Making certain changes to your diet may help you better manage your primary biliary cholangitis (PBC).

PBC is a chronic condition involving inflammation in the small bile ducts in your liver. The small bile ducts are tubes that carry bile, a fluid containing acids that help break down the fats in food.

Chronic inflammation in your small bile ducts can damage and eventually destroy them, causing bile to build up in your liver. This leads to liver damage and liver scarring, which may eventually cause liver failure.

Other common complications of PBC include:

  • high cholesterol levels
  • osteoporosis (low bone mass)
  • low levels of fat-soluble vitamins (vitamins A, D, E, and K)

Your doctor will prescribe medication to help slow down liver damage, manage symptoms, and prevent or manage complications from PBC.

They may also recommend certain changes to your eating habits, recommend certain dietary supplements, or refer you to a registered dietitian for support.

Read on to learn about some of the foods that may be helpful to eat, limit, or avoid.

There’s no single diet or eating plan recommended for people with PBC. Your dietary needs may change over time, depending on your overall health and how PBC is affecting you.

Eating a wide variety of fruits, vegetables, whole grains, nuts, seeds, and lean proteins can help you get the vitamins, minerals, and other nutrients your body needs.

Fruits and vegetables

The United States Department of Agriculture recommends filling half your plate with fruits and vegetables at every meal.

It’s best to eat a wide variety of fruits and vegetables of different colors to get a variety of nutrients.

For example:

  • Green leafy vegetables tend to be rich sources of vitamins A, E, and K, as well as calcium. Examples include spinach, collard greens, turnip greens, kale, and broccoli.
  • Orange and yellow fruits and vegetables are high in vitamin A. Examples include carrots, sweet potatoes, winter squash, summer squash, sweet bell peppers, cantaloupe, mangoes, and apricots.
  • Soybeans, pinto beans, and some other types of legumes are good sources of calcium.
  • Tomatoes are rich in vitamin A.

Fruits and vegetables are rich sources of soluble fiber too. Soluble fiber helps block your body’s absorption of cholesterol, which may help prevent or lower high blood cholesterol levels associated with PBC.

Whole grains

Whole grains are a great source of dietary fiber, which is beneficial for managing blood cholesterol levels.

Examples of whole grains include:

  • oat groats, rolled oats, and steel cut oats
  • whole wheat
  • whole barley
  • whole-grain rye
  • brown rice
  • buckwheat
  • quinoa
  • millet
  • corn

Some whole grain breakfast cereals and other products are also fortified with vitamin A, vitamin D, or calcium.

Nuts and seeds

Nuts and seeds are rich sources of dietary fiber, unsaturated fats, and other nutrients.

The following nuts and seeds are particularly high in vitamin E:

  • hazelnuts
  • peanuts
  • pine nuts
  • sunflower seeds

Nuts and seeds are calorie-dense, which means they provide a lot of calories per serving.

Fatty fish

Fatty fish are rich in vitamin D, protein, and unsaturated fats.

Dietary fats help your body absorb fat-soluble vitamins (vitamins A, D, E, and K).

It’s important to choose the right sources of dietary fat: The unsaturated fats in fatty fish are easier to digest than saturated fats because they require smaller amounts of bile acids to break down.

Examples of fatty fish include:

  • mackerel
  • rainbow trout
  • salmon
  • sardines
  • bluefin tuna

Canned salmon and canned sardines contain edible fish bones, which are also a good source of calcium.

Limiting alcohol, saturated fats, added sugars, and sodium may help reduce your risk of certain complications and support your overall health with PBC.

It’s also important to take steps to manage your risk of foodborne illness (also known as food poisoning).

Alcohol

Alcohol consumption can damage your liver, increasing your risk of:

  • fibrosis (liver scarring)
  • cirrhosis (severe liver scarring)
  • liver failure

It’s safest to avoid alcohol entirely if you have PBC.

