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Manikam NRM, Andrijono A, Witjaksono F, Kekalih A, Sunaryo J, Widya AS, Nurwidya F. Dynamic Changes in Body Composition and Protein Intake in Epithelial Ovarian Cancer Patients Undergoing Chemotherapy: A Preliminary Study. Asian Pac J Cancer Prev 2024; 25:555-562. [PMID: 38415542 PMCID: PMC11077131 DOI: 10.31557/apjcp.2024.25.2.555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 02/22/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND Ovarian cancer patients often face poor nutritional status, with body composition (BC) serving as a significant prognostic indicator. Skeletal muscle mass (SMM) and fat-free mass (FFM) are crucial predictors of both survival and hospitalization duration. Increasing protein intake has been linked to improvements in SMM and FFM. OBJECTIVE This study aimed to document the alterations in BC parameters among ovarian cancer patients undergoing chemotherapy and correlate these changes with their nutrient intake. METHODS Twelve female patients with stage III ovarian cancer who received first-line chemotherapy were categorized based on their body mass indices (BMI). BC parameters were assessed using an 8-point bioelectrical impedance analysis with a frequency of 50 Hz-60 Hz and measurement impedance range of 10 Ω-1000 Ω. Nutrient intake (energy, protein, fat, and carbohydrate) was assessed before (T0), during the 3rd (T3), and 6th cycle of chemotherapy (T6) through 24-hour food recall. RESULTS Significant increases in body weight (BW)were observed in the underweight group (from 40.9 to 46.8 kg, p=0.001), concomitant with enhancements in all BC parameters. While changes were noted in SMM, they were not statistically significant (p=0.105).Among the underweight group, a protein intake above 1.2 g/kg BW led to an uptrend trend in SMM. Conversely, FFM in overweight/obese patients decreased significantly (from 37.6 to 36.4 kg, p=0.005) due to a a reduction in body water. Throughout chemotherapy, fat mass (FM), visceral fat (VAT), and phase angle (PhA) increased in all patient groups, reflecting heightened fat and carbohydrate intake. CONCLUSION Among stage III ovarian cancer patients, BC undergoes dynamic changes dynamically during the course of chemotherapy, with more pronounced enhancements observed in FFM among underweight patients. Notably, improvements in PhA, SMM or FFM were particularly evident among underweight patients with a protein intake above 1.2 g/kg BW.
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Affiliation(s)
- Nurul Ratna M Manikam
- Department of Nutrition, Faculty of Medicine Universitas Indonesia- Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
| | - Andrijono Andrijono
- Department of Obstetric and Gynecology, Faculty of Medicine Universitas Indonesia- Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
| | - Fiastuti Witjaksono
- Department of Nutrition, Faculty of Medicine Universitas Indonesia- Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
| | - Aria Kekalih
- Occupational Medicine Division, Community Medicine Department, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
| | - Joscelind Sunaryo
- Department of Nutrition, Faculty of Medicine Universitas Indonesia- Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
| | - Arni S Widya
- Department of Nutrition, Faculty of Medicine Universitas Indonesia- Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
| | - Fariz Nurwidya
- Department of Pulmonology and Respiratory Medicine, Universitas Indonesia- Persahabatan Hospital, Jakarta, Indonesia.
