Nutrition in Chronic Liver Disease

  • Yala Kirthi Reddy
  • Benedict Maliakkal
  • Uchenna AgbimEmail author
Nutrition and Obesity (O Pickett-Blakely, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Obesity and Nutrition


Purpose of review

Malnutrition is a common finding in patients with chronic advanced liver disease (CLD) and is an important prognostic predictor for morbidity and mortality. This review aims to summarize the latest evidence-based guidelines and expert opinion regarding diagnosing malnutrition in patients with CLD and providing optimal solutions.

Recent findings

In addition to diet, evidence demonstrates sarcopenia and frailty are emerging concepts critical to outcomes in those with CLD. Thus, adequate assessment of nutritional status incorporates the interplay of nutrient intake, sarcopenia, and frailty.


Addressing malnutrition in patients with CLD requires understanding the multifactorial mechanisms contributing to nutritional deficiencies, but also careful assessment of functional capacity. Interventions mitigating or reversing sarcopenia and frailty are equally important to nutritional supplementation. While the latency period between compensated and decompensated cirrhosis provides a good window for fruitful interventions, we believe providers need to be vigilant early on the course of CLD to maximize nutritional gains and halt muscle loss.


Nutrition Malnutrition Cirrhosis Liver disease Sarcopenia Frailty 



Alcoholic liver disease


Appendicular skeletal muscle index


Branch chain amino acids


Bioelectrical impedance analysis


Body mass index


Chronic liver disease


Computed tomography


Dual energy X-ray absorptiometry


Diabetes mellitus


European Association for the Study of the Liver


Enteral nutrition


Glycosylated hemoglobin


Hepatocellular carcinoma


Hepatic encephalopathy


β-Hydroxy β-methylbutyrate


Large-volume paracentesis


Mid-arm muscle circumference


Model for end-stage liver disease


Magnetic resonance imaging


Mammalian target of rapamycin


Non-alcoholic fatty liver disease


Non-alcoholic steatohepatitis


Non-exercise activity thermogenesis


Parenteral nutrition


Resting energy expenditure


Spontaneous bacterial peritonitis


Small intestinal bacterial overgrowth


Skeletal muscle index


Compliance with Ethical Standards

Conflict of Interest


References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Yala Kirthi Reddy
    • 1
  • Benedict Maliakkal
    • 2
    • 3
  • Uchenna Agbim
    • 2
    • 3
    Email author
  1. 1.Department of MedicineUniversity of Tennessee Health Science CenterMemphisUSA
  2. 2.Division of Transplant Surgery, Department of SurgeryUniversity of Tennessee Health Science CenterMemphisUSA
  3. 3.Methodist Transplant InstituteMethodist University HospitalMemphisUSA

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