In the past, it was thought that consumption of protein even at normal levels increased the risk of hepatic encephalopathy in patients with decompensated cirrhosis.
This has been shown to be incorrect.
Many people with chronic liver disease are malnourished and require adequate protein to maintain a stable body weight. A diet with adequate protein and energy is therefore recommended.
I have decompensated cirrhosis and HE and know many people who are very ill and waiting for a liver transplant. When you very ill and have end-stage liver disease patients have difficulty eating and suffer from muscle wasting because they don't get enough protein. Friends have lost 30-60 pounds when this happens. End-stage liver disease patients need to have protein to maintain as much muscle as possible.
I agree with what Hector wrote. I would add that one still should try to limit the amount of protein to reasonable amounts. To eat what is considered "normal" by average American diet could lead one to consuming way more than is needed or healthy. In general serving sizes in the USA are too big, contain too much fat, salt, etc. Many of us may also suffer from excess iron and one might consider limiting red meat consumption and replacing it instead with either poultry, fish or vegetable based protein sources.
All things in moderation (with the possible exception of alcohol) for the most part until advanced staging may cause some dietary modification in one's diet. At least, that is what I think I've understood.
I am also cirrhotic and my albumin has always run low. During tx it slipped even lower during a spot when my appetite took a dive. I was strongly encouraged to use whatever means I could to increase my protein intake. I stuck with the protein drinks for a while, then when I felt better added more solid forms.
Even now, post tx, I have to work at it - especially since a big hunk of meat on the plate now gags me. Lean red meat on occasion is OK, but best to stick to your fish, chicken and legumes for your mainstay of protein. Snacky things can include cottage cheese, peanut butter, yogurts, hummus (but watch the salt if you purchase it and the crackers too).
I have (had) pre-diabetes also and was urged to combine carbs (like a whole grain cracker/bread) with a protein and this seems to have normalized those borderline glucose levels too.
in the book "The China Study", T. Colin Campbell, PhD states "in mice, HBV (hepatitis B) initiated the liver cancer but the cancer grew in response to feeding of higher levels of casein. In addition, blood cholesterol also increased. These observations fit perfectly with our human findings. Individuals that are chronically infect with HBV and who consume animal-based foods have high blood cholesterol and high rate of liver cancer. The virus provides the gun, and bad nutrition pulls the trigger."
i don't know if this applies to hepatitis c, but after reading this i cut back on casein. casein is found in cheese and milk, and i really do or did enjoy cheese. Dr. Campbell caught a lot of flack from the dairy and livestock industry for this book.
In the past it was thought cirrhotics should keep to low protein, but recent evidence shows that it not the case. As Hector and paen53 pointed out above, adequate protein of the right kind is important for patients with cirrhosis. It's generally advised to keep red meats to a minimum, and derive protein from veggies, beans & nuts, & fish. My husband who has cirrhosis now tries to substitute red meat, which was his staple for years, with peanut butter, fish, eggs, and beans. His hepatologist also encourages him to take protein shakes if he has a poor appetite to ensure adequate protein. Hope that helps. ~eureka
- Everything you wanted to know about protein and cirrhotics, but were afraid to ask -
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 compensated cirrhosis. 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.
Protein & hepatic encephalopathy(HE) in decompensated cirrhosis -
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.
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.
Why certain types of protein are better than other for cirrhotics -
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.
No more Mickey D's Big Macs!!! Darn.