Nutrition management plays a key role in the treatment of liver disease. There are several aspects that require attention to optimize the care to achieve the desired goals of liver healing or curative options. Vast majority of patients need counseling on dietary modification for metabolic syndrome (insulin resistance). Others need nutritional help for management of iron homeostasis, celiac disease, or copper metabolism. Above all, patients with advanced liver disease (cirrhosis) develop malnutrition especially those with alcohol liver disease.

Malnutrition in cirrhosis is multifactorial. Treating malnutrition requires a comprehensive

and multidisciplinary strategy and surveillance. Liver Institute providers are personally involved in dietary education, evaluation, and management. Nutritional evaluation & management is the key component of every visit. We have devised a formal approach to assess the gaps in adherence to achieve pre-set goals. Individualized recommendations are made based upon the gaps, to overcome the challenges or barriers to improve adherence. Our philosophy of nutritional management is to make changes in the diet while maintaining ethnic and cultural food taste. Much more emphasis is on improving vigilance.

In our quality control data analysis in patients with moderately severe decompensated cirrhosis, our model has correlated with improvement in functional status and overall, in disease parameters (published).