Vegetable versus animal protein diet in cirrhotic patients

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InfoTrac Web: InfoTrac OneFile. Source: JAMA, The Journal of the American Medical Association, Sept 15, 1993 v270 n11 p1309(1). Title: Vegetable versus animal protein diet in cirrhotic patients with chronic encephalopathy: a randomized cross-over comparison. (J Intern Med 1993;233:385-392) (Abstract) Author: G.P. Bianchi Subjects: Liver cirrhosis - Diet therapy Electronic Collection: A14417358 RN: A14417358 Full Text COPYRIGHT 1993 American Medical Association In a randomized cross-over comparison, the effects of a mainly vegetable protein diet were compared with an animal protein diet in eight patients withcirrhosis and chronic permanent encephalopathy, under optimum lactulose therapy. After a run-in period, patients were fed two equi-caloric, equi-nitrogenous diets for 7 days (71 g total proteins), containing either 50 g protein of animal origin or 50 g vegetable proteins. In the last 3 days of each period, nitrogen balance was significantly better during the vegetable protein diet (+0.2 (SD 1.4) g vs. -1.7 (2.4); P<0.01), the difference being entirely due to a reduced urinary nitrogen excretion. Average daytime integrated blood glucose was slightly higher during vegetable proteins, whereas insulin, plasma amino acids and ammonia were lower. The clinical grading of encephalopathy improved slightly on vegetable proteins, and psychometric tests improved significantly, but remained grossly abnormal. Compliance to dietary manipulation was good. The data prove that a mainly vegetable protein diet is worthwhile in cirrhotic patients with chronic encephalopathy under optimum lactulose therapy. Improved nitrogen balance maybe related to more effective nitrogen use for protein synthesis, probably due to blunted hormonal response, and largely outweighs the effects onencephalopathy. (1993;233:385-392) G. P. Bianchi et al. Correspondence to G. Marchesini, Istituto di Clinica Medica Generale E Terapia Medica, Universita di Bologna, Policlinico S. Orsola Via Massarenti 9, I-40138 Bologna, Italy. -- End --