Whey protein supplementation for the preservation of mass and muscular strength of patients with heart failure: study protocol for a randomized controlled trial (original) (raw)
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Gerontology and Geriatric Medicine, 2020
Approximately half of heart failure patients in the US have heart failure with preserved ejection fraction (HFpEF). HFpEF impairs physical performance and thus reduces quality of life. Increasing dietary protein intake can increase lean body mass and physical performance in healthy elderly individuals, but the effect of a high-quality protein supplement, with or without a structured exercise program, has not been investigated in HFpEF patients. Twenty-three obese elderly HFpEF patients with grade 1 or 2 diastolic dysfunction were randomized into three groups: control, protein supplementation alone, and protein plus exercise. Protein supplementation involved providing sufficient whey protein so that total intake was 1.2 g protein/kg/day. The exercise intervention was 2 days of hydrotherapy and 1 day of gym sessions per week under supervision of a fitness expert. Physical parameters and functional tests were performed at baseline and at 12 weeks. Protein supplementation alone failed t...
2013
There is ample research to support the potential benefits of a high protein diet on clinical outcomes in overweight/obese, diabetic subjects. However, nutritional management of overweight/obese individuals with heart failure (HF) and type 2 diabetes mellitus (DM) or metabolic syndrome (MS) is poorly understood and few clinical guidelines related to nutritional approaches exist for this subgroup. This article describes the design, methods, and baseline characteristics of study participants enrolled in Pro-HEART, a randomized clinical trial to determine the short term and long term effects of a high protein diet (30% protein [~110 g/day], 40% carbohydrates [150 g/day], 30% fat [~50 g/day]) versus a standard protein diet (15% protein [~55 g/day], 55% carbohydrates [~200 g/day], 30% fat [~50 g/day]) on body weight and adiposity, cardiac structure and function, functional status, lipid profile, glycemic control, and quality of life. Between August, 2009 and May, 2013, 61 individuals agreed to participate in the study; 52 (85%)mean age 58.2 ± 9.8 years; 15.4% Blacks; 57.7% Whites; 19.2% Hispanics; 7.7% Asians; 73.1% male; weight 112.0 ± 22.6 kgwere randomized to a 3-month intensive weight management program of either a high protein or standard protein diet; data were collected at baseline, 3 months, and 15 months. This study has the potential to reveal significant details about the role of macronutrients in weight management of overweight/obese individuals with HF and DM or MS.
Journal of Physiotherapy & Physical Rehabilitation, 2017
Objective: Cardiac cachexia is a condition associated with heart failure, particularly in the elderly, and is characterized by loss of muscle mass with or without the loss of fat mass. Approximately 15% of elderly heart failure patients will eventually develop cardiac cachexia; such a diagnosis is closely associated with high morbidity and increased mortality. While the mechanism(s) involved in the progression of cardiac cachexia is incompletely established, certain factors appear to be contributory. Dietary deficiencies, impaired bowel perfusion, and metabolic dysfunction all contribute to reduced muscle mass, increased muscle wasting, increased protein degradation, and reduced protein synthesis. Thus slowing or preventing the progression of cardiac cachexia relies heavily on dietary and exercise-based interventions in addition to standard heart failure treatments and medications. Methods: The aim of the present study was to test the feasibility of an at-home exercise and nutrition intervention program in a population of elderly with heart failure, in an effort to determine whether dietary protein supplementation and increased physical activity may slow the progression, or prevent the onset, of cardiac cachexia. Frail elderly patients over the age of 55 with symptoms of heart failure from UAMS were enrolled in one of two groups, intervention or control. To assess the effect of protein supplementation and exercise on the development of cardiac cachexia, data on various measures of muscle quality, cardiovascular health, mental status, and quality of life were collected and analyzed from the two groups at the beginning and end of the study period. Results: More than 50% of those who were initially enrolled actually completed the 6-month study. While both groups showed some improvement in their study measures, the protein and exercise group showed a greater tendency to improve than the control group by the end of the six months. Conclusion: These findings suggest that with a larger cohort, this intervention may show significant positive effects for elderly patients who are at risk of developing cardiac cachexia.