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Agraib LM, Al-Shami I, Alkhatib B, Al-Dalaeen AM. Do macronutrient intakes affect obesity indices in Jordanian adults? Am J Hum Biol 2023; 35:e23970. [PMID: 37506187 DOI: 10.1002/ajhb.23970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 07/13/2023] [Accepted: 07/15/2023] [Indexed: 07/30/2023] Open
Abstract
OBJECTIVE To determine whether macronutrient intake is associated with novel obesity indices, including the conicity index (CI), body adiposity index (BAI), abdominal volume index (AVI), body roundness index (BRI), and weight-adjusted-waist index (WWI). METHODOLOGY A cross-sectional survey was conducted with 491 adults (344 males and 147 females) working at different universities in Jordan (July-December 2019). Daily intake of energy (kcal), carbohydrates (g), protein (g), and fat (g) was obtained using 24-h recalls collected over 2 days. Additionally, obesity indices were calculated. RESULTS Regardless of sex, energy, and carbohydrate intakes had a moderately significant positive association, whereas protein and fat intakes had a weakly significant association with BAI, AVI, and BRI. CI and WWI showed a weakly significant association with all macronutrients in males, a moderate correlation with energy and carbohydrate intake, and a weak association with fat and protein intake in females. Male participants had significant increases in the CI (T1 = 1.29 ± 0.01 vs. T3 = 1.36 ± 0.01, p = .018), AVI (T1 = 17.96 ± 0.52 vs. T3 = 22.81 ± 0.57, p = .011), and WWI (T1 = 10.72 ± 0.11 vs. T3 = 11.29 ± 0.09, p = .047) indices scores through the carbohydrate intake tertiles. Additionally, there was a significant increase in scores of AVI (T1 = 18.60 ± 0.56 vs. T3 = 21.42 ± 0.46, p = .048) and an almost significant increase in CI (T1 = 1.30 ± 0.01vs. T3 = 1.33 ± 0.01, p = .056) through the tertiles of protein intake. CONCLUSION Macronutrients were significantly associated with all indices. The effect of macronutrients on obesity indices is sex-based. Among men, CI, AVI, and WWI were the indices most affected by carbohydrate and protein intakes. Future studies should further investigate food sources and macronutrient quality.
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Affiliation(s)
- Lana M Agraib
- Department of Food Science and Nutrition, Faculty of Agriculture, Jerash University, Jerash, Jordan
| | - Islam Al-Shami
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, Jordan
| | - Buthaina Alkhatib
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, Jordan
| | - Anfal M Al-Dalaeen
- Department of Clinical Nutrition and Dietetics, Applied Science Private University, Amman, Jordan
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Nutrition Strategies Promoting Healthy Aging: From Improvement of Cardiovascular and Brain Health to Prevention of Age-Associated Diseases. Nutrients 2022; 15:nu15010047. [PMID: 36615705 PMCID: PMC9824801 DOI: 10.3390/nu15010047] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 12/19/2022] [Accepted: 12/21/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND An increasing number of studies suggest that diet plays an important role in regulating aging processes and modulates the development of the most important age-related diseases. OBJECTIVE The aim of this review is to provide an overview of the relationship between nutrition and critical age-associated diseases. METHODS A literature review was conducted to survey recent pre-clinical and clinical findings related to the role of nutritional factors in modulation of fundamental cellular and molecular mechanisms of aging and their role in prevention of the genesis of the diseases of aging. RESULTS Studies show that the development of cardiovascular and cerebrovascular diseases, neurodegenerative diseases, cognitive impairment and dementia can be slowed down or prevented by certain diets with anti-aging action. The protective effects of diets, at least in part, may be mediated by their beneficial macro- (protein, fat, carbohydrate) and micronutrient (vitamins, minerals) composition. CONCLUSIONS Certain diets, such as the Mediterranean diet, may play a significant role in healthy aging by preventing the onset of certain diseases and by improving the aging process itself. This latter can be strengthened by incorporating fasting elements into the diet. As dietary recommendations change with age, this should be taken into consideration as well, when developing a diet tailored to the needs of elderly individuals. Future and ongoing clinical studies on complex anti-aging dietary interventions translating the results of preclinical investigations are expected to lead to novel nutritional guidelines for older adults in the near future.
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Correa-de-Araujo R, Bhasin S. Public Health Need, Molecular Targets, and Opportunities for the Accelerated Development of Function-Promoting Therapies: Proceedings of a National Institute on Aging Workshop. J Gerontol A Biol Sci Med Sci 2022; 77:2227-2237. [PMID: 36399442 PMCID: PMC10148729 DOI: 10.1093/gerona/glac181] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Indexed: 11/19/2022] Open
Abstract
Abstract
Background
People ≥ 65 years are expected to live a substantial portion of their remaining lives with a limiting physical condition and the numbers of affected individuals will increase substantially due to the growth of the population of older adults worldwide. The age-related loss of muscle mass, strength, and function is associated with an increased risk of physical disabilities, falls, loss of independence, metabolic disorders, and mortality. The development of function-promoting therapies to prevent and treat age-related skeletal muscle functional limitations is a pressing public health problem.
Methods
On March 20–22, 2022, the National Institute on Aging (NIA) held a workshop entitled “Development of Function-Promoting Therapies: Public Health Need, Molecular Targets, and Drug Development.”
