Understanding the diet and physical activity of liver transplant recipients and the factors influencing these behaviours will enable healthcare professionals to better support people having a liver transplant. Knowing whether diet and physical activity are associated with cardiovascular disease risk factors and quality of life, and if so which elements of diet and activity are important for this, will also help to improve care. The BOLT (behaviours and outcomes after liver transplant) study aims to investigate this.

COVID-19 update

The BOLT study was paused in March 2020 due to COVID-19. We have changed the design of the study so that liver transplant recipients can take part at home, without the need to come to an appointment. This enabled the study to restart in November 2020. We added three short questionnaires that measure stress, anxiety and depression as liver transplant recipients told us this is important to study as a result of the COVID-19 situation.

A common concern we have heard from liver transplant recipients is that their diet and exercise have changed due to the COVID-19 situation, and therefore they worried it’s not valuable for the research for them to take part in the study. There is no right or wrong way of eating or exercising for the BOLT study. As well as the impact of the liver transplant on diet and activity, we are also interested in the impact COVID-19 is having on behaviours and mental health, for example difficulties with exercising and changes in diet due to shielding. Taking part helped us to understand how to help recipients in similar situations in the future.

• More about BOLT
• Information for participants
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Publications

BOLT study publications on the MRC Epidemiology Unit publications database.

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More about BOLT

It is common for people to develop cardiovascular disease, obesity, diabetes, raised cholesterol and high blood pressure after a liver transplant. This increases the risk of poor health and lowers quality of life. A healthy diet and physical activity are important to enable people to stay healthy after transplant. We don’t know whether people have a healthy diet and are physically active after a transplant or not, or what influences these behaviours. This may be different to the general public due to the effects of liver disease, the transplant operation and medication.

The BOLT (behaviours and outcomes after liver transplant) study aimed to find out, for liver transplant recipients:

1. What are their diet and physical activity behaviours?
2. What are the factors influencing these behaviours?
3. Are diet and physical activity behaviours associated with cardiovascular disease risk factors and quality of life?

Knowing the answers to these questions will help to improve post-transplant care.

What does this research involve?

Part 1:

We invited patients who have had a liver transplant at Cambridge University Hospitals NHS Foundation Trust and are between 6 months and three years post-transplant to take part. We measured quality of life, diet, physical activity and things that might influence diet and activity. We collected information on risk factors for cardiovascular disease, such as blood pressure and cholesterol levels. With this information we are looking at the links between diet, activity, cardiovascular disease risk factors, quality of life and the reasons for diet and activity behaviours

Part 2:

We invited some participants from part 1 of the study to interviews to explore the things influencing their diet and activity in more depth. We chose people who have a range of diet and activity behaviours, so that a range of experiences are explore