Contemporary Clinical Trials, 2013
There is ample research to support the potential benefits of a high protein diet on clinical outcomes in overweight/obese, diabetic subjects. However, nutritional management of overweight/obese individuals with heart failure (HF) and type 2 diabetes mellitus (DM) or metabolic syndrome (MS) is poorly understood and few clinical guidelines related to nutritional approaches exist for this subgroup. This article describes the design, methods, and baseline characteristics of study participants enrolled in Pro-HEART, a randomized clinical trial to determine the short term and long term effects of a high protein diet (30% protein [~110 g/day], 40% carbohydrates [150 g/day], 30% fat [~50 g/day]) versus a standard protein diet (15% protein [~55 g/day], 55% carbohydrates [~200 g/day], 30% fat [~50 g/day]) on body weight and adiposity, cardiac structure and function, functional status, lipid profile, glycemic control, and quality of life. Between August, 2009 and May, 2013, 61 individuals agreed to participate in the study; 52 (85%)mean age 58.2 ± 9.8 years; 15.4% Blacks; 57.7% Whites; 19.2% Hispanics; 7.7% Asians; 73.1% male; weight 112.0 ± 22.6 kgwere randomized to a 3-month intensive weight management program of either a high protein or standard protein diet; data were collected at baseline, 3 months, and 15 months. This study has the potential to reveal significant details about the role of macronutrients in weight management of overweight/obese individuals with HF and DM or MS.
Current Opinion in Clinical Nutrition and Metabolic Care, 2008
Purpose of Review: Sarcopenia (skeletal muscle wasting with aging) is thought to underlie a number of serious age-related health issues. While it may be seen as inevitable, decreasing this gradual loss of muscle is vital for healthy aging. Thus, it is imperative to investigate exercise and nutrition-based strategies designed to build a reservoir of muscle mass as early as possible. Recent Findings: Elderly individuals are still able to respond to both resistance training and the anabolic signals provided by protein ingestion, provided specific amino acids, such as leucine, are present. Whey proteins are a rich source of these essential amino acids and rapidly elevate plasma amino acids, thus providing the foundations for preservation of muscle mass. Several studies involving supplementation with whey protein have shown to be effective in augmenting the effects of resistance exercise, in particular when supplementation occurs in the hours surrounding the exercise training. Summary: While further work is required, particularly in elderly people, simple dietary and exercise strategies that may improve the maintenance of skeletal muscle mass will likely result in a decrease in the overall burden of a number of diseases and improve the quality of life as we age.
International journal of food sciences and nutrition, 2016
We performed a systematic review to map the evidence and analyze the effect of whey protein supplementation in the elderly submitted to resistance training. A comprehensive search on Medline, LILACS, EMBASE, and the Cochrane Library for relevant publications was conducted until August 2015. The terms used in the search were: "Resistance training"; "Whey protein"; "Elderly". A total of 632 studies were screened. Five studies were included composing a sample of 391 patients. The supplement whey protein was associated with higher total protein ingestion 9.40 (95% CI: 4.03-14.78), and with an average change in plasma leucine concentration. The supplementation was also associated with increased mixed muscle protein synthesis 1.26 (95% CI: 0.46-2.07) compared to the control group. We observed an increase in total protein intake, resulting in increased concentration of leucine and mixed muscle protein fractional synthesis rate.
Journal of the International Society of Sports Nutrition, 2010
Background: We examined the effects of short-term consumption of whey protein isolate on muscle proteins and force recovery after eccentrically-induced muscle damage in healthy individuals. Methods: Seventeen untrained male participants (23 ± 5 yr, 180 ± 6 cm, 80 ± 11 kg) were randomly separated into two supplement groups: i) whey protein isolate (WPH; n = 9); or ii) carbohydrate (CHO; n = 8). Participants consumed 1.5 g/kg.bw/day supplement (~30 g consumed immediately, and then once with breakfast, lunch, in the afternoon and after the evening meal) for a period of 14 days following a unilateral eccentric contraction-based resistance exercise session, consisting of 4 sets of 10 repetitions at 120% of maximum voluntary contraction on the leg press, leg extension and leg flexion exercise machine. Plasma creatine kinase and lactate dehydrogenase (LDH) levels were assessed as blood markers of muscle damage. Muscle strength was examined by voluntary isokinetic knee extension using a Cybex dynamometer. Data were analyzed using repeated measures ANOVA with an alpha of 0.05. Results: Isometric knee extension strength was significantly higher following WPH supplementation 3 (P < 0.05) and 7 (P < 0.01) days into recovery from exercise-induced muscle damage compared to CHO supplementation. In addition, strong tendencies for higher isokinetic forces (extension and flexion) were observed during the recovery period following WPH supplementation, with knee extension strength being significantly greater (P < 0.05) after 7 days recovery. Plasma LDH levels tended to be lower (P = 0.06) in the WPH supplemented group during recovery. Conclusions: The major finding of this investigation was that whey protein isolate supplementation attenuated the impairment in isometric and isokinetic muscle forces during recovery from exercise-induced muscle injury.