If you choose to continue to drink alcohol, try to limit the amount you consume.

Talk with your doctor if you’re finding it difficult to avoid or limit alcohol. They may recommend counseling, medication, or both to help you make changes.

Foods high in saturated fat

Saturated fats are harder to digest when you have PBC because they require larger amounts of bile acids to break down than unsaturated fats do.

The American Heart Association warns that eating a diet high in saturated fats may also raise your levels of LDL cholesterol (also known as “bad” cholesterol).

Foods high in saturated fats include:

  • butter, cream, and other high fat dairy products
  • fatty cuts of beef, pork, lamb, and poultry
  • certain types of baked goods and fried foods

Dairy is rich in vitamin D and calcium, so your doctor or registered dietitian may encourage you to continue to eat dairy products but choose low fat options.

Foods high in added sugars

A diet that’s high in added sugars may contribute to fatty liver disease, according to a 2023 research review. Having both PBC and fatty liver disease increases your risk of liver damage.

Foods that are high in added sugars include:

  • many baked goods, candies, and other sweets
  • sugar-sweetened sodas and fruit drinks
  • sweetened breakfast cereals and snack bars

Talk with your doctor or registered dietitian to learn how to identify and reduce sources of added sugars.

Foods high in sodium

Depending on your current eating habits and health needs, your doctor or registered dietitian might encourage you to reduce your sodium intake.

Reducing sodium in your diet may help ease symptoms of edema or ascites, which affect some people with PBC. Edema is swelling that’s caused by fluid buildup in your tissues. Ascites is fluid buildup in your abdomen.

Examples of high sodium foods and ingredients include:

  • many types of processed and packaged foods
  • many types of pickles, condiments, and seasoning blends
  • table salt, sea salt, and other types of salt

Talk with your doctor or dietitian to learn how much sodium you should eat per day. They can teach you how to properly read food labels to learn how much sodium products contain, as well as how to choose and prepare lower sodium snacks and meals.

Foods that increase your risk of foodborne illness

  • raw or undercooked meat, including red meat and poultry
  • raw or undercooked fish and shellfish
  • unpasteurized milk

These foods may carry bacteria or viruses that can cause potentially severe infections.

You can reduce your risk of foodborne illness by cooking foods to safe internal temperatures:

  • 145°F (74°C) for fish and whole cuts of beef, veal, lamb, and pork
  • 160°F (71°C) for ground beef, veal, lamb, and pork
  • 165°F (74°C) for poultry, casseroles, and leftovers

Here are a few more tips to reduce your risk of foodborne illness:

  • Wash your hands, utensils, cutting boards, and countertops well before and after you prepare or eat food.
  • Store raw animal products separately from other foods and use a different cutting board for raw animal products than for foods you don’t plan to cook.
  • Promptly refrigerate or freeze perishable foods after you buy or cook them.

Your doctor or registered dietitian might recommend that you take certain dietary supplements, such as:

  • calcium and vitamin D supplements to help prevent or limit osteoporosis
  • vitamin A, D, E, or K supplements to increase the level of these nutrients in your body

Always talk with your doctor or dietitian before you start taking a new dietary supplement. They can help you understand the potential benefits and risks, as well as the safe amount to take.

Your doctor may prescribe medication to help treat PBC and manage potential complications.

Making certain dietary changes may also help you manage this condition. Your doctor or registered dietitian can help you learn which foods may be helpful to eat, as well as which foods to limit or avoid.

Eating a wide variety of fruits, vegetables, whole grains, nuts, seeds, and lean proteins can help you get the nutrients your body needs. Sometimes your doctor or dietitian might also recommend certain vitamin or mineral supplements.

Your doctor will advise you to limit or avoid alcohol. Depending on your current eating habits and needs, they may also encourage you to reduce the amount of saturated fat, added sugars, or sodium in your diet.

Taking steps to avoid foodborne illness is also important for protecting your health.