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1.
Effects of whey protein nutritional supplement on muscle function among community-dwelling frail older people: A multicenter study in China.
Kang, L, Gao, Y, Liu, X, Liang, Y, Chen, Y, Liang, Y, Zhang, L, Chen, W, Pang, H, Peng, LN
Archives of gerontology and geriatrics. 2019;:7-12
Abstract
BACKGROUND Frailty, featured by the presence of fatigue, weight loss, decrease in grip strength, decline gait speed and reduced activities substantially increase the risk of falls, disability, hospitalizations, and mortality of older people. Nutritional supplementation and resistance exercise may improve muscle function and reverse frailty status. OBJECTIVE To evaluate whether whey protein supplements can improve muscle function of frail older people in addition to resistance exercise. METHODS 115 community-dwelling older adults who met the Fried's criteria for frailty from four hospitals' out-patients clinic in Beijing, China completed the study. It's a case-control study which whey protein was used as daily supplementation for 12 weeks for active group and regular resistance exercise for active group and control group. Handgrip strength, gait speed, chair-stand test, balance score, and SPPB score were compared in both groups during the 12-week follow-up. RESULTS Overall, 115 subjects were enrolled for study with 66 in active group and 49 in control group. Handgrip strength, gait speed, and chair-stand time were all significantly improved in both groups with significant between-group differences. The active group improved significantly in handgrip strength compared with the control group, which between-group effect (95% confidence interval) for female was 0.107 kg (0.066-0.149), p = 0.008 and for male was 0.89 kg (0.579-1.201), p = 0.007. For chair-stand time, between-group effect (95% confidence interval) was -2.875 s (-3.62 to -2.124), p = 0.004 and for gait speed, between-group effect (95% confidence interval) was 0.109 m/s (0.090 to 0.130), p = 0.003. CONCLUSIONS The 12-week intervention of whey protein oral nutritional supplement revealed significant improvements in muscle function among the frailty elderly besides aiding with resistance exercise. These results warrant further investigations into the role of a multi-modal supplementation approach which could prevent adverse outcomes among frailty elderly at risk for various disabilities.
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2.
Muscle-targeted nutritional support for rehabilitation in patients with parkinsonian syndrome.
Barichella, M, Cereda, E, Pinelli, G, Iorio, L, Caroli, D, Masiero, I, Ferri, V, Cassani, E, Bolliri, C, Caronni, S, et al
Neurology. 2019;(5):e485-e496
Abstract
OBJECTIVE We evaluated the efficacy of muscle-targeted nutritional support on the functional outcomes of multidisciplinary intensive rehabilitation treatment (MIRT) in patients with Parkinson disease (PD) or parkinsonism. METHODS We conducted a pragmatic, bicentric, randomized (1:1), assessor-blind controlled trial (Protein, Leucine and Vitamin D Enhancing Rehabilitation [PRO-LEADER]; April 2017 to January 2018) in cognitively intact patients with PD or parkinsonism and undergoing a 30-day MIRT. Patients (n = 150) received a standard hospital diet with or without a whey protein-based nutritional supplement enriched with leucine and vitamin D twice daily. The primary efficacy endpoint was the increase in the distance walked during a 6-minute walking test (6MWT). Secondary endpoints were changes in 4-meter walking speed, Timed Up and Go test (TUG), Berg balance scale, handgrip strength, Self-assessment Parkinson's Disease Disability Scale, body weight, and skeletal muscle mass (SMM). RESULTS Nutritional support resulted in greater increase in the distance walked during 6MWT (mean 69.6 meters [95% confidence interval (CI) 60.7-78.6]) than no support (51.8 meters [95% CI 37.0-66.7]): center-adjusted mean difference, 18.1 meters (95% CI 0.9-35.3) (p = 0.039). Further adjustment for changes in dopaminergic therapy and SMM yielded consistent results: mean difference, 18.0 meters (95% CI 0.7-35.2) (p = 0.043). A meaningful effect was also found for the following secondary endpoints: 4-meter walking speed (p = 0.032), TUG (p = 0.046), SMM, and SMM index (p = 0.029). Six patients discontinued the nutritional therapy due to mild side effects. CONCLUSION The consumption of a whey protein-based nutritional formula enriched with leucine and vitamin D with MIRT improved lower extremity function and preserved muscle mass in patients with PD or parkinsonism.Clinicaltrials.gov IDENTIFIER NCT03124277. CLASSIFICATION OF EVIDENCE This study provides Class I evidence that for patients with parkinsonism undergoing intensive rehabilitation, a whey protein-based nutritional formula enriched with leucine and vitamin D increased distance walked on the 6MWT.
