Low-protein diets for hepatic encephalopathy debunked: Let them eat steak

Nutrition in Clinical Practice

Volumn 26, Issue 2, 2011, Pages 155-159

  Cabral, Chad Michael ^a   Burns, David L ^a  

^a LAHEY HOSPITAL AND MEDICAL CENTER   (United States)

Author keywords

dietary proteins; hepatic encephalopathy; liver cirrhosis; liver diseases; protein restricted diet; proteins

Indexed keywords

ARTICLE; HEPATIC ENCEPHALOPATHY; HUMAN; LIVER CIRRHOSIS; MAJOR CLINICAL STUDY; NUTRITION; PATIENT CARE; PATIENT SAFETY; PRACTICE GUIDELINE; PROTEIN CALORIE MALNUTRITION; PROTEIN INTAKE; PROTEIN RESTRICTION;

DIET, PROTEIN-RESTRICTED; DIETARY PROTEINS; EVIDENCE-BASED MEDICINE; HEPATIC ENCEPHALOPATHY; HUMANS; NUTRITIONAL REQUIREMENTS; RANDOMIZED CONTROLLED TRIALS AS TOPIC;

EID: 79954618040     PISSN: 08845336     EISSN: None     Source Type: Journal    
DOI: 10.1177/0884533611400086     Document Type: Article

References (29)

