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Autoimmune hepatitis is a chronic disease of the liver caused by an alteration of the immune response that attacks the body's own hepatocytes, progressively, leading to cirrhosis and liver failure.
There are few studies on dietary management in hepatitis and most of theme have focused on micronutrients specifically vitamin D to prevent osteoporosis, and decreased symptoms of other diseases associated, but few recommendations have been made regarding a complete dietary approach. Fiber has been proven to increase the excretion of nitrogen products and consequently reduce its blood levels and an adequate protein intake (1.2g/kg) has shown to decrease endogenous catabolism in cirrhotics patients.
The implementation of a high protein high fiber nutrition plan and improves nutritional status of patients with autoimmune cirrhosis.
Each participant will receive a high protein (1.2g/kg/day) and high fiber (30g/day) dietary plan. The monitoring of adherence to the diet will be once a month for the duration of the study period.
There will be an nutritional assessment by anthropometric techniques: arm circumference, triceps skinfold, weight, height and body mass index as parameters of malnutrition by taking the standard for cirrhotic patients. Body composition was measured by bioelectric impedance to obtain fat mass, lean and total fluid content.
The presence of minimal hepatic encephalopathy will be assessed by PHES and CFF and applied three times during the study and the quality of life questionnaire SF-36 CLDQ and will be held in direct interview at the first visit and at study end.
Were also measured serum concentrations of ammonium, TNF-alpha, IL-1, IL-6, IL-10, renin, angiotensin and aldosterone.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Autoimmune hepatitis (Non-cirrhotic) | Experimental | A personalized high protein high fiber dietary plan will be provided to each participant from both groups. Each participant will receive nutritional counseling once a month during six months. |
|
| Autoimmune hepatitis (Cirrhotic) | Experimental | A personalized high protein high fiber dietary plan will be provided to each participant from both groups. Each participant will receive nutritional counseling once a month during six months. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| High protein high fiber diet | Dietary Supplement | A personalized high protein high fiber dietary plan will be provided to each participant from both groups. Each participant will receive nutritional counseling once a month during six months. Each participant will receive nutritional counseling once month during six months. |
| Measure | Description | Time Frame |
|---|---|---|
| Nutritional Status | Measured with the following parameters:body weight and height (to calculate BMI), triceps skinfold and mid-arm circumference (to calculated mid-arm muscle circumference, fat mass, fat free mass total, intracellular and extracellular body water obtained by bioelectrical impedance analysis and individual vectors obtained by bioelectrical impedance vector analysis. | Participants will be assessed for six months |
| Measure | Description | Time Frame |
|---|---|---|
| Minimal hepatic encephalopathy | Assessed by psychometric Hepatic Encephalopathy (PHES) and Critical Flicker Frequency (CFF), at visit 0 months and 6 months visit. | Participants will be assessed for six months |
| Quality of life |
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Inclusion Criteria:
Autoimmune hepatitis (Non cirrhotic)
Autoimmune hepatitis (Cirrhotic)
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Aldo Torre Delgadillo, M.D. M.Sc | INCMNSZ | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán | Mexico City | D.f. | 14000 | Mexico |
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| ID | Term |
|---|---|
| D019693 | Hepatitis, Autoimmune |
| D005355 | Fibrosis |
| ID | Term |
|---|---|
| D006521 | Hepatitis, Chronic |
| D006505 | Hepatitis |
| D008107 | Liver Diseases |
| D004066 | Digestive System Diseases |
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|
Assessed by CLDQ and SF-36 questionnaires, at visit 0 months and 6 months visit.
| Participants will be assessed for six months |
| D001327 |
| Autoimmune Diseases |
| D007154 | Immune System Diseases |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |