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McCarty MF, DiNicolantonio JJ. An increased need for dietary cysteine in support of glutathione synthesis may underlie the increased risk for mortality associated with low protein intake in the elderly. AGE (DORDRECHT, NETHERLANDS) 2015; 37:96. [PMID: 26362762 PMCID: PMC5005830 DOI: 10.1007/s11357-015-9823-8] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Accepted: 07/28/2015] [Indexed: 06/05/2023]
Abstract
Restricted dietary intakes of protein or essential amino acids tend to slow aging and boost lifespan in rodents, presumably because they downregulate IGF-I/Akt/mTORC1 signaling that acts as a pacesetter for aging and promotes cancer induction. A recent analysis of the National Health and Nutrition Examination Survey (NHANES) III cohort has revealed that relatively low protein intakes in mid-life (under 10 % of calories) are indeed associated with decreased subsequent risk for mortality. However, in those over 65 at baseline, such low protein intakes were associated with increased risk for mortality. This finding accords well with other epidemiology correlating relatively high protein intakes with lower risk for loss of lean mass and bone density in the elderly. Increased efficiency of protein translation reflecting increased leucine intake and consequent greater mTORC1 activity may play a role in this effect; however, at present there is little solid evidence that leucine supplementation provides important long-term benefits to the elderly. Aside from its potential pro-anabolic impact, higher dietary protein intakes may protect the elderly in another way-by providing increased amino acid substrate for synthesis of key protective factors. There is growing evidence, in both rodents and humans, that glutathione synthesis declines with increasing age, likely reflecting diminished function of Nrf2-dependent inductive mechanisms that boost expression of glutamate cysteine ligase (GCL), rate-limiting for glutathione synthesis. Intracellular glutathione blunts the negative impact of reactive oxygen species (ROS) on cell health and functions both by acting as an oxidant scavenger and by opposing the pro-inflammatory influence of hydrogen peroxide on cell signaling. Fortunately, since GCL's K m for cysteine is close to intracellular cysteine levels, increased intakes of cysteine-achieved from whole proteins or via supplementation with N-acetylcysteine (NAC)-can achieve a compensatory increase in glutathione synthesis, such that more youthful tissue levels of this compound can be restored. Supplementation with phase 2 inducers-such as lipoic acid-can likewise increase glutathione levels by promoting increased GCL expression. In aging humans and/or rodents, NAC supplementation has exerted favorable effects on vascular health, muscle strength, bone density, cell-mediated immunity, markers of systemic inflammation, preservation of cognitive function, progression of neurodegeneration, and the clinical course of influenza-effects which could be expected to lessen mortality and stave off frailty. Hence, greater cysteine availability may explain much of the favorable impact of higher protein intakes on mortality and frailty risk in the elderly, and joint supplementation with NAC and lipoic acid could be notably protective in the elderly, particularly in those who follow plant-based diets relatively low in protein. It is less clear whether the lower arginine intake associated with low-protein diets has an adverse impact on vascular health.
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Affiliation(s)
- Mark F McCarty
- Catalytic Longevity, 7831 Rush Rose Dr., Apt. 316, Carlsbad, CA, 92009, USA.
| | - James J DiNicolantonio
- Preventive Cardiology Department, St. Luke's Mid America Heart Institute, Kansas City, MO, USA.
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Madeddu C, Mantovani G, Gramignano G, Macciò A. Advances in pharmacologic strategies for cancer cachexia. Expert Opin Pharmacother 2015; 16:2163-77. [PMID: 26330024 DOI: 10.1517/14656566.2015.1079621] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Cancer cachexia is a severe inflammatory metabolic syndrome accounting for fatigue, an impairment of normal activities and, eventually, death. The loss of muscle mass associated with body weight loss is the main feature of this syndrome. AREAS COVERED The present review aims to describe the advances in the pharmacological approaches for cancer cachexia, highlighting the impact on weight loss, muscle wasting and related outcomes. EXPERT OPINION Among the pharmacological agents, attention should yet be given to the currently most widely studied drugs, such as progestogens and NSAIDs. Emerging drugs, such as ghrelin and selective androgen receptor modulators, have obtained promising results in recent randomized clinical trials. Larger sample sizes and more robust data on the effectiveness of anti-cytokine agents are needed. Any pharmacological approach to counteract cancer cachexia should always be associated with an adequate caloric intake, obtained by diet or through enteral or parenteral supplementation, if indicated. Finally, we can currently state that a combined approach that simultaneously targets the fundamental pathways involved in the pathogenesis of cancer cachexia is likely to be the most effective in terms of improvements in body weight as well as muscle wasting, function, physical performance and quality of life.
