Patterns of energy intake in patients with cirrhosis and healthy volunteers

Fuel utilization and N economy are optimized in patients with cirrhosis by provision of several small meals throughout the day and a late-night snack of complex carbohydrate. Currently, however, only limited information is available on the patterns of energy intake in patients with chronic liver disease. The aims of the present study were to determine the number of days required to undertake such an investigation and to observe the daily distribution of energy intake in this patient population. Eight patients with cirrhosis and eight matched healthy volunteers kept weighed dietary intake records for fifteen separate days over a 6-month period. The records were analysed for energy intake per hour and the number and size of energy intake episodes per 24 h calculated. Intake was verified against resting energy expenditure. Fourteen separate observational days were required to investigate the pattern of energy intake in the cirrhotic patients while 20 d were required for healthy volunteers. Considerable inter- and intrasubject variations in the number and size of energy intake episodes were observed in both the patients and healthy volunteers. However, no significant differences were observed between the mean total number of daily energy intake episodes (6.3 (SD 1.6) v. 7.0 (SD 1.4)) or in the distribution of daily energy intake between the two groups. Most patients and volunteers tended to eat frequent small meals, often including a late-night snack, rather than two or three large meals daily. It should, therefore, be possible to establish optimum patterns of energy intake in these patients in line with recent guidelines.