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Entry ID
117
Entry Date
September 13, 2022 6:32 pm
Reference Id
i5JosXetMDkvGVRd
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Document Status
Published
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Language
English
Year
2020
Category
Presentation Preference
Title
Effects of registered dietitian counselling on dietary composition and malnutrition indices in cirrhosis patients
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Introduction/Purpose
In patients with cirrhosis, access to nutrition therapy for patients by a registered dietitian (RD) can be limited and little efficacy data exists.
Objective(s)/Process or Summary of Content
This observational study aimed to: 1) describe dietary intake, using an adapted Mediterranean diet Score (aMDS,13-point scale) along with calorie and protein intakes; 2) describe disease severity and malnutrition status using Meld-Na, Child Pugh(CP), handgrip strength (HGS), and subjective global assessment (SGA), and; 3) describe efficacy of nutrition therapy.
Method(s)/Systemic Approach Used
Malnourished outpatients (SGA B/C) with decompensated cirrhosis were recruited in Calgary, Alberta. Patients received an 8-week, RD-led intervention promoting increased protein and calories and Mediterranean diet (MD) behaviours. Three-day food records and malnutrition indices were collected at baseline and 8-weeks. Data is reported as proportions, and means and standard deviations or medians and interquartile range (IQR). Data was analyzed using paired sample t-tests.
Results/Conclusions
Nine patients were recruited and at 8-weeks seven completed all assessments. Participants were diagnosed with alcohol-related cirrhosis except one who was diagnosed with primary biliary cirrhosis, were 55% female, 62.3±10.9 years, dry body mass index (BMI)=21.3 ± 3.1
kg/m2, Meld-Na=11.0 ±3.9, CP=6.8±1.8, HGS=25.2±3.1kg, had a SGA=B, median caloric intake=2095 (IQR=1626-2515) kcal, median protein intake= 84 (IQR=67-107)grams, and a median aMDS score=5.0(IQR=2.5-5). At 8-weeks only HGS increased significantly to 27.4±6.8kg (p = 0.02). Although not significant, both calories and protein increased to 2595 (IQR=1906-2847)kcal and 88 (IQR=86-117)grams. Four patients also improved their aMDS score. The following MD behaviours improved: increased consumption of nuts (n=6), fish (n=3), legumes (n=1), and decreased sweets and baked goods (n=5).
kg/m2, Meld-Na=11.0 ±3.9, CP=6.8±1.8, HGS=25.2±3.1kg, had a SGA=B, median caloric intake=2095 (IQR=1626-2515) kcal, median protein intake= 84 (IQR=67-107)grams, and a median aMDS score=5.0(IQR=2.5-5). At 8-weeks only HGS increased significantly to 27.4±6.8kg (p = 0.02). Although not significant, both calories and protein increased to 2595 (IQR=1906-2847)kcal and 88 (IQR=86-117)grams. Four patients also improved their aMDS score. The following MD behaviours improved: increased consumption of nuts (n=6), fish (n=3), legumes (n=1), and decreased sweets and baked goods (n=5).
Conclusions(s)/Recommendations
A RD-led intervention appeared to improve caloric and protein intake and MDS. HGS also showed slightly improved muscle strength.
Significance to Dietetics
RDs may find it valuable to track caloric intake, protein grams, MD scores and HGS over time to monitor the success of nutrition therapy in cirrhosis patients.
Funded by
Cumming School of Medicine Seed Grant, University of Calgary
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