Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-05T05:40:29.938Z Has data issue: false hasContentIssue false

Patterns of energy intake in patients with cirrhosis and healthy volunteers

Published online by Cambridge University Press:  09 March 2007

Angela M. Madden
Affiliation:
University Department of Medicine, The Royal Free Campus, The Royal Free and University College Medical School, London NW3 2QG, UK
Marsha Y. Morgan*
Affiliation:
University Department of Medicine, The Royal Free Campus, The Royal Free and University College Medical School, London NW3 2QG, UK
*
*Corresponding author: Dr Marsha Morgan, fax +44 (0)171 435 8849.
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Fuel utilization and N economy are optimized in patients with cirrhosis by provision of several small meals throughout the day and a late-night snack of complex carbohydrate. Currently, however, only limited information is available on the patterns of energy intake in patients with chronic liver disease. The aims of the present study were to determine the number of days required to undertake such an investigation and to observe the daily distribution of energy intake in this patient population. Eight patients with cirrhosis and eight matched healthy volunteers kept weighed dietary intake records for fifteen separate days over a 6-month period. The records were analysed for energy intake per hour and the number and size of energy intake episodes per 24 h calculated. Intake was verified against resting energy expenditure. Fourteen separate observational days were required to investigate the pattern of energy intake in the cirrhotic patients while 20 d were required for healthy volunteers. Considerable inter- and intrasubject variations in the number and size of energy intake episodes were observed in both the patients and healthy volunteers. However, no significant differences were observed between the mean total number of daily energy intake episodes (6·3 (sd 1·6) v. 7·0 (sd 1·4)) or in the distribution of daily energy intake between the two groups. Most patients and volunteers tended to eat frequent small meals, often including a late-night snack, rather than two or three large meals daily. It should, therefore, be possible to establish optimum patterns of energy intake in these patients in line with recent guidelines.

