Effect of oral branched chain amino acid supplementation in the late evening on the nutritional state of patients with liver cirrhosis

Yamaguchi, Masayoshi; Takeda, Kunihiko; Sakamoto, Kazuhiko; Ohata, Mitsuru; Toda, Gotaro

doi:10.1016/s1386-6346(01)00105-x

Cited by 65 publications

(65 citation statements)

References 14 publications

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“…Acarbose, an a-glucosidase inhibitor given with LES, reduced the fasting b-hydroxybutyrate levels the next morning in alcoholic cirrhotic patients . Oral BCAA supplementation as the LES also may prevent protein catabolism and lipolysis (Yamauchi et al, 2001). However, it is not clear how nutrient components themselves affect energy metabolism; therefore, the effect of LES using standard Japanese rice ball on the fuel metabolism was studied in cirrhotic patients.…”

Section: Discussionmentioning

confidence: 99%

“…A late evening snack (LES) was recommended to minimize early starvation for overnight fasting in cirrhotic patients. It has been reported that supplementation of extra carbohydrate (Chang et al, 1997), oral branched chain amino acids (BCAA) (Yamauchi et al, 2001;Okamoto et al, 2003;Tsuchiya et al, 2005) and a-glucosidase inhibitor given with LES , all improved energy metabolism in cirrhotic patients. Therefore, LES supplementation to prevent early-onset starvation, and energy deficiency may be advisable in such patients to maintain nourishment.…”

Section: Introductionmentioning

confidence: 99%

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Effect of late evening snack with rice ball on energy metabolism in liver cirrhosis

et al. 2006

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Objective: This study investigates the effects of a late evening snack (LES), of 200 kcal of rice ball, on energy metabolism in cirrhotic patients. Impaired nutritional metabolism has been associated with cirrhosis, and frequent intake of small meals may prevent early-onset starvation, and maintain nourishment in these patients. Subjects: Twenty-one cirrhotic patients and 26 control subjects (Control) were recruited for this study. Patients were subsequently treated by LES (LC-LES) and by a non-LES regimen (LC-NLES).Method: Resting energy expenditure and respiratory quotient (RQ) were assessed by indirect calorimetry at 0830, 1130 and 1430. Blood glucose and non-esterified fatty acids (NEFA) were measured just before the energy metabolism measurements. The regular diet included three major meals and LES, at 0900, 1200, 1800 and 2100, respectively. The Control and LC-NLES groups received only the major meals, whereas the LC-LES group received three meals plus 200 kcal LES for 7 days. There was no difference in the total energy intake among Control, LC-NLES and LC-LES groups. Results: Respiratory quotient in LC-NLES was significantly lower than that of Control at 0830. Respiratory quotient value in LC-LES significantly elevated from that in LC-NLES. The RQ values did not differ among Control, LC-NLES and LC-LES at 2 h after the meal (1130 and 1430). Non-esterified fatty acids in LC-LES were lower than that in LC-NLES after overnight fasting. Conclusions: The ingestion of a 200 kcal rice ball LES can improve the nutritional metabolism in cirrhotic patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effect of late evening snack with rice ball on energy metabolism in liver cirrhosis

et al. 2006

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“…Also glucide intake at night shows a similar effect [75]. The disruption of muscle protein is suppressed by BCAA intake at night and glucose tolerability is improved by BCAA with glucide intake at night [76,77]. Because a simple LES addition induces energy overload promoting obesity and glucose intolerance, it is important that <200 kcal are allocated to the LES from the standard daily total energy intake.…”

Section: Nutrition Therapy For Lc With Pemmentioning

confidence: 99%

“…Because a simple LES addition induces energy overload promoting obesity and glucose intolerance, it is important that <200 kcal are allocated to the LES from the standard daily total energy intake. Concrete examples of LES are a snack mainly consisting of carbohydrates, general enteral nutrients, BCAA-rich enteral nutrition, and so on [76,[78][79][80][81][82]. It has been reported in LC patients with LES that energy metabolism (respiration quotient), serum-free fatty acid levels, and urine 3-methylhystidine levels improve in a week, and serum albumin levels, nitrogen balance, and QOL improve within 3 months [76,78,79].…”

