Protein-restricted diets are often prescribed for cirrhotic patients with hepatic encephalopathy. Yet protein restriction may lead to a worsening of nutritional status, without leading to any improvement of hepatic encephalopathy.
Juan Córdoba and fellow researchers from Barcelona, Spain, have therefore conducted a study to assess the effects of the amount of protein in the diet on the evolution of episodic hepatic encephalopathy.
They studied 30 cirrhotic patients admitted to hospital due to an episode of encephalopathy. The patients were randomized to receive either a low-protein diet with progressive increments or a normal diet for 14 days, in addition to standard measures to treat hepatic encephalopathy.
Protein synthesis and breakdown were then studied at day 2 and day 13 with the glycine-N15 infusion method.
Using this technique the researchers found there was no significant difference in the outcome of hepatic encephalopathy between the two treatment groups.
Although protein breakdown was greater in those patients receiving the low-protein diet, both groups showed similar levels of protein synthesis, regardless of whether they were fed a low or a normal protein diet.
The researchers conclude that diets with a normal content of protein, which are metabolically more adequate, can be safely administered to cirrhotic patients with episodic hepatic encephalopathy.
They add that restriction of the content of protein of the diet does not appear to have any beneficial effect for cirrhotic patients during an episode of encephalopathy.