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The Nutrition Landscape in Chronic Liver Disease
Bridgette B McNally1, Elizabeth J Carey2
1Department of Gastroenterology & Hepatology, Division of Hepatology, Mayo Clinic Arizona, Scottsdale, USA. mcnally.bridgette@mayo.edu.
Digestive Diseases and Sciences
|May 7, 2026
Summary
Malnutrition, frailty, sarcopenia, and visceral sarcopenic obesity are prevalent in chronic liver disease. Emerging therapies like GLP-1 RAs show promise, but careful monitoring for sarcopenia is crucial, especially post-transplant.
Area of Science:
- Hepatology
- Nutritional Science
- Metabolic Disorders
Background:
- Malnutrition, frailty, sarcopenia, and visceral sarcopenic obesity (VSO) are significant concerns in chronic liver disease (CLD).
- These conditions impact patient outcomes, particularly in pre- and post-liver transplantation settings.
- Understanding nutritional abnormalities is key to managing CLD.
Purpose of the Study:
- To review fundamental nutrition concepts in CLD.
- To examine the implications of nutritional derangements in CLD.
- To discuss current therapeutic recommendations for nutritional issues in CLD.
Main Methods:
- Comprehensive literature review of nutritional concepts in CLD.
- Analysis of diagnostic methods for frailty, sarcopenia, and VSO.
- Evaluation of current and emerging treatment strategies.
Main Results:
- Frailty, sarcopenia, and VSO are identifiable through clinical assessments and imaging, correlating with adverse outcomes.
- Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) show potential in managing metabolic dysfunction-associated steatotic liver disease (MASLD), promoting weight loss, and improving mortality in CLD patients.
- Bariatric and endobariatric interventions are increasingly utilized for obesity and VSO in CLD, including pre- and post-transplant phases.
Conclusions:
- GLP-1 RAs demonstrate efficacy in pre- and post-liver transplant contexts but require vigilant monitoring for sarcopenia.
- Further research is needed to clarify the role of bariatric surgery and endoscopic procedures in managing nutritional complications in CLD patients undergoing transplantation.
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