Effect of oral branched chain amino acid supplementation in the late evening on the nutritional state of patients with liver cirrhosis.

Previous studies have shown that nocturnal glucose supplementation and a late evening meal reduced raised protein turnover rates and led to a better nitrogen balance in patients with cirrhosis. In this study, we investigated whether or not oral branched chain amino acid (BCAA) supplementation in the late evening would improve the nutritional state of patients with liver cirrhosis. Fourteen patients with liver cirrhosis spent two 14 day periods in the ward. All the patients received three meals a day and two doses of BCAA supplementation. Meals were given at 0800, 1200, and 1830. BCAA supplementation was given at 0830 and 1900 (after dinner) and at 0830 and 2230 (late evening), respectively. The daily excretion of 3-methylhistidine, the ratio of 3-methyhistidine to creatinine, and serum free fatty acid in the late evening treatment group were significantly lower as compared to the usual treatment group. These results suggest that oral BCAA supplementation in the late evening also may be useful in improving protein catabolism and lypolysis in cirrhotic patients.