title: Dietary protein intakes in patients with hepatic encephalopathy and cirrhosis: current practice in NSW and ACT.
abstract: OBJECTIVE
  To ascertain whether current practice in teaching hospitals in New South Wales and the Australian Capital Territory delivers adequate dietary protein in the management of malnutrition in adults with cirrhosis, in accordance with European Society for Clinical Nutrition and Metabolism (ESPEN) guidelines for nutrition in liver disease.
  
  
  METHODS
  Cross-sectional study of dietitians using a self-administered, mail-back survey.
  
  
  METHODS
  Teaching hospitals in NSW and the ACT treating patients with cirrhosis.
  
  
  METHODS
  Dietitians seeing patients with cirrhosis in the 12 months prior to completing the survey.
  
  
  METHODS
  Current dietary protein prescription practice for patients with cirrhosis (with and without hepatic encephalopathy); use of nutritional supplements and enteral feeding for malnourished patients with cirrhosis.
  
  
  RESULTS
  Dietitians following the ESPEN guidelines were in the minority: 36% of the dietitians recommended an adequate protein intake for patients with hepatic encephalopathy. Sixty-four per cent of the dietitians had received referrals from the medical team requesting inappropriate protein-restricted diets for patients without hepatic encephalopathy. Seventy-eight per cent of the dietitians requested clarification of the recommended nutritional management of patients with cirrhosis.
  
  
  CONCLUSIONS
  Many medical and dietetic staff inappropriately restrict protein intake of patients with cirrhosis.
authors.affiliation: A W Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Sydney, NSW, Australia. joanne.heymanATcs.nsw.gov.au
authors.forename: Joanne K
authors.initials: JK
authors.lastname: Heyman
authors.forename: Carol J
authors.initials: CJ
authors.lastname: Whitfield
authors.forename: Kaye E
authors.initials: KE
authors.lastname: Brock
authors.forename: Geoffrey W
authors.initials: GW
authors.lastname: McCaughan
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Donaghy
mesh_terms: D000328:Adult; D020958:Australian Capital Territory; D002985:Clinical Protocols; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004044:Dietary Proteins / Q000008:administration & dosage*; D019587:Dietary Supplements; D004750:Enteral Nutrition; D006501:Hepatic Encephalopathy / Q000150:complications*; D006784:Hospitals, Teaching; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D044342:Malnutrition / Q000178:diet therapy; D009517:New South Wales; D012189:Retrospective Studies
chemical_list: D004044:Dietary Proteins