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Affiliation(s)
- Clelia Madeddu
- a 1 University of Cagliari, AOU Cagliari, Department of Medical Sciences M. Aresu , Cagliari, Italy
| | - Giovanni Mantovani
- b 2 University of Cagliari, AOU Cagliari, Department of Medical Sciences M. Aresu , Via Catalani 1b, 09100 Cagliari, Italy
| | - Giulia Gramignano
- c 3 N.S. Bonaria Hospital, Medical Oncology Unit , San Gavino, Italy
| | - Antonio Macciò
- d 4 A. Businco Hospital, Regional Referral Center for Cancer Diseases, Department of Gynecologic Oncology , Cagliari, Italy
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Wu H, Xia Y, Jiang J, Du H, Guo X, Liu X, Li C, Huang G, Niu K. Effect of beta-hydroxy-beta-methylbutyrate supplementation on muscle loss in older adults: A systematic review and meta-analysis. Arch Gerontol Geriatr 2015; 61:168-75. [DOI: 10.1016/j.archger.2015.06.020] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Revised: 06/27/2015] [Accepted: 06/29/2015] [Indexed: 11/25/2022]
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The role of leucine and its metabolites in protein and energy metabolism. Amino Acids 2015; 48:41-51. [DOI: 10.1007/s00726-015-2067-1] [Citation(s) in RCA: 162] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Accepted: 07/29/2015] [Indexed: 01/30/2023]
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Santos-Fandila A, Bueno-Vargas P, Zafra-Gómez A, López-Pedrosa JM, Ramírez M. Quantification of β-hydroxymethylbutyrate and leucine by ultrahigh performance liquid chromatography tandem mass spectrometry at different situations and stages of a rodent life. J Chromatogr B Analyt Technol Biomed Life Sci 2015; 995-996:54-63. [PMID: 26025886 DOI: 10.1016/j.jchromb.2015.05.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2014] [Revised: 04/15/2015] [Accepted: 05/14/2015] [Indexed: 10/23/2022]
Abstract
The main objective of this work was to develop a method to measure Leucine (Leu) and β-hydroxymethylbutyrate (HMB) at basal levels in serum, urine, milk and brain microdialysates in rats. Ultrahigh performance liquid chromatography-electrospray-tandem mass spectrometry (UHPLC-ESI-MS/MS) was used as analytical technique. The sample treatment was simple and consisted of dilution with methanol and centrifugation for serum and urine, dilution with water and filtration with an Amicon filter for milk, and treatment with formic acid with no further dilution for microdialyzates. The procedures for sampling and the UHPLC-MS/MS parameters were accurately optimized to achieve the highest recoveries and to enhance the analytical characteristics of the method. For chromatographic separation, an Acquity UPLC BEH Amide column using acetonitrile-water gradient with formic acid as additive was used. The total run time was 4min. The analytical characteristics (accuracy, selectivity and sensitivity) of the proposed method were evaluated. The limits of detection (LODs) obtained ranged from 0.4 to 7ngmL(-1) and the limits of quantification (LOQs) from 1 to 22ngmL(-1). Precision, expressed as relative standard deviation (% RSD), was lower than 15% in all cases, and the determination coefficient (R(2)) was equal or higher than 99.0% with a residual deviation for each calibration point lower than ±25%. Mean recoveries were between 85 and 115%. The method was successfully applied to these matrices being able to detect significant differences between physiological situations, strains and stages of life.
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Affiliation(s)
- A Santos-Fandila
- Abbott Nutrition Research & Development, Discovery Technology, Camino de Purchil 68, Granada E-18004, Spain; Research Group of Analytical Chemistry and Life Sciences, Department of Analytical Chemistry, University of Granada, Campus of Fuentenueva, Granada E-18071, Spain.