Results
The workshop covered a variety of topics including advances in muscle biology, novel candidate molecules, findings from randomized trials, and challenges in the design of clinical trials and regulatory approval of function-promoting therapies. Leading academic investigators, representatives from the National Institutes of Health (NIH) and the U.S. Food and Drug Administration (FDA), professional societies, pharmaceutical industry, and patient advocacy organizations shared research findings and identified research gaps and strategies to advance the development of function-promoting therapies. A diverse audience of 397 national and international professionals attended the conference.
Conclusions
Function-promoting therapies to prevent and treat physical disabilities associated with aging and chronic diseases are a public health imperative. Appropriately powered, well-designed clinical trials and synergistic collaboration among academic experts, patients and stakeholders, the NIH and the FDA, and the pharmaceutical industry are needed to accelerate the development of function-promoting therapies.
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Affiliation(s)
- Rosaly Correa-de-Araujo
- Division of Geriatrics and Clinical Gerontology, National Institute on Aging, National Institutes of Health, U.S. Department of Health and Human Services , Bethesda, Maryland , USA
| | - Shalender Bhasin
- Director, Research Program in Men’s Health: Aging and Metabolism. Director, Boston Claude D. Pepper Older Americans Independence Center, Brigham and Women’s Hospital , Boston, Massachusetts , USA
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Coelho-Júnior HJ, Calvani R, Tosato M, Landi F, Picca A, Marzetti E. Protein intake and physical function in older adults: A systematic review and meta-analysis. Ageing Res Rev 2022; 81:101731. [PMID: 36087703 DOI: 10.1016/j.arr.2022.101731] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 08/24/2022] [Accepted: 09/05/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND The present study explored cross-sectional and longitudinal associations between protein intake and physical function in older adults. METHODS We conducted a systematic review and meta-analysis of cross-sectional and longitudinal studies that investigated the association between protein intake and measures of physical function in older adults. Cross-sectional, case-control, and longitudinal cohort studies that investigated the association between protein intake and physical function as a primary or secondary outcome in people aged 60 + years were included. Studies published in languages other than English, Italian, Portuguese, or Spanish were excluded. Studies were retrieved from MEDLINE, SCOPUS, EMBASE, CINAHL, AgeLine, and Food Science Source databases through January 31, 2022. A pooled effect size was calculated based on standard mean differences (SMD), MD, log odds ratio (OR) and Z-score.. RESULTS Twenty-two cross-sectional studies examined a total of 11,332 community-dwellers, hospitalized older adults, and elite senior athletes with a mean age of approximately 75 years. The pooled analysis indicated that a protein intake higher than the recommended dietary allowance (RDA) was significantly associated with higher Short Physical Performance Battery (SPPB) scores (SMD: 0.63, 95% CI: 0.27, 0.99, P-value: 0.0006), faster walking speed, greater lower-limb (SMD: 0.22, 95% CI: 0.04, 0.40, P-value: 0.02) and isometric handgrip strength (Z-score: 0.087, 95% CI: 0.046-0.128, P-value: 0.0001), and better balance (SMD: 0.33, 95% CI: 0.05, 0.62, P-value: 0.02). Nine longitudinal studies investigated 12,424 community-dwelling and native older adults with a mean age of approximately 85 years. A protein intake higher than the current RDA was not associated with lower decline in either isometric handgrip strength (logOR: 0.99, 95% CI: 0.97-1.02, P-value= 0.67) or walking speed (logOR: 0.92, 95% CI: 0.77-1.10, P-value= 0.35). CONCLUSIONS A protein intake higher than the RDA is cross-sectionally associated with better physical performance and greater muscle strength in older adults. However, a high consumption of proteins does not seem to prevent physical function decline over time.
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Affiliation(s)
- Hélio José Coelho-Júnior
- Department of Geriatrics and Orthopedics, Università Cattolica del Sacro Cuore, Rome, Italy; Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy.
| | - Riccardo Calvani
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy.
