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Oral Branched-Chain Amino-Acid-Enriched Nutrient Mixture Good As Carbohydrate-Rich Meals In Reducing Fat Oxidation In Cirrhotic Patients

An oral branched-chain amino-acid-enriched nutrient mixture (BCAA mixture) is equal to carbohydrate-rich meals in reducing fat oxidation in cirrhotic patients, say Japanese researchers.

They found supplementation with a BCAA mixture showed similar results as a carbohydrate-rich late evening snack in such patients who, often without taking breakfast, have medical procedures such as diagnostic gastrointestinal endoscopy.

In this study, investigators at the Department of Nutrition and the Second Department of Medicine, The University of Tokushima, School of Medicine, Tokushima, Japan, looked at the effect of fasting over 12 hours on energy metabolism. They also tested whether the catabolic state could be improved by supplementation of BCAA containing various additional nutrients. They used indirect calorimetry to take metabolic measurement in 30 cirrhotic patients and 13 control subjects.

Following an overnight fast, a significantly lower respiratory quotient (RQ) was found in the cirrhotic patients, indicating accelerated fat oxidation and a catabolic state. Moreover, in seven cirrhotic patients RQ decreased rapidly with longer fasting, while in five normal subjects relatively stable values were seen. This suggests that caution is required with clinical procedures in patients who have fasted, the investigators say.

They also studied the effect on RQ of oral glucose, a carbohydrate-rich snack (rice ball), and the BCAA mixture (each, 210 kcal) in six patients with liver cirrhosis and six controls after an overnight fast.

In the cirrhotic patients, RQ and blood glucose levels were elevated to a similar degree by supplementation of the carbohydrate-rich snack and the BCAA mixture (210 kcal each). Significantly greater elevation of blood glucose levels was seen from oral administration of glucose (210 kcal) than the other snacks. This may be may be unfavourable for these patients who often have glucose intolerance, say the researchers.

Significantly improved RQ was found in the 30 subjects in the early morning following supplementation with the BCAA mixture in the late evening.
Journal of Gastroenterology, 2002, Vol 37, Issue 7;531-536. "Severe catabolic state after prolonged fasting in cirrhotic patients: effect of oral branched-chain amino-acid-enriched nutrient mixture"

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