Dietary Recommendation for Patient with Cirrhosis
Patients with cirrhosis need to follow a certain diet in order to prevent major complications that can lead to serious consequences. While we encourage patients to eat a general diet with high calorie content, the only restriction needed is “Salt.” Patients with cirrhosis needs to follow a “2g sodium diet.” There is NO reason to restrict eating meat or other poultry food. As a matter of fact, patients with cirrhosis tend to lose muscle mass quickly and therefore need a high protein intake every day to prevent excessive loss in their body muscle. This brochure addresses the 2-gram sodium diet and illustrates which food has high and low sodium content. Please read it and discuss it with your liver doctor or dietary specialist.
Low Salt Diet: 2 gram Sodium Diet
What is a 2 g sodium diet?
This is the diet that everybody with cirrhosis needs to follow every day. It requires the patient to take only 2 grams (2000 milligrams) of sodium daily. It is important to know that this is NOT a 2 g “Salt” diet but a 2 g “Sodium” diet.
Why do I need to follow this diet?
Because a high sodium diet will cause fluid retention in your abdomen (ascites) and legs and other complications that can make you sick.
What are the consequences of not following a 2 g sodium diet?
If you decide not to follow this diet, you will have one or more of these symptoms:
- Ascites (fluid in the belly)
- Swelling of legs or ankles
- Fluid buildup around the lungs
- Skin infection (cellulitis) or infection of the fluid in the abdomen called Spontaneous Bacterial Peritonitis (SBP)
- Change in electrolytes (sodium and potassium) balance in the blood
- Weakness and difficulty sleeping at night (insomnia)
- Decrease in appetite
What should I do to comply with a 2 g sodium diet?
You should usually avoid these items:
Eating in restaurants or fast food places.
Food in these places have large and in most cases unknown amounts of salt. Food in these places is prepared from processed or stored materials that have a high quantity of salt. Eating one time a week in outside restaurant is enough to cause you a lot of problems with fluid retention, even if you follow the diet for the remaining days.
1⁄2 teaspoon of table salt has almost 1200 milligrams sodium. This is over half of the amount you should have each day. If you strictly follow this diet, you may have only 1/8 teaspoon to season food. Don’t add salt blindly from salt shakers to your food, as you cannot determine the amount of salt you add.
Salt is added in large amounts to some regular foods. Examples are:
- Canned foods: soups, stews, sauces, gravy mixes, and some vegetables
- Frozen foods: dinners, entrees, vegetables with sauces
- Snack foods: salted chips, popcorn, pretzels, pork rinds and crackers
- Packaged starchy foods: seasoned noodle or rice dishes, stuffing mix, macaroni and cheese dinner
- Instant cooking foods to which you add hot water and stir: potatoes, cereals, noodles, etc. (salt is added to make precooked foods absorb water faster)
- Mixes: cornbread, biscuit, cake or pudding
- Meats and cheeses deli or lunch meats: bologna, ham, turkey, roast beef, or smoked meats such as corned beef, sausage of any kind (patty, link, Kielbasa, Italian, wieners or hot dogs), bacon, canned meats—potted meats, spreads, Spam®, Vienna sausage, etc.
- Cheeses: read labels and avoid those with more than 140 mg sodium per serving; examples are American cheese, Velveeta®, Cheez Whiz®, etc. •
Condiments, Sauces and Seasonings
- Mustard, ketchup, salad dressings, bouillon cubes or granules
- Sauces: Worcestershire, barbecue, pizza, chili, steak, soy. or horseradish sauce
- Meat tenderizer, monosodium glutamate
- Pickles and olives
- Any seasoning that has “salt” in the name or on the label;
- avoid celery salt, garlic salt and onion salt; however, it is okay to have garlic or onion powder or flakes
- read labels carefully—lemon pepper often has salt
What can you use to season your food?
- Tart flavor: try lemon or lime juice, vinegar
- Hot flavor: peppers are low in sodium; hot sauce has salt, but if you use just a drop or two it will not add up to much
- Herbs and spices: onions, garlic, salt-free seasonings like Mrs. Dash®
Can I use Mrs. Dash® or Salt substitute?
Yes, if you DO NOT have any problem with fluid retention in the past OR if you are NOT taking any water pills (Diuretics). Mrs. Dash® and other salt substitutes have large amounts of potassium which could be harmful to your heart if taken in large quantity. If you decide to use Mrs. Dash® please use it cautiously and in small amounts.
What are examples of low sodium foods?
- Beans, peas, rice, lentils, or pasta (dried and fresh, cooked without salt)
- Cereals (hot, regular cooking) Club soda
- Coffee (regular and decaffeinated)
- Fruits (fresh, frozen, and canned)
- Fruit drinks
- Herbs and spices (non-salt)
- Meats, fish, and poultry (fresh)
- Milk (chocolate skim)
- Milk (evaporated skim)
- Milk (nonfat dry)
- Milk (skim, low-fat, and regular)
- Seltzer water (flavored)
- Soda pop (regular and diet)
- Soy milk
- Tea (iced)
- Vegetables (fresh and plain frozen)
- Yogurt (plain and fruit flavored)
What are examples of high sodium food?
- Beef jerky
- Breaded meat (frozen)
- Breakfast sausage
- Chipped ham
- Corned beef
- Dried beef (jarred)
- Herring (jarred)
- Hot dogs
- Hot sausage
- Pickled loaf
- Pickled meats and eggs
- Pimento loaf
- Pot pies (frozen)
- Chicken (canned regular)
- Vienna sausage
- Pickles (sweet and dill)
- Pizza sauce
- Regular canned vegetables
- Regular jarred and canned tomatoes
- Sauerkraut Spaghetti sauce
- Stewed tomatoes
- Tomato and vegetable juice
- Tomato sauce
- Buttermilk, Canned milk
- Baked beans (canned)
- Batter mixes
- Biscuit and pancake mixes
- Corn and potato chips
- Hot cereals (instant)
- Macaroni and cheese (boxed)
- Popcorn (regular microwave)
- Stuffing mixes
- Waffles (frozen)
- Bouillon cubes and broth
- Soups (canned regular)
How can I know how much sodium in the food I am preparing?
You need to read the food label for every food container before you purchase it.
- Begin by reviewing the serving size and sodium content information. The serving size for the food in this listed label is 6.7 oz. (ounces). The sodium content for that serving is 11 mg.
- If you eat the same sized serving as the one listed on the label, then you are eating the amount of sodium that is listed.
- But if the amount you actually eat is either larger or smaller, the amount of sodium you will be eating will also be larger or smaller.
For example, if you eat a double portion of the food shown on the label to the left, you will also be eating twice as much sodium as listed on the label. A 13.4 oz. serving of the food above would contain 22 mg of sodium.