Short-term changes in energy metabolism after 1 month of a regular oral diet in severely malnourished cirrhotic patients

Resting energy expenditure should be measured in patients with cirrhosis, not predicted

“…It is surprising, given the obvious inaccuracy of the Harris-Benedict prediction of REE in patients with chronic liver disease identified in this and other studies, 17,18,[25][26][27][28][29][30][31][32][33] that only one previous attempt has been made to devise a disease-specific prediction formula. 40 Mü ller et al 40 devised such a formula based on age and a measure of FFM in 123 patients with cirrhosis.…”

“…24 However, underestimates of mean measured REE have been recorded in this patient group using these formulae with individual differences between predicted and measured values exceeding 20% in one third of patients. 17,18,[25][26][27][28][29][30][31][32][33] No information is, however, available on the relative accuracy of the predictions in various population subgroups. Similarly, little if any information is available on the accuracy of the estimates of REE obtained, in this patient population, using other prediction formulae.…”

“…They suggest, but do not advocate, that if the facilities for measurement are not available, then energy expenditure could be estimated by use of the Harris-Benedict prediction formulae. 24 However, it has been shown that these formulae may underestimate mean measured values of REE in patients with cirrhosis by up to 13%, 17,18,[25][26][27][28][29][30][31][32][33] though presently, it is unclear whether this discrepancy is equally evident in all population subgroups.A number of alternative prediction formulae are available, 34-39 but the accuracy of the REE estimates derived from these has not been studied systematically in patients with chronic liver disease. A prediction formula developed specifically for use in this patient population, which incorporated a measure of fat-free mass (FFM) derived using bioelectrical impedance analysis, has been proposed by Mü ller et al 40 but this has not been validated.…”

Macronutrient preference, dietary intake, and substrate oxidation among stable cirrhotic patients

“…Other researchers have reported depleted muscle mass in their cirrhotic patients. However, these have invariably been performed in patients recovering from a complication of liver disease [34][35] and loss of muscle mass is not a consistent finding among cirrhotic patients. 4 Energy and macronutrient intakes were significantly lower in the cirrhotic patient group when compared with controls.…”

A 12-week Double-blind Randomized Clinical Trial Of Vitamin D3 Supplementation On Body Fat Mass In Healthy Overweight And Obese Women

“…In some LC patients, intake of various nutrients decreases, which accelerates hepatic dysfunction including a metabolic disorder, resulting in protein energy malnutrition (PEM) [61][62][63][64][65]. Some investigations have shown that LC patients have a trend to take more energy via carbohydrates, which may reflect their insufficient glycogen storage, and fasting accelerates the oxidation of fat [66][67][68].…”