High-Protein, Healthy-Eating

High-Protein, Healthy-Eating

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NDR-UK Ref No: 9343
Publication Format: A5 leaflet
Classification: DT  
Pack size: 10
Publication date: 11/06
Last Review: 09/15
Next Review: 09/18

Information for people with liver disease who are following a high-protein, healthy-eating diet.

Classification: DT (Dietitian)

Advice is complex, condition specific and requires a Dietitian with knowledge, skills and experience in the condition.

The pack of leaflets aims to limit the progression of damage to the liver, which leads to cirrhosis and risks decompensation of the liver and liver failure.

To help patients:

  • Improve their nutritional status through increased lean body mass and strength
  • Meet their nutritional requirements
  • Understand malnutrition, liver disease and symptom management to enable them to meet their nutritional requirements.
  • Avoid enteral feeding via a food first approach to dietary intervention.
    - Malnourished – meet nutritional requirements.
    - Ascities – reduce salt advice.
    - Diabetes – dietary management.
  • The target group will know that symptoms of liver disease include fatigue, weight loss, extreme lethargy, bloated, nausea, vomiting, itching, further malnutrition.
  • The target group will understand that feeling full may be due to ascites.
  • Note that the Target Group must be given personalised advice related to their own condition and symptoms following feeding assessment that include height, weight, dry weight, skin folds and grip strength.
  • Akerman P, Jenkins R, Bistrian B, Preoperative nutrition assessment in liver transplantation. Nutrition 1993;9:350-356.
  • DiCecco S, Wieners E, Southorn P, et al. Assessment of nutritional status of patients with end-stage liver disease undergoing liver transplantation. Mayo Clin Proc 1989;64:95-102.
  • Italian Multicentre Co-operative Project on Nutrition in Liver Cirrhosis. Nutritional status in cirrhosis. J Hepatol 1994;21;317.
  • McCullogh A J, Bugianesie E. Protein calorie malnutrition and the aetiology of cirrhosis (editorial). Am J Gastroenterology 1997;92(5):734-738.
  • Koehn V, Burnand B, Niquelle M, et al. Prevalence of malnutrition in non-alcoholic medical inpatients: a comparative anthropometric study. J Parenter Enteral Nutr 1993;23:(Supp 1):31-35.
  • Kondrup J, Muller J, Energy and protein requirements of patients with chronic liver disease. Hepatol 1997;27:239-247.
  • Iversen J, Vilstrup J, Tygstrop N, Insulin sensitivity in alcoholic cirrhosis. Scand J Clin Lab Invest 1983:43:565-573.
  • Selberg O, Burchert W, Holf J, et al. Insulin resistance in liver cirrhosis: a PET-scan analysis of skeletal muscle glucose metabolism. J Clin Inves 1993;91:1897-1902.
  • Johansson V, Wahren J, Eriksson LS. Splanchnic and peripheral glucose metabolism in cirrhosis. J Hepatol 1994;20:760-767.
  • Muller M J, Boher K, Selberg O. Metabolism of energy yielding substrates in patients with liver cirrhosis. Clin Invest 1994;72:1821-1832.
  • Owen O E, Trapp V E, Reichard E A. Nature and Quantity of Foods Consumed in patients with alcoholic cirrhosis. J Clin Invest 1983;72:1821-1832.
  • Krunszynska Y, Williams N, Perry M, The relationship between insulin sensitivity and skeletal muscle enzyme activities in hepatic cirrhosis. Hepatol 1988;8:1615-1619.
  • Selberg O, Raddoch E, Walter G F. Skeletal muscle glycogen content in patients with cirrhosis. Hepatol 1994;20:135-141.
  • Scolapio M D, Bowen J, Stoner G, et al. Substrate oxidation in patients with cirrhosis: comparison with other nutritional matters. J Parenter Enteral Nutr 2000;24:150-153.
  • Neilson K, Kondrup J, Martinsen L et al. Long term oral re-feeding of patients with cirrhosis of the liver. Br J Nutr 1995;74:557-567.
  • Swart G R, van de Berg J W, Wattinema D L, et al. Elevated protein requirements in cirrhosis of the liver investigated by whole body protein turnover studies. Clin Sci 1988;75:101-107.
  • John W, Phillips R, Ott L, et al. Resting energy expenditure in patients with alcoholic hepatitis. J Parenter Enteral Nutr 1989;13(2):124-127.
