Small bites, big impact: The importance of evening snacks in patients with advanced chronic liver disease

Abstract

People with advanced chronic liver disease (ACLD) have an enhanced risk of malnutrition, which has multifactorial etiology and is mainly linked to a reduced energy and protein intake; malnutrition is critical for patients with cirrhosis since it is often associated with sarcopenia, a skeletal muscle depletion with a loss of muscle mass and function. Late-evening snacks have been extensively studied, and guidelines are recommended to counteract the effects of prolonged fasting at night in patients with ACLD. However, it has not been fully explored whether late evening snacking is clarified as a milestone to address the nutritional needs of people with ACLD or whether it has a potential role in improving body composition. In this randomised control trial, Yu et al demonstrated that long-term nocturnal snacks have the potential to significantly improve body composition by body fat mass, visceral fat area and body cell mass in patients with ACLD. While the improvement in skeletal muscle mass was minor, the promising results in other compositions provide hope for future research and patient care.

Keywords: Nutrition; Cirrhosis; Advanced chronic liver disease; Malnutrition; Sarcopenia; Skeletal muscle mass

Core Tip: This editorial discusses a randomized control trial by Yu et al published in the World Journal of Hepatology, examining the effect of nocturnal snacks on patients with advanced chronic liver disease. The study aimed to assess late evening snacks' impact on body composition in cirrhosis patients. Findings suggest that nocturnal snacks may improve body fat mass, visceral fat area, and body cell mass, though their effect on skeletal muscle mass is limited. This result underscores the need for additional research on optimizing nutritional interventions in these patients.