© 2014 American Society for Parenteral and Enteral Nutrition

jpen.sagepub.com hosted at online.sagepub.com Review Protein-energy malnutrition is the most common comorbidity associated with chronic liver disease.1,2 The severity of malnu-trition correlates with the degree of hepatic dysfunction and predicts the presence of disease-associated complications, patient survival, and outcomes following liver transplanta-tion.1–3 Optimizing nutrition status in patients with chronic liver disease is therefore of paramount importance. The challenges associated with providing appropriate nutri-tion in the setting of cirrhosis can be practical (eg, difficulties in assessing body composition, inadequacy of equations pre-dicting energy expenditure), patient-related (eg, poor appetite)