Feasibility of two levels of protein intake in patients with colorectal cancer: findings from the Protein Recommendation to Increase Muscle (PRIMe) randomized controlled pilot trial.

Autor:	Ford KL; Department of Agricultural, Food & Nutritional Science, University of Alberta, Edmonton., Sawyer MB; Department of Oncology, University of Alberta, Edmonton, Canada., Ghosh S; Department of Oncology, University of Alberta, Edmonton, Canada., Trottier CF; Department of Agricultural, Food & Nutritional Science, University of Alberta, Edmonton., Disi IR; Department of Agricultural, Food & Nutritional Science, University of Alberta, Edmonton; Department of Postgraduate Program of Anaesthesiology, Surgical Sciences and Perioperative Medicine, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil., Easaw J; Department of Oncology, University of Alberta, Edmonton, Canada., Mulder K; Department of Oncology, University of Alberta, Edmonton, Canada., Koski S; Department of Oncology, University of Alberta, Edmonton, Canada., Porter Starr KN; Durham VA Medical Centre, Durham; Department of Medicine, Duke University, Durham, USA., Bales CW; Durham VA Medical Centre, Durham; Department of Medicine, Duke University, Durham, USA., Arends J; Department of Medicine I, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany., Siervo M; School of Population Health, Curtin University, Perth, Australia., Deutz N; Center for Translational Research in Aging and Longevity, Texas A&M University, College Station, USA., Prado CM; Department of Agricultural, Food & Nutritional Science, University of Alberta, Edmonton. Electronic address: carla.prado@ualberta.ca.
Jazyk:	angličtina
Zdroj:	ESMO open [ESMO Open] 2024 Jul; Vol. 9 (7), pp. 103604. Date of Electronic Publication: 2024 Jun 26.
DOI:	10.1016/j.esmoop.2024.103604
Abstrakt:	Background: Low muscle mass (MM) predicts unfavorable outcomes in cancer. Protein intake supports muscle health, but oncologic recommendations are not well characterized. The objectives of this study were to evaluate the feasibility of dietary change to attain 1.0 or 2.0 g/kg/day protein diets, and the preliminary potential to halt MM loss and functional decline in patients starting chemotherapy for stage II-IV colorectal cancer. Patients and Methods: Patients were randomized to the diets and provided individualized counseling. Assessments at baseline, 6 weeks, and 12 weeks included weighed 3-day food records, appendicular lean soft tissue index (ALSTI) by dual-energy X-ray absorptiometry to estimate MM, and physical function by the Short Physical Performance Battery (SPPB) test. Results: Fifty patients (mean ± standard deviation: age, 57 ± 11 years; body mass index, 27.3 ± 5.6 kg/m 2 ; and protein intake, 1.1 ± 0.4 g/kg/day) were included at baseline. At week 12, protein intake reached 1.6 g/kg/day in the 2.0 g/kg/day group and 1.2 g/kg/day in the 1.0 g/kg/day group (P = 0.012), resulting in a group difference of 0.4 g/kg/day rather than 1.0 g/kg/day. Over one-half (59%) of patients in the 2.0 g/kg/day group maintained or gained MM compared with 44% of patients in the 1.0 g/kg/day group (P = 0.523). Percent change in ALSTI did not differ between groups [2.0 g/kg/day group (mean ± standard deviation): 0.5% ± 4.6%; 1.0 g/kg/day group: -0.4% ± 6.1%; P = 0.619]. No differences in physical function were observed between groups. However, actual protein intake and SPPB were positively associated (β = 0.37; 95% confidence interval 0.08-0.67; P = 0.014). Conclusion: Individualized nutrition counselling positively impacted protein intake. However, 2.0 g/kg/day was not attainable using our approach in this population, and group contamination occurred. Increased protein intake suggested positive effects on MM and physical function, highlighting the potential for nutrition to attenuate MM loss in patients with cancer. Nonetheless, muscle anabolism to any degree is clinically significant and beneficial to patients. Larger trials should explore the statistical significance and clinical relevance of protein interventions. Competing Interests: Disclosure KF reports honoraria from Abbott Nutrition. MS reports grant/research support from AstraZeneca and Bristol Myers Squibb; consultancy for ISPEN; and honoraria from AstraZeneca, BMS, Merck, IPSEN, Viatris, and Novartis. KM reports grant/research support from Deciphera, Blueprint Medicines, AstraZeneca, and Actuate; advisory role with Pfizer Canada. KP reports grant/research support from U.S. Department of Veterans Affairs Rehabilitation Research and Development Service pRogram); speakers bureau of Abbott Nutrition Health Institute. JA reports honoraria from Danone. MS reports honoraria and/or paid consultancy from Life2Good. ND reports honoraria from Abbott Nutrition. CP reports honoraria and/or paid consultancy from Abbott Nutrition, Nutricia, Nestlé Health Science, Pfizer, and AMRA medical; and investigator-initiated funding from Almased. All other authors have declared no conflicts of interest. (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
Databáze:	MEDLINE
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