Effect of a high-protein, high-fiber diet plus supplementation with branched-chain amino acids on the nutritional status of patients with cirrhosis

Ruiz-Margáin, Astrid; Macías-Rodríguez, Ricardo Ulises; Ríos-Torres, S.L.; Román-Calleja, B.M.; Méndez-Guerrero, Osvely; Rodríguez-Córdova, P.A.; Torre, Aldo

doi:10.1016/j.rgmxen.2017.02.005

Cited by 41 publications

(81 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Emerging evidence suggests that increased protein intake has the potential to improve the recovery of critically ill patients, as well as EB . This improvement has been reported in overall hospitalized patients, geriatric individuals, and recently in cirrhotic patients . The European Society for Parenteral and Enteral Nutrition (ESPEN) guidelines recommend early reestablishment of oral or enteral nutrient intake to decrease the risk of infections and to reduce the length of hospital stay …”

Section: Discussionmentioning

confidence: 99%

Energy Balance and Nutrition Status: A Prospective Assessment of Patients Undergoing Liver Transplantation

et al. 2019

View full text Add to dashboard Cite

Background Energy balance (EB) and its relation to nutrition status throughout the perioperative period of liver transplantation (LTx) patients has been poorly reported in the literature, and this is the primary objective of the current study. Methods A prospective observational study was conducted with patients undergoing LTx, who were assessed before and after the operation. Resting energy expenditure, total energy expenditure (TEE), dietary intake, and EB were evaluated, as well as anthropometry, handgrip strength, and standard phase angle (SPA). The presence of complications after the operation, length of intensive care unit and hospital stay, and death were registered. A P‐value < 0.05 was considered statistically significant. Results The average age was 54.1 ± 11.5 years; 79.3% of the patients were male, and the mean model for end‐stage liver disease (MELD) score was 16.7 ± 4.6. Negative EB was seen in 71.4% and 77.8% of patients before and after LTx, respectively. Food intake further decreased after the operation, leading to a significantly more negative EB. The prevalence of malnutrition ranged from 17.2% to 57.7% pretransplantation and 30.8% to 86.4% postoperatively, according to the different methods used. Increased preoperative TEE (0.040) and age (0.039) were predictive factors for complications, and low SPA was a predictive factor of death (0.038). Conclusion Negative EB was prevalent, and this was associated with high rates of malnutrition. These data reinforce the importance of individual nutrition assessment, including dietary intake, to tailor early nutrition interventions.

show abstract

Section: Discussionmentioning

confidence: 99%

Energy Balance and Nutrition Status: A Prospective Assessment of Patients Undergoing Liver Transplantation

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Patients may benefit from a higher percentage of protein intake from plant‐based and dairy‐sourced protein (Table ). One pathophysiological reason to support protein from plant‐based and dairy sources is an increased intake of branched‐chain amino acids (BCAAs) found within these foods . Because of the changes in amino acid metabolism and insulin resistance in patients with cirrhosis, there is an imbalance of BCAAs available for protein synthesis in skeletal muscle .…”

Section: Nutrition Priority Four: Protein Sourcementioning

confidence: 99%

“…Because of the changes in amino acid metabolism and insulin resistance in patients with cirrhosis, there is an imbalance of BCAAs available for protein synthesis in skeletal muscle . Increased intake of BCAA intake may improve appetite, increase muscle synthesis, and have an impact in improving quality of life . However, more randomized controlled studies comparing isonitrogenous (i.e., same total protein provision, but with composition from different food sources) interventions and their impact on outcomes are needed to provide more definitive recommendations.…”

Section: Nutrition Priority Four: Protein Sourcementioning

confidence: 99%

“…One pathophysiological reason to support protein from plant-based and dairy sources is an increased intake of branched-chain amino acids (BCAAs) found within these foods. 6,7 Because of the changes in amino acid metabolism and insulin resistance in patients with cirrhosis, there is an imbalance of BCAAs available for protein synthesis in skeletal muscle. 8 Increased intake of BCAA intake may improve appetite, increase muscle synthesis, and have an impact in improving quality of life.…”

Section: Nutrition Priority Four: Protein Sourcementioning

confidence: 99%

“…8 Increased intake of BCAA intake may improve appetite, increase muscle synthesis, and have an impact in improving quality of life. 7,9 However, more randomized controlled studies comparing isonitrogenous (i.e., same total protein provision, but with composition from different food sources) interventions and their impact on outcomes are needed to provide more definitive recommendations. It should be noted that patients should not be discouraged from consuming animal-based proteins, because it can be difficult to meet total protein needs without consumption of those foods.…”

Section: Nutrition Priority Four: Protein Sourcementioning

confidence: 99%

See 2 more Smart Citations

Nutrition Priorities: Diet Recommendations in Liver Cirrhosis

Moss

2019

Clinical Liver Disease

View full text Add to dashboard Cite

show abstract

Pharmacokinetics of AXA1665, a Novel Composition of Amino Acids, in Comparison With Protein Supplement: A Single‐Dose, Open‐Label, Randomized Study in Healthy Subjects

Vaidya

McLinden

Hinderliter

et al. 2023

Clinical Pharm in Drug Dev

View full text Add to dashboard Cite

We evaluated the safety and tolerability of AXA1665, a novel investigational fixed‐ratio amino acid (AA) composition, the pharmacokinetics (PK) of the constituent AAs within AXA1665, and their relative bioavailability versus standard protein supplement. This study was conducted in 2 phases; in the initial phase, healthy subjects (N = 16) were randomly assigned to 4 treatment sequences (AXA1665 4.9, 9.8, and 19.6 g or 35 g protein supplement) in an open‐label, single‐dose, 4‐way crossover study, while in the extension phase, they received single AXA1665 doses of 29.4 and 39.2 g in a sequential crossover manner. The net area under the plasma concentration–time curve (AUC) and observed time to reach maximum plasma concentration were estimated. A dose‐dependent increase in plasma AUC from time 0 to the last measurable concentration (AUClast) and maximum plasma concentration (Cmax) was observed for all AXA1665‐dosed AAs (4.9–39.2 g) except aspartic acid. AXA1665 19.6 g resulted in 1.5‐ to 9.5‐fold higher systemic exposure to all AXA1665‐dosed AAs except for aspartic acid and lysine and lower exposure to all nondosed AAs except for glutamine and alanine versus protein supplement. AXA1665 doses, up to 39.2 g, can deliver AXA1665‐dosed AAs in the systemic circulation in the linear AUC range.

show abstract

Effect of a high-protein, high-fiber diet plus supplementation with branched-chain amino acids on the nutritional status of patients with cirrhosis

Cited by 41 publications

References 17 publications

Energy Balance and Nutrition Status: A Prospective Assessment of Patients Undergoing Liver Transplantation

Energy Balance and Nutrition Status: A Prospective Assessment of Patients Undergoing Liver Transplantation

Nutrition Priorities: Diet Recommendations in Liver Cirrhosis

Pharmacokinetics of AXA1665, a Novel Composition of Amino Acids, in Comparison With Protein Supplement: A Single‐Dose, Open‐Label, Randomized Study in Healthy Subjects

Contact Info

Product

Resources

About