Type
Research Article
Copyright
Copyright © The Nutrition Society 1999

References

Balogh, M, Kahn, HA & Medalie, JH (1971) Random repeat 24-hour dietary recalls. American Journal of Clinical Nutrition 24, 31043110.Google Scholar
Bellisle, F, McDevitt, R & Prentice, AM (1997) Meal frequency and energy balance. British Journal of Nutrition 77, S57S70.CrossRefGoogle ScholarPubMed
Bernstein, IL, Zimmerman, JC, Czeisler, CA & Weitzman, ED (1981) Meal patterning in “free running” humans. Physiology and Behavior 27, 621623.CrossRefGoogle ScholarPubMed
Bingham, SA (1987) The dietary assessment of individuals; methods, accuracy, new techniques and recommendations. Nutrition Abstracts and Reviews 57, 705742.Google Scholar
British Nutrition Foundation (1984) Eating in the Early 1980's. Attitudes and Behaviour: Main Findings. London: British Nutrition Foundation.Google Scholar
Brownell, KD & Cohen, LR (1995) Adherence to dietary regimens. 2: Components of effective interventions. Behavioral Medicine 20, 155164.Google Scholar
Bursztein, S, Elwyn, DH, Askanazi, J & Kinney, JM (1989) Energy Metabolism, Indirect Calorimetry, and Nutrition. Baltimore, MD: Williams & Wilkins.Google Scholar
Chang, WK, Chao, YC, Tang, HS, Lang, HF & Hsu, CT (1997) Effects of extra-carbohydrate supplementation in the late evening on energy expenditure and substrate oxidation in patients with liver cirrhosis. Journal of Parenteral and Enteral Nutrition 21, 9699.CrossRefGoogle ScholarPubMed
Crawley, H (1988) Food Portion Sizes. London: H.M. Stationery Office.Google Scholar
de Castro, JM (1993) The effects of the spontaneous ingestion of particular foods or beverages on the meal pattern and overall nutrient intake of humans. Physiology and Behavior 53, 11331144.CrossRefGoogle ScholarPubMed
Gatenby, SJ (1997) Eating frequency: methodology and dietary aspects. British Journal of Nutrition 77, S7S20.Google Scholar
Goldberg, GR, Black, AE, Jebb, SA, Cole, TJ, Murgatroyd, PR, Coward, WA & Prentice, AM (1991) Critical evaluation of energy intake data using fundamental principles of energy physiology: 1. Derivation of cut off limits to identify under-recording. European Journal of Clinical Nutrition 45, 569581.Google Scholar
Kant, AK (1995) Frequency of eating occasions and weight changes in NHANES I Epidemiologic Follow-up Study. International Journal of Obesity and Related Metabolic Disorders 19, 468474.Google ScholarPubMed
Larkin, FA, Metzner, HL & Guire, KE (1991) Comparison of three consecutive-day and three random-day records of dietary intake. Journal of the American Dietetic Association 91, 15381542.Google Scholar
Levine, JA & Morgan, MY (1991) Assessment of dietary intake in man: a review of available methods. Journal of Nutritional Medicine 2, 6581.Google Scholar
MacKay, EM & MacKay, LL (1927) Concentration of urea in blood of normal individuals. Journal of Clinical Investigation 2, 295.Google Scholar
Neumann, U & Ziegenhorn, J (1977) Kinetic enzymatic method for the determination of urea in serum with the LKB 8600 reaction rate analyzer. Scandinavian Journal of Clinical and Laboratory Investigation 37, Suppl. 147, 90 Abstr. 97.Google Scholar
Nilsson, LH (1973) Liver glycogen content in man in the postabsorptive state. Scandinavian Journal of Clinical and Laboratory Investigation 32, 317323.Google Scholar
Owen, OE, Trapp, VE, Reichard, GA, Mozzoli, MA, Moctezuma, J, Paul, P, Skutches, CL & Boden, G (1983) Nature and quantity of fuels consumed in patients with alcoholic cirrhosis. Journal of Clinical Investigation 72, 18211832.CrossRefGoogle ScholarPubMed
Plauth, M, Merli, M, Kondrup, J, Weimann, A, Ferenci, P & Müller, MJ (1997) ESPEN guidelines for nutrition in liver disease and transplantation. Clinical Nutrition 16, 4355.Google Scholar
Pugh, RNH, Murray-Lyon, IM, Dawson, JL, Pietroni, MC & Williams, R (1973) Transection of the oesophagus for bleeding oesophageal varices. British Journal of Surgery 60, 646649.Google Scholar
Schlettwein-Gsell, D (1992) Nutrition and the quality of life, a measure for the outcome of nutritional investigation. American Journal of Clinical Nutrition 55, 1263S1266S.CrossRefGoogle Scholar
Steindl, PE, Finn, B, Bendok, B, Rothke, S, Zee, PC & Blei, AT (1995) Disruption of the diurnal rhythm of plasma melatonin in cirrhosis. Annals of Internal Medicine 123, 274277.Google Scholar
Summerbell, CD, Moody, RC, Shanks, J, Stock, MJ & Geissler, C (1995) Sources of energy from meals vs snacks in 220 people in four age groups. European Journal of Clinical Nutrition 49, 3341.Google Scholar
Summerbell, CD, Moody, RC, Shanks, J, Stock, MJ & Geissler, C (1996) Relationship between feeding pattern and body mass index in 220 free-living people in four age groups. European Journal of Clinical Nutrition 50, 513519.Google ScholarPubMed
Swart, GR, Zillikens, MC, van Vuure, JK & van den Berg, JWO (1989) Effect of a late evening meal on nitrogen balance in patients with cirrhosis of the liver. British Medical Journal 299, 12021203.CrossRefGoogle ScholarPubMed
Verboeket-van de Venne, WPHG, Westerterp, KR, van Hoek, B & Swart, GR (1993) Habitual pattern of food intake in patients with liver disease. Clinical Nutrition 12, 293297.CrossRefGoogle ScholarPubMed
Verboeket-van de Venne, WPHG, Westerterp, KR, van Hoek, B & Swart, GR (1995) Energy expenditure and substrate metabolism in patients with cirrhosis of the liver: effects of the pattern of food intake. Gut 36, 110116.CrossRefGoogle ScholarPubMed
Zillikens, MC, van den Berg, JWO, Wattimena, JLD, Rietveld, T & Swart, GR (1993) Nocturnal oral glucose supplementation. The effects on protein metabolism in cirrhotic patients and in healthy controls. Journal of Hepatology 17, 377383.Google Scholar