Nutritional assessment and factors affecting dietary intake in patients with cirrhosis: A single-center observational study

WHAT IS KNOWN•Malnutrition is very common in patients with cirrhosis and affects pretransplant and post transplant morbidity and mortality.•High-calorie and high-protein diet is recommended in patients with cirrhosis.•Three subjective global assessment and anthropometric measurements are used for assessment of malnutrition because no standard method is available.WHAT IS NEW HERE•Midarm muscle circumference and handgrip strength is a good bedside tool for assessing malnutrition in patient with cirrhosis.•Majority of patients, even well nourished as per subjective global assessment, did not take required calories and protein intake as recommended by European Association for the Study of the Liver guidelines.•Poor appetite, early satiety, low-sodium diet, and social myths regarding diet in liver disease are the commonest cause of malnutrition in Asian Indian population. Malnutrition is predictor of morbidity and mortality in patients with cirrhosis. We investigated prevalence of malnutrition and factors affecting dietary intake in patients with cirrhosis. Single-center cross-sectional observational study. A total of 251 patients with cirrhosis underwent dietary and nutritional assessment by subjective global assessment (SGA) and anthropometric measurement (dry body mass index, midarm circumference, midarm muscle circumference, triceps skinfold thickness, handgrip strength). Dietary intake was assessed in terms of total calories and protein intake, percentage of recommended intake, and per kilogram body weight per day. Factors influencing dietary intake were also assessed. Of 251 patients 199 (79%) were male and 52 (21%) were female (mean age, 51 ± 14 y, Child's A:B:C: 83:116:52). In SGA analysis 87 (35%) were well nourished (SGA-A), 106 (42%) were moderately nourished (SGA-B), and 58 (23%) were severely malnourished (SGA-C). Patients with Child's C score were severely malnourished compared with patients with Child's B and A scores. Midarm circumference, midarm muscle circumference, triceps skinfold thickness, and handgrip strength were significantly higher in SGA-A than SGA-B and SGA-C. Patients in SGA-A (1939 ± 479 kcal/d) consumed significantly higher calories than SGA-B (1494 ± 216 kcal/d) and SGA-C (1321 ± 213 kcal/d). Percentage of recommended calories intake (SGA-A [76%], SGA-B [61%], SGA-C [59%], P = 0.001) and calories/kg/d is also higher in SGA-A than SGA-B and SGA-C. The results with protein intake were similar (SGA-A [61 ± 14 gm/d], SGA-B [56 ± 7 g