| | - P Bueno-Vargas
- Abbott Nutrition Research & Development, Discovery Technology, Camino de Purchil 68, Granada E-18004, Spain
| | - A Zafra-Gómez
- Research Group of Analytical Chemistry and Life Sciences, Department of Analytical Chemistry, University of Granada, Campus of Fuentenueva, Granada E-18071, Spain
| | - J M López-Pedrosa
- Abbott Nutrition Research & Development, Discovery Technology, Camino de Purchil 68, Granada E-18004, Spain
| | - M Ramírez
- Abbott Nutrition Research & Development, Discovery Technology, Camino de Purchil 68, Granada E-18004, Spain
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Abstract
The aim of the present paper is to critically review the details of the published nutrition intervention trials, with and without exercise, targeting sarcopenia. Sarcopenia is the loss of muscle mass, strength and/or performance with age. Since amino acids and energy are required for muscle synthesis it is possible that nutritional intake influences sarcopenia. Nutritional studies are challenging to carry out because of the complexity of modulating dietary intake. It is very difficult to change one nutrient without influencing many others, which means that many of the published studies are problematic to interpret. The studies included evaluate whole protein, essential amino acids and β-hydroxyl β-methylbutyrate (HMB). Whole-protein supplementation failed to show a consistent effect on muscle mass, strength or function. This can be explained by the variations in study design, composition of the protein supplement and the failure to monitor voluntary food intake, adherence and baseline nutritional status. Essential amino-acid supplements showed an inconsistent effect but there are only two trials that have significant differences in methodology and the supplement used. The HMB studies are suggestive of a beneficial effect on older adults, but larger well-controlled studies are required that measure outcomes relevant to sarcopenia, ideally in sarcopenic populations. The issues of timing and distribution of protein intake, and increased splanchnic amino-acid sequestration are discussed, and recommendations for future trials are made.
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Bonnefoy M, Berrut G, Lesourd B, Ferry M, Gilbert T, Guérin O, Hanon O, Jeandel C, Paillaud E, Raynaud-Simon A, Ruault G, Rolland Y. Frailty and nutrition: searching for evidence. J Nutr Health Aging 2015; 19:250-7. [PMID: 25732208 DOI: 10.1007/s12603-014-0568-3] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Frailty is a geriatric syndrome that predicts disability, morbidity and mortality in the elderly. Poor nutritional status is one of the main risk factors for frailty. Macronutrients and micronutrients deficiencies are associated with frailty. Recent studies suggest that improving nutritional status for macronutrients and micronutrients may reduce the risk of frailty. Specific diets such as the Mediterranean diet rich in anti-oxidants, is currently investigated in the prevention of frailty. The aim of this paper is to summarize the current body of knowledge on the relations between nutrition and frailty, and provide recommendations for future nutritional research on the field of frailty.
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Affiliation(s)
- M Bonnefoy
- Marc Bonnefoy - service universitaire de gériatrie - Groupement Hospitalier Sud - 69495 Pierre-Bénite Cedex - France - tél 33 (0)4 78 86 15 80 - Fax 33 (0)4 78 86 57 27 -
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Kim M, Sung B, Kang YJ, Kim DH, Lee Y, Hwang SY, Yoon JH, Yoo MA, Kim CM, Chung HY, Kim ND. The combination of ursolic acid and leucine potentiates the differentiation of C2C12 murine myoblasts through the mTOR signaling pathway. Int J Mol Med 2015; 35:755-62. [PMID: 25529824 DOI: 10.3892/ijmm.2014.2046] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 12/08/2014] [Indexed: 11/06/2022] Open
Abstract
Aging causes phenotypic changes in skeletal muscle progenitor cells that lead to the progressive loss of myogenic differentiation and thus a decrease in muscle mass. The naturally occurring triterpene, ursolic acid, has been reported to be an effective agent for the prevention of muscle loss by suppressing degenerative muscular dystrophy. Leucine, a branched-chain amino acid, and its metabolite, β-hydroxy-β-methylbutyric acid, have been reported to enhance protein synthesis in skeletal muscle. Therefore, the aim of the present study was to investigate whether the combination of ursolic acid and leucine promotes greater myogenic differentiation compared to either agent alone in C2C12 murine myoblasts. Morphological changes were observed and creatine kinase (CK) activity analysis was performed to determine the conditions through which the combination of ursolic acid and leucine would exert the most prominent effects on muscle cell differentiation. The effect of the combination of ursolic acid and leucine on the expression of myogenic differentiation marker genes was examined by RT-PCR and western blot analysis. The combination of ursolic acid (0.5 µM) and leucine (10 µM) proved to be the most effective in promoting myogenic differentiation. The combination of ursolic acid and leucine significantly increased CK activity than treatment with either agent alone. The level of myosin heavy chain, a myogenic differentiation marker protein, was also enhanced by the combination of ursolic acid and leucine. The combination of ursolic acid and leucine significantly induced the expression of myogenic differentiation marker genes, such as myogenic differentiation 1 (MyoD) and myogenin, at both the mRNA and protein level. In addition, the number of myotubes and the fusion index were increased. These findings indicate that the combination of ursolic acid and leucine promotes muscle cell differentiation, thus suggesting that this combination of agents may prove to be beneficial in increasing muscle mass.