| | - Matteo Tosato
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Francesco Landi
- Department of Geriatrics and Orthopedics, Università Cattolica del Sacro Cuore, Rome, Italy; Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Anna Picca
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Emanuele Marzetti
- Department of Geriatrics and Orthopedics, Università Cattolica del Sacro Cuore, Rome, Italy; Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
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Kirk B, Mooney K, Vogrin S, Jackson M, Duque G, Khaiyat O, Amirabdollahian F. Leucine-enriched whey protein supplementation, resistance-based exercise, and cardiometabolic health in older adults: a randomized controlled trial. J Cachexia Sarcopenia Muscle 2021; 12:2022-2033. [PMID: 34520104 PMCID: PMC8718053 DOI: 10.1002/jcsm.12805] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 07/26/2021] [Accepted: 08/23/2021] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Increasing protein intake (above the Recommended Dietary Amount) alone or with resistance-based exercise is suggested to improve cardiometabolic health; however, randomized controlled trials (RCTs) are needed to confirm this. METHODS The Liverpool Hope University-Sarcopenia Aging Trial (LHU-SAT) was a 16 week RCT (ClinicalTrials.gov Identifier: NCT02912130) of 100 community-dwelling older adults [mean age: 68.73 ± 5.80 years, body mass index: 27.06 ± 5.18 kg/m2 (52% women)] who were randomized to four independent groups [Control (C), Exercise (E), Exercise + Protein (EP), Protein (P)]. E and EP completed supervised and progressive resistance-based exercise (resistance exercise: two times per week, functional circuit exercise: once per week), while EP and P were supplemented with a leucine-enriched whey protein drink (three times per day) based on individual body weight (0.50 g/kg/meal, 1.50 g/kg/day). Outcome measures including arterial stiffness (pulse wave velocity), fasting plasma/serum biomarkers [glucose/glycated haemoglobin, total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein, insulin, resistin, leptin, adiponectin, C-reactive protein, tumour necrosis factor-alpha, interleukin-6, cystatin-C, & ferritin], insulin resistance (HOMA-IR), and kidney function (eGFR) were measured before and after intervention. RESULTS Total protein intake (habitual diet plus supplementation) increased to 1.55 ± 0.69 g/kg/day in EP and to 1.93 ± 0.72 g/kg/day in P, and remained significantly lower (P < 0.001) in unsupplemented groups (E: 1.08 ± 0.33 g/kg/day, C: 1.00 ± 0.26 g/kg/day). At 16 weeks, there was a group-by-time interaction whereby absolute changes in LDL-cholesterol were lower in EP [mean difference: -0.79 mmol/L, 95% confidence interval (CI): -1.29, -0.28, P = 0.002] and P (mean difference: -0.76 mmol/L, 95% CI: -1.26, -0.26, P = 0.003) vs. C. Serum insulin also showed group-by-time interactions at 16 weeks whereby fold changes were lower in EP (mean difference: -0.40, 95% CI: -0.65, -0.16, P = 0.001) and P (mean difference: -0.32, 95% CI: -0.56, -0.08, P = 0.009) vs. C, and fold changes in HOMA-IR improved in EP (mean difference: -0.37, 95% CI: -0.64, -0.10, P = 0.007) and P (mean difference: -0.27, 95% CI: -0.53, -0.00, P = 0.048) vs. C. Serum resistin declined in P only (group-by-time interaction at 16 weeks: P = 0.009). No other interactions were observed in outcome measures (P > 0.05), and kidney function (eGFR) remained unaltered. CONCLUSIONS Sixteen weeks of leucine-enriched whey protein supplementation alone and combined with resistance-based exercise improved cardiometabolic health markers in older adults.