Supplemental protein in support of muscle mass and health: advantage whey
Journal of food science, 2015
Skeletal muscle is an integral body tissue playing key roles in strength, performance, physical function, and metabolic regulation. It is essential for athletes to ensure that they have optimal amounts of muscle mass to ensure peak performance in their given sport. However, the role of maintaining muscle mass during weight loss and as we age is an emerging concept, having implications in chronic disease prevention, functional capacity, and quality of life. Higher-protein diets have been shown to: (1) promote gains in muscle mass, especially when paired with resistance training; (2) spare muscle mass loss during caloric restriction; and (3) attenuate the natural loss of muscle mass that accompanies aging. Protein quality is important to the gain and maintenance of muscle mass. Protein quality is a function of protein digestibility, amino acid content, and the resulting amino acid availability to support metabolic function. Whey protein is one of the highest-quality proteins given its...
Jorjani Biomedicine Journal, 2021
Background and Objective: Clinical studies have indicated, that exercise activity and supplementation may have different effects on heart function and health. The aim of this study was to assess the effects of weight training with whey protein supplementation on ANP, BNP, and Galactin-3 in 60-65 years old sedentary men. Material and Methods: This study was based on a quasi-experimental design. The sample population was selected from volunteers out of the Kahrizak charity sanitarium of the Tehran province. Forthy men were randomly assigned to 4 groups (control, exercise, whey protein, and exercise + whey protein). Whey protein and exercise + whey protein groups were asked to consume whey protein. Training protocol lasted for 6 weeks. Blood levels of ANP, BNP, and Galactin-3, before and after the study were measured. Normality and variance heterogeneity was assessed using Shapiro-Wilk and Levene's tests respectively. The significance of differences between training and supplementation groups was assessed by ANOVA and LSD hock post-test. Results: The results showed that weight training program and in combination with whey protein supplementation significantly reduced Atrial natriuretic peptide (P=0.001), Brain natriuretic peptide (P=0.001), and Galactin-3 (P=0.001), compared to the control group (P<0.01). Conclusion: The reduction of cardiac injury indices and structural and physiological recovery and the increase of cardiac function have been affected by the synergy of his training and protein.
European Journal of Heart Failure, 2008
Background: An adequate energy-protein intake (EPI) when combined with amino acid supplementation may have a positive impact nutritional and metabolic status in patients with chronic heart failure (CHF). Methods and results: Thirty eight stable CHF patients (27 males, 73.5±4 years; BMI 22.5±1.4 kg/m), with severe depletion of muscle mass and were randomised to oral supplements of essential amino acids 8 g/day (EAA group; n=21) or no supplements (controls; n=17). patients had adequate EPI (energy ≥ 30 kcal/kg; proteins >1.1 g/kg). At baseline and 2-months after randomisation, the patients underwent metabolic (plasma lactate, pyruvate concentration; serum insulin level; estimate of insulin 2 Citation tools Go To resistance by HOMA index), nutritional (measure of nitrogen balance), and functional (exercise test, walking test) evaluations. Body weight increased by >1 kg in 80% of supplemented patients (mean 2.96 kg) and in 30% of controls (mean 2.3 kg) (interaction <0.05). Changes in arm muscle area, nitrogen balance, and HOMA index were similar between the two treatment groups. Plasma lactate and pyruvate levels increased in controls (p<0.01 for both) but decreased in the supplemented group (p<0.01 and 0.02 respectively). EAA supplemented patients but not controls improved both exercise output and peak oxygen consumption and walking test. Conclusions: Adequate EPI when combined with essential amino acid supplementation may improve nutritional and metabolic status in most muscle-depleted CHF patients.