title: A randomized trial of exercise and dietary counseling after liver transplantation.
abstract: We report results of a randomized clinical trial of a combined intervention of exercise and dietary counseling (ExD) after orthotopic liver transplantation (OLT). Of the 151 patients randomized into ExD or usual care (UC), 119 completed testing 2, 6 and 12 months post-OLT. Testing included assessment of exercise capacity (VO(2peak)), quadricep muscle strength, body composition (DXA), nutritional intake (Block 95) and health-related quality of life (SF-36). The intervention consisted of individualized counseling and follow-up to home-based exercise and dietary modification. Repeated measure ANOVA was performed to determine differences over time between ExD and UC with a secondary analysis to determine differences over time between adherers (Adh), nonadherers (Nadh) to the intervention and UC. The ExD group showed greater increases in VO(2peak) (p = 0.036), and self-reported general health (p = 0.038) compared to UC. Both groups demonstrated increases in muscle strength, body weight, body fat and other SF-36 scale scores. Adherence to the intervention was 37% with positive trends in VO(2peak) and body composition observed in Adh compared to Nadh and UC. These data suggest improvements in exercise capacity and body composition are achieved with nutrition and exercise behavior modifications initiated early after OLT and with regular follow-up.
authors.affiliation: Department of Physiological Nursing, University of California, San Francisco, USA. joanne.krasnoff@nursing.ucsf.edu
authors.forename: J B
authors.initials: JB
authors.lastname: Krasnoff
authors.forename: A Q
authors.initials: AQ
authors.lastname: Vintro
authors.forename: N L
authors.initials: NL
authors.lastname: Ascher
authors.forename: N M
authors.initials: NM
authors.lastname: Bass
authors.forename: S M
authors.initials: SM
authors.lastname: Paul
authors.forename: M J
authors.initials: MJ
authors.lastname: Dodd
authors.forename: P L
authors.initials: PL
authors.lastname: Painter
mesh_terms: D000273:Adipose Tissue / Q000473:pathology; D001827:Body Height; D001835:Body Weight; D004032:Diet; D015444:Exercise; D005260:Female; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D009132:Muscles / Q000502:physiology; D011788:Quality of Life; D013997:Time Factors