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Affiliation(s)
- Ben Kirk
- Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia.,Australian Institute for Musculoskeletal Science (AIMSS), Geroscience & Osteosarcopenia Research Program, The University of Melbourne and Western Health, Melbourne, VIC, Australia.,School of Health Sciences, Liverpool Hope University, Liverpool, UK
| | - Kate Mooney
- School of Health Sciences, Liverpool Hope University, Liverpool, UK
| | - Sara Vogrin
- Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia.,Australian Institute for Musculoskeletal Science (AIMSS), Geroscience & Osteosarcopenia Research Program, The University of Melbourne and Western Health, Melbourne, VIC, Australia
| | - Matthew Jackson
- School of Health Sciences, Liverpool Hope University, Liverpool, UK
| | - Gustavo Duque
- Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia.,Australian Institute for Musculoskeletal Science (AIMSS), Geroscience & Osteosarcopenia Research Program, The University of Melbourne and Western Health, Melbourne, VIC, Australia
| | - Omid Khaiyat
- School of Health Sciences, Liverpool Hope University, Liverpool, UK
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Bhasin S, Ozimek N. Optimizing the Diagnostic Accuracy and Treatment Decisions in Men with Testosterone Deficiency. Endocr Pract 2021; 27:1252-1259. [PMID: 34390882 DOI: 10.1016/j.eprac.2021.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 08/02/2021] [Accepted: 08/03/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE This narrative review offers a guideline-based approach to optimizing the diagnostic evaluation and treatment decision-making in men being evaluated for testosterone deficiency. METHODS A narrative review RESULTS: Testosterone deficiency is a clinical syndrome that results from the inability of the testes to produce normal amounts of testosterone, and is characterized by a constellation of symptoms and signs associated with consistently low testosterone concentrations. The diagnosis of testosterone deficiency is made by ascertainment of symptoms and signs; measurement of total and, if indicated, free testosterone levels, in early morning fasting samples on 2 or more days; measurement of LH and FSH to distinguish primary from secondary hypogonadism; and additional evaluation to ascertain the cause of testosterone deficiency. Non-specificity of symptoms and signs; variations in testosterone levels over time; inaccuracy in the measurement of total and free testosterone levels; variations in binding protein concentrations; and the suboptimal reference ranges contribute to diagnostic inaccuracy. Testosterone treatment is indicated for men with symptomatic testosterone deficiency. Testosterone treatment should be avoided in men with prostate or breast cancer, erythrocytosis, thrombophilia, increased risk of prostate cancer or severe lower urinary tract symptoms without prior urological evaluation, recent major adverse cardiovascular event, uncontrolled heart failure or severe untreated sleep apnea. Testosterone replacement therapy should be accompanied by a standardized monitoring plan. CONCLUSION The shared decision to treat should be guided by consideration of the burden of symptoms, potential benefits and risks, patient's values, and the cost and burden of long-term treatment and monitoring.
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Affiliation(s)
- Shalender Bhasin
- Harvard Medical School, Research Program in Men's Health: Aging and Metabolism, Boston Claude D. Pepper Older Americans Independence Center, Brigham and Women's Hospital, Boston, Massachusetts.
| | - Noelle Ozimek
- Harvard Medical School, Research Program in Men's Health: Aging and Metabolism, Boston Claude D. Pepper Older Americans Independence Center, Brigham and Women's Hospital, Boston, Massachusetts
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Bel Lassen P, Belda E, Prifti E, Dao MC, Specque F, Henegar C, Rinaldi L, Wang X, Kennedy SP, Zucker JD, Calame W, Lamarche B, Claus SP, Clément K. Protein supplementation during an energy-restricted diet induces visceral fat loss and gut microbiota amino acid metabolism activation: a randomized trial. Sci Rep 2021; 11:15620. [PMID: 34341379 PMCID: PMC8329187 DOI: 10.1038/s41598-021-94916-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 07/12/2021] [Indexed: 01/07/2023] Open
Abstract
Interactions between diet and gut microbiota are critical regulators of energy metabolism. The effects of fibre intake have been deeply studied but little is known about the impact of proteins. Here, we investigated the effects of high protein supplementation (Investigational Product, IP) in a double blind, randomised placebo-controled intervention study (NCT01755104) where 107 participants received the IP or an isocaloric normoproteic comparator (CP) alongside a mild caloric restriction. Gut microbiota profiles were explored in a patient subset (n = 53) using shotgun metagenomic sequencing. Visceral fat decreased in both groups (IP group: - 20.8 ± 23.2 cm2; CP group: - 14.5 ± 24.3 cm2) with a greater reduction (p < 0.05) with the IP supplementation in the Per Protocol population. Microbial diversity increased in individuals with a baseline low gene count (p < 0.05). The decrease in weight, fat mass and visceral fat mass significantly correlated with the increase in microbial diversity (p < 0.05). Protein supplementation had little effects on bacteria composition but major differences were seen at functional level. Protein supplementation stimulated bacterial amino acid metabolism (90% amino-acid synthesis functions enriched with IP versus 13% in CP group (p < 0.01)). Protein supplementation alongside a mild energy restriction induces visceral fat mass loss and an activation of gut microbiota amino-acid metabolism.Clinical trial registration: NCT01755104 (24/12/2012). https://clinicaltrials.gov/ct2/show/record/NCT01755104?term=NCT01755104&draw=2&rank=1 .
