Adherence to Mediterranean diet in liver transplant recipients: a cross-sectional multicenter study

Gitto, Stefano; Golfieri, Lucia; Sofi, Francesco; Tamè, Maria Rosa; Vitale, Giovanni; Maria, Nicola De; Marzi, Luca; Mega, Andrea; Valente, Giovanna; Borghi, Alberto; Forte, Paolo; Cescon, Matteo; Benedetto, Fabrizio Di; Andreone, Pietro; Petranelli, Marco; Dinu, Monica; Carrai, P; Arcangeli, Giulio; Grandi, Silvana; Lau, Chloe; Morelli, Maria Cristina; Simone, Paolo De; Chiesi, Francesca; Marra, Fabio

doi:10.23736/s2724-5985.22.03290-9

Cited by 4 publications

(3 citation statements)

References 35 publications

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“…Therefore, the exercise prescription proposed in this study may be reasonable because adult transplant recipients are among the most sedentary of all populations with chronic disease, with a daily step count of 3164 ± 2842 steps [ 5 ]. The values MED-LITE recorded in this study align with the data recently published on a larger sample of the same geographical area following indications on the Mediterranean diet [ 16 ]. The group that received only indications on the Mediterranean diet, albeit not significantly, showed higher values than the group that also followed the exercise program.…”

Section: Discussionsupporting

confidence: 90%

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Unsupervised Exercise Intervention vs. Adherence to a Mediterranean Diet Alone: The Role of Bioelectrical Impedance Vector Analysis and Cardiovascular Performance in Liver-Transplanted Recipients

Mascherini,

Corsi,

Falconi

et al. 2024

Nutrients

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(1) Background: Cardiovascular disease is one of the leading causes of mortality after liver transplantation. Body composition and cardiovascular performance assessment represent a potential approach for modulating lifestyle correction and proper follow-up in chronic disease patients. This study aimed to verify the additional role of an unsupervised physical activity program in a sample of male liver transplant recipients who follow the Mediterranean diet. (2) Methods: Thirty-three male liver transplant recipients were enrolled. Sixteen subjects followed a moderate-intensity home exercise program in addition to nutritional support, and seventeen received advice on the Mediterranean diet. After six months, bioelectrical vector impedance analysis (BIVA) and cardiopulmonary exercise testing (CPET) were performed. (3) Results: No differences in CPET (VO2 peak: exercise 21.4 ± 4.1 vs. diet 23.5 ± 6.5 mL/kg/min; p = 0.283) and BIVA (Z/H: exercise 288.3 ± 33.9 vs. diet 310.5 ± 34.2 Ω/m; p = 0.071) were found. Furthermore, the BIVA values of resistance correlate with the submaximal performance of the Ve/VCO2 slope (R = 0.509; p < 0.05) and phase angle with the maximal effort of the VO2 peak (R = 0.557; p < 0.05). (4) Conclusions: Unsupervised physical exercise alone for six months does not substantially modify liver transplant recipients’ cardiovascular performance and hydration status, despite their adherence to a Mediterranean diet. The body composition analysis is useful to stratify the risk profile, and it is potentially associated with better outcomes in transplanted subjects.

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Section: Discussionsupporting

confidence: 90%

“…Studies initially focused on controlling caloric, fat, and protein intake, also using supplements [ 9 , 14 ]. More recently, attention has begun, with promising results, to focus on promoting the Mediterranean diet to increase healthy eating habits after liver transplantation [ 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

Unsupervised Exercise Intervention vs. Adherence to a Mediterranean Diet Alone: The Role of Bioelectrical Impedance Vector Analysis and Cardiovascular Performance in Liver-Transplanted Recipients

Mascherini,

Corsi,

Falconi

et al. 2024

Nutrients

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“…Regarding diet, the Mediterranean diet has proven to be a nutritional approach capable of reducing cardiovascular risk even in liver transplant recipients [108,109]. However, a moderate-to-low adherence to the Mediterranean diet has been observed in liver transplant recipients, highlighting the importance of educating patients in the early post-liver transplant phases about the need to follow an appropriate dietary regimen [110]. Furthermore, regarding the impact of immunosuppressive agents, particular attention must be paid to corticosteroids due to their orexigenic, catabolic, and adipose tissue deposition capacities, as well as to calcineurin inhibitors, as they are independent predictors of weight gain [107].…”

