@article{2987238,
    title = "Assessment of dietary habits and the adequacy of dietary intake of patients with cirrhosis-the KIRRHOS study",
    author = "Georgiou, A. and Yannakoulia, M. and Papatheodoridis, G.V. and Deutsch, M. and Alexopoulou, A. and Vlachogiannakos, J. and Ioannidou, P. and Papageorgiou, M.-V. and Voulgaris, T. and Papadopoulos, N. and Tsibouris, P. and Kontogianni, M.D.",
    journal = "Clinical Nutrition Open Science",
    year = "2021",
    volume = "40",
    number = "6",
    pages = "3992-3998",
    publisher = "Churchill Livingstone",
    doi = "10.1016/j.clnu.2021.04.044",
    keywords = "carbohydrate, adult;  Article;  body composition;  body mass;  body weight gain;  body weight loss;  caloric intake;  chronic hepatitis B;  colonoscopy;  dietary intake;  disease severity;  energy expenditure;  female;  fluid retention;  follow up;  food intake;  grip strength;  hepatic encephalopathy;  human;  liver cirrhosis;  major clinical study;  male;  middle aged;  muscle mass;  physical activity;  smoking;  aged;  complication;  diet;  eating;  energy metabolism;  feeding behavior;  liver cirrhosis;  malnutrition;  Mediterranean diet;  nutritional assessment;  nutritional status;  nutritional value;  pathophysiology;  physiology, Aged;  Diet;  Diet Surveys;  Diet, Mediterranean;  Eating;  Energy Intake;  Energy Metabolism;  Feeding Behavior;  Female;  Humans;  Liver Cirrhosis;  Male;  Malnutrition;  Middle Aged;  Nutrition Assessment;  Nutritional Status;  Nutritive Value",
    abstract = "Background & aims: Undernutrition is widely prevalent in patients with cirrhosis and affects prognosis. Given the lack of data regarding the dietary intake (DI) and habits of patients with cirrhosis, the aim of the present study was to evaluate them by assessing diet's adequacy compared to the new guidelines, and the association of DI with nutritional status indicators. Methods: One hundred and eighty-seven patients (57.8% male, 59.9 ± 10.9 years old, 44.9% decompensated ones) with cirrhosis of various etiologies were enrolled. The patients' DI was assessed using three 24 h recalls, which were analyzed regarding macronutrients’ intake, food groups consumption, adherence to the Mediterranean diet and meal patterns. The Goldberg cut-off limits for the ratio of energy intake to resting energy expenditure were used to evaluate dietary underreporting and patients were accordingly classified as low or adequate energy reporters (LERs and AERs). Results: Among the AERs (n = 91, 48.7%) only 29.7% and 31.9% met current recommendations regarding energy and protein intake, accordingly. Patients reported low intake of several healthy food groups and low adherence to the Mediterranean diet. They reported a median of 4.3 eating episodes per day and they frequently omitted late evening snack. Nevertheless, no statistically significant associations were found between parameters of DI and annual and two-year survival. Conclusions: Low energy reporting was very frequent in this sample of patients with liver cirrhosis. Diet quality was rather poor, whereas energy and protein intakes were lower than those recommended. © 2021 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism"
}