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Cited by 325Clinical Nutrition and GastroenterologyLiver Disease and TransplantationNutrition and Health in Aging

Nocturnal nutritional supplementation improves total body protein status of patients with liver cirrhosis: A randomized 12‐month trial†

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Plank, Lindsay D., Gane, Edward J., Peng, Szelin, Muthu, Carl, Mathur, Sachin, Gillanders, Lyn, McIlroy, Kerry, Donaghy, Anthony J. +1 more·2008·Hepatology
DOI 10.1002/hep.22367
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Abstract

UNLABELLED: Patients with liver cirrhosis exhibit early onset of gluconeogenesis after short-term fasting. This accelerated metabolic reaction to starvation may underlie their increased protein requirements and muscle depletion. A randomized controlled trial was conducted to test the hypothesis that provision of a late-evening nutritional supplement over a 12-month period would improve body protein stores in patients with cirrhosis. A total of 103 patients (68 male, 35 female; median age 51, range 28-74; Child-Pugh grading: 52A, 31B, 20C) were randomized to receive either daytime (between 0900 and 1900 hours) or nighttime (between 2100 and 0700 hours) supplementary nutrition (710 kcal/day). Primary etiology of liver disease was chronic viral hepatitis (67), alcohol (15), cholestatic (6), and other (15). Total body protein (TBP) was measured by neutron activation analysis at baseline, 3, 6, and 12 months. Total daily energy and protein intakes were assessed at baseline and at 3 months by comprehensive dietary recall. As a percentage of values predicted when well, TBP at baseline was similar for the daytime (85 +/- 2[standard error of the mean]%) and nighttime (84 +/- 2%) groups. For the nighttime group, significant increases in TBP were measured at 3 (0.38 +/- 0.10 kg, P = 0.0004), 6 (0.48 +/- 0.13 kg, P = 0.0007), and 12 months (0.53 +/- 0.17 kg, P = 0.003) compared to baseline. For the daytime group, no significant changes in TBP were seen. Daily energy and protein intakes at 3 months were higher than at baseline in both groups (P < 0.0001), and these changes did not differ between the groups. CONCLUSION: Provision of a nighttime feed to patients with cirrhosis results in body protein accretion equivalent to about 2 kg of lean tissue sustained over 12 months. This improved nutritional status may have important implications for the clinical course of these patients.

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Crossref · 10.1002/hep.22367

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  • A late-evening snack containing complex carbohydrates and protein reduces lipid oxidation, improves nitrogen balance, reduces skeletal muscle proteolysis, increases muscle mass, reduces hepatic encephalopathy and improves quality of life.

    “Alateevening snack containing complex carbohydrates and protein reduces lipid oxidation, improves nitrogen balance, reduces skeletal muscle proteolysis, increases muscle mass, reduces hepatic encephalopathy and improves quality of life.”

    From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [457]

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Authors
Plank, L. D., Gane, E. J., Peng, S., Muthu, C., Mathur, S., Gillanders, L., McIlroy, K., Donaghy, A. J., & McCall, J. L.
Affiliations
  • University of Auckland (NZ)
  • Auckland City Hospital (NZ)
  • Royal Prince Alfred Hospital (AU)
Corresponding author
Plank, Lindsay D.
ORCID
Venue
Hepatology
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2008-08
Volume
48
Issue
2
Pages
557-566
ISSN
0270-9139 (ISSN-L)
DOI
10.1002/hep.22367
OpenAlex
W1984945109
Cited by
325
References
38
Citations by year
2026: 18 · 2025: 17 · 2024: 19 · 2023: 38 · 2022: 24 · 2021: 28 · 2020: 20 · 2019: 39 · 2018: 18 · 2017: 17 · 2016: 13 · 2015: 11 · 2014: 12 · 2013: 13 · 2012: 16
FWCI
6.95
Type
journal article
Language
en
Open access
Licence
Locations
  • Hepatology (publishedVersion)
  • PubMed (publishedVersion)
  • ResearchSpace (University of Auckland) (submittedVersion, cc-by)
Topics
  • Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
  • Health Sciences › Medicine › Hepatology › Liver Disease and Transplantation
  • Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
Keywords
liver cirrhosis, nocturnal feeding, total body protein, protein accretion, protein requirements, gluconeogenesis, muscle atrophy, nutritional status, energy intake, protein intake
MeSH terms
Adult, Aged, Energy Intake, Circadian Rhythm, Dietary Proteins, Female, Humans, Insulin-Like Growth Factor I, Liver Cirrhosis, Male, Middle Aged, Neutron Activation Analysis, Nutritional Status, Proteins, Quality of Life, Growth Hormone, Nutritional Support, Insulin-Like Growth Factor Binding Protein 3

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