1. Schafer DF, Jones EA Hepatic encephalopathy and the gamma-aminobutyric- acid neurotransmitter system. Lancet. 1982 ; 1: 18-20. (Pubitemid 12246565)
2. Lautz HU, Selberg O., Körber J., Bürger M., Müller MJ Protein-calorie malnutrition in liver cirrhosis. Clin Investig. 1992 ; 70: 478-486.
3. Mendenhall CL, Moritz TE, Roselle GA, et al. A study of oral nutritional support with oxandrolone in malnourished patients with alcoholic hepatitis: results of a Department of Veterans Affairs cooperative study. Hepatology. 1993 ; 17: 564-576. (Pubitemid 23115499)
4. Alberino F., Gatta A., Amodio P., et al. Nutrition and survival in patients with liver cirrhosis. Nutrition. 2001 ; 17: 445-450. (Pubitemid 32505665)
5. Phillips GB, Schwartz R., Gabuzda GJ Jr, Davidson CS The syndrome of impending hepatic coma in patients with cirrhosis of the liver given certain nitrogenous substances. N Engl J Med. 1952 ; 247: 239-246.
6. Chadalavada R., Sappati Biyyani RS, Maxwell J., Mullen K. Nutrition in hepatic encephalopathy. Nutr Clin Pract. 2010 ; 25: 257-264.
7. Nompleggi DJ, Bonkovsky HL Nutritional supplementation in chronic liver disease: an analytical review. Hepatology. 1994 ; 19: 518-533. (Pubitemid 24046800)
8. Córdoba J., López-Hellín J., Planas M., et al. Normal protein diet for episodic hepatic encephalopathy: results of a randomized study. J Hepatol. 2004 ; 41: 38-43. (Pubitemid 39005150)
9. Swart GR, van den Berg JW, Wattimena JL, Rietveld T., van Vuure JK, Frenkel M. Elevated protein requirements in cirrhosis of the liver investigated by whole body protein turnover studies. Clin Sci (Lond). 1988 ; 75: 101-107.
10. Nutritional status in cirrhosis. Italian Multicentre Cooperative Project on Nutrition in Liver Cirrhosis. J Hepatol. 1994 ; 21: 317-325.
11. Morgan MY, Madden AM, Soulsby CT, Morris RW Derivation and validation of a new global method for assessing nutritional status in patients with cirrhosis. Hepatology. 2006 ; 44: 823-835. (Pubitemid 46489545)
12. Gunsar F., Raimondo ML, Jones S., et al. Nutritional status and prognosis in cirrhotic patients. Aliment Pharmacol Ther. 2006 ; 24: 563-572. (Pubitemid 44127837)
13. Gheorghe L., Iacob R., V dan R, Iacob S., Gheorghe C. Improvement of hepatic encephalopathy using a modified high-calorie high-protein diet. Rom J Gastroenterol. 2005 ; 14: 231-238. (Pubitemid 41494475)
14. Heyman JK, Whitfield CJ, Brock KE, McCaughan GW, Donaghy AJ Dietary protein intakes in patients with hepatic encephalopathy and cirrhosis: current practice in NSW and ACT. Med J Aust. 2006 ; 185: 542-543. (Pubitemid 44816940)
15. Le Cornu KA, McKiernan FJ, Kapadia SA, Neuberger JM A prospective randomized study of preoperative nutritional supplementation in patients awaiting elective orthotopic liver transplantation. Transplantation. 2000 ; 69: 1364-1369. (Pubitemid 30238725)
16. Wolfe RR, Miller SL The recommended dietary allowance of protein: a misunderstood concept. JAMA. 2008 ; 299: 2891-2893. (Pubitemid 351930889)
17. Charlton M. Branched-chain amino acid enriched supplements as therapy for liver disease. J Nutr. 2006 ; 136: 295S - 298S. (Pubitemid 43156528)
18. Abou-Assi SG, Mihas AA, Gavis EA, et al. Safety of an immune-enhancing nutrition supplement in cirrhotic patients with history of encephalopathy. JPEN J Parenter Enteral Nutr. 2006 ; 30: 91-96. (Pubitemid 44314782)
19. Weber FL, Jr., Bagby BS, Licate L., Kelsen SG Effects of branched-chain amino acids on nitrogen metabolism in patients with cirrhosis. Hepatology. 1990 ; 11: 942-950. (Pubitemid 20221028)
20. Bianchi GP, Marchesini G., Zoli M., et al. Oral BCAA supplementation in cirrhosis with chronic encephalopathy: effects on prolactin and estradiol levels. Hepatogastroenterology. 1992 ; 39: 443-446.
21. Marchesini G., Dioguardi FS, Bianchi GP, et al. Long-term oral branched-chain amino acid treatment in chronic hepatic encephalopathy: a randomized double-blind casein-controlled trial. The Italian Multicenter Study Group. J Hepatol. 1990 ; 11: 92-101. (Pubitemid 20250834)
22. Marchesini G., Marzocchi R., Noia M., Bianchi G. Branched-chain amino acid supplementation in patients with liver diseases. J Nutr. 2005 ; 135: 1596S - 1601S. (Pubitemid 40791677)
23. Nakaya Y., Harada N., Kakui S., et al. Severe catabolic state after prolonged fasting in cirrhotic patients: effect of oral branched-chain amino-acid-enriched nutrient mixture. J Gastroenterol. 2002 ; 37: 531-536.
24. Bianchi GP, Marchesini G., Fabbri A., et al. Vegetable versus animal protein diet in cirrhotic patients with chronic encephalopathy: a randomized cross-over comparison. J Intern Med. 1993 ; 233: 385-392. (Pubitemid 23139326)
25. Uribe M., Marquez MA, Garcia Ramos G., et al. Treatment of chronic portal-systemic encephalopathy with vegetable and animal protein diets: a controlled crossover study. Dig Dis Sci. 1982 ; 27: 1109-1116. (Pubitemid 13198254)
26. Cummings JH, Branch W., Jenkins DJ, Southgate DA, Houston H., James WP Colonic response to dietary fibre from carrot, cabbage, apple, bran. Lancet. 1978 ; 1: 5-9.
27. Shawcross D., Jalan R. Dispelling myths in the treatment of hepatic encephalopathy. Lancet. 2005 ; 365: 431-433. (Pubitemid 40179231)
28. Lawrence KR, Klee JA Rifaximin for the treatment of hepatic encephalopathy. Pharmacotherapy. 2008 ; 28: 1019-1032.
29. Riordan SM, Williams R. The intestinal flora and bacterial infection in cirrhosis. J Hepatol. 2006 ; 45: 744-757. (Pubitemid 44466668)