Nutrition in liver disease.
OBJECTIVE
The aim of this paper is to describe the relevant medical literature published between spring 2003 and spring 2005 in the field of malnutrition in liver disease and its management.


RESULTS
The most relevant articles covered in this paper provide data regarding the absence of energy imbalance in patients with stable cirrhosis, thus arguing against its potential role in the development of malnutrition; the increase in body cell mass and muscle mass as the major components of weight gain after portal-systemic shunting; the largest published randomized controlled trial of the positive effect of branched-chain amino acid supplements on the long-term outcome of patients with cirrhosis; studies using stable isotope labeled substrates, suggesting that dietary fat could be absorbed via the portal vein in patients with cirrhosis; and a randomized controlled trial suggesting the possibility that probiotics may decrease the infection rate after liver transplantation.


CONCLUSIONS
In spite of the data provided by these and other articles described in the review, the major controversial issues in the field of nutritional management of liver disease remain open. Particularly remarkable is the lack of consensus regarding the nutritional management of acute liver failure.
Cabré
Eduard
E
Department of Gastroenterology, Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain. ecabre@ns.hugtip.scs.es
Gassull
Miquel A
MA
D004734:Energy Metabolism / Q000502:physiology; D006801:Humans; D008107:Liver Diseases / Q000150:complications* / Q000178:diet therapy / Q000628:therapy; D016031:Liver Transplantation; D044342:Malnutrition / Q000178:diet therapy / Q000209:etiology* / Q000628:therapy*; D009747:Nutritional Physiological Phenomena; D009751:Nutritional Requirements; D018529:Nutritional Support; D012720:Severity of Illness Index