Protein-energy malnutrition affects chronically ill patients

Protein-energy malnutrition or PEM has been identified as a major life-threatening problem in patients with chronic diseases such as those involving the liver.

Studies have shown that if a person suffering from a chronic illness succumbs to malnutrition, a significant deterioration of body functions ensues, which adversely affects recovery.

This is particularly true for those suffering from cirrhosis and other liver diseases, who have been found to have low levels of branched-chain amino acids (BCAAs) and albumin (protein) in their blood, leading to PEM.

Thus, supplementation with BCAAs is recommended for these patients. To address this need of liver-impaired patients, Otsuka (Philippines) Pharmaceuticals Inc. launched BCAA as Aminoleban Oral for the treatment of hepatic encephalopathy, and as an essential nutritional supplement for liver failure patients.

To stress the importance of diet and other supportive management, and the role of Aminoleban in managing liver cirrhosis, Otsuka is expanding its public outreach program to help more patients with liver impairment through the establishment of the PEM Pal Club (Protein-Energy Malnutrition Pal Club), a patient support system that aims to provide patient education through lay fora which will be conducted in different Bantay Atay Centers nationwide.

Local medical doctors, supported by nutritionists, will present the lectures, thus ensuring ethical and accurate information. The PEM Pal hotline and website will serve as communication media to all patients and their caregivers who wish to learn more about liver disease prevention and management.

Lastly, Aminoleban Oral discounts will be provided to all patients registered by their attending physicians to the PEM Pal Club.

The role of BCAA supplementation has been established in well-designed clinical trials. A study by Dr. Hisataki Moriwaki and his colleagues at the Gifu University School of Medicine showed that BCAA supplementation aids in the synthesis and secretion of albumin, and improves the quality of life and survival of patients with liver cirrhosis.

Similar results were obtained by Dr. Yasutoshi Muto and his colleagues in a study published in the journal Clinical Gastroenterology and Hepatology.

The study showed that long-term administration of BCAA supplements slows down the progression of liver failure and is associated with better survival in patients with cirrhosis.

Many experts believe that BCAA supplementation can help address the problem of malnutrition in patients with chronic liver problems.

Malnutrition, according to the World Health Organization, is the "imbalance between the supply of nutrients and energy and the body’s demand for them to ensure growth, maintenance, and specific functions."

Patients with chronic diseases such as liver cirrhosis, cancer, renal ailments, and AIDS often suffer from malnutrition — specifically, protein-energy malnutrition — due to poor nutrient intake and the body’s impaired ability to process food and nutrients.

In general, PEM develops in children and adults who consume insufficient protein and calories to meet the body’s nutritional needs. In developing countries, PEM is one of the leading causes of child mortality.

In industrialized countries such as the United States, however, PEM affects the elderly living in nursing homes and patients suffering from chronic diseases. As many as half of patients hospitalized and 55 percent of elderly patients in the US suffer from PEM.

Malnutrition is also common among hospitalized Filipino patients. A 1998 survey by St. Luke’s Medical Center showed that among hospitalized patients, 34 percent were malnourished and 34 percent were underweight.