue regrowth and repair.

Nutrition FAQs

If you are struggling with your appetite and food intake, try some of the suggestions below:-

  • Try to eat small but frequent meals
  • Avoid skipping meals and snacks, however small, every little helps
  • Make the most of the times you want to eat and try to enjoy your food
  • Avoid drinking with meals as this may fill you up and spoil your appetite
  • Keep snacks by your bed
  • If you don’t feel like solid food try a nourishing drink, e.g. full fat milk, Horlicks, smoothie, milkshake
  • Prepare meals in advance when you have more energy and make extra for the freezer
  • If the smell of food is unappetising, consider cold foods
  • Accept offers from friends and family to help with cooking and shopping
  • A short walk or fresh air before a meal, may increase your appetite
  • Consider ready meals, these can be just as nutritious
  • Use meals on wheels services or home delivery services offering pre prepared meals
  • Include convenience foods (such as tinned, dried or frozen foods) in your weekly shop as these will last longer e.g. longer-life milk, savoury snacks, plain biscuits, rice puddings, corned beef, baked beans, soups, tinned puddings and custard.

If you are struggling with your appetite and losing weight unintentionally speak to your health care professional who can consider if you require a referral to a Dietitian.  In some cases, prescribed oral nutritional supplements may be required.  A Dietitian can assess and advise if these are required. Try to have 3 meals a day and snacks in between

  • Ideas for snacks include: cheese and biscuits, scone, tea cake, yoghurt, biscuits, olives, cake, sausage roll, slice of pizza, cereal, mini dessert, spring roll or hummus and dip. Focus on foods you fancy
  • Try to avoid filling yourself up with large servings of fruit, vegetables or salads as they do not provide much energy
  • If you usually use low fat, low sugar ’diet’ foods and drinks, switch to the non-diet ones (e.g. whole milk)
  • Add ingredients such as cream, cheese, butter, olive oil, cream cheese, milk powder and lentils to foods like soups, stews, curries, scrambled eggs, vegetables, potatoes.
  • Add honey, syrup and jams to porridge, milky puddings, or toast
  • Fortify your usual milk by whisking 4 tablespoons of skimmed milk powder into 1 pint of milk
  • Focus on nourishing drinks. These can include: full fat or semi skimmed milk, malted drinks, such as Horlicks or Ovaltine made with milk, smoothies, fruit juice and full sugar fizzy drinks.  Milk is a good source of energy and protein
  • Try to have a pudding after your main course or as an in-between meal snack, e.g. sponge and custard, cheesecake, ice cream and fruit, trifle or rice pudding
  • You could try and make your own homemade milkshakes, using a mixture of cream, yoghurt, honey, blended fruit, ice cream and flavoured milkshakes powers
  • Powdered nutritional supplements are available from chemists or supermarkets and may be useful, but can be expensive
  • Please note, if you have diabetes, consult with your Dietitian/health care provider as some of the above suggestions may not be suitable

When your liver is not working properly, your body needs more protein than normal.  Protein is often known as the building blocks for building and repairing body tissues.  Eating too little protein, particularly for long periods of time, may lead to muscle weakness, frailty and slow recovery from illness or surgery   The goal is to eat approximately 1.2-1.5g protein per each kg body weight.

Good sources of protein include meat, fish, eggs, soy, tofu, beans, pulses, nuts and seeds and dairy foods such as milk, yoghurt and cheese.  As a guide aim to have at least 25g protein with each of your 3 meals a day.  Milky drinks, such as hot chocolate or ovaltine and milky puddings such as custard and rice pudding after or between meals will help boost your protein intake.  The table below includes some examples of protein rich foods and ways to achieve a good protein intake.

Combining a good intake of protein with exercise is ideal for maintaining and building muscle and making you feel stronger.


Average portions

Approximate protein content

Meat and Fish



Chicken breast

1 breast fillet (30g)


Bolognese sauce, made with

extra lean minced beef



Lamb chop

1 chop (70g)


Sausage, thick pork

2 sausages (80g)


Bacon back, grilled

2 rashers (50g)


Pork chop

1 chop (75g)



1 thick slice (23g)


Beef burger

1 burger (34g)


Roast beef

2 thick slices (90g)


Pork pie

Individual (75g)


Sausage roll

1 medium (60g)


Shepherds pie/cottage pie

Average portion 310g


Chilli con carne (no rice)

Average portion (155g)


Cornish pasty with beef

Medium (155g)


Chicken curry (no rice)

Medium portion 260g


Tinned sardines in oil

Small can (100g drained)


