Aim: The aim of this study was to determine the relation between different food groups intake, nutritional status of cirrhotic patient and the stage of the disease.
Background: Protein-energy malnutrition (PEM) is a common problem in cirrhotic patients. Food intake assessment is highly important in the investigation regarding the health-disease process.
Methods: In this cross-sectional study, sixty eight ambulatory cirrhotic patients, with a mean age of 54 years, were included. In order to assess the stage of the disease and malnutrition status, Child-Pugh score and Subjective Global Assessment index were used respectively. Dietary intakes were assessed using a 168-item semi-quantitative validated food frequency questionnaire. Odds ratios (OR) and the corresponding 95% confidence intervals (CI) were computed, using logistic regression models.
Results: After adjustment for confounders, we found significant inverse relations between intakes of nuts (OR=0.140, CI=0.031-0.625) and olive (OR=0.212, CI=0.049-0.917) with severity of disease and boiled potatoes (OR=0.154, CI=0.040-0.592) and legumes (OR=0.090, CI=0.020-0.406) with malnutrition status. Inversely, solid fats (OR=3.324, CI=1.080-10.238) and mayonnaise (OR=5.215, CI=1.203-22.612) were positively associated with disease severity and malnutrition, respectively.
Conclusion: These findings suggest that selection of healthy foods was negatively associated with severity of hepatic cirrhosis whereas unhealthy food groups had a positive relation with disease severity and malnutrition.
Keywords: food groups, hepatic cirrhosis, malnutrition, Child-Pugh score.
(Please cite as: Pashayee-khamene F, Saber-firoozi M, Hatami B, Hekmatdoost A, Rashidkhani B, Aghamohammadi V, et al. Food groups intake of cirrhotic patients, comparison with the nutritional status and disease stage. Gastroenterol Hepatol Bed Bench 2019;12(3):226-232).
Carvalho L, Parise ER. Evaluation of nutritional status of nonhospitalized patients with liver cirrhosis. Arq Gastroenterol 2006;43:269-74.
Nunes FF, Bassani L, Fernandes SA, Deutrich ME, Pivatto BC, Marroni CA. Food consumption of cirrhotic patients, comparison with the nutritional status and disease staging. Arq Gastroenterol 2016;53:250-6.
Huisman EJ, Trip EJ, Siersema PD, van Hoek B, van Erpecum KJ. Protein energy malnutrition predicts complications in liver cirrhosis. Eur J Gastroenterol Hepatol 2011;23:982-9.
Manguso F, D'Ambra G, Menchise A, Sollazzo R, D'Agostino L. Effects of an appropriate oral diet on the nutritional status of patients with HCV-related liver cirrhosis: a prospective study. Clin Nutr 2005;24:751-9.
Gunsar F, Raimondo ML, Jones S, Terreni N, Wong C, Patch D, et al. Nutritional status and prognosis in cirrhotic patients. Aliment Pharmacol Ther 2006;24:563-72.
EASL Clinical Practice Guidelines on nutrition in chronic liver disease. J Hepatol 2019;70:172-193.
Ehsani Ardakani MJ, Safaei A, Arefi Oskouie A, Haghparast H, Haghazali M, Mohaghegh Shalmani H, et al. Evaluation of liver cirrhosis and hepatocellular carcinoma using Protein-Protein Interaction Networks. Gastroenterol Hepatol Bed Bench 2016;9:S14-22.
Mirmiran P, Esfahani FH, Mehrabi Y, Hedayati M, Azizi F. Reliability and relative validity of an FFQ for nutrients in the Tehran lipid and glucose study. Public Health Nutr 2010;13:654-62.
Detsky AS, McLaughlin JR, Baker JP, Johnston N, Whittaker S, Mendelson RA, et al. What is subjective global assessment of nutritional status? JPEN J Parenter Enteral Nutr 1987;11:8-13.
Yari Z, Rahimlou M, Poustchi H, Hekmatdoost A. Flaxseed Supplementation in Metabolic Syndrome Management: A Pilot Randomized, Open-labeled, Controlled Study. Int J Food Sci Nutr 2016;30:1339-44.
Juakiem W, Torres DM, Harrison SA. Nutrition in cirrhosis and chronic liver disease. Clin Liver Dis 2014;18:179-90.
Thandassery RB, Montano-Loza AJ. Role of Nutrition and Muscle in Cirrhosis. Curr Treat Option On 2016;14:257-73.
McClain CJ. Nutrition in Patients With Cirrhosis. J Gastroenterol Hepatol 2016;12:507-10.
Anand AC. Nutrition and Muscle in Cirrhosis. J Clin Exp Hepatol 2017;7:340-57.
Bemeur C, Butterworth RF. Nutrition in the management of cirrhosis and its neurological complications. J Clin Exp Hepatol 2014;4:141-50.
Soto-Alarcon SA, Valenzuela R, Valenzuela A, Videla LA. Liver Protective Effects of Extra Virgin Olive Oil: Interaction between Its Chemical Composition and the Cell-signaling Pathways Involved in Protection. Endocr Metab Immune Disord Drug Targets 2018;18:75-84.
Jenkins DJ, Thorne MJ, Taylor RH, Bloom SR, Sarson DL, Jenkins AL, et al. Slowly digested carbohydrate food improves impaired carbohydrate tolerance in patients with cirrhosis. Clin sci 1984;66:649-57.
Gupta V, Mah X, Garcia MC, Antonypillai C, Poorten DVD. Oily fish, coffee and walnuts: Dietary treatment for nonalcoholic fatty liver disease. World J Gastroenterol 2015;21:10621-35.
Weber FL, Jr., Minco D, Fresard KM, Banwell JG. Effects of vegetable diets on nitrogen metabolism in cirrhotic subjects. Gastroenterol 1985;89:538-44.
Bianchi GP, Marchesini G, Fabbri A, Rondelli A, Bugianesi E, Zoli M, et al. Vegetable versus animal protein diet in cirrhotic patients with chronic encephalopathy. A randomized cross-over comparison. J Intern Med 1993;233:385-92.