Standard Hypercaloric, Hyperproteic vs. Leucine-Enriched Oral Supplements in Patients with Cancer-Induced Sarcopenia, a Randomized Clinical Trial

Herrera-Martínez, Aura D.; León Idougourram, Soraya; Muñoz Jiménez, Concepción; Rodríguez-Alonso, Rosa; Alonso Echague, Rosario; Chica Palomino, Sonia; Sanz Sanz, Ana; Manzano García, Gregorio; Gálvez Moreno, María Ángeles; Calañas Continente, Alfonso; Molina Puertas, María José

doi:10.3390/nu15122726

Cited by 15 publications

(12 citation statements)

References 46 publications

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“…Nutritional support is essential in several human diseases [ 1 ]. Heart failure (HF) is a chronic disease with an increasing incidence (26 million people worldwide), especially in the elderly [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Mediterranean Diet, Vitamin D, and Hypercaloric, Hyperproteic Oral Supplements for Treating Sarcopenia in Patients with Heart Failure—A Randomized Clinical Trial

Herrera-Martínez,

Muñoz Jiménez,

López Aguilera

et al. 2023

Nutrients

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Background: Malnutrition and sarcopenia frequently affect patients with heart failure (HF), in which clinical outcomes and survival is decreased. Thus, appropriate nutritional screening and early nutrition support are highly recommended. Currently, nutritional support is not a standard of care in patients with HF, and the use of commercially available oral supplements (OSs) could provide an additional benefit to medical treatment in these patients. Aim: To compare the effect of the Mediterranean diet in combination with hypercaloric, hyperproteic OS in patients with HF. Patients and methods: An open label, controlled clinical study in which patients were randomly assigned to receive a Mediterranean diet (control group) vs. hypercaloric, hyperproteic OS (intervention group) for twenty-four weeks. Thirty-eight patients were included; epidemiological, clinical, anthropometric, ultrasound (muscle echography of the rectus femoris muscle of the quadriceps and abdominal adipose tissue), and biochemical evaluations were performed. All patients received additional supplementation with vitamin D. Results: Baseline malnutrition according to the GLIM criteria was observed in 30% of patients, while 65.8% presented with sarcopenia. Body cell mass, lean mass, and body mass increased in the intervention group (absolute increase of 0.5, p = 0.03, 1.2 kg, p = 0.03, and 0.1 kg, p = 0.03 respectively). In contrast, fat mass increased in the control group (4.5 kg, p = 0.05). According to the RF ultrasound, adipose tissue, muscle area, and circumference tended to decrease in the intervention group; it is probable that 24 weeks was too short a period of time for evaluating changes in muscle area or circumference, as previously observed in another group of patients. In contrast, functionality, determined by the up-and-go test, significantly improved in all patients (difference 12.6 s, p < 0.001), including the control (10 s improvement, p < 0.001) and the intervention group (improvement of 8.9 s, p < 0.001). Self-reported QoL significantly increased in all groups, from 68.7 ± 22.2 at baseline to 77.7 ± 18.7 (p = 0.01). When heart functionality was evaluated, LVEF increased in the whole cohort (38.7 ± 16.6 vs. 42.2 ± 8.9, p < 0.01); this increase was higher in the intervention group (34.2 ± 16.1 at baseline vs. 45.0% ± 17.0 after 24 weeks, p < 0.05). Serum values of NT-proBNP also significantly decreased in the whole cohort (p < 0.01), especially in the intervention group (p = 0.02). After adjusting by age and sex, nutritional support, baseline LVEF, NT-proBNP, and body composition parameters of functionality tests were not associated with mortality or new hospital admissions in this cohort. Conclusion: Nutritional support with hypercaloric, hyperproteic OS, Mediterranean diet, and vitamin D supplementation were associated with decreased NT-proBNP and improvements in LVEF, functionality, and quality of life in patients with HF, despite a significant decrease in hospital admissions.

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Section: Introductionmentioning

confidence: 99%

Mediterranean Diet, Vitamin D, and Hypercaloric, Hyperproteic Oral Supplements for Treating Sarcopenia in Patients with Heart Failure—A Randomized Clinical Trial

Herrera-Martínez,

Muñoz Jiménez,

López Aguilera

et al. 2023

Nutrients

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“…DXA is considered a gold standard for measuring body composition parameters; unfortunately, is not routinely used due to the required logistics, costs, and low-grade radiation exposure [19]. In this context, novel techniques have emerged, such as safe, easy-to-use, and cheap alternatives for measuring body composition parameters [9,[20][21][22]. Among them, electrical bioimpedance analysis (BIA) is probably the most frequently used method.…”

Section: Discussionmentioning

confidence: 99%

Differences in the Evaluation of Malnutrition and Body Composition Using Bioelectrical Impedance Analysis, Nutritional Ultrasound, and Dual-Energy X-ray Absorptiometry in Patients with Heart Failure

