We are currently at a pivotal moment regarding the awareness, diagnosis, treatment, and management of liver diseases worldwide. The burden of these conditions extends beyond mere epidemiological data—over two million deaths annually are attributed to liver diseases (4% of all global deaths). It is also assessed through composite health indicators that combine two variables: quality and quantity of life. Liver disease has the greatest impact on individuals aged 25 to 49 years, where it ranks as the twelfth leading cause of disability-adjusted life-years (DALYs) (1).
Another approach to evaluating the burden of these conditions is through the investment allocated for research. According to data from the National Institutes of Health, the U.S. government is projected to allocate $954 million in 2024 for the study of liver diseases (2).
Despite regional differences, the global significance of liver diseases is evident (1).
Despite efforts to ensure timely diagnosis and advances in treatment (3), delays and inadequacies in routine clinical care hinder the recognition of macro- and micronutrient deficiencies, resulting from metabolic disorders—an inherent characteristic of chronic liver diseases—thereby preventing adequate nutritional support for these patients (4, 5).
While there are recommendations for using nutrition as an adjunctive treatment in the multidisciplinary management of these patients (6, 7), nutritional interventions are not frequently implemented.
The following sections outline key aspects for managing certain liver diseases. In cirrhosis of any etiology, malnutrition and sarcopenia have been associated with higher mortality and reduced survival. A meta-analysis by Cui et al., indicates a prevalence of 41%, and suggests incorporating sarcopenia screening into the initial evaluation of every cirrhotic patient.
On the other end of the spectrum, metabolic dysfunction-associated steatotic liver disease (MASLD), the most common chronic liver disease and a risk factor for cardiovascular disease and mortality worldwide, has been studied by Liu et al., who propose that timely and appropriate supplementation with vitamins and trace elements may aid in disease recovery or delay its progression, thereby improving patient outcomes.
Similarly, studies by Li et al., and Chen et al., demonstrate that dietary intake of folic acid, choline, vitamin B1, and vitamin B2 may be associated with hepatic steatosis, providing insights into potential dietary strategies for postmenopausal women. Additionally, magnesium supplementation may prevent and treat hepatic steatosis, with variations depending on gender and ethnicity.
In summary, nutritional therapy plays a crucial role in the management of liver disease, and its omission could negatively impact clinical outcomes and the quality of life of affected individuals.
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Author contributions
SR: Conceptualization, Data curation, Formal analysis, Funding acquisition, Investigation, Methodology, Project administration, Resources, Software, Supervision, Validation, Visualization, Writing – original draft, Writing – review & editing.
Funding
The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.
Conflict of interest
The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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References
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Devarbhavi H Asrani SK Arab JP Nartey YA Pose E Kamath PS . Global burden of liver disease: 2023 update. J Hepatol. (2023) 79:516–37. 10.1016/j.jhep.2023.03.017
2.
Estimates Estimates of Funding for Various Research Condition and Disease Categories (RCDC) [homepage] . National Institutes of Health (2024). Available at: https://report.nih.gov/funding/categorical-spending#/ (accessed August 14, 2021).
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Uhl P Fricker G Haberkorn U Mier W . Current status in the therapy of liver diseases. Int J Mol Sci. (2014) 15:7500–12. 10.3390/ijms15057500
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Traub J Reiss L Aliwa B Stadlbauer V . Malnutrition in patients with liver cirrhosis. Nutrients. (2021) 13:540. 10.3390/nu13020540
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Fernandes SA Bassani L Nunes FF Aydos ME Alves AV Marroni CA . Nutritional assessment in patients with cirrhosis. Arq Gastroenterol. (2012) 49:19–27. 10.1590/S0004-28032012000100005
6.
Merli M Berzigotti A Zelber-Sagi S Dasarathy S Montagnese S Genton L et al . EASL Clinical Practice Guidelines on nutrition in chronic liver disease. J Hepatol. (2019) 70:172–93. 10.1016/j.jhep.2018.06.024
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Plauth M Bernal W Dasarathy S Merli M Plank LD Schütz T et al . ESPEN guideline on clinical nutrition in liver disease. Clin Nutr. (2019) 38:485–521. 10.1016/j.clnu.2018.12.022
Summary
Keywords
liver disease, nutritional approach, therapeutic, cirrhosis, metabolic dysfunction-associated steatotic liver disease (MASLD)
Citation
Rodríguez Villafuerte S (2024) Editorial: Nutritional approaches in chronic liver diseases. Front. Nutr. 11:1480541. doi: 10.3389/fnut.2024.1480541
Received
14 August 2024
Accepted
28 August 2024
Published
13 September 2024
Volume
11 - 2024
Edited and reviewed by
Maurizio Muscaritoli, Sapienza University of Rome, Italy
Updates
Copyright
© 2024 Rodríguez Villafuerte.
This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Santiago Rodríguez Villafuerte santy_rodri03@yahoo.com
Disclaimer
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.