Many myths surround the topic of diet and liver disease, including foods to "feed" the liver, foods to "cleanse" it and other weird and wonderful ideas.

Below are a few simple dietary tips.

• Special or therapeutic diets
• Eating for health
• Types of food

Special or therapeutic diets

Special or therapeutic diets for liver disease are actually only necessary when specific symptoms develop:

Ascites (accumulation of fluid in the abdomen) and oedema (swelling of ankles and/or legs with excess fluid)

These symptoms may be treated with a combination of diuretics (water tablets), fluid restrictions and reduced salt diets. This sort of diet is potentially quite restrictive and must be supervised by a dietitian.

Steatorhoea (fatty stools - pale, bulky and difficult to flush)

Usually needs to be treated with a reduced fat diet. Again, dietetic supervision is essential as vital calories may be lost.

It is also important to note that there is no benefit in starting these diets before symptoms develop; this may actually be detrimental to health.

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Eating for health

The main aim, regardless of the severity or degree of liver disease, is to keep nutritionally well. This means trying to keep to a healthy or stable weight. The reason for this is that, with liver disease, changes occur in the way we manufacture our energy. Usually, the liver creates a store of energy called glycogen which is then released during periods of fasting, either between meals or overnight. This store is then replenished when we eat.

However, with liver disease, this store of glycogen is not replaced after it is used and gradually dwindles. This means that overnight, or during long periods between meals, the body must find other ways to provide energy. This is when muscle and fat tissues are broken down to provide this energy.

Many people find that they cannot last for long periods without eating something and this feeling reflects the body's depleted stores. We can provide ourselves with sufficient energy by following a few simple dietary tips.

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Types of food

Complex carbohydrates (starchy foods)

• Rice
• Bread
• Potatoes
• Breakfast cereal
• Pasta
• Crackers/crispbreads

This group of foods are an excellent energy source, releasing energy over a few hours.

It is essential to include some form of starch at each meal and a supper-time snack. Choose wholemeal varieties where possible. If your appetite is poor or you can only manage small portions you may need between-meal snacks to top-up, such as:

• plain biscuits
• crackers
• toast
• crumpets
• teacakes
• toaster muffins

Also beware that high-fibre foods are very filling so may not be advised in this instance.

Proteins

• Meat/poultry
• Dairy produce
• Fish
• Pulses
• Eggs
• Quorn/tofu

Essential for building and renewing tissues and muscle mass. Aim for two portions a day. We usually take one with a main meal and one at our light meal. Again if your appetite is poor or you are struggling to keep your weight up, extra protein is useful to help re-build muscles.

Fruit and vegetables

These provide us with vitamins, minerals and fibre. We are encouraged to aim for five portions a day. This may sound a lot but is easier to achieve than it appears. By having two vegetables or salad with your main meal, adding tomatoes, cucumber or lettuce to a sandwich, and having a piece or two of fruit during the day you can easily reach this target.

Vitamin supplements are not necessary if you eat a wide variety of foods.

Fats and sugars

These foods are high in calories and are also the ones many of us most like to eat.  Confectionery, fried foods and treats are not forbidden; you just need to watch your quantities. If your appetite is poor, these foods are a easy source of energy and if your appetite is fine, they are a nice treat.

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