Section: Post-transplant Lifestylementioning

confidence: 99%

Metabolic Disorders in Liver Transplant Recipients: The State of the Art

Gabrielli,

Golfieri,

Nascimbeni

et al. 2024

JCM

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Liver transplantation represents a chief therapeutic approach for acute liver failure, end-stage liver disease and hepatocellular carcinoma. Despite witnessing advancements in short- and medium-term survival over recent decades, attributed to refinements in surgical techniques and immunosuppressive protocols, long-term mortality remains impervious to modification. Notably, cardiovascular disease emerges as a predominant cause of mortality among liver transplant recipients. This trend is accentuated by the increasing prominence of non-alcoholic steatohepatitis-related cirrhosis as an indication for liver transplantation. Moreover, the administration of immunosuppressive agents is intricately linked to the degradation of the metabolic profile in liver transplant recipients, thereby contributing to the initiation or exacerbation of cardiovascular risk factors, such as hypertension, diabetes, and dyslipidaemia. In addition, the post-liver transplantation period is marked by a decline in lifestyle quality and a failure to acknowledge the psychological distress experienced by patients throughout the transplant process. These factors can precipitate a deterioration in the patient’s metabolic profile, exacerbated by suboptimal therapeutic compliance. This narrative review aims to comprehensively address the principal metabolic disorders intricately associated with liver transplantation.

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Physical activity in liver transplant recipients: a large multicenter study

Gitto,

Golfieri,

Gabrielli

et al. 2023

Intern Emerg Med

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Aim Healthy lifestyle and appropriate diet are of critical importance after liver transplant (LT). We provided an analysis of the main patterns of physical activity and found factors associated with physical activity itself. Methods Clinically stable LT recipients were enrolled between June and September 2021. Patients completed a composite questionnaire about physical activity, adherence to Mediterranean Diet (MD), quality of life (QoL), and employment. Correlations were analysed using the Pearson coefficients while different subgroups were compared by t-test for independent samples or ANOVAs. Multivariable logistic regression analysis was conducted to find predictors of inactivity. Results We enrolled 511 subjects (71% males, mean age 63 ± 10.8 years). One hundred and ninety-three patients reported high level of physical activity, 197 a minimal activity and 121 declared insufficient activity. Among these latter, 29 subjects were totally inactive. Considering the 482 LT recipients performing some kind of physical activity, almost all reported a low-quality, non-structured activity. At multivariate analysis, time from LT (odds ratio 0.94, 95% CI 0.89–0.99, p = 0.017), sedentary lifestyle (odds ratio 0.99, 95% CI 0.19–0.81, p = 0.012), low adherence to MD (odds ratio 1.22, 95% CI 1.01–1.48, p = 0.049), and low level of QoL (physical dimension) (odds ratio 1.13, 95% CI 1.08–1.17, p < 0.001), were independently associated with total inactivity. Conclusion A large portion of LT recipients report an insufficient level of physical activity or are wholly inactive. Inactivity increases with time from LT and was strongly associated with suboptimal diet and low QoL.

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Adherence to Mediterranean diet in liver transplant recipients: a cross-sectional multicenter study

Cited by 4 publications

References 35 publications

Unsupervised Exercise Intervention vs. Adherence to a Mediterranean Diet Alone: The Role of Bioelectrical Impedance Vector Analysis and Cardiovascular Performance in Liver-Transplanted Recipients

Unsupervised Exercise Intervention vs. Adherence to a Mediterranean Diet Alone: The Role of Bioelectrical Impedance Vector Analysis and Cardiovascular Performance in Liver-Transplanted Recipients

Metabolic Disorders in Liver Transplant Recipients: The State of the Art

Physical activity in liver transplant recipients: a large multicenter study

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