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Nutritional treatment with branched-chain amino acids in advanced liver cirrhosis.
J Gastroenterol 2000; 35 Suppl 12:7-12JG

Abstract

During the last 20 years there has been much interest in nutritional treatment for patients with advanced cirrhosis. Most studies have measured the potential benefit of nutritional supplements of dietary proteins, generic protein hydrolysates, or specific branched-chain amino acid (BCAA)-enriched formulas in regard to nutritional parameters and hepatic encephalopathy. The issue is not definitively settled; data are conflicting and meta-analyses have failed to produce unequivocal results. A consensus review, recently produced under the auspices of the European Society for Parenteral and Enteral Nutrition, concluded that: (1) patients with cirrhosis tend to be hypermetabolic, and a higher-than-normal supply of dietary proteins is needed to achieve nitrogen balance; (2) most patients tolerate a normal or even increased dietary protein intake, without risk of hepatic encephalopathy; (3) a modified eating pattern, based on several meals and a late evening snack, is useful; (4) in severely malnourished patients, amino acid supplements may be considered to provide the necessary amount of proteins to meet protein requirements; (5) in a few patients intolerant to the required protein intake, BCAA supplements may be considered to provide the necessary nitrogen intake without detrimental effects on the mental state, perhaps even improving it. Future studies are needed to quantify the advantage of nutritional support with amino acids or BCAA supplements on overall well-being, complications, and ultimately survival with a long-lasting disease where self-perceived health-related quality of life is a major outcome.

Authors+Show Affiliations

Department of Internal Medicine and Gastroenterology, University of Bologna, Policlinico S Orsola, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

10779207

Citation

Marchesini, G, et al. "Nutritional Treatment With Branched-chain Amino Acids in Advanced Liver Cirrhosis." Journal of Gastroenterology, vol. 35 Suppl 12, 2000, pp. 7-12.
Marchesini G, Bianchi G, Rossi B, et al. Nutritional treatment with branched-chain amino acids in advanced liver cirrhosis. J Gastroenterol. 2000;35 Suppl 12:7-12.
Marchesini, G., Bianchi, G., Rossi, B., Brizi, M., & Melchionda, N. (2000). Nutritional treatment with branched-chain amino acids in advanced liver cirrhosis. Journal of Gastroenterology, 35 Suppl 12, pp. 7-12.
Marchesini G, et al. Nutritional Treatment With Branched-chain Amino Acids in Advanced Liver Cirrhosis. J Gastroenterol. 2000;35 Suppl 12:7-12. PubMed PMID: 10779207.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nutritional treatment with branched-chain amino acids in advanced liver cirrhosis. AU - Marchesini,G, AU - Bianchi,G, AU - Rossi,B, AU - Brizi,M, AU - Melchionda,N, PY - 2000/4/25/pubmed PY - 2000/7/6/medline PY - 2000/4/25/entrez SP - 7 EP - 12 JF - Journal of gastroenterology JO - J. Gastroenterol. VL - 35 Suppl 12 N2 - During the last 20 years there has been much interest in nutritional treatment for patients with advanced cirrhosis. Most studies have measured the potential benefit of nutritional supplements of dietary proteins, generic protein hydrolysates, or specific branched-chain amino acid (BCAA)-enriched formulas in regard to nutritional parameters and hepatic encephalopathy. The issue is not definitively settled; data are conflicting and meta-analyses have failed to produce unequivocal results. A consensus review, recently produced under the auspices of the European Society for Parenteral and Enteral Nutrition, concluded that: (1) patients with cirrhosis tend to be hypermetabolic, and a higher-than-normal supply of dietary proteins is needed to achieve nitrogen balance; (2) most patients tolerate a normal or even increased dietary protein intake, without risk of hepatic encephalopathy; (3) a modified eating pattern, based on several meals and a late evening snack, is useful; (4) in severely malnourished patients, amino acid supplements may be considered to provide the necessary amount of proteins to meet protein requirements; (5) in a few patients intolerant to the required protein intake, BCAA supplements may be considered to provide the necessary nitrogen intake without detrimental effects on the mental state, perhaps even improving it. Future studies are needed to quantify the advantage of nutritional support with amino acids or BCAA supplements on overall well-being, complications, and ultimately survival with a long-lasting disease where self-perceived health-related quality of life is a major outcome. SN - 0944-1174 UR - https://www.unboundmedicine.com/medline/citation/10779207/Nutritional_treatment_with_branched_chain_amino_acids_in_advanced_liver_cirrhosis_ L2 - https://medlineplus.gov/cirrhosis.html DB - PRIME DP - Unbound Medicine ER -