Mixed

A 16-week intensive lifestyle intervention combining a hypocaloric normoproteic diet and supervised moderate exercise significantly reduces hepatic venous pressure gradient (HVPG) and body weight in patients with compensated cirrhosis and obesity, without causing clinical decompensation.

For patients with compensated cirrhosis and obesity, a structured 16-week program involving a moderate caloric deficit (500-1000 kcal/day) with adequate protein (0.8 g/kg ideal body weight) and supervised moderate exercise (60 mins/week) can safely reduce portal pressure and body weight. This approach does not appear to worsen liver function or cause decompensation, challenging the notion that such interventions are unsafe in this population.