What Should People with Cirrhosis of the Liver Eat?

October 5, 2025 •

4 min read

According to research, malnutrition is a common complication of cirrhosis, affecting between 5% and 99% of patients depending on the disease stage. For this reason, knowing what should people with cirrhosis of the liver eat is a vital part of managing the condition, helping to prevent muscle wasting and control symptoms like fluid retention. A targeted dietary approach can significantly improve outcomes and quality of life.

Quick Summary

A diet for cirrhosis prioritizes high-protein, low-sodium, and frequent, small meals to combat malnutrition and manage fluid retention. It emphasizes lean proteins, whole grains, and healthy fats while strictly avoiding alcohol, processed foods, and high-sodium items.

Key Points

High-Protein Focus: A high-protein diet (1.2-1.5 g/kg/day) is essential to prevent muscle wasting (sarcopenia) and combat malnutrition, which are common in cirrhosis.
Minimize Fasting Periods: Eating 5-6 small, frequent meals and including a protein and carbohydrate-rich late-evening snack helps prevent the body from breaking down muscle for energy during the night.
Reduce Sodium Intake: Limiting sodium to less than 2000 mg daily helps prevent or manage fluid buildup in the abdomen (ascites) and legs (edema), common complications of advanced liver disease.
Avoid Specific Foods: Raw or undercooked seafood and meat, processed foods, and alcohol must be strictly avoided to reduce the risk of infection and prevent further liver damage.
Prioritize Whole, Unprocessed Foods: Focus on fresh fruits, vegetables, whole grains, lean proteins, and healthy fats while using herbs and spices for flavor instead of salt.
Seek Professional Guidance: Always consult a doctor or dietitian specializing in liver disease before making significant dietary changes to ensure the plan is safe and tailored to your specific condition.

The Critical Role of Nutrition in Managing Cirrhosis

For individuals with cirrhosis, or advanced scarring of the liver, nutrition is a cornerstone of medical management. A poorly functioning liver has a reduced capacity to process nutrients, store energy, and produce proteins, which can lead to malnutrition, loss of muscle mass (sarcopenia), and complications like fluid buildup (ascites) and hepatic encephalopathy. A well-structured diet can help prevent these complications, improve energy levels, and enhance overall quality of life. It is important to work closely with a doctor or a registered dietitian who specializes in liver disease to create a personalized plan.

Combatting Malnutrition and Sarcopenia

Malnutrition is a major concern for people with cirrhosis because the damaged liver can't store energy efficiently, causing the body to break down muscle protein for fuel. To counteract this, a high-protein, high-calorie diet is often recommended, contradicting outdated advice to restrict protein. Regular, consistent intake of protein and calories is necessary to maintain muscle mass and prevent the body from breaking down its own tissues. Experts recommend a protein intake of 1.2 to 1.5 grams per kilogram of body weight per day.

Manage Fluid Retention with Low-Sodium Choices

A damaged liver and high pressure in the portal vein can cause fluid to leak into the abdomen (ascites) or legs (edema). Consuming less sodium is a key strategy to reduce this fluid retention. This means avoiding adding salt to meals and steering clear of many processed, canned, and restaurant foods, which are notoriously high in sodium. Flavor can be added with a variety of fresh herbs, spices, garlic, onion, and lemon juice. For those with ascites, a fluid restriction may also be necessary, though this should be discussed with a doctor.

Key Dietary Strategies for Cirrhosis

Eat Small, Frequent Meals and a Late-Night Snack

Since the cirrhotic liver cannot store glycogen efficiently, the body can enter a fasting-like state after only a few hours without food, leading to muscle breakdown. To minimize the overnight fasting period, healthcare providers recommend eating 5 to 6 small meals or snacks throughout the day, including a snack before bed. A late-evening meal, rich in protein and carbohydrates, can help maintain protein stores and blood sugar levels overnight.

Choose Wholesome Fats and Complex Carbohydrates

While fried and high-fat foods should be limited, incorporating healthy, unsaturated fats is important. Sources like olive oil, avocado, and omega-3-rich fish such as salmon and tuna are beneficial. The diet should also be rich in complex carbohydrates, including whole grains, fruits, and vegetables, which provide sustained energy and fiber.

Foods to Include in Your Cirrhosis Diet

Lean Proteins: Skinless chicken and turkey, fish, eggs, and egg whites are excellent choices.
Dairy and Plant-Based Proteins: Low-fat dairy products like Greek yogurt and cottage cheese, along with plant-based options such as tofu, lentils, beans, and unsalted nuts and seeds.
Whole Grains: Oatmeal, brown rice, quinoa, and whole-grain breads are good sources of fiber and energy.
Fruits and Vegetables: Fresh or frozen varieties are best. Leafy greens like spinach, berries, apples, and carrots are rich in vitamins, minerals, and antioxidants.
Healthy Fats: Olive oil, avocado, and fatty fish are sources of beneficial fats.
Flavoring: Use fresh herbs, spices, garlic, ginger, and lemon juice to replace salt.

