ABSTRACT
Introduction .................................................................................................................................... 140 Etiology of Nutritional Abnormalities in Patients with Liver Disease .......................................... 140
Decreased Appetite.................................................................................................................... 140 Abdominal Pain ......................................................................................................................... 140 Dietary Alterations .................................................................................................................... 140 Steatorrhea................................................................................................................................. 141 Malabsorption ........................................................................................................................... 141 Hypermetabolism ...................................................................................................................... 142
Macronutrient Consumption Requirements for Patients with Liver Disease ................................. 142 Protein ....................................................................................................................................... 142
Dietary Recommendations for Protein and Energy .............................................................. 143 Carbohydrates ........................................................................................................................... 143
Dietary Recommendations for Carbohydrate ....................................................................... 143 Fat .............................................................................................................................................. 144
Dietary Recommendations for Fat ....................................................................................... 144 Type of Fat ............................................................................................................................ 144 Cholesterol ........................................................................................................................... 145
Nutrition and Cirrhosis .................................................................................................................. 145 Dark Chocolate.......................................................................................................................... 145 Caffeine ..................................................................................................................................... 145 Green Tea .................................................................................................................................. 146 Fruit ........................................................................................................................................... 146 Role of Branch Chain Amino Acids .......................................................................................... 147
Complications of Cirrhosis ............................................................................................................ 147 Ascites ....................................................................................................................................... 147 Hepatic Encephalopathy ............................................................................................................ 148
Role of Diet .......................................................................................................................... 148 Role of Probiotics ................................................................................................................. 149 Role of Branch Chain Amino Acids ..................................................................................... 149
Hepatocellular Carcinoma ......................................................................................................... 149 Coffee and HCC ................................................................................................................... 149 Lycopene and HCC .............................................................................................................. 150 Selenium and HCC ............................................................................................................... 150 Vitamin A in the Treatment of HCC ..................................................................................... 151 Vitamin K in the Treatment of HCC .................................................................................... 151
A clear understanding of the interplay between nutrition and the liver is essential for any practitioner treating patients with liver disease. Nutritional derangements have been implicated in the pathogenesis of many liver diseases, and nutritional supplementation or restrictions are integral to the treatment of many liver diseases. Alternatively, hepatic dysfunction has a signi˜cant effect on nutritional status, contributing to increased morbidity and mortality. This chapter will address the various etiologies of nutritional abnormalities that occur in patients with liver disease, in addition to discussing the nutritional management of cirrhosis and its complications-hepatic encephalopathy (HE), ascites, and hepatocellular cancer.
