This document discusses nutrition and liver diseases. It begins by providing an overview of liver anatomy and functions. The liver plays a key role in metabolizing nutrients, storing vitamins and minerals, filtering blood, and converting ammonia to urea. Chronic liver diseases can develop from viral infections, alcohol use, toxins, and autoimmune conditions. Cirrhosis is a common end-stage result, severely damaging liver structure and function. Malnutrition is common in cirrhosis patients due to reduced food intake and absorption. Treatment focuses on meeting calorie, protein, sodium, fluid and vitamin needs. Jaundice and hepatitis are also discussed, including causes, symptoms and dietary recommendations like hydration and avoiding alcohol.

1. Nutrition and liver
diseases
Presented by
Dr.P.Nazni
Reader & Head i/c
Department of Food Science
Periyar University
Salem 636 011, Tamilnadu, India

2. Liver
 The liver is located in the
upper right-hand portion of
the abdominal cavity,
beneath the diaphragm, and
on top of the stomach, right
kidney, and intestines.
Shaped like a cone, the liver
is a dark reddish-brown
organ that weighs about 3
pounds.

3. Why it’s called a “Liver”
 Synthesizes
 Clotting factor
 Albumin
 Glycogen
 Stores
 Glycogen
 Albumin
 Fat soluble
Vitamins
 Metabolizes
 Medications
 Toxins
 Amino acids

4. Functions of the Liver:
A Brief Overview
 Largest organ in body, integral to most
metabolic functions of body, performing over
500 tasks
 Only 10-20% of functioning liver is required to
sustain life
 Removal of liver will result in death within 24
hours

5. Functions of the Liver
 Main functions include:
 Metabolism of CHO, protein, fat
 Storage/activation vitamins and minerals
 Formation/excretion of bile
 Steroid metabolism, detoxifier of drugs/alcohol
 Action as (bacteria) filter and fluid chamber
 Conversion of ammonia to urea
 Gastrointestinal tract significant source of ammonia
 Generated from ingested protein substances that are
deaminated by colonic bacteria
 Ammonia enters circulation via portal vein
 Converted to urea by liver for excretion

6. Liver Diseases
 Duration
 Acute vs Chronic
 Pathophysiology
 Hepatocellular vs
Cholestasic
 Etiology
 Viral
 Alcohol
 Toxin
 Autoimmune
 Stage/Severity
 ESLD
 Cirrhosis
Viral hepatitis A, B, C, D, E (and G)
Alcoholic liver disease
Non-alcoholic liver disease
Cholestatic liver disease
Hepatocellular carcinoma
Inherited disorders
Classifications

7. Cirrhosis is common
end result of many
chronic liver disorders
 Severe damage to structure &
function of normal cells
 Inhibits normal blood flow
 Decrease in # functional hepatocytes
 Results in portal hypertension &
ascites
 Portal systemic shunting
Blood bypasses the liver via shunt,
thus bypassing detoxification
Toxins remain in circulating blood
Neurtoxic substances can precipitate
hepatic encephalopathy

8. www.gutfeelings.com/ CRLIVER.JPG
www.gicare.com/ pated/gifs/elv0004.gif
Fatty liver

9. Normal healthy liver, surface is smooth
and uniform
Sever cirrhosis, surface is very nodular
www.gihealth.com/ newsletter/34/two_livers.jpg

10. Complications of liver cirrhosis
 Portal hypertension
 Esophageal varices (EV)
 Ascites
 Hyperammonaemia
 Hepatic encephalopathy (HE)
 Hepatorenal syndrome

11. www.murrasaca.com/ Hepaticirrosis.htm

12.  Malnutrition is an early and typical aspect
of hepatic cirrhosis.
 70% of p’t with cirrhosis have signs of
PT/Cal malnutrition.

