Association Between Dietary Patterns and Sarcopenia in Patients With Liver Cirrhosis: A Cross-Sectional Study

Sarcopenia is a prevalent and debilitating complication in patients with liver cirrhosis, contributing to poor clinical outcomes. Although diet quality is believed to influence muscle health, the role of overall dietary patterns in patients with cirrhosis remains inadequately explored. This study examined the relationship between dietary patterns and sarcopenia in individuals with liver cirrhosis.

In this cross-sectional study, 92 adults with clinically confirmed liver cirrhosis were enrolled from a tertiary academic center between February 2024 and January 2025. Standardized protocols were used to collect sociodemographic data, anthropometric measurements, physical activity data, and dietary intake information. Principal component analysis identified major dietary patterns based on a validated 168-item food frequency questionnaire. Sarcopenia was diagnosed using AWGS 2019 criteria, incorporating mid-upper arm circumference, handgrip strength, and the 6-min walk test. Multivariable logistic regression models examined associations between dietary patterns and sarcopenia, adjusting for age, sex, energy intake, physical activity, and comorbidities.

Sarcopenia was identified in 66.3% of participants. Patients with sarcopenia exhibited significantly lower BMI, mid-arm and calf circumference, and physical performance compared to their non-sarcopenic counterparts (all p < 0.01). Adherence to a Western dietary pattern, characterized by high intake of red and processed meats, refined grains, and fried foods, was positively associated with sarcopenia (adjusted OR for second tertile: 5.99; 95% CI: 1.53-23.43). Conversely, higher adherence to a healthy dietary pattern, rich in vegetables, nuts, oils, and whole grains, was inversely associated with sarcopenia (adjusted OR for the highest tertile: 0.35; 95% CI: 0.11-1.52).

Our findings highlight the potential of dietary pattern modification as a strategy for preventing sarcopenia in cirrhotic patients. Integrating nutritional screening and dietary counseling into routine hepatology care may offer a low-risk, cost-effective approach to improving functional outcomes in this high-risk population.