Choice of nutritional supplementation of high quality protein for patients with liver disease

  According to a national epidemiological survey in 2006, the number of people with chronic hepatitis B progressing to cirrhosis is about 600,000-1,800,000 per year. Such a large number of patients with cirrhosis are commonly malnourished, with literature reporting up to 40% to 80%. Malnourished patients with cirrhosis are often accompanied by hypoproteinemia, followed by peritoneal effusion and spontaneous peritonitis, and such patients are mostly immunocompromised, which will lead to secondary infections and other adverse complications, so malnourished patients are more likely to lead to the progression of cirrhosis.  The underlying causes of malnutrition in patients with cirrhosis are many, firstly, due to the decline in metabolic capacity of the liver, patients with cirrhosis have insufficient decomposition and synthesis of carbohydrates, proteins, fats and other nutritional elements, resulting in a long-term high metabolic state of extrahepatic tissues; secondly, patients with cirrhosis are often accompanied by severe digestive symptoms such as poor nausea, vomiting and feeling of fullness, resulting in insufficient direct nutritional intake and long-term The impact of portal hypertension on the gastrointestinal system is often combined with a decrease in nutrient absorption capacity; in addition, the restrictions imposed by doctors on patients’ diets during the treatment of diseases can also lead to nutritional imbalance in patients.  How can we improve the malnutrition of cirrhotic patients? According to the guidelines for enteral nutrition in liver disease developed by the European Nutrition Society in 2006, it is recommended that patients eat sufficient carbohydrates, reasonable high-quality protein and moderate fat every day, and the recommended intake of high-quality protein is 1.2 to 1.5kcal/Kg/d; there is no doubt that milk is a better source of high-quality protein, so can goat’s milk be used as a source of high-quality protein?  Goat milk has been regarded as an excellent nutritional tonic since ancient times. According to the Compendium of Materia Medica, goat milk can benefit the five viscera, tonic kidney deficiency, benefit essence, nourish the heart and lungs, benefit the skin, moisten the hair, brighten the eyes, and make people moist. It is believed that goat milk has the following characteristics: it is easier to digest and absorb than cow’s milk because it contains more alpha-lactalbumin and less casein, and the clot formed in the stomach is fine and soft, so it is easier to digest and absorb; goat milk is less likely to cause allergies, especially for people who are lactose intolerant; the immunoglobulin content in goat milk is high, which can increase the body’s ability to fight diseases.  So can goat’s milk be a better food source for cirrhotic patients to improve their nutritional status? Will patients suffer from bloating discomfort and diarrhea after consuming it? Will the consumption of goat milk improve the nutritional status of patients? And thus improve the liver’s ability to synthesize protein? With a series of questions and and doubts, we carried out a study on the improvement of protein synthesis function in cirrhotic patients with Kabrek whole fat goat milk powder.  Study design: We conducted a study on cirrhosis with blood prealbumin below 100 mg/L. In addition to normal diet, patients in the test group were supplemented with about 60 g of Kabrek whole fat goat milk powder daily and a series of indexes such as albumin, prealbumin and body mass index were monitored.  Results: It was clinically observed that all patients had no discomfort when taking Kabrick whole fat goat milk powder. 2 patients gradually disappeared their previous stomach discomfort after taking this goat milk powder, and their appetite was better than before. 2 patients used to have diarrhea when eating cow’s milk and cow’s milk powder, but after taking Kabrick whole fat goat milk powder, they did not have any discomfort such as diarrhea. Through statistical analysis, there were statistically significant differences in the indexes of albumin, prealbumin, and body mass index of the patients in the test group after 12 weeks of addition of Kabrek goat milk powder compared with the control group; there were no differences in the indexes of blood lipids and blood glucose compared with the control group. We found that the addition of goat milk powder could improve the protein synthesis in cirrhotic patients, which in turn improved the liver function of cirrhotic patients. Thus, we believe that goat milk powder can be used as an ingredient for high-quality protein supplementation in cirrhotic patients, and thus explored a new way to improve the nutritional status of patients with cirrhosis with dietary therapy, and the mechanism of how goat milk powder improves liver function awaits further basic research.