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World J Gastroenterol. Jun 21, 2014; 20(23): 7286-7297
Published online Jun 21, 2014. doi: 10.3748/wjg.v20.i23.7286
Nutrition and exercise in the management of liver cirrhosis
Nobuyuki Toshikuni, Tomiyasu Arisawa, Mikihiro Tsutsumi
Nobuyuki Toshikuni, Tomiyasu Arisawa, Department of Gastroenterology, Kanazawa Medical University, Ishikawa 920-0293, Japan
Mikihiro Tsutsumi, Department of Hepatology, Kanazawa Medical University, Ishikawa 920-0293, Japan
Author contributions: Toshikuni N wrote the manuscript; Arisawa T and Tsutsumi M supervised the work.
Correspondence to: Nobuyuki Toshikuni, MD, Department of Gastroenterology, Kanazawa Medical University, 1-1 Daigaku, Uchinada-machi, Ishikawa 920-0293, Japan. n.toshikuni@gmail.com
Telephone: +81-76-2862211 Fax: +81-76-2860892
Received: January 4, 2014
Revised: March 22, 2014
Accepted: April 30, 2014
Published online: June 21, 2014
Core Tip

Core tip: Recent studies have shown that sarcopenia is a predictor of poor survival in liver cirrhosis (LC) patients. LC-associated sarcopenia develops based on impaired nutrient metabolism and decreased physical activity. To improve this condition, nutrition and exercise management is imperative. Energy intake with branched chain amino acid supplementation is a promising method for nutrition management. Exercise can increase skeletal muscle volume and strength; however, nutritional status and LC complications should be assessed before exercise management begins. Obesity is another health issue for LC patients; improvement of insulin resistance is a key component in nutrition and exercise management for obese LC patients.