Dietary Recommendations for Protein for Those With Hepatitis/Liver Disease
When a person thinks of protein, a juicy hamburger or a roast chicken may come to mind. However, remember that protein has vegetable sources as well as animal sources. (See Table 23.1 on page xx for the protein content of certain foods.) Protein intake must be adjusted in accordance with a person’s body weight and the degree of liver damage present. Approximately 0.8 grams of protein per kilogram (2.2 pounds) of body weight is recommended in the diet each day for someone with stable liver disease. As such, total protein intake would range between about 40 and 100 grams per day—equaling the approximate 20 to 30 percent of daily calories derived from protein that a person should ideally consume.
When choosing animal protein, it is important to choose lean (low-fat) cuts of meat- such as fish, white meat chicken and white meat turkey. Keep in mind that even the leanest cuts of red meat are high in fat content. In fact, approximately 50 to 75 percent of calories from most red meats actually come from fat! Even a carefully trimmed cut of fine lean red meat probably derives about 50 percent of its calories from fat. This becomes especially significant for people with liver disease due to being overweight, as a diet high in fat may contribute to such a person’s liver-related abnormalities. (See Fat on page xx for more information.)
People with unstable liver disease (decompensated cirrhosis) need to lower the percentage of animal protein they consume and they need to eat mostly vegetable sources of protein. A diet high in animal protein (which contains a lot of ammonia) may precipitate an episode of encephalopathy among these people. Researchers aren’t exactly sure what causes encephalopathy, but they suspect that an excess of ammonia in the body may be one of the triggers. Some popular weight-loss diets involve the consumption of a very high amount of red meat animal protein. People with cirrhosis are advised to avoid any such diets.
Vegetarian diets, on the other hand, have a low ammonia content and have been shown to be much less likely than animal protein diets to induce encephalopathy. Also, vegetable fiber plays a role in helping to eliminate harmful waste substances, such as ammonia, from the body. Therefore, people prone to encephalopathy are advised to maintain a high intake of vegetable protein and a low intake of animal protein, or even better, to become vegetarians. This type of diet will help control mental symptoms in people suffering from some degree of chronic encephalopathy—that is, those who have some degree of mental confusion and/or memory loss all the time. Also, high-fiber, vegetable protein diets may reduce sugar levels in some people and may, therefore, be especially useful to diabetic people with cirrhosis and possibly in people with nonalcoholic fatty liver disease (NAFLD). However, even vegetable proteins are not perfect and also may be subject to dietary restriction. For instance, if a person suddenly develops encephalopathy, it may be necessary to limit any type of protein consumption to 20 grams or less per day, until this episode resolves.
All contents of this article are Copyright © Melissa Palmer, MD
Melissa Palmer, MD is the author of " Dr. Melissa Palmer's Guide of Hepatitis and Liver Disease". (Published 2004. Penguin Putnam).
The offices of Melissa Palmer, M.D. are located at:
1097 Old Country Road Suite 104
Plainview, N.Y 11803
or
500 Portion Road
Lake Ronkonkoma, N.Y. 11779
To arrange an appointment with Dr. Palmer, call
(516) 939-2626