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).
Dr. Palmer is an internationally renowned hepatologist who has been practicing medicine since 1985. Prior to 2012, she maintained perhaps the largest medical practice devoted to liver disease in the United States. Dr. Palmer is Clinical Professor of Medicine at New York University Medical Center. Dr. Palmer graduated from Columbia University with a B.A. and was trained in hepatology (as well as medical school) at the Mount Sinai School of Medicine in New York City.
Dr. Palmer is Board Certified in Gastroenterology and in Internal Medicine.
She has authored numerous scientific publications in the field of hepatology in such peer-reviewed journals as Hepatology, Gastroenterology, Seminars of Liver Disease, Transplantation and Archives of Internal Medicine.
She is frequently called upon by the media for her opinion on various topics related to liver disease. Dr. Palmer has appeared many times on television as a liver disease expert and has been quoted in such publications as TIME magazine, Cosmopolitan magazine, Prevention magazine, the Los Angeles Times, and Newsday. She also has appeared in numerous videos and CD-Roms aimed at educating doctors and the public about hepatitis C and other liver diseases, such as primary biliary cirrhosis. Dr. Palmer lectures to the medical and general public on liver disease-related topics on a regular basis.
Dr. Palmer has performed numerous clinical trials on various experimental medications for the treatment of hepatitis.
Dr. Palmer is currently available for lecturing, investor and hedge-fund consultations, consultations to industry, and media interviews and appearances-- including television. For such matters, she can be contacted through hepatitismedia@gmail.com.