The Association of Dietary Macronutrient Quality and Mortality Among Patients With Liver Cirrhosis: A Prospective Cohort Study

Background and Aims Cirrhosis, an end‐stage manifestation of chronic liver disease, is a leading contributor to morbidity and mortality worldwide. Diet quality is an important component in determining the prognosis of various chronic diseases. In this prospective cohort study, we aimed to investigate the association between the macronutrient quality index (MQI) and mortality risk among patients with liver cirrhosis. Methods In this prospective cohort study, 121 recently diagnosed cirrhotic patients were monitored for 60 months. The dietary intake of patients was evaluated using a 168‐item food frequency questionnaire, after which MQI and its sub‐indices including carbohydrate quality index (CQI), fat quality index (FQI), and protein quality index (PQI) were calculated. Crude and multivariable‐adjusted hazard ratio (HR) with 95% confidence interval (CI) were estimated based on cox proportional hazard models. Results The findings showed that a higher MQI score was significantly associated with a 65% reduction in risk of mortality after adjusting for potential confounders (p trend = 0.024). Also, CQI (HR = 0.32, 95% CI = 0.1–0.97, p trend=0.026) and FQI (HR = 0.25, 95% CI = 0.07–0.9, p trend=0.023) indicated significant reverse associations, while PQI (HR = 0.33, 95% CI = 0.1–1.1, p trend=0.122) failed to show a significant association with mortality risk. Conclusion A thorough evaluation of MQI and its sub‐indices and mortality risk in patients with cirrhosis revealed that improving the quality of macronutrient intake could considerably increase survival in cirrhotic patients.