Study on Vegan and Vegetarian Alternatives in Cirrhosis Patients

A recent study published in the Clinical and Translational Gastroenterology journal highlights the potential benefits of substituting meat-based meals with vegan or vegetarian alternatives in patients with cirrhosis. This research elucidates how dietary choices can influence ammonia production and metabolomics in these patients by providing valuable insights for dietary management in cirrhosis.

The study focused on outpatients with cirrhosis who typically follow a Western meat-based diet. The participants with and without a history of hepatic encephalopathy (HE) were randomized into three groups. Each group received a burger containing 20 grams of protein, either from meat, vegan (V), or vegetarian (VG) sources. The study further monitored blood ammonia levels and conducted metabolomic analysis with the help of liquid chromatography-mass spectrometry at baseline and hourly for three hours post-meal.

The study revealed significant differences in ammonia levels and metabolomic profiles between the groups. Also, serum ammonia levels increased in the meat group but remained stable in the vegan and vegetarian groups. This suggests that substituting meat with plant-based alternatives can reduce ammoniagenesis in the patients with cirrhosis.

The meat group experienced a decrease in metabolites associated with branched-chain amino acids and acylcarnitines, while lipid profile alterations were also observed. Also, higher levels of sphingomyelins and lower levels of lysophospholipids were observed in the meat group when compared to the vegan and vegetarian groups, which highlighted the distinct changes of metabolomic analysis.

The findings indicate that intermittent substitution of meat-based meals with vegan or vegetarian alternatives can positively affect ammonia levels and metabolomic profiles in cirrhosis patients. This could be particularly beneficial in managing HE, a severe complication of cirrhosis characterized by elevated ammonia levels and cognitive dysfunction. The study found that stool microbiome composition was similar across all groups at baseline, suggesting that the observed metabolic changes were directly related to the dietary intervention rather than the underlying microbiome differences.

Overall, vegan and vegetarian meal substitutions could offer a practical dietary strategy for managing cirrhosis and preventing complications such as HE by reducing ammonia generation and favorably altering the metabolomic profiles. Further studies to explore long-term impacts and the mechanisms behind these dietary effects are imperative.

Reference

Badal, B. D., Fagan, A., Tate, V., Mousel, T., Gallagher, M. L., Puri, P., Davis, B., Miller, J., Sikaroodi, M., Gillevet, P., Gedguadas, R., Kupcinkas, J., Thacker, L., & Bajaj, J. S. (2024). Substitution of One Meat-based meal with Vegetarian and Vegan Alternatives Generates Lower Ammonia and Alters Metabolites in Cirrhosis: A Randomized Clinical Trial. In Clinical and Translational Gastroenterology. Ovid Technologies (Wolters Kluwer Health). https://doi.org/10.14309/ctg.0000000000000707