Benitez-Velasco,

Alzas-Teomiro,

Zurera Gómez

et al. 2024

Nutrients

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Background: Although malnutrition is frequently observed in patients with heart failure (HF), this diagnosis should be performed carefully since HF itself is associated with increased inflammatory activity, which affects body weight, functionality, and some nutritional parameters; thus, its isolated interpretation can erroneously identify surrogate markers of severity as markers of malnutrition. In this context, we aimed to evaluate the prevalence of malnutrition using different classification systems and perform a comprehensive nutritional evaluation to determine the reliability of different diagnostic techniques. Patients and methods: Eighty-three patients with a recent hospital admission due to HF were evaluated. GLIM diagnosis criteria and subjective global assessment (SGA) were performed; a comprehensive anthropometric, functional, and biochemical nutritional evaluation was performed, in which bioelectrical impedance analysis (BIA), nutritional ultrasound, and dual-energy X-ray absorptiometry (DXA) were performed. Additionally, mortality and additional admissions due to HF were determined after a mean follow up of 18 months. Results: Malnutrition according to the GLIM criteria (54%) accurately distinguished patients with impaired functionality, lower lean mass, skeletal mass index, and appendicular muscle mass (BIA), as well as lower trunk fat mass, trunk lean mass, fat-free mass (DXA), and decreased albumin and increased C-reactive protein serum levels. According to SGA, there were significant changes in body composition parameters determined by BIA, muscle ultrasound, and functional tests between well-nourished patients and patients with risk of malnutrition (53.7%) or who had malnutrition (7.1%), but not when the last two groups were compared. BIA and DXA showed strong correlations when evaluating muscle and fat mass in HF patients, but correlations with nutritional ultrasound were limited, as well as functional tests. A multivariate analysis showed that no significant association was observed between body composition and mortality, but preperitoneal fat was associated with an increased risk of new hospital admissions (OR: 0.73). Conclusions: GLIM criteria identified a lower percentage of patients with HF and malnutrition compared with SGA; thus, SGA could have a role in preventing malnutrition in HF patients. Nutritional evaluation with BIA and DXA in patients with HF showed reliable results of body composition parameters in HF, and both help with the diagnosis of malnutrition according to the GLIM or SGA criteria and could provide complementary information in some specific cases.

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“…70 On the other hand, Herrera-Martinez et al compared studies using high-calorie, high-protein, and leucine-rich oral supplements and vitamin D interventions in cancer patients with sarcopenia and found that the muscle mass of patients in the two groups remained stable, with no distinct advantage of leucine observed. 71 Additionally, studies on citrulline supplementation did not show any significant improvement in sarcopenia. 72 Teixeira et al conducted a dietary supplement intervention study on a patient with type 1 diabetes and sarcopenia.…”

Section: Dovepressmentioning

confidence: 97%

Non-Pharmacological Strategies for Managing Sarcopenia in Chronic Diseases

Hu,

Wang,

et al. 2024

CIA

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This article focuses on a range of non-pharmacological strategies for managing sarcopenia in chronic diseases, including exercise, dietary supplements, traditional Chinese exercise, intestinal microecology, and rehabilitation therapies for individuals with limited limb movement. By analyzing multiple studies, the article aims to summarize the available evidence to manage sarcopenia in individuals with chronic diseases. The results strongly emphasize the role of resistance training in addressing chronic diseases and secondary sarcopenia. Maintaining the appropriate frequency and intensity of resistance training can help prevent muscle atrophy and effectively reduce inflammation. Although aerobic exercise has limited ability to improve skeletal muscle mass, it does have some positive effects on physical function. Building upon this, the article explores the potential benefits of combined training approaches, highlighting their helpfulness for overall quality of life. Additionally, the article also highlights the importance of dietary supplements in combating muscle atrophy in chronic diseases. It focuses on the importance of protein intake, supplements rich in essential amino acids and omega-3, as well as sufficient vitamin D to prevent muscle atrophy. Combining exercise with dietary supplements appears to be an effective strategy for preventing sarcopenia, although the optimal dosage and type of supplement remain unclear. Furthermore, the article explores the potential benefits of intestinal microecology in sarcopenia. Probiotics, prebiotics, and bacterial products are suggested as new treatment options for sarcopenia. Additionally, emerging therapies such as whole body vibration training, blood flow restriction, and electrical stimulation show promise in treating sarcopenia with limited limb movement. Overall, this article provides valuable insights into non-pharmacological strategies for managing sarcopenia in individuals with chronic diseases. It emphasizes the importance of a holistic and integrated approach that incorporates exercise, nutrition, and multidisciplinary interventions, which have the potential to promote health in the elderly population. Future research should prioritize high-quality randomized controlled trials and utilize wearable devices, smartphone applications, and other advanced surveillance methods to investigate the most effective intervention strategies for sarcopenia associated with different chronic diseases.

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Standard Hypercaloric, Hyperproteic vs. Leucine-Enriched Oral Supplements in Patients with Cancer-Induced Sarcopenia, a Randomized Clinical Trial

Cited by 15 publications

References 46 publications

Mediterranean Diet, Vitamin D, and Hypercaloric, Hyperproteic Oral Supplements for Treating Sarcopenia in Patients with Heart Failure—A Randomized Clinical Trial

Mediterranean Diet, Vitamin D, and Hypercaloric, Hyperproteic Oral Supplements for Treating Sarcopenia in Patients with Heart Failure—A Randomized Clinical Trial

Differences in the Evaluation of Malnutrition and Body Composition Using Bioelectrical Impedance Analysis, Nutritional Ultrasound, and Dual-Energy X-ray Absorptiometry in Patients with Heart Failure

Non-Pharmacological Strategies for Managing Sarcopenia in Chronic Diseases

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