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#Gastroenterology #Hepatology #Multispeciality
The basis of a good clinical practice is secure and accurate diagnosis. Mounting evidences supports that poor nutrition is one of the prominent factors related to disorders of the liver, thus, a specific nutrition diagnosis is essential for offering best care and experiencing positive results. There is an emerging data of rising opportunities for better-structured approaches to create a secure and reliable nutritional diagnoses in patients with liver disease.
Nutrition is the set of integrated processes by which cells, tissues, organs and the whole body acquire the energy and nutrients to retain normal structure and perform the required functions. This can be attained via dietary supply and the potential of the body to convert the substrates and cofactors needed for metabolism. Moreover, observations demonstrate that diet, metabolic capacity, activity of the microbiome, body composition and the level of demand for energy and nutrients are highly affected by physical activity and also differ according to physiological and pathological disease states. An important role in regulating these metabolic processes is played by the liver as its ability to maintain these functional capabilities is established during the early life of an individual. However, situations in which these capabilities gets exceeded and the role of liver in maintaining the milieu interieur gets compromised, deterioration of health occurs.
Hence, certain measures such as stress tests that can determine flow through gateway pathways can be used to analyze the maximal capacity and functional reserve for critical functions. Moreover, the failure of the liver to appropriately integrate body lipid metabolism and the deposition of abnormal lipid causes clinical manifestations of impaired regulation in terms of weight loss, like the fatty liver of severe malnutrition, as well as in cases of excessive energy, such as in non-alcoholic fatty liver disease.
Recent reports suggest that the use of stable isotopic probes and the updated definition of the variability in the metabolome in different nutritional and pathological states promotes the great potential for appropriate clinical tools which would facilitate a more accurate nutritional diagnosis. Currently, it is believed that approaches that can establish regulation of metabolic state without causing excessive stress on the liver are the mainstay options for successful nutritional support.
Source: Jackson AA. Nutrition and Liver Health. Dig Dis. 2017;35(4):411-417.