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Affiliation(s)
- Pierre Bel Lassen
- Sorbonne Université, Inserm, Nutrition and Obesity: Systemic Approaches Research Unit, NutriOmics, Sorbonne Université, 91 boulevard de l'Hôpital, 75013, Paris, France
- Assistance Publique Hôpitaux de Paris, Nutrition Department, Pitié Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris, 75013, Paris, France
| | - Eugeni Belda
- Sorbonne Université, Inserm, Nutrition and Obesity: Systemic Approaches Research Unit, NutriOmics, Sorbonne Université, 91 boulevard de l'Hôpital, 75013, Paris, France
- Integrative Phenomics, Paris, France
| | - Edi Prifti
- Sorbonne Université, Inserm, Nutrition and Obesity: Systemic Approaches Research Unit, NutriOmics, Sorbonne Université, 91 boulevard de l'Hôpital, 75013, Paris, France
- Sorbonne Université, IRD, UMMISCO, Unité de Modélisation Mathématique et Informatique des Systèmes Complexes, Sorbonne Université, 93143, Bondy, France
| | - Maria Carlota Dao
- Sorbonne Université, Inserm, Nutrition and Obesity: Systemic Approaches Research Unit, NutriOmics, Sorbonne Université, 91 boulevard de l'Hôpital, 75013, Paris, France
| | - Florian Specque
- Sorbonne Université, IRD, UMMISCO, Unité de Modélisation Mathématique et Informatique des Systèmes Complexes, Sorbonne Université, 93143, Bondy, France
| | - Corneliu Henegar
- Sorbonne Université, Inserm, Nutrition and Obesity: Systemic Approaches Research Unit, NutriOmics, Sorbonne Université, 91 boulevard de l'Hôpital, 75013, Paris, France
| | - Laure Rinaldi
- YSOPIA Bioscience, 17 place de la Bourse, 33076, Bordeaux, France
| | - Xuedan Wang
- Department of Food and Nutritional Sciences, School of Chemistry, Food and Pharmacy, The University of Reading, Reading, RG6 6AP, UK
| | - Sean P Kennedy
- CNRS, Institut Pasteur, Department of Computational Biology, USR 3756 , CNRS, 75015, Paris, France
| | - Jean-Daniel Zucker
- Sorbonne Université, Inserm, Nutrition and Obesity: Systemic Approaches Research Unit, NutriOmics, Sorbonne Université, 91 boulevard de l'Hôpital, 75013, Paris, France
- Sorbonne Université, IRD, UMMISCO, Unité de Modélisation Mathématique et Informatique des Systèmes Complexes, Sorbonne Université, 93143, Bondy, France
| | - Wim Calame
- StatistiCal BV, Strandwal 148, 2241 MN, Wassenaar, The Netherlands
| | - Benoît Lamarche
- Laval University, Institute On Nutrition and Functional Foods, Laval University, Québec, QC, G1V 0A6, Canada
| | - Sandrine P Claus
- YSOPIA Bioscience, 17 place de la Bourse, 33076, Bordeaux, France.
| | - Karine Clément
- Sorbonne Université, Inserm, Nutrition and Obesity: Systemic Approaches Research Unit, NutriOmics, Sorbonne Université, 91 boulevard de l'Hôpital, 75013, Paris, France.
- Assistance Publique Hôpitaux de Paris, Nutrition Department, Pitié Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris, 75013, Paris, France.
