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Nutrition in Chronic Liver Disease

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

Abstract

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.

Summary

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.

Keywords

Nutrition Malnutrition Cirrhosis Liver disease Sarcopenia Frailty 

Abbreviations

ALD

Alcoholic liver disease

ASMI

Appendicular skeletal muscle index

BCAAs

Branch chain amino acids

BIA

Bioelectrical impedance analysis

BMI

Body mass index

CLD

Chronic liver disease

CT

Computed tomography

DEXA

Dual energy X-ray absorptiometry

DM

Diabetes mellitus

EASL

European Association for the Study of the Liver

EN

Enteral nutrition

HBA1c

Glycosylated hemoglobin

HCC

Hepatocellular carcinoma

HE

Hepatic encephalopathy

HMB

β-Hydroxy β-methylbutyrate

LVP

Large-volume paracentesis

MAMC

Mid-arm muscle circumference

MELD

Model for end-stage liver disease

MRI

Magnetic resonance imaging

mTOR

Mammalian target of rapamycin

NAFLD

Non-alcoholic fatty liver disease

NASH

Non-alcoholic steatohepatitis

NEAT

Non-exercise activity thermogenesis

PN

Parenteral nutrition

REE

Resting energy expenditure

SBP

Spontaneous bacterial peritonitis

SIBO

Small intestinal bacterial overgrowth

SMI

Skeletal muscle index

Notes

Compliance with Ethical Standards

Conflict of Interest

None.

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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