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Low fat intake is associated with pathological manifestations and poor recovery in patients with hepatocellular carcinoma

Kazuki Yamada1, Takeshi Suda1*, Yuko S Komoro2, Tsutomu Kanefuji1, Tomoyuki Kubota1, Toshiko Murayama2, Hideaki Nakayama3 and Yutaka Aoyagi1

Author Affiliations

1 Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8122, Japan

2 Nutrition Control Center, Niigata University Medical and Dental Hospital, Niigata 951-8520, Japan

3 Division of Pneumology, Niigata University Medical and Dental Hospital, Niigata 951-8520, Japan

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Nutrition Journal 2013, 12:79  doi:10.1186/1475-2891-12-79

Published: 8 June 2013



This study aimed to clarify whether dietary deviation is associated with pathological manifestations in hepatocellular carcinoma (HCC) patients.


Dietary intake was estimated in 35 HCC cases before and after hospitalization by referencing digital camera images of each meal. Pathological conditions were evaluated in nitrogen balance, non-protein respiratory quotient (npRQ), neuropsychiatric testing and recovery speed from HCC treatment.


On admission, nitrogen balance and npRQ were negative and less than 0.85, respectively. Five patients were judged to have suffered from minimal hepatic encephalopathy that tended to be associated with a lowered value of npRQ (p = 0.082). The energy from fat intake showed a tendency of positive correlation with npRQ (p = 0.11), and the patients with minimal hepatic encephalopathy took significantly fewer energy from fat (p = 0.024). The energy difference from fat between diets at home versus those in the hospital showed a significant positive correlation with npRQ change after admission (p = 0.014). The recovery speed from invasive treatments for HCC showed a significant negative correlation with npRQ alteration after admission (p = 0.0002, r = −0.73).


These results suggest the lower fat intake leads to deterioration of energy state in HCC patients, which associates with poor recovery from invasive treatments and various pathological manifestations.

Hepatocellular carcinoma; Protein-energy malnutrition; Minimal hepatic encephalopathy; Non-protein respiratory quotient