13. Way to lead malnutrition
 food intake (anorexia, nausea, drugs)
 malabsorption
 energy and PT requirement
 paracenthesis induced PT loss
 complications

14. Nutrition in the complications of liver
cirrhosis
 Calories (Cal)
 Fat
 Protein (PT)
 Carbohydrate (CHO)
 Sodium (Na)
 Fluid
 Vitamins

15.  Total Cal=30 kcal/kg
 Fat=30-35% of total Cal
 PT=1g/kg/d
CHO=remainder of the Cal requirement
 Na : not exceed 2g(88mmol)/d
 Daily sodium intake :
130 (mmol/kg) * wt change (kg/d) + 24h urinary
Na (mmol/d) – 10 (mmol/d)
 Na free diet : energy, PT, lean body mass
 Na intake should be restricted before fluid
 Fluid : no need to restrict at the beginning
 Vitamins : supplement water and fat solutable vit.(B1,
B12, folate, A, D, E, K)

16. Jaundice
 Jaundice is not a disease but rather a sign that can occur in many
different diseases. Jaundice is the yellowish staining of the skin
and sclerae
Yellow coloration of the eyes, skin,
tongue and urine.
Loss of appetite.
Dull pain in the liver region.
Nausea,
severe constipation,
extreme weakness.
Fever,
headache and undue fatigue.
Symptoms of Jaundice

17. Causes of jaundice
 Blockage in the bile ducts
 Gallstones.
 Hepatitis virus,
 Typhoid, cancer, malaria, and anemia.
 Improper or short flow of the blood in
the liver
 Tuberculosis, and yellow fever.
 It can be inborn.
 Red blood corpuscles in able to
function properly.
 There is problem in the functioning of
liver.

18. Jaundice Diet
 Barley water, fruit juices are
effective.
 Do not give fatty foods and also
avoid foods which agitate stomach.
 Do not give cereals and pulses.
 In case of fever give fruit diet and
fresh fruit juices to drink and to take
good rest.
 Grapes, black soya beans, nuts,
sweet potatoes are effective fruits for
jaundice patients.
Barley water
fruit juices

19. Natural treatment for Jaundice
 Take half to one teaspoon of papaya leaves paste and add
half to one tablespoon of honey and mix it well. Eat this
regularly for one-two week.
 Take 10-15 basil leaves (tulsi leaves) and make its paste;
add this in a half glass of freshly made radish juice.
 Amla
 Drink lemon juice
 Take 7-10 leaves (dry) of snake gourd and boil in a cup of
water. Boil 10-15 coriander seeds in half liter water.
mixture of snake gourd along with coriander solution three
times a day.
 Orange juice

20. Hepatitis
 Hepatitis (plural hepatitides) implies inflammation of the liver
characterized by the presence of inflammatory cells in the tissue of
the organ.
Types of hepatitis
Hepatitis A - This is caused by eating infected food or water
 Hepatitis B - This is an STD (sexually transmitted disease). It is caused by
the virus HBV (Hepatitis B Virus)
-Unprotected sexual intercourse
-Using a syringe that was used by an infected person
-A baby can become infected through his mother's milk if
she is infected.
- Being bitten by someone who is infected.
Hepatitis C - Hepatitis C is usually spread through direct contact with
the blood of a person who has the disease.
Hepatitis D - Only a person who is already infected with Hepatitis B.
Hepatitis E - A person can become infected by drinking water that
contains HEV (Hepatitis E Virus).
Hepatitis X - Hepatitis of an unknown virus.
Hepatitis G - This is a type of hepatitis caused by the Hepatitis G virus
(HGV).

21. Signs and Symptoms of Hepatitis?
 The acute phase of hepatitis
Diarrhea
 Fatigue
 Loss of appetite
 Mild fever
 Muscle or joint aches
 Nausea
 Slight abdominal pain
 Vomiting
 Weight loss
 The acute phase is not usually
dangerous,

22. Diet therapy
 Hydration
 No alcohol
 Low fat, moderate protein, high CHO diet,
high calorie
 Small frequent meals
 Vit B, C, K

23. Thank You!