{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T05:04:17Z","timestamp":1790053457887,"version":"4.0.1"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2020,11,12]],"date-time":"2020-11-12T00:00:00Z","timestamp":1605139200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Institutes of Health through the Michigan Institute for Clinical and Health Research","award":["KL2TR002241"],"award-info":[{"award-number":["KL2TR002241"]}]},{"DOI":"10.13039\/100000062","name":"NIDDK","doi-asserted-by":"publisher","award":["1K23DK117055-01A1"],"award-info":[{"award-number":["1K23DK117055-01A1"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Ascites is a costly, morbid complication of cirrhosis. Although a low-sodium diet is central to the clinical management of ascites, its efficacy is limited by poor adherence. We aimed to determine the feasibility and impact of low-sodium medically tailored meals (MTM) intervention.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We enrolled 40 persons with cirrhosis and ascites at the time of a paracentesis in a 12-week, 1:1 randomized trial of standard of care (SOC) (low-sodium diet educational handout) or MTM with &amp;lt;2,000\u2009mg of sodium, &amp;gt;2,100\u2009kcal, and &amp;gt;80\u2009g of protein including a nocturnal protein supplement. We determined the proportion of eligible candidates recruited and adherence to MTM. The primary outcome was the number of paracenteses performed during weeks 0\u201312. We also collected ascites-specific quality-of-life (ASI-7) scores.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The median age of the enrolled subjects was 54 (IQR, 47\u201363) years, 46% were female, with median MELD-Na 18 (IQR, 11\u201323) and albumin 2.7 (IQR, 2.5\u20133.3) g\/dL. At baseline, subjects reported a median of two (IQR, 1\u20133) paracenteses in the prior 4\u2009weeks. Adherence to the meal schedule was excellent save for when hospitalizations occurred. After 12\u2009weeks, patients in the MTM arm required fewer paracenteses per week than those in the SOC group [median (IQR): 0.34 (0.14\u20130.54) vs 0.45 (0.25\u20130.64)]. During the trial, four (20%) SOC patients died, whereas two (10%) died and one (5%) was transplanted in the MTM arm. Ascites-specific quality of life improved to a greater degree in the MTM arm compared to the SOC arm, by 25% (IQR, \u201311% to 61%) vs 13% (IQR, \u201328% to 54%).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>A trial of MTM for persons with ascites is feasible and potentially effective. Both arms experienced benefits, highlighting the role for improved education and closer monitoring in this challenging condition.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/gastro\/goaa059","type":"journal-article","created":{"date-parts":[[2020,8,26]],"date-time":"2020-08-26T19:13:12Z","timestamp":1598469192000},"page":"453-456","source":"Crossref","is-referenced-by-count":22,"title":["Medically tailored meals for the management of symptomatic ascites: the SALTYFOOD pilot randomized clinical trial"],"prefix":"10.1093","volume":"8","author":[{"given":"Elliot B","family":"Tapper","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI, USA"},{"name":"Gastroenterology Section, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jad","family":"Baki","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha","family":"Nikirk","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Hummel","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumeet K","family":"Asrani","sequence":"additional","affiliation":[{"name":"Baylor University Medical Center, Dallas, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna S","family":"Lok","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,11,12]]},"reference":[{"key":"2021010812502380500_goaa059-B1","doi-asserted-by":"crossref","first-page":"2375","DOI":"10.1002\/hep.29756","article-title":"Patient reported outcomes in cirrhosis: a scoping review of the literature","volume":"67","author":"Tapper","year":"2018","journal-title":"Hepatology"},{"key":"2021010812502380500_goaa059-B2","doi-asserted-by":"crossref","first-page":"872","DOI":"10.1002\/hep.29887","article-title":"The high burden of alcoholic cirrhosis in privately insured persons in the United States","volume":"68","author":"Mellinger","year":"2018","journal-title":"Hepatology"},{"key":"2021010812502380500_goaa059-B3","doi-asserted-by":"crossref","first-page":"2087","DOI":"10.1002\/hep.22853","article-title":"Management of adult patients with ascites due to cirrhosis: an update","volume":"49","author":"Runyon","year":"2009","journal-title":"Hepatology"},{"key":"2021010812502380500_goaa059-B4","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1002\/hep.1840140205","article-title":"A pathophysiological interpretation of unresponsiveness to spironolactone in a stepped-care approach to the diuretic treatment of ascites in nonazotemic cirrhotic patients","volume":"14","author":"Gatta","year":"1991","journal-title":"Hepatology"},{"key":"2021010812502380500_goaa059-B5","doi-asserted-by":"crossref","first-page":"1508","DOI":"10.1111\/liv.12583","article-title":"Adherence to a moderate sodium restriction diet in outpatients with cirrhosis and ascites: a real-life cross-sectional study","volume":"35","author":"Morando","year":"2015","journal-title":"Liver Int"},{"key":"2021010812502380500_goaa059-B6","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1007\/s11901-020-00513-1","article-title":"Do nutritional interventions improve the outcomes of patients with cirrhosis and ascites: a systematic review of randomized trials","volume":"19","author":"Baki","year":"2020","journal-title":"Curr Hepatol Rep"},{"key":"2021010812502380500_goaa059-B7","doi-asserted-by":"crossref","first-page":"e004886","DOI":"10.1161\/CIRCHEARTFAILURE.117.004886","article-title":"Home-delivered meals postdischarge from heart failure hospitalization: the GOURMET-HF pilot study","volume":"11","author":"Hummel","year":"2018","journal-title":"Circ Heart Fail"},{"key":"2021010812502380500_goaa059-B8","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1377\/hlthaff.2017.0999","article-title":"Meal delivery programs reduce the use of costly health care in dually eligible Medicare and Medicaid beneficiaries","volume":"37","author":"Berkowitz","year":"2018","journal-title":"Health Aff (Millwood)"},{"key":"2021010812502380500_goaa059-B9","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1093\/gastro\/goz005","article-title":"Design and rationale of 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