The effects of a diet based on vegetable and dairy protein on nutritional status and MELD score in patients with liver cirrhosis: a randomized controlled study.

内容摘要

Liver cirrhosis is a progressive disease that can lead to serious complications including malnutrition which worsen the patient's condition and pose a significant threat to life. The choice of protein source plays a crucial role in the clinical management of these patients; however, concerns remain regarding their nutritional adequacy and patient tolerance. This RCT evaluated the effects of a diet based on vegetable and dairy protein versus a standard isocaloric, isonitrogenous diet on nutritional status and liver disease severity in cirrhotic patients. Forty-six adults with liver cirrhosis were randomized using a computer-generated random number sequence into two groups for a 12-week intervention. Malnutrition status based on the Royal Free Hospital-Global Assessment (RFH-GA), Model for End-Stage Liver Disease (MELD) score (as the primary outcome) as well as dietary intake, anthropometric measurements, and biochemical parameters, including serum albumin and total protein were assessed at baseline and at study completion. The intervention group received a diet where the primary protein sources were from vegetables (e.g., legumes, soy) and dairy (e.g., milk, yogurt, cheese). Both groups followed an isocaloric, isonitrogenous diet, ensuring total protein intake was adequate and comparable. Intake records and interviews monitored dietary adherence. Compared to controls, the intervention group showed significant improvements in MELD score (-1.87; 95% CI: -3.03 to -0.71, p-between&#x2009;<&#x2009;0.01), serum creatinine (-0.04; 95% CI: -0.14 to -0.01, p-between&#x2009;=&#x2009;0.01), and INR (-0.10; 95% CI: -0.17 to -0.02, p-between&#x2009;=&#x2009;0.01). Although serum total protein decreased within the intervention group (-0.25&#x2009;&#xb1;&#x2009;0.11, p-within&#x2009;=&#x2009;0.03), the between-group difference was not significant (-0.21; 95% CI: -0.49 to 0.06, p-between&#x2009;=&#x2009;0.13), and there were no changes in serum albumin or nutritional status categories-suggesting no clinical deterioration. Adherence to a 12-week vegetable- and dairy-based protein diet in patients with liver cirrhosis significantly reduced short-term disease severity without adversely affecting nutritional status. Longer-term studies are needed to evaluate the durability of these effects. The trial was registered in the Iranian Registry of Clinical Trials on June 8, 2023, under the registration number IRCT20220426054667N2. The full trial record can be accessed at https://irct.behdasht.gov.ir/trial/69973.