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Nutrition and exercise in the management of liver cirrhosis.

Abstract

Liver cirrhosis (LC) patients often have protein-energy malnutrition (PEM) and decreased physical activity. These conditions often lead to sarcopenia, which is the loss of skeletal muscle volume and increased muscle weakness. Recent studies have demonstrated that PEM and sarcopenia are predictors for poor survival in LC patients. Nutrition and exercise management can improve PEM and sarcopenia in those patients. Nutrition management includes sufficient dietary intake and improved nutrient metabolism. With the current high prevalence of obesity, the number of obese LC patients has increased, and restriction of excessive caloric intake without the exacerbation of impaired nutrient metabolism is required for such patients. Branched chain amino acids are good candidates for supplemental nutrients for both obese and non-obese LC patients. Exercise management can increase skeletal muscle volume and strength and improve insulin resistance; however, nutritional status and LC complications should be assessed before an exercise management regimen is implemented in LC patients. The establishment of optimal exercise regimens for LC patients is currently required. In this review, we describe nutritional status and its clinical impact on the outcomes of LC patients and discuss general nutrition and exercise management in LC patients.

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  • Authors+Show Affiliations

    ,

    Nobuyuki Toshikuni, Tomiyasu Arisawa, Department of Gastroenterology, Kanazawa Medical University, Ishikawa 920-0293, Japan.

    ,

    Nobuyuki Toshikuni, Tomiyasu Arisawa, Department of Gastroenterology, Kanazawa Medical University, Ishikawa 920-0293, Japan.

    Nobuyuki Toshikuni, Tomiyasu Arisawa, Department of Gastroenterology, Kanazawa Medical University, Ishikawa 920-0293, Japan.

    Source

    World journal of gastroenterology 20:23 2014 Jun 21 pg 7286-97

    MeSH

    Caloric Restriction
    Combined Modality Therapy
    Diet
    Dietary Supplements
    Energy Metabolism
    Exercise Therapy
    Humans
    Liver Cirrhosis
    Nutrition Assessment
    Nutritional Status
    Predictive Value of Tests
    Protein-Energy Malnutrition
    Risk Factors
    Sarcopenia
    Treatment Outcome

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    24966599

    Citation

    Toshikuni, Nobuyuki, et al. "Nutrition and Exercise in the Management of Liver Cirrhosis." World Journal of Gastroenterology, vol. 20, no. 23, 2014, pp. 7286-97.
    Toshikuni N, Arisawa T, Tsutsumi M. Nutrition and exercise in the management of liver cirrhosis. World J Gastroenterol. 2014;20(23):7286-97.
    Toshikuni, N., Arisawa, T., & Tsutsumi, M. (2014). Nutrition and exercise in the management of liver cirrhosis. World Journal of Gastroenterology, 20(23), pp. 7286-97. doi:10.3748/wjg.v20.i23.7286.
    Toshikuni N, Arisawa T, Tsutsumi M. Nutrition and Exercise in the Management of Liver Cirrhosis. World J Gastroenterol. 2014 Jun 21;20(23):7286-97. PubMed PMID: 24966599.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Nutrition and exercise in the management of liver cirrhosis. AU - Toshikuni,Nobuyuki, AU - Arisawa,Tomiyasu, AU - Tsutsumi,Mikihiro, PY - 2014/01/04/received PY - 2014/03/22/revised PY - 2014/04/30/accepted PY - 2014/6/27/entrez PY - 2014/6/27/pubmed PY - 2015/4/14/medline KW - Exercise KW - Liver cirrhosis KW - Obesity KW - Protein-energy malnutrition KW - Sarcopenia SP - 7286 EP - 97 JF - World journal of gastroenterology JO - World J. Gastroenterol. VL - 20 IS - 23 N2 - Liver cirrhosis (LC) patients often have protein-energy malnutrition (PEM) and decreased physical activity. These conditions often lead to sarcopenia, which is the loss of skeletal muscle volume and increased muscle weakness. Recent studies have demonstrated that PEM and sarcopenia are predictors for poor survival in LC patients. Nutrition and exercise management can improve PEM and sarcopenia in those patients. Nutrition management includes sufficient dietary intake and improved nutrient metabolism. With the current high prevalence of obesity, the number of obese LC patients has increased, and restriction of excessive caloric intake without the exacerbation of impaired nutrient metabolism is required for such patients. Branched chain amino acids are good candidates for supplemental nutrients for both obese and non-obese LC patients. Exercise management can increase skeletal muscle volume and strength and improve insulin resistance; however, nutritional status and LC complications should be assessed before an exercise management regimen is implemented in LC patients. The establishment of optimal exercise regimens for LC patients is currently required. In this review, we describe nutritional status and its clinical impact on the outcomes of LC patients and discuss general nutrition and exercise management in LC patients. SN - 2219-2840 UR - https://www.unboundmedicine.com/medline/citation/24966599/Nutrition_and_exercise_in_the_management_of_liver_cirrhosis_ L2 - http://www.wjgnet.com/1007-9327/full/v20/i23/7286.htm DB - PRIME DP - Unbound Medicine ER -