Understanding liver disease
Liver disease includes metabolic dysfunction-associated steatotic liver disease (MASLD, formerly called NAFLD), alcohol-related liver disease, viral hepatitis and cirrhosis, the scarring that can follow any of them. Fatty liver is now the most common cause and is closely tied to weight, type 2 diabetes and cholesterol.
Nutrition plays two very different roles. In fatty liver disease, weight loss and diet changes can reduce liver fat, inflammation and even scarring. In cirrhosis the priority flips: many people lose muscle, so the plan protects protein and energy intake while managing fluid and sodium.
How a dietitian helps with liver disease
Fatty liver: a realistic weight-loss plan, Mediterranean-style eating and fewer sweetened drinks and refined carbohydrates.
Cirrhosis: enough protein and energy to protect your muscle, with a late-evening snack to shorten the overnight fast.
Ascites and fluid retention: a sodium limit you can actually keep, so you do not end up eating less overall.
Checking for deficiencies common in liver disease, such as vitamin D, zinc and B vitamins, especially with alcohol use.
Coordinating with your hepatologist or gastroenterologist around medications, procedures and alcohol.
What the evidence says
In MASLD, losing at least 5% of body weight reduces liver fat; 7 to 10% can improve inflammation, and 10% or more can improve scarring (fibrosis).
European guidelines recommend 1.2 to 1.5 g of protein per kg of body weight a day in cirrhosis; restricting protein is no longer advised for most people.
A moderate sodium limit, about 2,000 mg a day, is used for ascites; stricter limits often backfire by cutting your overall intake.
Sweetened drinks and alcohol both add to liver fat; for most types of liver disease, alcohol is best avoided entirely.
Your nutrition care
Nutrition care for liver disease starts with a full assessment: your medical history, current medications, recent lab results, weight history and the way you actually eat. From there your Registered Dietitian builds a plan around your diagnosis, your treatment goals and the foods you like, and adjusts it at each follow-up as your results come in.
We see patients in person at our Ottawa and Gatineau clinics and by secure video across Ontario and Quebec, so you can keep appointments between medical visits without travelling. With your consent, we share the plan with your physician or specialist team so everyone is working from the same numbers.
Not sure where to start? Book a free initial consultation. We will go over your situation, answer your questions and tell you honestly whether nutrition therapy is likely to help.
Book NowQuestions about nutrition care for liver disease
Can fatty liver disease be reversed with diet?
Often, yes. In metabolic dysfunction-associated steatotic liver disease (MASLD, formerly NAFLD), losing 7 to 10 % of body weight reduces liver fat and can improve inflammation and even scarring. A Mediterranean-style pattern, less added sugar, especially from sweetened drinks, and little or no alcohol all help, even before weight changes.
I have cirrhosis. Should I limit protein?
Usually not. Protein restriction is no longer recommended for most people with cirrhosis, who often lose muscle and need more protein, around 1.2 to 1.5 g per kg of body weight per day, plus a late-evening snack to shorten the overnight fast. Your dietitian adjusts this to your stage and to complications such as fluid retention.
How strict should my sodium limit be with ascites?
A moderate limit, around 2,000 mg of sodium a day, is commonly recommended when fluid builds up in the abdomen. Stricter limits can make food so unappealing that you eat less and lose more muscle, so we aim for a balance you can keep.
Is coffee good or bad for my liver?
Studies consistently link regular coffee drinking with slower progression of liver scarring. It is not a treatment on its own, but for most people with liver disease there is no reason to give it up.
Can I see a dietitian for liver disease online?
Yes. We offer secure video appointments across Ontario and Quebec, as well as in-person visits at our Ottawa and Gatineau clinics. Online visits include the same assessment, plan and follow-ups.
Sources and guidelines
This page is general information, not individual advice. Your dietitian sets your own targets.