Muscle biopsy studies on malnutrition in patients with liver cirrhosis: Preliminary results of long-term treatment with a branched-chain amino acid enriched diet

Protein-calorie undernutrition is common in patients with liver cirrhosis and may have many causes. In recent years it has become more and more evident that the maintenance of adequate nutrition is an essential part of the management of these patients, because malnutrition is positively associated with energy and mortality and may induce severe derangements of liver function. It is obvious that nutritional therapy should minimize the toxicity arising from protein metabolism while improving the nutritional state, but it is less clear how this should be done in practice. Traditional dietary protein restriction can lessen the risk of hepatic encephalopathy, but often results in chronic protein malnutrition. Besides, despite careful instruction and considerable effort, it is often difficult to increase food intake also in cirrhotic patients on an unrestricted diet because of anorexia, nausea and taste abnormalities.