  • Hamberg O, Neilsen K and Hendrik V. Effects of an increase in protein intake on hepatic efficacy for urea synthesis in healthy subjects and patients with cirrhosis. Hepatol 1992;14:237-243.
  • Shanbhogue R, Bristrian B, Jenkins R, et al. Resting energy expenditure in patients with end stage liver disease and in normal population. J Parenter Enteral Nutr 1987;11(3):305-307.
  • Dolz C, Raurich J M, Ibanez J, et al. Ascites increases the resting energy expenditure in liver cirrhosis. Gastroenterology 1991;100:738-744.
  • Wicks C and Madden A. A Practical Guide to Nutrition in Liver Disease 2nd Edition 1994. The Liver Interest Group of the British Dietetic Association. (Out of Print).
  • Schneewiess B. Energy metabolism in patients with acute and chronic liver disease. Hepatol 1990;11(3):387-393.
  • Plauth M, Merli M, Kondrup J, et al. Consensus statement:ESPEN Guidelines for Nutrition in Liver Disease and Transplantation. Clin Nutr 1997;16:43-55.
  • Muller M J, Bottcher J, Selberg O, et al. Hyper metabolism in clinically stable patients with liver cirrhosis. Am J Clin Nutr 1999;69(6):1194-1201.
  • Madden A. Resting energy expenditure should be measured in patients with cirrhosis, not predicted. Hepatol 1999;30(3):655-664.
  • Walsh T S, Wigmore S J, Hopton P, et al. Energy expenditure in acetaminophen-induced fulminant hepatic failure. Crit care Med 2000;28(3):649-654.
  • Schofield W N. Predicting basal metabolic rate, new standard of previous work. Hum Nutr: Clin Nutr. 1985;44:1-19.
  • Hasse J. Nutritional assessment and support of organ transplant recipients. J Parenter Enteral Nutr 2001;25(3):120-131.
  • Verboeket-van de Venne W P H G, Westerterp K R, van Hoek B, Swart G R. Energy expenditure and substrate metabolism in patients with cirrhosis of the liver: effects of the pattern of food intake. Gut 1995;36(1):110-116.
  • Swart G R, Zillikens M C, van Vuure J K, van den Berg J W. Effect of late evening meal on nitrogen balance in patients with cirrhosis of the liver. BMJ 1989;299(6709):1202-1203.
  • Kearns PJ, Young H, Garcia G, et al. Accelerated improvement of alcoholic liver disease with enteral nutrition. Gastroenterology 1992;102:200-205.
  • Cabre E, Gonzalez-Huix F, Abad Lacruz A, et al. Effect of total enteral nutrition on the short-term outcome of severely malnourished cirrhotics. A randomized controlled trial. Gastroenterology 1990;98:715-720.
  • 33 Kondrup J, Nielsen R, Juul A. Effect of long-term re-feeding on protein metabolism in patients with cirrhosis of the liver. Brit J. Nutr 1997;77:197-222.
  • Archer S B, Burnett R J and Fischer J E, Current uses and abuses of total parenteral nutrition. Advances in Surgery 1996;29:165-182.
  • Friedman L S, Keefe E B and Maddrey W C. Handbook of Liver Disease 1998 Churchill Livingstone.
  • Klein S et al. Nutrition Support in clinical practice: review of published data and recommendations for the future. J Parenter Enteral Nutr 1997:21(3):133-156.
  • D.Liver Group. Audit of TPN usage in specialist liver centres. Unpublished data.
  • Todorovic V, Micklewright A (Editors). A Pocket Guide to Clinical Nutrition. 2000 BDA
  • Wicks C, Somasundarum, S Bjarnason I, Menzies et al. Comparison of enteral feeding and total parenteral nutrition after liver transplantation. Lancet 1994;24;344(8926):837-40
  • EPEN guidelines for nutrition in liver disease and transplantation. Clinical nutrition 1997; 16(2):43-55.
High-protein, High-Energy, Reduced-Salt

High-protein, High-Energy, Reduced-Salt

New edition! Information for people with liver disease who must follow a high-protein, high-energy, reduced-salt diet.

  • Pack size: 10
  • Classification: DT
  • NDR-UK ref: 9344

Price per pack

£13.00
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  • Pack size: 10
  • Classification: PiL
  • NDR-UK ref: 9007

Price per pack

£11.00
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High-Protein, High-Energy, Reduced-Fat

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Current review extended with update expected in the autumn. Information for people with liver disease who are following a high-protein, high-energy, reduced-fat diet.

  • Pack size: 10
  • Classification: DT
  • NDR-UK ref: 9345

Price per pack

£12.00