Guidelines on nutritional management in Japanese patients with liver cirrhosis from the perspective of preventing hepatocellular carcinoma.
OBJECTIVE
The Japanese Nutritional Study Group for Liver Cirrhosis (JNUS) was assembled in 2008 with the support of a Health Labor Sciences Research Grant from the Ministry of Health, Labor and Welfare of Japan. The goal of the study group was to propose new nutritional guidelines for Japanese patients with liver cirrhosis (LC), with the aim of preventing hepatocellular carcinoma.


METHODS
Between 2008 and 2010, the member investigators of JNUS conducted various clinical and experimental studies on nutrition on LC. These included anthropometric studies, a questionnaire study on daily nutrient intake, clinical trials, experimental studies using animal models, re-evaluation of previous publications and patient education. Over this 3-year period, the group members regularly discussed the nutritional issues related to LC, and a proposal was finally produced.


RESULTS
Based on the results of JNUS projects and discussions among the members, general recommendations were made on how Japanese patients with LC should be managed nutritionally. These recommendations were proposed with a specific regard to the prevention of hepatocarcinogenesis.


CONCLUSIONS
The new JNUS guidelines on nutritional management for Japanese patients with LC will be useful for the actual nutritional management of patients with LC. The JNUS members hope that these guidelines will form the basis for future discussions and provide some direction in nutritional studies in the field of hepatology.
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Iwate Medical University             Morioka Municipal Hospital, Iwate             Division of Gastroenterology and Hepatology/Oncology, Department of Medicine, Hokkaido Medical University, Hokkaido             Division of Gastroenterology, Tohoku University Graduate School of Medicine, Miyagi             Department of Gastroenterology and Hepatology, Koshigaya Hospital, Dokkyo Medical University, Saitama             Department of Gastroenterology, Gifu University Graduate School of Medicine, Gifu             Department of Food and Human Health Science, Graduate School of Human Life Science, Osaka City University             Department of Hepatobiliary and Pancreatic Oncology, Osaka Medical Center for Cancer and Cardiovascular diseases, Osaka             Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Hyogo             Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan.
Kazuyuki
K
Suzuki
Ryujin
R
Endo
Yutaka
Y
Kohgo
Takaaki
T
Ohtake
Yoshiyuki
Y
Ueno
Akinobu
A
Kato
Kazutomo
K
Suzuki
Ryo
R
Shiraki
Hisataka
H
Moriwaki
Daiki
D
Habu
Masaki
M
Saito
Shuhei
S
Nishiguchi
Kazuhiro
K
Katayama
Isao
I
Sakaida