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3.
A whey/guar "preload" improves postprandial glycaemia and glycated haemoglobin levels in type 2 diabetes: A 12-week, single-blind, randomized, placebo-controlled trial.
Watson, LE, Phillips, LK, Wu, T, Bound, MJ, Checklin, HL, Grivell, J, Jones, KL, Clifton, PM, Horowitz, M, Rayner, CK
Diabetes, obesity & metabolism. 2019;(4):930-938
Abstract
AIMS: To evaluate the effects of 12 weeks of treatment with a whey/guar preload on gastric emptying, postprandial glycaemia and glycated haemoglobin (HbA1c) levels in people with type 2 diabetes (T2DM). MATERIALS AND METHODS A total of 79 people with T2DM, managed on diet or metformin (HbA1c 49 ± 0.7 mmol/mol [6.6 ± 0.1%]), were randomized, in single-blind fashion, to receive 150 mL flavoured preloads, containing either 17 g whey protein plus 5 g guar (n = 37) or flavoured placebo (n = 42), 15 minutes before two meals, each day for 12 weeks. Blood glucose and gastric emptying (breath test) were measured before and after a mashed potato meal at baseline (without preload), and after the preload at the beginning (week 1) and end (week 12) of treatment. HbA1c levels, energy intake, weight and body composition were also evaluated. RESULTS Gastric emptying was slower (P < 0.01) and postprandial blood glucose levels lower (P < 0.05) with the whey/guar preload compared to placebo preload, and the magnitude of reduction in glycaemia was related to the rate of gastric emptying at both week 1 (r = -0.54, P < 0.001) and week 12 (r = -0.54, P < 0.0001). At the end of treatment, there was a 1 mmol/mol [0.1%] reduction in HbA1c in the whey/guar group compared to the placebo group (49 ± 1.0 mmol/mol [6.6 ± 0.05%] vs. 50 ± 0.8 mmol/mol [6.7 ± 0.05%]; P < 0.05). There were no differences in energy intake, body weight, or lean or fat mass between the groups. CONCLUSIONS In patients with well-controlled T2DM, 12 weeks' treatment with a low-dose whey/guar preload, taken twice daily before meals, had sustained effects of slowing gastric emptying and reducing postprandial blood glucose, which were associated with a modest reduction in HbA1c, without causing weight gain.
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4.
Results from the randomized controlled IHOPE trial suggest no effects of oral protein supplementation and exercise training on physical function in hemodialysis patients.
Jeong, JH, Biruete, A, Tomayko, EJ, Wu, PT, Fitschen, P, Chung, HR, Ali, M, McAuley, E, Fernhall, B, Phillips, SA, et al
Kidney international. 2019;(3):777-786
Abstract
Few long-term studies have assessed whether changes in both diet and exercise can improve the health and quality of life (QOL) of hemodialysis (HD) patients. Here we examined whether 12 months of intradialytic protein supplementation and endurance exercise improves physical function, risk of cardiovascular disease (CVD), and QOL in HD patients in a randomized controlled trial (RCT). A total of 138 HD patients (average age 58 years) were assigned for 12 months to control, intradialytic protein, or protein plus exercise groups. The protein and protein plus exercise groups consumed an oral protein supplement (30 grams of whey) three days/week during dialysis. The protein plus exercise group cycled for 30-45 minutes during dialysis treatment. The primary outcome was change in physical function at 12 months, assessed by a shuttle walk test. Secondary outcomes included arterial stiffness, blood pressure, body composition, muscle strength, markers of nutritional status, and QOL. Assessments were conducted at baseline, 6 and 12 months. In total, 101 patients completed the intervention. There were no significant differences between groups in shuttle walk test performance from baseline to 12 months. There were trends for improvements in some secondary measures of physical function and strength in the protein and protein plus exercise groups at six or 12 months, but these did not reach statistical significance. Thus, our trial did not demonstrate significant improvements in markers of physical function, risk of CVD or QOL after one year of intradialytic oral OPS and aerobic exercise training. More comprehensive lifestyle management may be needed to uncover robust improvements in the health and QOL of HD patients.