Section: Nutrition Therapy For Lc With Pemmentioning

confidence: 99%

A 12-week Double-blind Randomized Clinical Trial Of Vitamin D3 Supplementation On Body Fat Mass In Healthy Overweight And Obese Women

Coles¹

2013

Clinical Nutrition

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The dietary intake of patients with nonalcoholic fatty liver disease (NAFLD) is generally characterized by high levels of carbohydrate, fat, and/or cholesterol, and these dietary patterns influence hepatic lipid metabolism in the patients. Therefore, careful investigation of dietary habits could lead to better nutrition therapy in NAFLD patients. The main treatment for chronic hepatitis C (CHC) is interferon-based antiviral therapy, which often causes a decrease in appetite and energy intake; hence, nutritional support is also required during therapy to prevent undernourishment, treatment interruption, and a reduction in quality of life. Moreover, addition of some nutrients that act to suppress viral proliferation is recommended. As a substitutive treatment, low-iron diet therapy, which is relatively safe and effective for preventing hepatocellular carcinoma, is also recommended for CHC patients. Some patients with liver cirrhosis (LC) have decreased dietary energy and protein intake, while the number of LC patients with overeating and obesity is increasing, indicating that the nutritional state of LC patients has a broad spectrum. Therefore, nutrition therapy for LC patients should be planned on an assessment of their complications, nutritional state, and dietary intake. Late evening snacks, branched-chain amino acids, zinc, and probiotics are considered for effective nutritional utilization.

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“…51,52 More recently, a randomized trial reported that a complete nutritional supplementation (710 Kcal and 26 g protein) given in the late evening hours (from 9 pm to 7 am) is able to improve the total body protein measured by the neutron activation analysis in patients with liver cirrhosis. 53 Nocturnal supplementations with snacks enriched with branched chain amino acids (BCAA) have also been suggested to be effective in improving the nutritional status of cirrhotic patients 54 being even better than the supplements of ordinary food. 55 Main nutritional recommendations in liver cirrhosis are summarized in Table 5.…”

Section: Indications For Malnourished Patients Waiting For Liver Tranmentioning

confidence: 99%

Nutritional Status and Liver Transplantation

Merli¹,

Giusto²,

Giannelli³

et al. 2011

Journal of Clinical and Experimental Hepatology

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Chronic liver disease has a profound effect on nutritional status and undernourishment is almost universally present in patients with end-stage liver disease undergoing liver transplantation. In the last decades, due to epidemiological changes, a trend showing an increase in patients with end-stage liver disease and associated obesity has also been reported in developed countries. Nutrition abnormalities may influence the outcome after transplantation therefore, the importance to carefully assess the nutritional status in the work-up of patients candidates for liver transplantation is widely accepted. More attention has been given to malnourished patients as they represent the greater number. The subjective global nutritional assessment and anthropometric measurements are recognized in current guidelines to be adequate in identifying those patients at risk of malnutrition. Cirrhotic patients with a depletion in lean body mass and fat deposits have an increased surgical risk and malnutrition may impact on morbidity, mortality and costs in the post-transplantation setting. For this reason an adequate calorie and protein intake should always be ensured to malnourished cirrhotic patient either through the diet, or using oral nutritional supplements or by enteral or parenteral nutrition although studies supporting the efficacy of nutritional supplementation in improving the clinical outcomes after transplantation are still scarce. When liver function is restored, an amelioration in the nutritional status is expected. After liver transplantation in fact dietary intake rapidly normalizes and fat mass is progressively regained while the recovery of muscle mass can be slower. In some patients unregulated weight gain may lead to over-nutrition and may favor metabolic disorders (hypertension, hyperglycemia, hyperlipidemia). This condition, defined as 'metabolic syndrome', may play a negative role on the overall survival of liver transplant patients. In this report we review data on nutrition and liver transplantation. © 2011 INASL

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Effect of oral branched chain amino acid supplementation in the late evening on the nutritional state of patients with liver cirrhosis

Cited by 65 publications

References 14 publications

Effect of late evening snack with rice ball on energy metabolism in liver cirrhosis

Effect of late evening snack with rice ball on energy metabolism in liver cirrhosis

A 12-week Double-blind Randomized Clinical Trial Of Vitamin D3 Supplementation On Body Fat Mass In Healthy Overweight And Obese Women

Nutritional Status and Liver Transplantation

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