To avoid fasting-associated starvation during the night in cirrhosis, which is recommended?

To avoid fasting-associated starvation during the night in cirrhosis, which is recommended?

• A. Nocturnal parenteral nutrition
• B. Nocturnal tube feeding
• C. Late evening snack
• D. Branched chain amino acids

Answer: (C)

The idea is to prevent overnight catabolism in cirrhosis by supplying energy during the long overnight fast. A late evening snack provides calories (especially complex carbohydrates) that spare muscle protein and help maintain nitrogen balance, reducing the risk of overnight starvation. This simple, oral approach is preferred because it directly targets the nighttime energy deficit without the invasiveness and risks of nocturnal parenteral nutrition or tube feeding. Branched-chain amino acids can support protein intake and may help with encephalopathy, but by themselves they don’t supply the overnight calories needed to prevent fasting-derived muscle breakdown.

The idea is to prevent overnight catabolism in cirrhosis by supplying energy during the long overnight fast. A late evening snack provides calories (especially complex carbohydrates) that spare muscle protein and help maintain nitrogen balance, reducing the risk of overnight starvation. This simple, oral approach is preferred because it directly targets the nighttime energy deficit without the invasiveness and risks of nocturnal parenteral nutrition or tube feeding. Branched-chain amino acids can support protein intake and may help with encephalopathy, but by themselves they don’t supply the overnight calories needed to prevent fasting-derived muscle breakdown.