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Affiliation(s)
- Minjung Kim
- Department of Pharmacy, College of Pharmacy, Pusan National University, Busan 609‑735, Republic of Korea
| | - Bokyung Sung
- Department of Pharmacy, College of Pharmacy, Pusan National University, Busan 609‑735, Republic of Korea
| | - Yong Jung Kang
- Department of Pharmacy, College of Pharmacy, Pusan National University, Busan 609‑735, Republic of Korea
| | - Dong Hwan Kim
- Department of Pharmacy, College of Pharmacy, Pusan National University, Busan 609‑735, Republic of Korea
| | - Yujin Lee
- Department of Pharmacy, College of Pharmacy, Pusan National University, Busan 609‑735, Republic of Korea
| | - Seong Yeon Hwang
- Department of Pharmacy, College of Pharmacy, Pusan National University, Busan 609‑735, Republic of Korea
| | - Jeong-Hyun Yoon
- Department of Pharmacy, College of Pharmacy, Pusan National University, Busan 609‑735, Republic of Korea
| | - Mi-Ae Yoo
- Department of Molecular Biology, Pusan National University, Busan 609‑735, Republic of Korea
| | - Cheol Min Kim
- Research Center for Anti‑Aging Technology Development, Pusan National University, Busan 609‑735, Republic of Korea
| | - Hae Young Chung
- Department of Pharmacy, College of Pharmacy, Pusan National University, Busan 609‑735, Republic of Korea
| | - Nam Deuk Kim
- Department of Pharmacy, College of Pharmacy, Pusan National University, Busan 609‑735, Republic of Korea
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60
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Daré LR, Dias DV, Rosa Junior GM, Bueno CRS, Buchaim RL, Rodrigues ADC, Andreo JC. Effect of β-hydroxy-β-methylbutyrate in masticatory muscles of rats. J Anat 2014; 226:40-6. [PMID: 25400135 DOI: 10.1111/joa.12256] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2014] [Indexed: 12/23/2022] Open
Abstract
The aim of this research was to examine the influence of β-hydroxy-β-methylbutyrate (HMB) on changes in the profile of muscle fibers, whether these alterations were similar between the elevator and depressor muscles of the jaw, and whether the effects would be similar in male and female animals. Fifty-eight rats aged 60 days (29 animals of each gender) were divided into four groups: the initial control group (ICG) was sacrificed at the beginning of the experiment; the placebo control group (PCG) received saline and was fed ad libitum; the experimental group (EG) received 0.3 g kg(-1) of HMB daily for 4 weeks by gavage as well as the same amount of food consumed by the PCG in the previous day; and the experimental ad libitum group (EAG) received the same dose of the supplement along with food ad libitum. Samples included the digastric and masseter muscles for the histoenzymological analysis. Data were subjected to statistical analysis with a significance level of P < 0.05. Use of HMB caused a decrease in the percentage of fast twitch glycolytic (FG) fibers and an increase in fast twitch oxidative glycolytic (FOG) fibers in males in both experimental groups (EG and EAG). However, it produced no increase in the muscle fiber area, in either gender, in the masseter muscle. In the digastric muscle, the HMB did not change the frequency or the area of any muscle fiber types in either gender. Our data suggest that the use of HMB caused small changes in the enzymological profile of fibers of the mastication muscles; the changes were different in the elevator and depressor muscles of the jaw and the results were different depending on gender.
