Home-Based Physical Activity and Diet Intervention to Improve Physical Function in Advanced Liver Disease: A Randomized Pilot Trial

Chen, Hui Wei; Ferrando, Arny A.; White, Michelle G.; Dennis, Richard A.; Xie, Jesse J.; Pauly, Margaret; Park, Sanghee; Bartter, Thaddeus; Dunn, Michael A.; Ruiz-Margáin, Astrid; Kim, Woojin; Duarte‐Rojo, Andrés

doi:10.1007/s10620-019-06034-2

Cited by 66 publications

(125 citation statements)

References 15 publications

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“…Currently, the recommended standard of care (SOC) for patients with cirrhosis and sarcopenia is adequate protein nutrition ( 24 – 28 ), physical activity ( 29 ), and a late evening snack ( 30 ). When combined with exercise, essential AAs have been shown to increase muscle mass in patients with cirrhosis ( 31 , 32 ). BCAA supplementation in these patients has also demonstrated stimulation of muscle protein synthesis and improved clinical outcomes ( 33 – 37 ).…”

Section: Introductionmentioning

confidence: 99%

Safety, Tolerability, and Physiological Effects of AXA1665, a Novel Composition of Amino Acids, in Subjects With Child–Pugh A and B Cirrhosis

Chakravarthy

Neutel

Confer

et al. 2020

Clinical and Translational Gastroenterology

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INTRODUCTION: AXA1665 is a novel investigational amino acid (AA) composition specifically designed to impact AA imbalance, ammoniagenesis, and dysregulated anabolic activity associated with cirrhosis. METHODS: This 2-part study examined AXA1665 effects on safety, tolerability, and hepatic/muscle physiology in subjects with Child–Pugh A and B cirrhosis. Part 1 established plasma ammonia and AA concentration baselines with a standardized protein supplement. Part 2 included two 15-day domiciled periods separated by a 14-day washout. In period 1, subjects were randomly distributed to 2 groups: AXA1665 14.7 g t.i.d. (group 1) or control t.i.d. (group 2). In period 2, subjects from group 1 crossed over to control and those in group 2 crossed over to AXA1665 4.9 g t.i.d. All subjects were maintained on standard of care (standardized meals; 30-minute daily, supervised, mandatory physical activity; and daily late-evening snack). RESULTS: In parts 1 and 2, 23 and 17 participants were enrolled, respectively. Dose-dependent increases were observed in plasma concentrations of AXA1665-constituent AAs. Fasted branched-chain AA-to-aromatic AA and valine-to-phenylalanine ratios were both increased (AXA1665 14.7 g t.i.d. control-adjusted change: 44.3% ± 2.7% and 47.2% ± 3.9%, respectively; P < 0.0001). Despite provision of additional nitrogen, mean fasted plasma ammonia concentration at day 15 numerically decreased (−21.1% in AXA1665 14.7 g t.i.d. vs −3.8% in control; P > 0.05). AXA1665 14.7 g t.i.d. produced a leaner body composition and significantly decreased Liver Frailty Index at day 15 vs control (−0.70 ± 0.15 vs −0.14 ± 0.17; P < 0.05). AXA1665 was safe and well tolerated. DISCUSSION: AXA1665 has potential to mitigate core metabolic derangements associated with cirrhosis.

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Section: Introductionmentioning

confidence: 99%

Safety, Tolerability, and Physiological Effects of AXA1665, a Novel Composition of Amino Acids, in Subjects With Child–Pugh A and B Cirrhosis

Chakravarthy

Neutel

Confer

et al. 2020

Clinical and Translational Gastroenterology

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“…This study indicated that symptoms had an impact QOL, yet performing exercise and consuming F&V did not. Although some studies have reported exercise-induced improvement in the metabolic pro le [40], a randomized controlled trial on home-based physical activity and diet intervention showed no improvement in QOL [41]. Thus, more evidence addressing the bene ts of exercise and diet in relation to cirrhosis is still needed, with emphasis on individuals with cardiovascular risk, musculoskeletal disorders, and complications related to cirrhosis.…”

Section: Discussionmentioning

confidence: 99%

Symptom, Adopting Healthy Life Style, and Quality of Life in Patients with Liver Cirrhosis: A Cross-Sectional Study

