Dietary recommendations for patients with chronic liver diseases: the need for increased awareness among non-hepatologist physicians

BACKGROUND& AIM: Nutritional awareness is a significant challenge for patients with chronic liver diseases (CLD), especially for those with conditions such as ascites, hepatic encephalopathy, and fatty liver disease. This survey aims to assess nutritional awareness regarding liver disease among healthcare providers (hepatologists and non-hepatologists). METHODS: A structured online questionnaire was created based on clinical knowledge and established guidelines related to nutrition in liver disease. The survey consisted of 13 questions addressing nutritional considerations for liver disease patients. RESULTS: A total of 124 out of 362 survey recipients responded. Among them, 60.5% were hepatologists, while the remaining respondents included general practitioners, endocrinologists, and cardiologists. Hepatologists were more likely than non-hepatologists to recognize the significance of nutritional guidance for their patients, with 74.7% of hepatologists supporting this view compared to only 40.8% of non-hepatologists (p < 0.001). For patients with compensated cirrhosis, 82.7% of hepatologists preferred no dietary restrictions, whereas only 46.9% of non-hepatologists agreed (p < 0.001). Both groups favored protein restriction in cases of hepatic encephalopathy, (p = 0.2). Regarding patients with ascites, both hepatologists and non-hepatologists recommended salt restriction, with hepatologists showing a stronger inclination. When it comes to alcohol consumption, 80% of hepatologists and 61.2% of non-hepatologists favored restricting alcohol intake in patients with chronic liver disease (p = 0.03). CONCLUSION: There are notable differences in nutritional priorities and recommendations between hepatologists and non-hepatologists. There is a pressing need to raise awareness among non-hepatologist physicians concerning dietary recommendations for patients with chronic liver disease.