*EMBARGOED All research presented at the 2023 ACG Annual Scientific Meeting and Postgraduate Course is strictly embargoed until Sunday, October 22, 2023, at 3:00 pm PT.

Oral 39 – Plant-Based Meals Generate Lower Ammonia and Have a Unique Metabolomic Signature Compared to Meat-Based Meals Despite Similar Baseline Microbiome in Patients with Cirrhosis: A Randomized Clinical Trial
Tuesday, October 24, 2023 | 2:35 PM – 2:45 PM PT | Location: Ballroom B
Author Insight from Jasmohan S. Bajaj, MD, MS, FACG, Virginia Commonwealth University and Richmond VAMC, Richmond, VA
What’s new here and important for clinicians?
- Substituting just one meat-based meal with a vegan or vegetarian meal led to decreased ammonia production regardless of prior hepatic encephalopathy (HE), which may be related to changing metabolite levels associated with HE despite similar stool microbiome in outpatients with cirrhosis
- Consider encouraging patients with cirrhosis who usually follow a Western meat-based diet, with and without prior HE, to eat more fruits and vegetables and try vegan/vegetarian meals. Ask your patient to work with a dietician on nutrition and diet.
- Larger studies with longer duration are needed to determine whether having the occasional vegetarian or vegan meals could prevent HE in patients who normally follow a Western meat-based diet.
What do patients need to know?
Cirrhosis and hepatic encephalopathy, a disorder in which poor liver function affects the brain, are associated with high ammonia levels. Meat-based meals produce higher levels of ammonia than vegan/vegetarian meals. We already know that a diet with plenty of fruits and vegetables and protein from could be beneficial. Substituting a vegan/vegetarian meal occasionally for a typical Western meat-based meal on occasion may help your liver health. How often and for how long, we don’t know. Talk with your physician and a dietician about how you can improve your diet and nutrition.

Author Contact
Jasmohan S. Bajaj, MD, MS, FACG, Virginia Commonwealth University and Richmond VAMC, Richmond, VA
jasmohan.bajaj [at] vcuhealth.org
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