Lee¹,

Chung²

2020

Preprint

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Background: Previous studies have not considered a broad range of symptoms and the association with healthy behavior and quality of life of patients with liver cirrhosis. Objectives: The purposes of the study were to examine the association of symptom with adopting exercise and consuming fruits and vegetables, and to identify factors associated with quality of life in patients with liver cirrhosis.Methods: This cross-sectional study enrolled 91 consecutive patients with liver cirrhosis in one tertiary general hospital in South Korea between February 2016 and January 2017. Each study participant completed a self-administered questionnaire that measured symptom, stage-of-change in performing exercise and consumption of fruits and vegetables, and the Korean version of the 36-item Short-Form Health Survey. Multivariate logistic regression analysis and multiple regression models was used respectively to examine the association of each symptom with engaging in exercise and increasing consumption of fruits and vegetables and to evaluate factors affecting quality of life.Results: Experiencing nausea was associated with increased intensity of exercise but experiencing shortness of breath was associated with decreased intensity of exercise. Experiencing right upper quadrant pain was associated with increased consumption of fruits and vegetables and muscle cramps, anorexia, right upper quadrant pain and body pain, itching, ascites or edema, bruising, and change in appearance negatively affected quality of life.Conclusions: The results suggest that the types of symptoms experienced by a patient with liver cirrhosis hinder or promote the patient’s adoption of exercise and dietary behavior. Experiencing symptoms may negatively affect quality of life. Caregivers should provide supportive care to patients with liver cirrhosis, which includes assessing and managing symptoms to improve quality of life.

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“…This study indicated that symptoms had an impact on QOL, yet higher SOC in engaging exercise and consumption of F&V did not. Although some studies have reported an exercise-induced improvement in the metabolic pro le [51], a randomized controlled trial on home-based physical activity and diet intervention showed no QOL improvement [52]. Thus, more evidence based on prospective or experimental studies that supports the bene ts of exercise and diet in relation to cirrhosis is still needed, with emphasis on individuals with cardiovascular risk, musculoskeletal disorders, and complications related to cirrhosis.…”

Section: Discussionmentioning

confidence: 99%

Relationship Between Symptoms and Stage of Change in Both Adopting a Healthy Life Style and Quality of Life in Patients with Liver Cirrhosis: A Cross-Sectional Study

Lee

Chung

2020

Preprint

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Background: Previous studies of patients with liver cirrhosis have not considered the broad range of symptoms or the association between healthy behavior and quality of life. The purposes of this study were to examine the association between symptoms and adopting exercise and consuming fruits and vegetables and to identify factors associated with quality of life in patients with liver cirrhosis.Methods: This cross-sectional study enrolled 91 consecutive patients with liver cirrhosis in one tertiary general hospital in South Korea between February 2016 and January 2017. Each study participant completed a self-administered questionnaire that measured symptom, stage of change in engaging in exercise and consumption of fruits and vegetables, and the Korean version of the 36-item Short-Form Health Survey. Multivariate ordinal logistic regression analysis and multiple regression models was used, respectively, to examine the association between each symptom with stage of change in engaging in exercise and consumption of fruits and vegetables and to evaluate factors affecting quality of life.Results: Experiencing nausea was associated with a higher stage of change in engaging in exercise, but experiencing shortness of breath was associated with a lower stage of change in engaging in exercise. Experiencing right upper quadrant pain was associated with a higher stage of change in engaging in consumption of fruits and vegetables. Muscle cramps, anorexia, right upper quadrant pain and body pain, itching, ascites or edema, bruising, and change in appearance negatively affected quality of life.Conclusions: The results suggest that the types of symptoms experienced by a patient with liver cirrhosis hinder or promote the patient’s adoption of exercise and dietary behavior. Experiencing symptoms may negatively affect quality of life. Caregivers should provide supportive care to patients with liver cirrhosis, which includes assessing and managing symptoms to improve quality of life.

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Home-Based Physical Activity and Diet Intervention to Improve Physical Function in Advanced Liver Disease: A Randomized Pilot Trial

Cited by 66 publications

References 15 publications

Safety, Tolerability, and Physiological Effects of AXA1665, a Novel Composition of Amino Acids, in Subjects With Child–Pugh A and B Cirrhosis

Safety, Tolerability, and Physiological Effects of AXA1665, a Novel Composition of Amino Acids, in Subjects With Child–Pugh A and B Cirrhosis

Symptom, Adopting Healthy Life Style, and Quality of Life in Patients with Liver Cirrhosis: A Cross-Sectional Study

Relationship Between Symptoms and Stage of Change in Both Adopting a Healthy Life Style and Quality of Life in Patients with Liver Cirrhosis: A Cross-Sectional Study

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