Battered cod

1 fillet (180g)


Fish fingers

3 (90g)


Salmon steak



Smoked salmon

½ average pack (70g)


Tinned tuna

1 can (100g)


Prawn cocktail



Tinned mackerel

1 can (125g)


Eggs and dairy foods




1 medium (50g)


Cheddar cheese

2 slices (40g)


Yoghurt, whole, plain

1 pot (125g)


Cottage cheese

½ pot (150g)


High protein yoghurt, (e.g. Skyr, Arla Protein, Lindahl’s Kvarg)

1 pot (150g)


Milky puddings

(rice pudding / custard)

1 pot (120g)


Milk, semi-skimmed



Milk on cereal



Skimmed milk powder

4tbsp (36g)


Plan based proteins










½ cup (100g cooked)


Roasted peanuts

1 bag (50g)


Nuts (almonds, cashew, brazil)

1 handful (25g)


Baked beans

1 small can (150g)



1 tablespoon (40g)



1 (60g)


Vegetable lasagne

1 portion (420g)


Lentils – green

1 tablespoon (40g)



1 portion (70g)


Peanut butter

1 portion pack (25g)


Grains and cereals




½ cup (40g)


Porridge (made with milk)




2 biscuits (40g)


White/wholemeal bread

2 slices (70g)


Seeded bread

2 medium slices (90g)


Pasta (cooked)

1 cup (200g)


Rice (boiled)




1 plain


If you develop ascites, you can help reduce the build up of ascites by reducing the amount of salt in your diet.   About 70% of our salt intake comes from processed or every day foods, such as bread, crisps, breakfast cereals and ready meals.  Cooking from fresh where possible will help reduce your salt intake. 

Foods high in salt include:-

  • Cured meats including: bacon, ham, sausages, salami
  • Cheese – is a good source of protein, but avoid every day
  • Smoked meats and fish
  • Salted crisps, pretzels and nuts, olives
  • Stock cubes, gravy, ketchup, soy sauce, Bovril, Marmite
  • Tinned or packet soups and tinned vegetables
  • Ready meals – check the packaging label for the lower salt options.


Try to reduce your intake of these foods or have smaller amounts.


Tips to reduce your salt intake:-

  • Avoiding salt in cooking or at the table
  • Gradually reduce your salt intake as your taste buds will adapt
  • Choose unsalted snacks - crisps, nuts, popcorn
  • Use herbs, spices, pepper, lemon for seasoning instead of salt.


It may be helpful to look at food labels as most food packaging has traffic light coding so you can tell whether a food has high, medium or low amounts of fat, saturated fat, sugars and salt .  Try to avoid foods that are coloured red for salt.  The salt content of some foods may surprise you.

If reducing your salt intake compromises your overall nutritional intake so you are losing weight unintentionally, this can be harmful.  A balance is required, discuss this with your Dietitian.


Breakfast Ideas








1 scrambled egg with

2 slices of bacon

2 kipper fillets with bread and butter

Scrambled eggs on toast or porridge or cereal with fortified milk

Vegan peanut butter on toast

Lunch ideas








Ham & cheese omelette or cold ham & cheese ploughman’s or chicken sandwich

Sardines on toast or sandwiches:

-smoked salmon &

 cream cheese

-tuna mayonnaise

-prawn cocktail

Cheese omelette or bean soup with grated cheese or cheese on toast or sandwiches:

-egg mayonnaise

-cheese and pickle

Baked beans & vegan cheese on toast or sandwiches:

-hummous & carrot

-vegan cheese

-nut butter & banana

Dinner ideas








Lamb hotpot with potatoes or beef casserole or spaghetti bolognese with grated cheese or sausage & mash with gravy or chicken pie & chips

Small fish and chips (takeaway) or fisherman’s pie or tuna bake or fishcakes & peas

Vegetarian lasagne or macaroni cheese or cheese & tomato pizza

Vegan bean chilli & rice or vegan lentil dahl or tofu stir fry

Snack Ideas






Cheese and crackers, scotch egg, (meat or vegetarian options),

cocktail sausages, (meat or vegetarian options) yoghurt, custard, rice pudding, chocolate mousse, fruit posset.

Nut butter & rice

cakes, vegan cheese & crackers, hummous & breadsticks, vegan ice-cream







Milky drinks: milkshakes, smoothie, coffee, hot chocolate, malted drinks.

Adapt with plant based milk


British Dietetic Association:

Food Standard Agency: 


For more information and dietary advice please download our nutrition leaflet:

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