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BMJ. 1989 Nov 11;299(6709):1202-3.

Effect of a late evening meal on nitrogen balance in patients with cirrhosis of the liver.

Author information

  • 1Department of Internal Medicine II, University Hospital Dijkzigt, Rotterdam, The Netherlands.

Abstract

OBJECTIVE:

To assess whether a late evening meal would improve nitrogen balance in patients with cirrhosis of the liver.

DESIGN:

Randomised crossover study of meal schedules comparing three meals a day with four or six meals a day, the four and six meal schedules both including a late evening meal (2300).

SETTING:

Metabolic ward.

PATIENTS:

Seven men and two women aged 34-66 with cirrhosis of the liver (Child's grade B).

INTERVENTIONS:

Patients spent two seven day periods in the ward. For five days of each period they received, in random order, isonitrogenous isocaloric diets supplied in three meals a day and in four or six meals a day.

MAIN OUTCOME MEASURE:

Nitrogen balance, calculated as the difference between dietary intake and the total of urinary, faecal, and integumental nitrogen loss.

RESULTS:

Faecal nitrogen loss was no different between three meals a day and four or six meals a day. On both four and six meals a day, however, patients had nitrogen balances that were more positive (or less negative) than on three meals a day (1.26 (SD 2.1) g/24 h v 0.26 (2.2) g/24 h, p less than 0.01). Six meals a day did not produce significantly better improvements in nitrogen balance than four meals a day.

CONCLUSIONS:

A late evening meal seemed to improve the efficiency of nitrogen metabolism, but longer term studies are needed to assess whether this leads to a better nutritional state.

PMID:
2513050
[PubMed - indexed for MEDLINE]
PMCID:
PMC1838097
Free PMC Article
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