Effect of a leucine-rich supplement in combination with nutrition and physical exercise in advanced cancer patients: A randomized controlled intervention trial
| Autor: | Peter J. Meffert, Miklos Pless, Reinhard Imoberdorf, Martina Schmocker, Peter E. Ballmer, LJ Storck, Maya Ruehlin, D Gisi, Sabine Gaeumann |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male 0301 basic medicine medicine.medical_specialty Cachexia Nutritional Status 030209 endocrinology & metabolism Physical exercise Critical Care and Intensive Care Medicine Single Center law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial Quality of life Leucine law Neoplasms medicine Clinical endpoint Humans Exercise Fatigue Aged Aged 80 and over 030109 nutrition & dietetics Nutrition and Dietetics Hand Strength business.industry Cancer Multimodal therapy Middle Aged Physical Functional Performance medicine.disease Combined Modality Therapy Exercise Therapy Treatment Outcome Dietary Supplements Exercise Test Quality of Life Physical therapy Patient Compliance Female Nutrition Therapy business |
| Zdroj: | Clinical Nutrition. 39:3637-3644 |
| ISSN: | 0261-5614 |
| DOI: | 10.1016/j.clnu.2020.04.008 |
| Popis: | Summary Background & aims Branched-chain amino acids and specifically leucine stimulate protein synthesis and may overcome an anabolic resistance in malnourished and cachectic cancer patients. Therefore, we hypothesized that the addition of a leucine-rich supplement to a multimodal therapy improves physical function in advanced cancer patients. Methods This single center, randomized trial examined a multimodal therapy over 12 weeks in patients with advanced cancer. The intervention group received a leucine-rich supplement in combination with a nutrition and physical exercise program. Patients in the control group received standard care. Primary endpoint was physical function measured with the short physical performance battery (SPPB). Secondary endpoints were further physical performance tests, nutritional status, dietary intake, fatigue, quality of life (QoL) and clinical course. All parameters were evaluated at baseline, after three and at six months. Results 23 women and 29 men with an average age of 63.1 ± 10.3 (range 30–81) years and BMI of 25.4 ± 4.7 kg/m2 were randomized either to the intervention (n = 27) or control (n = 25) group. Patients in the intervention group joined a mean of 28.4 ± 7.4 training sessions (78.8%), 3.2 ± 0.6 nutritional counselling sessions (106.7%) and consumed on average 85.4 ± 33.2 supplements (71.2%). Inter-group comparison showed no significant difference in the primary endpoint SPPB after three (p = 0.184, 95% CI: −1.43, 0.29) and six months (p = 0.986, 95% CI: −0.87, 0.89). However, the secondary endpoint handgrip strength improved significantly from 35.8 ± 9.8 kg at baseline to 37.6 ± 10.0 kg at three months in the intervention group compared to 35.7 ± 8.8 kg at baseline to 34.0 ± 10.1 kg at three months in the control group (p Conclusions The present trial demonstrated a good adherence to the multimodal therapy as well as a significant improvement of handgrip strength in patients with advanced cancer. In addition, the clinical course data underlined the safety of the program. However, we failed to show significant improvements in further physical performance tests, especially our primary outcome factor SPPB as well as nutritional status, fatigue or QoL. |
| Databáze: | OpenAIRE |
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