Division of Metabolic Diseases and Clinical Nutrition, Department of Specialistic Medicines, University Hospital of Modena and Reggio Emilia, Largo del Pozzo 71, 41125 Modena, Italy.
Gastroenterology Unit, Department of Medical Specialties, University Hospital of Modena, University of Modena & Reggio Emilia, 41121 Modena, Italy.
Nutrients. 2023 Aug 5;15(15):3471. doi: 10.3390/nu15153471.
The efficacy of the late-evening snack (LES) has been extensively studied due to the impact of the longest intermeal duration occurring at night in patients with cirrhosis. While actual clinical guidelines on nutrition in chronic liver disease recommend an LES, no specific nutritional compositions have been reported by the European Association for the Study of the Liver (EASL) and the European Society for Clinical Nutrition and Metabolism (ESPEN). Late-evening snacks vary greatly among studies, including natural foods and/or nutritional supplements, yet oral supplements still need to fully meet the LES's nutritional composition. In addition, many hepatologists need to gain experience in nutritional approaches and have access to registered dieticians who can help them manage patients with liver disease. Therefore, this review study aims to summarise evidence regarding using LESs and the mechanisms behind long starvation in patients with cirrhosis. It also provides a practical nutritional guide with several LES options based on common natural foods tailored to special patients' nutritional requirements and geographical backgrounds. In preventing accelerated starvation and related protein malnutrition and sarcopenia in patients with cirrhosis, the nutritional composition of LESs is essential. The proper and straightforward application of the LES's rational nutrition is an advantage to cirrhotic patients and should be carried out by healthcare professionals to enhance the overall liver function and nutritional status of patients with cirrhosis.
由于肝硬化患者夜间最长的两餐间隔时间会对其产生影响，因此人们对夜宵（LES）的功效进行了广泛的研究。尽管慢性肝病营养实际临床指南推荐使用夜宵，但欧洲肝脏研究协会（EASL）和欧洲临床营养与代谢学会（ESPEN）并未报告夜宵的具体营养成分。夜宵在不同的研究中差异很大，包括天然食品和/或营养补充剂，但口服补充剂仍需充分满足夜宵的营养成分。此外，许多肝病学家需要在营养方法方面积累经验，并能够获得注册营养师的帮助，以帮助他们管理肝病患者。因此，本综述研究旨在总结有关使用夜宵和肝硬化患者长时间饥饿背后机制的证据。它还提供了一个实用的营养指南，其中包含几种基于常见天然食物的夜宵选择，以满足特殊患者的营养需求和地理背景。在预防肝硬化患者加速饥饿和相关的蛋白质营养不良和肌肉减少症方面，夜宵的营养成分至关重要。正确、直接地应用夜宵的合理营养是肝硬化患者的优势，应由医疗保健专业人员来实施，以增强肝硬化患者的整体肝功能和营养状况。
