The Importance of Proper Nutrition

• Proper nutrition can help reduce carbon dioxide levels and improve breathing.
• Specifically, it is important to focus on the percentages of total carbohydrate, fat, and protein that patients consume to see how their diet composition impacts their respiratory quotient (RQ), RQ is defined as the ratio of carbon dioxide produced to oxygen consumed.
• Following metabolism, carbohydrate, fat, and protein are all converted to carbon dioxide and water in the presence of oxygen.
• However, the ratio of carbon dioxide produced to oxygen consumed differs per macronutrient; the RQ for carbohydrate is 1, fat is 0.7, and protein is 0.8.
• From a nutritional standpoint, this means that eating carbohydrates will yield the most carbon dioxide
• While eating fats will yield the least carbon dioxide.
• A high-fat, low-carbohydrate diet would reduce patient RQ levels and carbon dioxide production. In fact, patients who have difficulty increasing ventilation following a carbohydrate load or patients with severe dyspnea (shortness of breath) or hypercapnia (High blood Co2) may benefit from a high-fat diet.

Nutritional Management in Liver Disease

Liver diseases may have a number of causes like infections, toxins, metabolic,Exessive intake of alcohol or nutritional factors, carcinoma etc. It is associated with decreased intake of food, nausea, vomiting & taste abnormalities

Nutrition therapy should be considered as an important tool in the therapeutic management of patients with liver disorders

Goals of Nutrition Support

1. To provide adequate energy & protein in order to facilitate hepatic cell regeneration as an increased number of functioning hepatocytes will improve liver metabolism & nutrition status
2. To avoid excess production of ammonia from endogenous or exogenous protein catabolism.
3. To correct vitamin /mineral deficiences.
4. To avoid potential complications that may occur as a result of inappropriate nutrition support ,which include,
   • Hypoglycemia or hyperglycemia
   • Hypertriglyceridemia
   • Hepatic encephalopathy
   • Fluid overload
   • Electrolyte imbalance
   • Death