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Blackwell JEM, Gharahdaghi N, Brook MS, Watanabe S, Boereboom CL, Doleman B, Lund JN, Wilkinson DJ, Smith K, Atherton PJ, Williams JP, Phillips BE. The physiological impact of high-intensity interval training in octogenarians with comorbidities. J Cachexia Sarcopenia Muscle 2021; 12:866-879. [PMID: 34060253 PMCID: PMC8350218 DOI: 10.1002/jcsm.12724] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 04/22/2021] [Accepted: 05/07/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Declines in cardiorespiratory fitness (CRF) and fat-free mass (FFM) with age are linked to mortality, morbidity and poor quality of life. High-intensity interval training (HIIT) has been shown to improve CRF and FFM in many groups, but its efficacy in the very old, in whom comorbidities are present is undefined. We aimed to assess the efficacy of and physiological/metabolic responses to HIIT, in a cohort of octogenarians with comorbidities (e.g. hypertension and osteoarthritis). METHODS Twenty-eight volunteers (18 men, 10 women, 81.2 ± 0.6 years, 27.1 ± 0.6 kg·m-2 ) with American Society of Anaesthesiology (ASA) Grade 2-3 status each completed 4 weeks (12 sessions) HIIT after a control period of equal duration. Before and after each 4 week period, subjects underwent body composition assessments and cardiopulmonary exercise testing. Quadriceps muscle biopsies (m. vastus lateralis) were taken to quantify anabolic signalling, mitochondrial oxidative phosphorylation, and cumulative muscle protein synthesis (MPS) over 4-weeks. RESULTS In comorbid octogenarians, HIIT elicited improvements in CRF (anaerobic threshold: +1.2 ± 0.4 ml·kg-1 ·min-1 , P = 0.001). HIIT also augmented total FFM (47.2 ± 1.4 to 47.6 ± 1.3 kg, P = 0.04), while decreasing total fat mass (24.8 ± 1.3 to 24 ± 1.2 kg, P = 0.0002) and body fat percentage (33.1 ± 1.5 to 32.1 ± 1.4%, P = 0.0008). Mechanistically, mitochondrial oxidative phosphorylation capacity increased after HIIT (i.e. citrate synthase activity: 52.4 ± 4 to 67.9 ± 5.1 nmol·min-1 ·mg-1 , P = 0.005; membrane protein complexes (C): C-II, 1.4-fold increase, P = 0.002; C-III, 1.2-fold increase, P = 0.03), as did rates of MPS (1.3 ± 0.1 to 1.5 ± 0.1%·day-1 , P = 0.03). The increase in MPS was supported by up-regulated phosphorylation of anabolic signalling proteins (e.g. AKT, p70S6K, and 4E-BP1; all P < 0.05). There were no changes in any of these parameters during the control period. No adverse events were reported throughout the study. CONCLUSIONS The HIIT enhances skeletal muscle mass and CRF in octogenarians with disease, with up-regulation of MPS and mitochondrial capacity likely underlying these improvements. HIIT can be safely delivered to octogenarians with disease and is an effective, time-efficient intervention to improve muscle mass and physical function in a short time frame.
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Affiliation(s)
- James E M Blackwell
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, Royal Derby Hospital Centre, University of Nottingham, Derby, UK.,Department of Surgery & Anaesthetics, Royal Derby Hospital, Derby, UK
| | - Nima Gharahdaghi
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, Royal Derby Hospital Centre, University of Nottingham, Derby, UK.,National Institute of Health Research (NIHR), Nottingham Biomedical Research Centre (BRC), Nottingham, UK
| | - Matthew S Brook
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, Royal Derby Hospital Centre, University of Nottingham, Derby, UK.,National Institute of Health Research (NIHR), Nottingham Biomedical Research Centre (BRC), Nottingham, UK
| | - Shinya Watanabe
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, Royal Derby Hospital Centre, University of Nottingham, Derby, UK
| | - Catherine L Boereboom
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, Royal Derby Hospital Centre, University of Nottingham, Derby, UK
| | - Brett Doleman
- Department of Surgery & Anaesthetics, Royal Derby Hospital, Derby, UK
| | - Jonathan N Lund
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, Royal Derby Hospital Centre, University of Nottingham, Derby, UK.,Department of Surgery & Anaesthetics, Royal Derby Hospital, Derby, UK
| | - Daniel J Wilkinson
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, Royal Derby Hospital Centre, University of Nottingham, Derby, UK.,National Institute of Health Research (NIHR), Nottingham Biomedical Research Centre (BRC), Nottingham, UK
| | - Kenneth Smith
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, Royal Derby Hospital Centre, University of Nottingham, Derby, UK.,National Institute of Health Research (NIHR), Nottingham Biomedical Research Centre (BRC), Nottingham, UK
| | - Philip J Atherton
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, Royal Derby Hospital Centre, University of Nottingham, Derby, UK.,National Institute of Health Research (NIHR), Nottingham Biomedical Research Centre (BRC), Nottingham, UK
| | - John P Williams
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, Royal Derby Hospital Centre, University of Nottingham, Derby, UK.,Department of Surgery & Anaesthetics, Royal Derby Hospital, Derby, UK
| | - Bethan E Phillips
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, Royal Derby Hospital Centre, University of Nottingham, Derby, UK.,National Institute of Health Research (NIHR), Nottingham Biomedical Research Centre (BRC), Nottingham, UK
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