Baj JS, Torre A, Rojas ML, et al. - As diet and ethnicity affect gut microbiota, which influences cognition and hospitalizations in cirrhosis, researchers here investigated study interactions of diet with microbiota and impact on hospitalizations and cognition in American and Mexican cohorts. They followed 275 age‐balanced individuals (133 US [40 Control, 50 Compensated cirrhosis, 43 Decompensated cirrhosis] and 142 Mexican [41 Control, 49 Compensated cirrhosis, 52 Decompensated cirrhosis]) for 90‐day hospitalizations. Comparable MELD/cirrhosis severity was observed. All decompensated patients had diet with lower protein and animal fat content, but in Mexico, this was worse. Minimal hepatic encephalopathy (MHE) and hospitalizations were observed in correlation with changes in diet and microbiota, especially related to animal fat and protein intake and Prevotellaceae, in Mexican patients with cirrhosis compared with an American cohort. These hospitalizations may be prevented with nutritional counselling to enhance protein intake in cirrhosis.