articleThe American Journal of GastroenterologyMay 1, 2025GREEN OA

ACG Clinical Guideline: Malnutrition and Nutritional Recommendations in Liver Disease

University of Louisville · VA Palo Alto Health Care System · +8 more institutions

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Abstract

Malnutrition, defined as deficiency, excess, or imbalance of nutrients, is a common complication in patients with liver disease, especially those with cirrhosis. Malnutrition may present as an isolated micronutrient deficiency, such as zinc deficiency, and it commonly presents as frailty and/or sarcopenia in patients with advanced liver disease. Patients with cirrhosis and/or alcohol-associated hepatitis should be assessed for malnutrition because it adversely affects patient outcomes including mortality, as well as waitlist and posttransplant outcomes among liver transplant candidates. The prevalence of malnutrition varies based on the method of assessment and disease severity, being higher in those with…

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