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

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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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Authors: Tsien, C. D., McCullough, A. J., & Dasarathy, S.
Affiliations: Cleveland Clinic (US)
Corresponding author: Dasarathy, Srinivasan
ORCID: Tsien, Cynthia D
McCullough, Arthur J
Dasarathy, Srinivasan
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 (medical) › 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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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

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

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