Dietary Intake, Nutritional Status, and Sarcopenia in Patients with Liver Cirrhosis: a Cross-Sectional Study

Abstract

BACKGROUND:

Liver cirrhosis is associated with significant nutritional challenges, including malnutrition and sarcopenia, which impact clinical outcomes. This study aimed to evaluate the nutritional status, dietary intake, and sarcopenia in patients with liver cirrhosis and to explore potential sex-specific differences.

METHODS:

In this cross-sectional study, 92 adult patients with clinically confirmed cirrhosis were recruited from a tertiary referral center between February 2024 and January 2025. Nutritional status was assessed using anthropometric measurements. A validated 168-item Food Frequency Questionnaire (FFQ) was used to estimate habitual energy intake, macronutrient intake, and daily servings of major food groups. Sarcopenia was defined according to the Asian Working Group for Sarcopenia (AWGS 2019), incorporating handgrip strength, mid-upper arm circumference (MUAC), and six-minute walk distance.  

RESULTS:

Among 92 patients with liver cirrhosis (mean age 49.1 ± 13.5 years; 57.6% men), sarcopenia was present in 66.3% and was more frequent among unmarried individuals (P = 0.046). Only 38% met vegetable intake recommendations, 56.5% achieved plant-based protein targets, and 20.7% reached the dairy intake threshold. A comparative analysis of dietary intake revealed no statistically significant differences in total energy, total protein, or most micronutrients between sarcopenic and non-sarcopenic patients.

CONCLUSION:

Sarcopenia remains highly prevalent among patients with liver cirrhosis, alongside notable deficiencies in vegetable and dairy consumption. The interplay among social, anthropometric, and functional factors underscores the need for integrated, multidisciplinary strategies to improve outcomes for this vulnerable population.