Journal of Nutrition & Food Sciences
Open Access

Abstract

Malnutrition and Sarcopenia in Advanced Liver Disease

Sevastianos VA and Dourakis SP

Sarcopenia as a syndrome characterized by the progressive and generalized loss of skeletal muscle mass and strength that can lead to adverse outcomes, such as physical disability, poor quality of life, and death. The prevalence of malnutrition in chronic liver disease may range from 20% to 90%. Potentially all patients with cirrhosis are malnourished to some degree due to changes in nutrient ingestion, absorption, and utilization. Sarcopenia is common in liver transplant candidates and recipients and was associated with worse outcomes, including reduced survival. But it is of note that over - weigh or obesity does not exclude sarcopenia even in liver transplanted patients. The diagnosis of sarcopenia requires documentation of both low muscle mass and function. If possible, multidisciplinary, early intervention and aggressive treatment of nutrient deficiencies can prevent the physical downward trend that affects many patients with an advanced liver disease. Referral for transplant evaluation in appropriate patients should occur before the emergence of the clinical evidence of malnutrition. The degree of malnutrition allows the physicians to counsel the patient and family regarding the prognosis before and after transplantation. Frequent meals and nocturnal oral supplements represent a good nutritional strategy for cirrhotics, in order to decrease gluconeogenesis and protein catabolism.