A Low Daily Intake of Simple Sugars in the Diet Is Associated with Improved Liver Function in Cirrhotic Liver Transplant Candidates

Abstract

(1) Background: We investigated, for the first time, whether dietary simple sugar intake affects MELD score changes over time in a cohort of cirrhotic liver transplant candidates. (2) Methods: the MELD score, dietary habits using a 3-day food diary, and visceral adipose tissue index (VATI) measured with CT scan were assessed in 80 consecutive outpatient cirrhotic patients at baseline, after counseling to follow current nutritional guidelines. The MELD score was reassessed after six months and the DELTA-MELD was calculated as the MELD at the second assessment minus the MELD at baseline. (3) Results: Compared with the baseline, the MELD score of cirrhotic patients at the end of the study was decreased, stable, or increased in 36%, 8% and 56% of patients, respectively. In separate multiple linear regression models, DELTA-MELD was positively and independently correlated with the daily intake of simple sugars expressed in g/kg body weight (p = 0.01) or as a percentage of total caloric intake (p = 0.0004) and with the number of daily portions of fruit, added sugar, jam, and honey (p = 0.003). These associations were present almost exclusively in patients with VATI above the median value. (4) Conclusions: In cirrhotic patients with high amounts of visceral adipose tissue the consumption of simple sugars and fructose should be limited to improve their clinical outcome.

Keywords: DELTA-MELD; cirrhosis; cirrhotic diet; liver transplant; simple sugars; visceral adipose tissue.

Figure 1

Schematic diagram depicting the study population.

Figure 2

Boxplots of the amount of dietary carbohydrates consumed each day according to temporal changes in MELD score by all cirrhotic patients. (A) Intake of simple sugars expressed in g/Kg of body weight; (B) intake of simple sugars expressed as a percentage of total energy; (C) intake of starch. NS: not significant.

Figure 3

Boxplots of the amounts of simple sugars consumed each day according to temporal changes in the MELD score by cirrhotic patients according to visceral adipose tissue. (A) Dietary simple sugars intake expressed as g/Kg of body weight among patients with high VATI. (B) Dietary simple sugars intake expressed as a percentage of total energy among patients with high VATI. (C) Dietary simple sugars intake expressed as g/Kg of body weight among patients with low VATI. (D) Dietary simple sugars intake expressed as a percentage of total energy among patients with low VATI. NS: not significant.