Effects of Extra‐Carbohydrate Supplementation in the Late Evening on Energy Expenditure and Substrate Oxidation in Patients With Liver Cirrhosis

Chang, Wei‐Kuo; Chao, You‐Chen; Tang, Haoning; Lang, Hui-Fen; Hsu, Chung‐Te

doi:10.1177/014860719702100296

Cited by 92 publications

(68 citation statements)

References 22 publications

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“…Theoretically, LES should shorten nocturnal fasting. In the previous studies with cirrhosis patients, LES has been shown to improve fuel utilization (Chang et al, 1997;Verboeket-van de Venne et al, 1995) and nitrogen economy (Zillikens et al, 1993;Swart et al, 1989). Late evening snack with liquid nutrient (Ensure Liquid) increased RQ and carbohydrate oxidation rates (Miwa et al, 2000).…”

Section: Discussionmentioning

confidence: 97%

“…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: 97%

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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“…Nutritional recommendations for cirrhotic patients with HE should follow ISHEN practice consensus recently published by Amodio et al 15 These recommendations, including specific pattern of dietary intake, 133,134 which should also be based on individual nutritional assessment, are summarized in Table 2.…”

Section: Nutritional Recommendations For He In Cirrhosismentioning

confidence: 99%

Nutrition in the Management of Cirrhosis and its Neurological Complications

Bémeur

Butterworth

2014

Journal of Clinical and Experimental Hepatology

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“…[12][13][14][15] However, there is no consensus in the data on energy expenditure, and thus energy requirements, in this patient population. [16][17][18][19][20][21][22] Plauth et al 23 recommended that energy requirements should be determined in patients with cirrhosis by measurement of their resting energy expenditure (REE) using indirect calorimetry. They suggest, but do not advocate, that if the facilities for measurement are not available, then energy expenditure could be estimated by use of the Harris-Benedict prediction formulae.…”

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confidence: 99%

Resting energy expenditure should be measured in patients with cirrhosis, not predicted

Madden

Morgan

1999

Hepatology

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MeasurementsPatients with cirrhosis are frequently malnourished, 1-3 and this may have a detrimental effect on outcome. 4-7 Adequate nutritional support must be provided if the outlook for these patients is to be optimized, [8][9][10][11] but this requires a knowledge of their nutrient requirements. Detailed studies have been undertaken on protein and nitrogen balance in these patients and consistent increases in their requirements clearly demonstrated. 12-15 However, there is no consensus in the data on energy expenditure, and thus energy requirements, in this patient population. [16][17][18][19][20][21][22] Plauth et al. 23 recommended that energy requirements should be determined in patients with cirrhosis by measurement of their resting energy expenditure (REE) using indirect calorimetry. They suggest, but do not advocate, that if the facilities for measurement are not available, then energy expenditure could be estimated by use of the Harris-Benedict prediction formulae. 24 However, it has been shown that these formulae may underestimate mean measured values of REE in patients with cirrhosis by up to 13%, 17,18,[25][26][27][28][29][30][31][32][33] though presently, it is unclear whether this discrepancy is equally evident in all population subgroups.A number of alternative prediction formulae are available, 34-39 but the accuracy of the REE estimates derived from these has not been studied systematically in patients with chronic liver disease. A prediction formula developed specifically for use in this patient population, which incorporated a measure of fat-free mass (FFM) derived using bioelectrical impedance analysis, has been proposed by Mü ller et al. 40 but this has not been validated.The aims of this study were, therefore: 1) to compare values for REE predicted using the Harris-Benedict, 24 Schofield, 36 Mifflin, 39 Cunningham, 35 and Owen 37,38 formulae with measured values in both patients with cirrhosis and a comparable group of healthy volunteers; 2) to compare values for REE predicted using the ''disease-specific'' Mü ller 40 formula with measured values in patients with cirrhosis; 3) to determine if the predictions made in the patients with cirrhosis are adversely affected by malnutrition, fluid retention, the etiology of the liver injury, or the degree of hepatic decompensation; and 4) to derive an equation for predicting REE in this patient population and to assess its validity. PATIENTS AND METHODSThe patient population comprised 56 men and 44 women, with a mean (range) age of 48.5 (26-71) years, with cirrhosis of varying etiology and severity. The etiology of the liver injury was determined using historical, clinical, laboratory, radiological, and histological variables, while the functional severity of the liver disease was assessed using Pugh' s modification of Child' s grading system 41 (Table 1). Fifty-nine patients were assessed as in-patients, while the remaining 41 were assessed as out-patients. All patients with alcohol-related cirrhosis had been abstinent from alcohol for periods ra...

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Effects of Extra‐Carbohydrate Supplementation in the Late Evening on Energy Expenditure and Substrate Oxidation in Patients With Liver Cirrhosis

Abstract: These preliminary data suggest that extra-carbohydrate supplementation before bedtime can shorten nocturnal fasting with a more economic fuel utilization and effectively diminish fat and protein oxidation in cirrhotic patients.

Cited by 92 publications

References 22 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

Nutrition in the Management of Cirrhosis and its Neurological Complications

Resting energy expenditure should be measured in patients with cirrhosis, not predicted

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