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Affiliation(s)
- Leticia R Daré
- Department of Biological Sciences, Bauru Dental School, University of São Paulo, Bauru, Brazil
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Kraemer WJ, Hatfield DL, Comstock BA, Fragala MS, Davitt PM, Cortis C, Wilson JM, Lee EC, Newton RU, Dunn-Lewis C, Häkkinen K, Szivak TK, Hooper DR, Flanagan SD, Looney DP, White MT, Volek JS, Maresh CM. Influence of HMB Supplementation and Resistance Training on Cytokine Responses to Resistance Exercise. J Am Coll Nutr 2014; 33:247-55. [DOI: 10.1080/07315724.2014.911669] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Szcześniak KA, Ostaszewski P, Fuller JC, Ciecierska A, Sadkowski T. Dietary supplementation of β-hydroxy-β-methylbutyrate in animals - a review. J Anim Physiol Anim Nutr (Berl) 2014; 99:405-17. [DOI: 10.1111/jpn.12234] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Accepted: 07/06/2014] [Indexed: 01/10/2023]
Affiliation(s)
- K. A. Szcześniak
- Department of Physiological Sciences; Faculty of Veterinary Medicine; Warsaw University of Life Science - SGGW; Warsaw Poland
| | - P. Ostaszewski
- Department of Physiological Sciences; Faculty of Veterinary Medicine; Warsaw University of Life Science - SGGW; Warsaw Poland
| | - J. C. Fuller
- Metabolic Technologies, Inc.; Iowa State University Research Park; Ames IA USA
| | - A. Ciecierska
- Department of Physiological Sciences; Faculty of Veterinary Medicine; Warsaw University of Life Science - SGGW; Warsaw Poland
| | - T. Sadkowski
- Department of Physiological Sciences; Faculty of Veterinary Medicine; Warsaw University of Life Science - SGGW; Warsaw Poland
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Helms ER, Aragon AA, Fitschen PJ. Evidence-based recommendations for natural bodybuilding contest preparation: nutrition and supplementation. J Int Soc Sports Nutr 2014; 11:20. [PMID: 24864135 PMCID: PMC4033492 DOI: 10.1186/1550-2783-11-20] [Citation(s) in RCA: 96] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2013] [Accepted: 04/29/2014] [Indexed: 12/19/2022] Open
Abstract
The popularity of natural bodybuilding is increasing; however, evidence-based recommendations for it are lacking. This paper reviewed the scientific literature relevant to competition preparation on nutrition and supplementation, resulting in the following recommendations. Caloric intake should be set at a level that results in bodyweight losses of approximately 0.5 to 1%/wk to maximize muscle retention. Within this caloric intake, most but not all bodybuilders will respond best to consuming 2.3-3.1 g/kg of lean body mass per day of protein, 15-30% of calories from fat, and the reminder of calories from carbohydrate. Eating three to six meals per day with a meal containing 0.4-0.5 g/kg bodyweight of protein prior and subsequent to resistance training likely maximizes any theoretical benefits of nutrient timing and frequency. However, alterations in nutrient timing and frequency appear to have little effect on fat loss or lean mass retention. Among popular supplements, creatine monohydrate, caffeine and beta-alanine appear to have beneficial effects relevant to contest preparation, however others do not or warrant further study. The practice of dehydration and electrolyte manipulation in the final days and hours prior to competition can be dangerous, and may not improve appearance. Increasing carbohydrate intake at the end of preparation has a theoretical rationale to improve appearance, however it is understudied. Thus, if carbohydrate loading is pursued it should be practiced prior to competition and its benefit assessed individually. Finally, competitors should be aware of the increased risk of developing eating and body image disorders in aesthetic sport and therefore should have access to the appropriate mental health professionals.
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Affiliation(s)
- Eric R Helms
- Sport Performance Research in New Zealand (SPRINZ) at AUT Millennium Institute, AUT University, 17 Antares Place, Mairangi Bay, Auckland 0632, New Zealand
| | | | - Peter J Fitschen
- Division of Nutritional Sciences, University of Illinois, Urbana, IL, USA
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Chevalier S, Winter A. Do patients with advanced cancer have any potential for protein anabolism in response to amino acid therapy? Curr Opin Clin Nutr Metab Care 2014; 17:213-8. [PMID: 24572834 DOI: 10.1097/mco.0000000000000047] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE OF REVIEW There is evidence that protein anabolism is achievable before cancer evolves into refractory cachexia with attenuation of muscle loss and even muscle gain. This review summarizes recent observations on the role of total and specific amino acids in promoting protein anabolism in human cancer and revisits prior studies in this context. RECENT FINDINGS Analysis of muscle changes in advanced cancer patients indicated opportunities for inducing anabolism. Maintenance and gain in muscle was reported in a majority of patients, from initiation of oncologic treatment and before the final refractory stage. In addition to being substrates, some amino acids, for example leucine, act as intracellular signals to promote protein synthesis. Recent acute studies demonstrated that provision of amino acids, sufficient to considerably elevate circulating leucine concentrations concurrent with other amino acid and nutrient availability, resulted in significant protein anabolism in cancer patients. This occurred even during weight loss and inflammation. SUMMARY Patients with cancer have an anabolic potential to be exploited early on in cachexia development. High-leucine and protein supplements are worth testing as part of a multimodal anabolic approach in long-term trials to confirm their efficacy to sustain anabolism, and attenuate or even reverse muscle wasting.
