Effect of High-protein High-fiber Diet in Patients With Autoimmune Hepatitis
Effect of High-protein High-fiber Diet in Patients With Autoimmune Hepatitis
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.
Inclusion Criteria:

 Autoimmune hepatitis (Non cirrhotic)

 -  Diagnose of Autoimmune hepatitis

 -  Presence of antinuclear antibody (ANA, SMA)

 -  Biochemical evidence, based on elevation of transaminases

 -  Biopsy compatible with Autoimmune hepatitis

 -  Ambulatory patients

 Autoimmune hepatitis (Cirrhotic)

 -  Presence of antinuclear antibody (ANA, SMA)

 -  Biochemical evidence, based on elevation of transaminases

 -  Biopsy compatible with autoimmune cirrhosis

 -  Hepatic cirrhosis by USD

 -  Ambulatory patients

 -  Diagnose of Autoimmune cirrhosis by two or more of the following criteria:

 -  Albumin <3.4g/dl

 -  INR>1.2

 -  Total bilirubin >2mg/dl

 -  Presence of esophageal varices by endoscopy

 Exclusion Criteria:

 -  Hospitalized patients

 -  Overlapping syndrome with predominant primary biliary cirrhosis

 -  Chronic renal failure

 -  Hepatocellular carcinoma

 -  Neuropsychiatric disorders