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Semin Liver Dis
DOI: 10.1055/a-2725-5313
Review Article

Nutrition and Liver Disease

Authors

  • Allison Franz

    1   Department of Medicine, University of Louisville School of Medicine, Louisville, Kentucky, United States

  • Henry Shay

    1   Department of Medicine, University of Louisville School of Medicine, Louisville, Kentucky, United States

  • Irina Kirpich

    2   Department of Microbiology and Immunology, University of Louisville School of Medicine, Louisville, Kentucky, United States

  • Craig J. McClain

    3   Department of Medicine, and Pharmacology and Toxicology, University of Louisville School of Medicine, Louisville, Kentucky, United States
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Graphical Abstract

Abstract

The liver is a dynamic organ that plays a central role in metabolism and serves several critical functions in maintaining overall nutritional health, including helping maintain metabolic homeostasis by ensuring energy needs are met, eliminating waste products, and maintaining nutrient balance. Hepatic injury/liver dysfunction can compromise multiple metabolic processes and lead to complications such as malnutrition (deficiencies, excesses, or imbalances in a person's nutritional or caloric intake). The adverse clinical consequences of malnutrition vary widely from global malnutrition that can result in frailty, cachexia, and/or sarcopenia to micronutrient imbalances that can lead to individual functional alterations. Malnutrition is associated with a higher rate of complications including ascites, hepatic encephalopathy, and variceal bleeding, progressing to liver failure and poor survival outcomes. Malnutrition prior to liver transplantation is associated with worse postoperative quality of life, worse outcomes following decompensation events, and higher recurrence rates of hepatocellular carcinoma. Several treatment options are discussed.

Keywords

malnutrition - sarcopenia - steatohepatitis - micronutrients - cirrhosis


Publication History

Received: 18 June 2025

Accepted: 16 October 2025

Article published online:
28 November 2025

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