Foods to Strictly Limit or Avoid

Alcohol: Completely avoid all alcohol, as it can cause further, irreversible liver damage.
High-Sodium Foods: This includes processed meats (bacon, sausage, deli meats), canned soups and vegetables (unless specified low-sodium), pickles, most fast food, and many condiments like soy sauce.
Unhealthy Fats: Limit or avoid fried foods, margarine, and vegetable shortening, which are high in trans and saturated fats.
Refined Carbohydrates and Sugars: Avoid sugary drinks like soda and fruit juice, pastries, white bread, and other highly processed baked goods.
Raw or Undercooked Foods: Due to impaired immune function, people with cirrhosis should avoid raw or undercooked meat, poultry, fish, shellfish, and unpasteurized milk to prevent infection.

Comparison of Healthy vs. Unhealthy Food Choices


Food Type	Healthy Choice (Recommended)	Unhealthy Choice (Limit/Avoid)
Protein	Lean chicken, fish, beans, tofu, eggs	High-fat red meat, processed deli meats, sausage
Flavoring	Fresh herbs, spices, garlic, onion, lemon	Table salt, soy sauce, many bottled marinades
Grains	Whole-grain bread, brown rice, oatmeal	White bread, white rice, sugary cereals
Fats	Olive oil, avocado, fatty fish (salmon)	Fried foods, butter, margarine, shortening
Beverages	Water, herbal tea, coffee (in moderation)	Alcohol, soda, sugary drinks, high-sodium broths
Dairy	Low-fat Greek yogurt, low-sodium cottage cheese	Full-fat dairy, high-sodium cheeses

A Note on Micronutrient Supplements

Cirrhosis can lead to deficiencies in essential vitamins and minerals, including zinc and fat-soluble vitamins (A, D, E, K). While a balanced diet is the primary focus, a doctor or dietitian may recommend specific supplements. Always consult a healthcare professional before starting any supplement regimen, as some can be harmful to a damaged liver.

Conclusion

Optimizing your diet is a powerful and necessary step in managing cirrhosis. By focusing on nutrient-dense, high-protein, and low-sodium foods, and eating smaller, more frequent meals, individuals can help prevent malnutrition, manage fluid retention, and support their overall health. Avoiding alcohol, highly processed items, and foods high in unhealthy fats and sugar is critical. Because each patient's needs are unique, collaborating with a liver specialist or registered dietitian is the most effective approach to developing a safe and personalized nutrition plan. For further information and detailed guidelines, consult with your healthcare team. The British Liver Trust also offers comprehensive information on diet and cirrhosis.

Frequently Asked Questions

Protein is crucial for repairing body tissues and maintaining muscle mass. With cirrhosis, the body's metabolism is altered, leading to muscle loss (sarcopenia), and increased protein intake helps counteract this effect. For most people with cirrhosis, a high-protein diet (1.2-1.5 g/kg/day) is recommended, and protein restriction is now considered outdated advice.

Fluid buildup is managed primarily by restricting sodium (salt) intake, typically to less than 2000 mg per day. To achieve this, avoid processed foods, canned items, cured meats, and high-sodium condiments. Use fresh herbs, spices, and lemon juice for flavor instead.

While lean animal proteins are generally recommended, red and processed meats are high in saturated fats and sodium, which can increase inflammation and fluid retention. Lean poultry, fish, eggs, and plant-based proteins like legumes and tofu are healthier, safer options that should be prioritized.

Focus on healthy, unsaturated fats found in sources like olive oil, avocado, and fatty fish (e.g., salmon). Avoid trans fats and excess saturated fats, which are common in fried foods, commercial baked goods, and full-fat dairy.

People with cirrhosis have a reduced ability to store energy, so they burn muscle for fuel during overnight fasting. A bedtime snack rich in protein and carbohydrates minimizes this overnight fasting period, helps maintain muscle mass, and keeps blood sugar stable.

No, because cirrhosis impairs the immune system, increasing the risk of serious infections from bacteria or viruses found in undercooked or raw foods. All meat, fish, shellfish, and eggs should be fully cooked, and unpasteurized milk and milk products should be avoided.

Cirrhosis can lead to deficiencies in certain vitamins (A, D, E, K, B vitamins) and minerals (zinc). However, supplements should only be taken under the guidance of a healthcare professional, as some can be toxic to a damaged liver in high doses.