Current management strategies for sarcopenia and frailty in cirrhosis: Missing link in transplant candidacy

Table 3 Nutritional and exercise-based therapeutic recommendations for patients with cirrhosis

Therapeutic recommendation	Details
Nutrition	N/A
Protein intake[51,60,65,66]	1.2-1.5 g/kg body weight per day; Up to 2.0 g/kg body weight per day for critically ill
Timing and pattern[51,71,73]	Small meals every 3-4 waking hours; Early breakfast; Late evening or nighttime snack
Branched-chain amino acid supplementation[27-32]	If unable to meet daily protein requirements
Not critically ill	0.25 g/kg body weight per day; Critically ill: Insufficient evidence to supplement in this population
Exercise	Safety screening and assessment; Variceal prophylaxis as required; Supervised training programs; Start low, go slow; Moderate intensity; Motivational interviewing, maximizing engagement and adherence[51,60,91]; Aerobic exercise such as walking 4-7 days a week for a total of 150 minutes; Resistance exercises such as weight or band training for 2-3 days per week; Flexibility and balance exercises, including stretching for 2-3 days per week