Nutrition Interventions for Liver Disease

Liver disease can have major impacts on nutrition status. Join Beth RD, LDN, CNSC, CSSD as she discusses the signs of liver disease, complications that can arise, and how to approach nutrition assessment and management. This is part 1 of a 2 part video set.
Part 2 focuses on nutrition support for liver disease with a case study and can be found here!
• Nutrition Support for ...
Closed captions provided by Tze Xin Goh, MS, RDN
0:15 Liver functions
1:39 Acute liver disease
2:39 Chronic liver disease
4:09 Complications of liver disease
5:05 High malnutrition risk
6:06 Barriers to PO intake
7:33 Nutrition assessment
8:27 Estimating dry weight
10:44 Nutrition needs
13:45 Goals of nutrition therapy
14:52 Avoiding prolonged fasting
15:50 Vitamin considerations
16:59 Mineral considerations
Resources:
Trefts E, Gannon M, Wasserman DH. The liver. Curr Biol. 2017;27(21):R1147-R1151. doi:10.1016/j.cub.2017.09.019
Kozeniecki M, Ludke R, Kerner J, Patterson B. Micronutrients in Liver Disease: Roles, Risk Factors for Deficiency,
and Recommendations for Supplementation. Nutr Clin Pract. 2020;35(1):50-62. doi:10.1002/ncp.10451
Ghufran A. Nutrition in Chronic Liver Disease: A Point-of-Care Review. Nutr Clin Pract. 2020;35(2):211-217.
doi:10.1002/ncp.10470
Plank LD, Gane EJ, Peng S, et al. Nocturnal nutritional supplementation improves total body protein status of patients with liver
cirrhosis: a randomized 12-month trial. Hepatology. 2008;48(2):557-566. doi:10.1002/hep.22367
Johnson TM, Overgard EB, Cohen AE, DiBaise JK. Nutrition assessment and management in advanced liver disease. Nutr Clin
Pract. 2013;28(1):15-29. doi:10.1177/0884533612469027
Owen OE, Reichle FA, Mozzoli MA, et al. Hepatic, gut, and renal substrate flux rates in patients with hepatic cirrhosis. J Clin
Invest. 1981;68(1):240-252. doi:10.1172/jci110240
Mueller C, Lord LM, Marian M, McClave S, Miller SJ. The Aspen Adult Nutrition Support Core Curriculum. Silver Spring, MD, USA:
American Society for Parenteral and Enteral Nutrition; 2017.
Hasse JM, DiCecco SR. Enteral Nutrition in Chronic Liver Disease: Translating Evidence Into Practice. Nutr Clin Pract.
2015;30(4):474-487. doi:10.1177/0884533615591058

[@DianeMarcil-q9t]

What is too much protein and what about protein drinks ?

[@anitarao8547]

hi love watching the videos so informative. can you pls do a video on how to write weight loss and weight gain note and what interventions to write. thanks Alos if the client is nutritionally stable what interventions one should consider in writing

[@louellaeischen6709]

Thank you for the information.

[@masm3608]

Thanks for this information.

[@virginiainnes9042]

My mom has complete liver failure and is on the transplant list. But she is not doing well at all and the wait has been very long. I have a question: should someone with liver failure (not due to alcohol) restrict their carbohydrates to reduced amounts and increase protein? What amount healthy fats? Thank you and God bless!

[@DietitiansinNutritionSupport]

I’m sorry to hear that your mom is not doing very well. This question is difficult to answer without knowing more about your mom’s medical history. If the reason for her liver failure is non-alcoholic fatty liver disease (NAFLD), there may be some merit in limiting carbohydrate intake and, more specifically, carbohydrates coming from simple sugars, especially fructose. However, if her liver failure is from something else, such as a virus or autoimmune disorder, limiting carbohydrate isn’t necessarily recommended. For the most part, a balanced diet high in fruits, vegetables, and whole grains as the carbohydrate sources will work for most liver patients. Protein and healthy fats are also important parts of the diet. I would encourage you to reach out to a dietitian within the transplant clinic where your mom was evaluated for transplant, as they can offer more concise advice based on your mom’s individual case. Best of luck!
- Beth

[@BevLeeChannel]

How does alcohol or a liquid diet lead to malnutrition?

[@DietitiansinNutritionSupport]

Thanks for your question! Alcohol itself doesn’t necessarily lead to malnutrition, but alcoholic cirrhosis certainly can for multiple reasons, including:
1) Decreased energy and protein intake (drinking alcohol instead of eating a balanced diet)
2) Systemic inflammatory state leading to hypermetabolism
3) Altered nutrient metabolism (the liver plays a significant role in nutrient metabolism, so when it doesn’t work properly…)
4) Malabsorption

[@آلاء-ك8ز4خ]

Keep going 🫡thank you

[@khizrabanu897]

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