Patients with advanced liver disease have several risk factors to develop nutritional deficiencies. Accurate nutritional assessment is a real challenge because many of the traditionally measured parameters of nutritional status vary with severity of liver disease independently of nutritional status. The objective of this study was to compare different tools used to assess the nutritional status of patients waiting for a liver transplant. Patients were nutritionally assessed by SGA, anthropometry, handgrip dynamometry and biochemical tests. Clinical variables were cross analyzed with the nutritional assessment methods. There were 159 patients followed. Malnutrition ranged from 6.3% to 80.8% according to the different methods used. Agreement among all the methods was low (K < 0.26). Malnutrition prevalence according to different nutritional assessment tools did not differ among this group of patients in relation to the etiology of liver disease (p > 0.05) but increased with the more advanced stages of disease according to the Child-Pugh score. Only SGA showed significant relationships with clinical variables (Child-Pugh scores, p < 0.05; presence of ascites and/or edema, p < 0.01; and encephalopathy, p < 0.01). The various methods used showed great variability of results, lack agreement among them, and only SGA showed correlation with the progression of liver disease.

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Objective: To assess changes in daily habits, food choices, and lifestyle of adult Brazilians before and during the COVID-19 pandemic. Design: This observational study was carried out with Brazilian adults through an online questionnaire five months after the social distance measures implementation. The McNemar, McNemar-Bowker, and Wilcoxon tests were used to investigate differences before and during the COVID pandemic period, adopting the statistical significance of p <0.05. Setting: Brazil. Participants: 1,368 volunteers aged 18+ years. Results: The volunteers reported a lower frequency of breakfast, morning, and lunch snacks (p<0.05) and a higher frequency of evening snacks and other meal categories during the pandemic period (p<0.05). The results showed an increase in the consumption of bakery products, instant meals and fast-food, while the consumption of vegetables and fruits decreased (p<0.005). There was a significant increase in the frequency of consumption of alcoholic beverages (p<0.001), but a reduction in the dose (p<0.001); increased frequency of smoking (p=0.007); an increase in sleep and screen time in hours, and decrease in physical activity (p<0.001). Conclusions: It was possible to observe an increase in screen time, hours of sleep, smoking, and drinking frequency. On the other hand, there was a reduction in the dose of alcoholic beverages but also in the practice of physical activity. Eating habits also changed, reducing the performance of daytime meals and increasing the performance of nighttime meals. The frequency of consumption of instant meals and fast-food has increased, while consumption of fruits and vegetables has decreased.

The majority of patients are overweight or obese after LTx, and many of the associated risk factors are modifiable. Thus, patients, especially those who already have identified risk factors for overweight and obesity, undergoing LTx should be encouraged to engage in lifestyle changes early.

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MS prevalence increased over the years after LTx because of the increases in waist circumference and blood glucose. MS and its components are associated with modifiable factors, such as greater BMI, body fat and carbohydrate and fat intake.