*Purpose: The study was designed to look at relationships between diet and exercise interventions and liver disease prognosis in terms of survival and ability to carry on daily activities; which has not yet been assessed. Functioning ability was classified according to the Eastern Cooperative Oncology Group (ECOG) scale.

*Methods: The liver disease registry was scanned for patients with decompensated cirrhosis. Data on demographics, liver disease risk factors and prognosis measures: Model for End-Stage Liver Disease (MELD), symptoms and Child-Pugh score (CTP) was prospectively collected. Patients were counseled for goal-oriented changes in diet and exercise; combined into LI Score based on Table1. Subjects were then stratified into a group of negative or no change in LI (LI-), and a group with positive change (LI+).

*Results: A total of 102 patients; 49 in LI- and 53 in LI+, were monitored over a mean follow-up period of 397 days. The mean age of subjects was 60.8 and 56.5 (SD±12). Analysis showed a significant correlation between LI and ∆ ECOG (Baseline to last visit) (r=-0.43) and most recent ECOG (r=-0.48) and a significant increase in mortality risk in the LI- compared to the LI+ group (p=0.02). 61.4% of the LI+ group became compensated by the end of the study compared to 38.6% in the LI- group. MELD score also decreased by 2 points in the LI+ group, although not significant. Finally, there was a trend of improvement in CTP (r= 0.17).

*Conclusions: Periodic goal-oriented counseling and close monitoring in decompensated cirrhosis patients is safe and effectively improved functional ability and decreased risk of death. These findings confirm that changes in LI can be a significant tool in improving outcomes of liver disease, especially in patients waiting for liver transplant.

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