Comparison of Effectiveness Between Protein and BCAA in Late Evening Snack on Vietnamese Liver Cirrhotic Outpatients: a Randomized Clinical Trial.

Background and aims: Late-evening snacks bring multiple benefits to liver cirrhosis patients. However, a consensus on the nutrient composition of the snack is still not clear. This study showed a direct comparison between a protein snack and a a branched-chained amino acid (BCAA) snack.

Methods: A randomized clinical trial with 32 Vietnamese liver cirrhosis outpatients (61.0, 57-63 years), allocated into two groups: Protein group (n=16) and BCAA group (n=16) took place. Both groups received a snack providing 270-300 kcal, 50g carbohydrates, <5g lipid, and 13g of protein with 8g being protein powder in Protein group and 4g protein powder and 4g BCAA powder in BCAA group. Serum biochemical parameters, anthropometric data, and Chronic Liver Disease Questionnaire scores were examined in both groups before and after the 3-week intervention.

Results: After receiving the snacks for 3 weeks, albumin was significantly increased in the Protein group (p<0.01) while it was not in the BCAA group. Only the ALT liver enzyme was statistically decreased in the Protein group (p<0.01). After the intervention, the handgrip strength of the Protein group increased from 24.3kg (±9.1 SD) to 25.7kg (±9.2 SD) (p=0.012); while, in BCAA group, the mean also changed from 24.7kg (±6.6 SD) to 25.6kg (±7.4 SD) (p=0.237). The overall Chronic Liver Disease Questionnaire score was significantly increased from 6.0 to 6.7 and 6.6 in the Protein group and the BCAA group, respectively.

Conclusions: A protein snack is an effective dietary intervention in improving albumin, biochemical parameters, and nutritional status for compensated liver cirrhosis outpatients. Considering cost, availability, and taste, a BCAA snack might be unnecessary for liver cirrhosis outpatients.