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Affiliation(s)
- Stéphanie Chevalier
- aDepartment of Medicine bSchool of Dietetics and Human Nutrition, McGill University cMcGill University Health Centre-Research Institute, Montreal, Quebec, Canada
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65
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Fuller JC, Arp LH, Diehl LM, Landin KL, Baier SM, Rathmacher JA. Subchronic toxicity study of β-hydroxy-β-methylbutyric free acid in Sprague–Dawley rats. Food Chem Toxicol 2014; 67:145-53. [DOI: 10.1016/j.fct.2014.02.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Revised: 02/04/2014] [Accepted: 02/12/2014] [Indexed: 10/25/2022]
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Deutz NEP, Bauer JM, Barazzoni R, Biolo G, Boirie Y, Bosy-Westphal A, Cederholm T, Cruz-Jentoft A, Krznariç Z, Nair KS, Singer P, Teta D, Tipton K, Calder PC. Protein intake and exercise for optimal muscle function with aging: recommendations from the ESPEN Expert Group. Clin Nutr 2014; 33:929-36. [PMID: 24814383 DOI: 10.1016/j.clnu.2014.04.007] [Citation(s) in RCA: 932] [Impact Index Per Article: 93.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 04/09/2014] [Indexed: 12/12/2022]
Abstract
The aging process is associated with gradual and progressive loss of muscle mass along with lowered strength and physical endurance. This condition, sarcopenia, has been widely observed with aging in sedentary adults. Regular aerobic and resistance exercise programs have been shown to counteract most aspects of sarcopenia. In addition, good nutrition, especially adequate protein and energy intake, can help limit and treat age-related declines in muscle mass, strength, and functional abilities. Protein nutrition in combination with exercise is considered optimal for maintaining muscle function. With the goal of providing recommendations for health care professionals to help older adults sustain muscle strength and function into older age, the European Society for Clinical Nutrition and Metabolism (ESPEN) hosted a Workshop on Protein Requirements in the Elderly, held in Dubrovnik on November 24 and 25, 2013. Based on the evidence presented and discussed, the following recommendations are made (a) for healthy older people, the diet should provide at least 1.0-1.2 g protein/kg body weight/day, (b) for older people who are malnourished or at risk of malnutrition because they have acute or chronic illness, the diet should provide 1.2-1.5 g protein/kg body weight/day, with even higher intake for individuals with severe illness or injury, and (c) daily physical activity or exercise (resistance training, aerobic exercise) should be undertaken by all older people, for as long as possible.
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Affiliation(s)
- Nicolaas E P Deutz
- Center for Translational Research in Aging & Longevity, Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA.
| | - Jürgen M Bauer
- Department of Geriatric Medicine, Carl von Ossietzky University, Klinikum, Oldenburg, Germany
| | - Rocco Barazzoni
- Department of Medical, Surgical and Health Sciences, Internal Medicine, University of Trieste, Trieste, Italy
| | - Gianni Biolo
- Department of Medical, Surgical and Health Sciences, Internal Medicine, University of Trieste, Trieste, Italy
| | - Yves Boirie
- Université d'Auvergne, INRA, CRNH, Centre Hospitalier Universitaire, Clermont-Ferrand, France
| | - Anja Bosy-Westphal
- Institut für Ernährungsmedizin, Universität Hohenheim, Stuttgart, Germany
| | - Tommy Cederholm
- Clinical Nutrition and Metabolism, Department of Public Health and Caring Sciences, Uppsala University, Sweden; Department of Geriatric Medicine, Uppsala University Hospital, Sweden
| | | | - Zeljko Krznariç
- Department of Clinical Nutrition, University Hospital Center and School of Medicine, Zagreb, Croatia
| | | | - Pierre Singer
- Department of Intensive Care, Institute for Nutrition Research, Rabin Medical Center, Beilinson Hospital, Sackler School of Medicine, Tel Aviv University, Israel
| | - Daniel Teta
- Centre Hospitalier Universitaire Vaudois, Service de Néphrologie, Lausanne, Switzerland
| | - Kevin Tipton
- Health and Exercise Sciences Research Group, University of Stirling, Stirling, Scotland
| | - Philip C Calder
- Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, United Kingdom; NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, United Kingdom
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Santos-Fandila A, Zafra-Gómez A, Barranco A, Navalón A, Rueda R, Ramírez M. Quantitative determination of β-hydroxymethylbutyrate and leucine in culture media and microdialysates from rat brain by UHPLC-tandem mass spectrometry. Anal Bioanal Chem 2014; 406:2863-72. [PMID: 24590106 DOI: 10.1007/s00216-014-7694-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Revised: 01/10/2014] [Accepted: 02/12/2014] [Indexed: 10/25/2022]
Abstract
The main objective of the present work was to develop a method to determine β-hydroxymethylbutyrate (HMB) and leucine (Leu) in culture media and brain microdialysates. An accurate, selective, and cost-effective method, based on the use of ultrahigh-performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS), was developed for the identification and quantification of both compounds. The method consisted of sample dilution, direct injection onto the chromatographic equipment, and quantification with a triple quadrupole mass spectrometer using an electrospray ionization interface in positive mode. The procedure and the UHPLC-MS/MS parameters were accurately optimized to achieve the highest recoveries and to enhance the analytical characteristics of the method. For chromatographic separation, an Acquity UPLC BEH Hilic column using acetonitrile-water gradient with formic acid as additive was employed. The total run time was 4 min. The limits of detection (LODs) obtained ranged from 0.01 to 0.04 μg mL(-1), and the limits of quantification (LOQs) ranged from 0.04 to 0.12 μg mL(-1). Precision (expressed as relative standard deviation) was lower than 15 %, and the determination coefficient (R (2)) was higher than 99.0 % with a residual deviation for each calibration point lower than ±25 %. Mean recoveries were between 85 and 115 %. The method was successfully applied to the analysis of both compounds, HMB and Leu, in samples obtained from an experiment of blood-brain barrier (BBB) passage in vitro and to an experiment of brain microdialysis in rats in vivo after an oral challenge with HMB to detect its appearance in the brain.
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Affiliation(s)
- A Santos-Fandila
- Discovery R&D, Abbott Nutrition Research and Development, Abbott Laboratories, Camino de Purchil 68, 18004, Granada, Spain,
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Rahman A, Wilund K, Fitschen PJ, Jeejeebhoy K, Agarwala R, Drover JW, Mourtzakis M. Elderly persons with ICU-acquired weakness: the potential role for β-hydroxy-β-methylbutyrate (HMB) supplementation? JPEN J Parenter Enteral Nutr 2013; 38:567-75. [PMID: 24072740 DOI: 10.1177/0148607113502545] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2013] [Accepted: 07/30/2013] [Indexed: 11/17/2022]
Abstract
Intensive care unit (ICU)-acquired weakness is common and characterized by muscle loss, weakness, and paralysis. It is associated with poor short-term outcomes, including increased mortality, but the consequences of reduced long-term outcomes, including decreased physical function and quality of life, can be just as devastating. ICU-acquired weakness is particularly relevant to elderly patients who are increasingly consuming ICU resources and are at increased risk for ICU-acquired weakness and complications, including mortality. Elderly patients often enter critical illness with reduced muscle mass and function and are also at increased risk for accelerated disuse atrophy with acute illness. Increasingly, intensivists and researchers are focusing on strategies and therapies aimed at improving long-term neuromuscular function. β-Hydroxy-β-methylbutyrate (HMB), an ergogenic supplement, has shown efficacy in elderly patients and certain clinical populations in counteracting muscle loss. The present review discusses ICU-acquired weakness, as well as the unique physiology of muscle loss and skeletal muscle function in elderly patients, and then summarizes the evidence for HMB in elderly patients and in clinical populations. We subsequently postulate on the potential role and strategies in studying HMB in elderly ICU patients to improve muscle mass and function.
