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Publication date: 2010-03-31
Pol. J. Food Nutr. Sci. 2010;60(1):63–70
Two therapeutic diets have been formulated (A & B) and prepared in bakery form for patients with liver cirrhosis. The formulation was based on the presence of protein of high Fisher ratio and fat rich in medium chain triglycerides. Both formulas contained edible sources of antioxidants. Honey was added as a sweetener. Proximate analysis of Formula B and its contents of amino acids and fatty acids were carried out. Formula A was analysed in previous research for the same above mentioned composition. The two formulas were sensory evaluated by liver cirrhotic patients. Potential benefits of both formulas in addition of nutritional advice were evaluated in liver cirrhotic patients. Biochemical parameters reflecting liver function (plasma AST, ALT, ALP, total bilirubin, direct bilirubin and ammonia), oxidative stress (plasma NO and MDA) and nutritional status (plasma total protein, albumin, globulin and A/G ratio) were studied before and after two months of dietary intervention. The nutritional status of patients was evaluated through anthropometric measurements, food intake and selected biochemical parameters. Proximate analysis results showed that formula B contain 17.6% protein and 7.5% fat. Amino acids analysis of the same formula showed that its Fisher ratio was 2.49. GC analysis of fatty acids revealed that medium chain fatty acids constitute 38.6% of total fatty acids. The results of sensory evaluation showed that overall score of formula A was significantly higher than that of formula B. Nutritional status determined through triceps skin fold at the start of the clinical study showed 38% of cases were normal, 8% were severely malnourished and 54% over normal. Analysis of mean dietary intake of patients in the beginning of the study revealed that all liver cirrhotic patients were hypo-caloric. All estimated nutrients were lower than RDA except for protein. Mean dietary intake of patient after two months of the study revealed that all patients increased their caloric intake however they were still hypo-caloric. Comparing biochemical parameters of patients before and after dietary intervention of either formulas and nutritional advice revealed that all parameters reflecting liver dysfunction were non significantly improved. However AST activity significantly decreased on supplementation of diet A. A significant increase in plasma albumin and total protein was noticed in patients after both dietary interventions which may reflect some improvements in liver synthetic function and nutritional status. Ammonia was only significantly decreased in patients given formula A. Nitric oxide and MDA were significantly reduced in both dietary interventions with different degrees. In conclusion, both dietary interventions in addition of dietary advice in the present study have beneficial effects towards liver cirrhotic patients concerning reduction of oxidative stress and inflammation. Formula A was superior in reducing plasma AST activity and ammonia level.