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Cited by 252Nutrition and Health in AgingClinical Nutrition and GastroenterologyLiver Disease and Transplantation

Late evening snack: exploiting a period of anabolic opportunity in cirrhosis

Tsien, Cynthia D, McCullough, Arthur J, Dasarathy, Srinivasan·2012·Journal of Gastroenterology and Hepatology
DOI 10.1111/j.1440-1746.2011.06951.x
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Abstract

BACKGROUND AND AIM: Cirrhosis is a state of accelerated starvation with impaired protein synthesis. Increased rate of gluconeogenesis and alterations in skeletal muscle signaling pathways result in anabolic resistance and consequent loss of muscle mass or sarcopenia in cirrhosis. Late evening snack (LES) is an intervention to reduce the postabsorptive (fasting) phase with the potential to improve substrate utilization and reverse sarcopenia. Published reports were evaluated to examine the effect of LES on regulation of substrate utilization (short-term studies) and nutritional outcomes (long-term studies). METHODS: PubMed, EMBASE, Google scholar and OVID databases were searched. All studies published on LES in cirrhosis were included. Studies that included few (n < 3) subjects and patients with hepatocellular carcinoma were excluded. RESULTS: Late evening snack decreased lipid oxidation and improved nitrogen balance, irrespective of the composition or type of formulation used. Daytime isocaloric isonitrogenous snacks did not have the metabolic or clinical benefit of LES. LES decreased skeletal muscle proteolysis. No studies have examined its effect on muscle protein synthesis. There was inconsistent translation into an increase in lean body or skeletal muscle mass. Improved quality of life occurs but decreased mortality or need for transplantation has not been reported. The optimal composition of LES has not been defined, but based on mechanistic considerations, a branched chain supplemented LES holds most promise. CONCLUSIONS: Late evening snack holds the most promise as an intervention to reverse anabolic resistance and sarcopenia of cirrhosis with improved quality of life in patients with cirrhosis. Long term benefit and improved survival need critical evaluation.

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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 [458]

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Authors
Tsien, C. D., McCullough, A. J., & Dasarathy, S.
Affiliations
Cleveland Clinic (US)
Corresponding author
Dasarathy, Srinivasan
ORCID
Venue
Journal of Gastroenterology and Hepatology
Publisher
Wiley
Published
2012-02-21
Volume
27
Issue
3
Pages
430-441
ISSN
  • 0815-9319 (ISSN-L)
  • 1440-1746
DOI
10.1111/j.1440-1746.2011.06951.x
OpenAlex
W1882094537
Cited by
252
References
75
Citations by year
2026: 13 · 2025: 16 · 2024: 19 · 2023: 23 · 2022: 20 · 2021: 28 · 2020: 22 · 2019: 29 · 2018: 18 · 2017: 11 · 2016: 19 · 2015: 8 · 2014: 14 · 2013: 6 · 2012: 6
FWCI
0.89
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Journal of Gastroenterology and Hepatology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
  • Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
  • Health Sciences › Medicine › Hepatology › Liver Disease and Transplantation
Keywords
liver cirrhosis, sarcopenia, anabolic resistance, nitrogen balance, lipid oxidation, skeletal muscle proteolysis, branched-chain amino acids, substrate utilization, dietary intervention, quality of life
MeSH terms
Eating, Food, Humans, Liver Cirrhosis, Quality of Life, Time Factors, Dietary Supplements, Sarcopenia

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