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Affiliation(s)
- Adam Rahman
- Department of Medicine, Division of Gastroenterology, Western University, London, Ontario, Canada
| | - Kenneth Wilund
- Department of Kinesiology and Community Health College of Applied Health Sciences, University of Illinois, Urbana-Champaign, Illinois
| | - Peter J Fitschen
- Division of Nutritional Sciences, University of Illinois, Urbana-Champaign, Illinois
| | - Khursheed Jeejeebhoy
- Department of Medicine, University of Toronto, Toronto, Canada Department of Nutritional Sciences, University of Toronto, Toronto, Canada Department of Physiology, University of Toronto, Toronto, Canada
| | - Ravi Agarwala
- Department of Anesthesia, Critical Care Medicine Section, Wake University School of Medicine, Winston-Salem, North Carolina
| | - John W Drover
- Department of Surgery (General Surgery), Queen's University, Kingston, Ontario, Canada Critical Care Program, Queen's University, Kingston, Ontario, Canada
| | - Marina Mourtzakis
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
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Bauer J, Biolo G, Cederholm T, Cesari M, Cruz-Jentoft AJ, Morley JE, Phillips S, Sieber C, Stehle P, Teta D, Visvanathan R, Volpi E, Boirie Y. Evidence-Based Recommendations for Optimal Dietary Protein Intake in Older People: A Position Paper From the PROT-AGE Study Group. J Am Med Dir Assoc 2013; 14:542-59. [DOI: 10.1016/j.jamda.2013.05.021] [Citation(s) in RCA: 1068] [Impact Index Per Article: 97.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Accepted: 05/29/2013] [Indexed: 12/20/2022]
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Wilson JM, Fitschen PJ, Campbell B, Wilson GJ, Zanchi N, Taylor L, Wilborn C, Kalman DS, Stout JR, Hoffman JR, Ziegenfuss TN, Lopez HL, Kreider RB, Smith-Ryan AE, Antonio J. International Society of Sports Nutrition Position Stand: beta-hydroxy-beta-methylbutyrate (HMB). J Int Soc Sports Nutr 2013; 10:6. [PMID: 23374455 PMCID: PMC3568064 DOI: 10.1186/1550-2783-10-6] [Citation(s) in RCA: 91] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Accepted: 01/31/2013] [Indexed: 12/12/2022] Open
Abstract
Position Statement: The International Society of Sports Nutrition (ISSN) bases the following position stand on a critical analysis of the literature on the use of beta-hydroxy-beta-methylbutyrate (HMB) as a nutritional supplement. The ISSN has concluded the following. 1. HMB can be used to enhance recovery by attenuating exercise induced skeletal muscle damage in trained and untrained populations. 2. If consuming HMB, an athlete will benefit from consuming the supplement in close proximity to their workout. 3. HMB appears to be most effective when consumed for 2 weeks prior to an exercise bout. 4. Thirty-eight mg·kg·BM-1 daily of HMB has been demonstrated to enhance skeletal muscle hypertrophy, strength, and power in untrained and trained populations when the appropriate exercise prescription is utilized. 5. Currently, two forms of HMB have been used: Calcium HMB (HMB-Ca) and a free acid form of HMB (HMB-FA). HMB-FA may increase plasma absorption and retention of HMB to a greater extent than HMB-CA. However, research with HMB-FA is in its infancy, and there is not enough research to support whether one form is superior. 6. HMB has been demonstrated to increase LBM and functionality in elderly, sedentary populations. 7. HMB ingestion in conjunction with a structured exercise program may result in greater declines in fat mass (FM). 8. HMB's mechanisms of action include an inhibition and increase of proteolysis and protein synthesis, respectively. 9. Chronic consumption of HMB is safe in both young and old populations.
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Affiliation(s)
- Jacob M Wilson
- Department of Health Sciences and Human Performance, University of Tampa, Tampa, FL, USA
| | - Peter J Fitschen
- Division of Nutritional Sciences, University of Illinois, Urbana, IL, USA
| | - Bill Campbell
- Exercise and Performance Nutrition Laboratory, Dept. of Physical Education and Exercise Science, University of South Florida, 4202 E. Fowler Avenue, PED 214, Tampa, FL, 33620, USA
| | - Gabriel J Wilson
- Department of Nutritional Sciences, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
| | - Nelo Zanchi
- Laboratory of Applied Nutrition and Metabolism, Physical Education and School of Sports, University of São Paulo, São Paulo, Brazil
| | - Lem Taylor
- Human Performance Laboratory, Exercise & Sport Science Department, University of Mary Hardin-Baylor, Belton, TX, 76513, USA
| | - Colin Wilborn
- Human Performance Laboratory, Exercise & Sport Science Department, University of Mary Hardin-Baylor, Belton, TX, 76513, USA
| | - Douglas S Kalman
- Miami Research Associates, Endocrinology & Nutrition Department, 6141 Sunset Drive - Suite 301, Miami, FL, 33143, USA
| | - Jeffrey R Stout
- Institute of Exercise Physiology and Wellness, University of Central Florida, Orlando, FL, 32816, USA
| | - Jay R Hoffman
- Institute of Exercise Physiology and Wellness, University of Central Florida, Orlando, FL, 32816, USA
| | | | - Hector L Lopez
- The Center for Applied Health Sciences, Stow, OH, 44224, USA.,Supplement Safety Solutions, Bedford, MA, USA
| | - Richard B Kreider
- Exercise & Sport Nutrition Lab, Department of Health & Kinesiology, Texas A&M University, College Station, TX, USA
| | - Abbie E Smith-Ryan
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina Chapel Hill, Chapel Hill, NC, 27599-8605, USA
| | - Jose Antonio
- Exercise and Sports Science, Nova Southeastern University, Davie, FL, 33314, USA
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