International Journal of Clinical Nutrition
ISSN (Print): 2376-1385 ISSN (Online): 2376-1393 Website: http://www.sciepub.com/journal/ijcn Editor-in-chief: Apply for this position
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International Journal of Clinical Nutrition. 2017, 5(1), 1-7
DOI: 10.12691/ijcn-5-1-1
Open AccessArticle

Exploration of Nutritional Concepts among Patients of Chronic Liver Diseases and Their Health Care Providers

Ahmed K Nabeeh1, Abdel-Rahman AH Moukhtar1, Shahira A El-Etreby1, and Adel A. Ibraim2

1Departments of Hepatology and Gastroenterology, Faculty of Medicine, Mansoura University, Mansoura, Egypt

2Department of Occupational Medicine & Public Health, Faculty of Medicine, Mansoura University, Mansoura, Egypt

Pub. Date: February 06, 2017

Cite this paper:
Ahmed K Nabeeh, Abdel-Rahman AH Moukhtar, Shahira A El-Etreby and Adel A. Ibraim. Exploration of Nutritional Concepts among Patients of Chronic Liver Diseases and Their Health Care Providers. International Journal of Clinical Nutrition. 2017; 5(1):1-7. doi: 10.12691/ijcn-5-1-1

Abstract

Background: Nutrition in chronic liver disease (CLD) is an important area of research that could have an influential role on morbidity and mortality. To date, no clear guidelines were established for nutrition in CLD. Aim of the work: to assess the thoughts of patients and the knowledge of their health care providers about nutritional concepts in CLD. Patients & methods: This cross-sectional study enrolled two groups; patients group involving 350 CLD patients and health care providers group (involving 32 physicians and 31 nurses). All participants answered a validated questionnaire about nutritional knowledge (for health care providers) and behaviors (for the patients). Results: The majority of the patients (96.9%) denoted receiving nutritional advices from physicians. There was no role for nurses in nutritional education of patients. Proteins, lipids and minerals have the main interest in physicians' advices in frequencies of 93.4%, 96%, and 92.9%, respectively. Patients were taking proteins of plant rather than animal origin in amounts less than they need fearing of its complications. Another notable misconception was the intake of large amounts of carbohydrates. Dealing with lipids was the best by patients (only 19.7% were taking high amounts of lipids). But minerals, specially iron were restricted by large number of patients due to misconceptions. Conclusion: There are many misconceptions about nutrition in the majority of patients with CLD, and to lesser extent in their healthcare providers. Emerging of Egyptian nutritional guideline that highlights improving the dietitian role in nutritional services in our hospitals is mandatory for a sensible achievement in this area in the future.

Keywords:
nutrition chronic liver disease protein lipid carbohydrate

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References:

[1]  Mokdad AA, Lopez AD, Shahraz S, Lozano R, Mokdad AH, Stanaway J, Murray CJ, Naghavi M. Liver cirrhosis mortality in 187 countries between 1980 and 2010: a systematic analysis. BMC Medicine, 12: 145. 2014.
 
[2]  Marchesini G, Ross B, Brizi M, Melchionda N. Nutritional treatment with branched chain amino-acids in advanced liver cirrhosis J. Gastroenterology, 35 (suppl. 12): 7-12. 2000.
 
[3]  Huynh DK, Selvanderan SP, Harley HAJ, Holloway RH, Nguyen NQ. Nutritional care in hospitalized patients with chronic liver disease. World J Gastroenterol December 7; 21(45): 12835-12842. 2015.
 
[4]  Silva M, Gomesb S, Peixotoa A, Torres-Ramalhoc P, Cardosoa H, Azevedod R, Azevedod R, Cunhad C, Macedoa G. Nutrition in Chronic Liver Disease.GE Port J Gastroenterol. 22(6): 268-276. 2015.
 
[5]  Lalama MA, Saloum Y. Nutrition, Fluid, and Electrolytes in Chronic Liver Disease. Clinical Liver Disease; 7(1): 18-20. 2016.
 
[6]  Plauth M, Cabré E, Campillo B, Kondrup J, Marchesini G, Schütz T, Shenkin A, Wendon J; ESPEN. ESPEN guidelines on parental nutrition: Hepatology. Clin Nutrition, 28:346-444. 2009.
 
[7]  Pugh RNH, Murray-Lyon IM, Dawson JL, Pietroni MC, Williams R. Transection of the oesophagus for bleeding oesophageal varices. Br. J. Surg.; 60(8): 646-649. 1973.
 
[8]  Ball LE, Leveritt MD. Development of a validated questionnaire to measure the self-perceived competence of primary health professionals in providing nutrition care to patients with chronic disease. Fam Pract. Dec; 32(6):706-10. 2011.
 
[9]  Bavdekar A, Bhave S, and Pandit A. Nutrition management in chronic liver disease. Indian J Pediatr.; 69: 427-31. 2002.
 
[10]  Marchesini G, Ross B and Brizi M. Nutritional treatment with branched chain amino-acids in advanced liver cirrhosis J. Gastroenterology 35 (suppl. 12): 7-12. 2000.
 
[11]  Krenitsky J. Nutrition Update in Hepatic Failure. Nutrition Issues in Gastroenterology. Practical Gastroenterology 2014. [https://med.virginia.edu/ginutrition/wp-content/uploads/.../2014/.../Parrish-April-14.p].
 
[12]  Petrides A, Stanley T, Matthews DE, Vogt C, Bush AJ, Lambeth H. Insulin resistance in live cirrhosis. Hepatology; 28: 141-149. 1998.
 
[13]  Richardson R, Hinds A and Davidson H. Influence of Metabolic Sequelae of Liver Cirrhosis on Nutritional Intake. Am. J. Clin. Nut., 69 (2): 331-337. 1999.
 
[14]  Palmer M. "Dr. Melissa Palmer's Guide of Hepatitis and Liver Disease". Published by Penguin Putnam NY, 2004.
 
[15]  Hasse J and Matarese L. Modern nutrition therapy for liver and biliary system Dis. In: Mlahenl K and Escott-Stump S (Eds.). Food, Nutrition and Diet Therapy, 10th ed. WB Saunders Company, 2000, pp 696-712.
 
[16]  Preda CM, Ghita R, Ghita C, Mindru C, Vlaciu L, Andrei A, et al. A retrospective study of bacterial infections in cirrhosis. Maedica (Buchar); 6:185-92. 2011.
 
[17]  Sundaram V, Manne V, Al-Osaimi AMS. Ascites and spontaneous bacterial peritonitis: Recommendations from two United States Centers. Saudi J Gastroenterol. Sep-Oct; 20(5): 279-287. 2014.