Liver Cirrhosis (LC) is a state of accelerated starvation. A late evening snack improves proteinenergy malnutrition, caused by overnight starvation and the catabolic state of patients with LC. This study was designed to evaluate the effects of amazake, a traditional sweet Japanese beverage, as a late evening snack for cirrhotic patients. Methods: Serum biochemical parameters and the visual analogue scale (VAS) were examined at 0, 4, 8, and 12 weeks. Each patient drank 200 kcal of amazake at

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... ime every night for 12 weeks. Trial registration: UMIN-CTR UMIN000010550 Results: Four patients (mean age 67.3 ± 5.7 years) with viral LC were recruited and their VAS score determined, along with a biochemical examination of the blood. White blood cell counts (WBC), especially neutrophil counts, were elevated following a period of amazake intake. Each VAS score was reduced following amazake intake. Amazake intake improved the Quality of Life (QOL) in all terms of sense of abdomen distension, edema, fatigue, muscle cramps, loss of appetite, taste disorder, constipation, diarrhea, vomiting, and sleep disorder. Any sense of abdominal distension, constipation and vomiting had disappeared after 8 weeks of amazake intake and taste disorder and sleep disorder had disappeared after 12 weeks of amazake intake. No major clinical events or virological rebounds occurred in the subjects. Conclusions: Amazake, which is rich in vitamins and amino acids, could be effective in reducing the subjective symptoms and improving the QOL of patients with LC.