High-Protein, High-Energy

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

Credit: 17

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NDR-UK Ref No: 9342E
Classification: DT
Related Printed Version: 9342
Publication Date: 11/06
Last Review Date: 2017
Next Review Date: 2020
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.
  • European association for the Study of Liver (2010) EASL clinical practice guidelines on the management of Ascites, spontaneous bacterial peritonitis and hepatorenal syndrome in cirrhosis. Journal of Hepatology 53: 397 – 417
  • Hamlin S and Leaper J (2014) Liver and Biliary disease in Manual of Dietetic Practice - Edited by Gandy J; In Conjunction With The British Dietetic Association. Fifth Edition
  • O’Brien A, Williams R. (2008) Nutrition in end-stage liver disease: principles and practice. Gastroenterology 134: 1729–1740.
  • Plank LD, Gane EJ, Peng s et al (2008) nocturnal nutritional supplementation improves total body protein status of patients with liver cirrhosis: a randomized 12 month trial. Hepatology 48: 557-566
  • Plauthm, Cabre E, Riggio O et al (2006) ESPEN Guidelines on Enteral Nutrition: Liver Disease. Clinical Nutrition 25: 285-294.
  • Sanchez AJ, Aranda-Michel J. (2006) Nutrition for the liver transplant patient. Liver Transplantation 12: 1310–1316.
  • Saunders J, Brian A, Wright M, Stroud M. (2010) Malnutrition and nutrition support in patients with liver disease. Frontline Gastroenterology 1: 105–511.
  • Stickel F, Inderbitzin D, Candinas D. (2008) Role of nutrition in liver transplantation for end-stage chronic liver disease. Nutrition Reviews 66: 47–54.
  • Swart GR, Zillikens MC, van Vuure JK, van den Berg JW. (1989) Effect of a late evening meal on nitrogen balance in patients with cirrhosis of the liver. BMJ 299: 1202–1203.
  • Tsiaousi ET, Hatzitolios AI, Trygonis SK, Savopoulos CG. (2008) Malnutrition in end stage liver disease: recommendations and nutritional support. Journal of Gastroenterology and Hepatology 23: 527–533.
  • Tsien CD, McCullough AJ, Dasarathy S. (2012) Late evening snack –Exploiting a period of anabolic opportunity in cirrhosis. Journal of Gastroenterology and Hepatology 27: 430–431.
  • Tsuchiya M, Sakaida I, Okamoto M, Okita K. (2005) The effect of a late evening snack in patients with liver cirrhosis. Hepatology Research 31: 95–103.
  • Yamanaka-Okumura H, Nakamura T, Takeuchi H, et al. (2006) Effect of late evening snack with rice ball on energy metabolism in liver cirrhosis. European Journal of Clinical Nutrition 60: 1067–1072.

Eating Well and Keeping Well with Diabetes

Simple information for older and/or frail people with diabetes to help support healthy living and diabetes control. Developed with BDA Older People Specialist Group.

Last Review Date: 09/16
Classification: HP
NDR-UK ref: 9019
Credits: 15
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High-Protein, Healthy-Eating

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

Last Review Date: 2017
Classification: DT
NDR-UK ref: 9343E
Credits: 17

High-Protein, High-Energy, Reduced-Fat

Information for people with liver disease who are following a high-protein, high-energy, reduced-fat diet.

Last Review Date: 2017
Classification: DT
NDR-UK ref: 9345E
Credits: 22