3. Nutrition’s Influence on HE Prognosis
Dietary management is a cornerstone in the prognosis of hepatic encephalopathy, with a particular emphasis on protein intake. The traditional view of protein restriction in HE patients is evolving; current guidelines suggest that adequate protein is essential, even in those with compromised liver function, to prevent muscle wasting and to support liver regeneration.
The type of protein may also affect HE outcomes. Vegetable and dairy proteins are metabolized differently compared to meat proteins and are often recommended for HE patients. They produce fewer ammonia-generating amino acids, which in turn can alleviate the severity of HE symptoms.
The role of branched-chain amino acids (BCAAs) has also been highlighted in recent studies. Supplementing with BCAAs may not only help to meet protein requirements but also improve neurological symptoms by competing with aromatic amino acids that are associated with neurotoxicity in HE.
Furthermore, the timing of meals can influence HE prognosis. Consuming smaller, more frequent meals and a nighttime snack can help maintain stable blood glucose levels and provide a steady supply of nutrients, which is beneficial for liver function and can potentially mitigate HE symptoms.
While these nutritional strategies are promising, they require personalized adjustment and rigorous adherence. Nutritionists and healthcare providers must work closely with patients to tailor dietary plans that are both effective and sustainable, thus supporting a better prognosis in the long run. (3)