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5.
Differential Stimulation of Post-Exercise Myofibrillar Protein Synthesis in Humans Following Isonitrogenous, Isocaloric Pre-Exercise Feeding.
Davies, RW, Bass, JJ, Carson, BP, Norton, C, Kozior, M, Amigo-Benavent, M, Wilkinson, DJ, Brook, MS, Atherton, PJ, Smith, K, et al
Nutrients. 2019;(7)
Abstract
The aim of this study was to test the effects of two disparate isonitrogenous, isocaloric pre-exercise feeds on deuterium-oxide (D2O) derived measures of myofibrillar protein synthesis (myoPS) in humans. Methods: In a double-blind parallel group design, 22 resistance-trained men aged 18 to 35 years ingested a meal (6 kcal·kg-1, 0.8 g·kg-1 carbohydrate, 0.2 g·kg-1 fat) with 0.33 g·kg-1 nonessential amino acids blend (NEAA) or whey protein (WHEY), prior to resistance exercise (70% 1RM back-squats, 10 reps per set to failure, 25% duty cycle). Biopsies of M. vastus lateralis were obtained pre-ingestion (PRE) and +3 h post-exercise (POST). The myofibrillar fractional synthetic rate (myoFSR) was calculated via deuterium labelling of myofibrillar-bound alanine, measured by gas chromatography-pyrolysis-isotope ratio mass spectrometry (GC-Pyr-IRMS). Data are a mean percentage change (95% CI). Results: There was no discernable change in myoFSR following NEAA (10(-5, 25) %, p = 0.235), whereas an increase in myoFSR was observed after WHEY (28 (13, 43) %, p = 0.003). Conclusions: Measured by a D2O tracer technique, a disparate myoPS response was observed between NEAA and WHEY. Pre-exercise ingestion of whey protein increased post-exercise myoPS, whereas a NEAA blend did not, supporting the use of NEAA as a viable isonitrogenous negative control.
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6.
A high whey protein, vitamin D and E supplement preserves muscle mass, strength, and quality of life in sarcopenic older adults: A double-blind randomized controlled trial.
Bo, Y, Liu, C, Ji, Z, Yang, R, An, Q, Zhang, X, You, J, Duan, D, Sun, Y, Zhu, Y, et al
Clinical nutrition (Edinburgh, Scotland). 2019;(1):159-164
Abstract
OBJECTIVE Sarcopenia, an age-related decline of muscle mass, strength, and physical function, was associated with falls, frailty, and poor quality of life. The aim of the current study is to examine the effect of nutritional supplement containing whey protein, vitamin D and E on measures of sarcopenia. METHODS A total of 60 sarcopenic older adult subjects participated in the current randomized, double-blind, placebo-controlled (iso-caloric control product) trial for 6 months. Muscle mass [Relative skeletal mass index (RSMI) measured by bioimpedance analysis (BIA)], muscle strength (handgrip strength), physical function (6-m gait speed, chair stand test, and timed-up-and-go test, TUG), quality of life (measured by Short-Form 36-Item Health Survey, SF-36), and blood biochemical indexes were measured before and after the 6-month intervention. RESULTS Compared to placebo group, nutritional supplementation improves RSMI (mean difference: 0.18 kg/m2, 95%CI: 0.01-0.35, P = 0.040), handgrip strength (mean difference: 2.68 kg, 95%CI: 0.71-4.65, P = 0.009), SF-36 mental component summary (SF-36 MCS) (mean difference: 11.26, 95%CI: 3.86-18.65, P = 0.004), SF-36 physical component summary (SF-36 PCS) (mean difference: 20.21, 95%CI: 11.30-29.12, P < 0.001), serum IGF-1 (mean difference: 14.34 ng/mL, 95%CI: 2.06-26.73), IL-2 (mean difference: -575.32 pg/mL, 95%CI: -1116.94 ∼ -33.70, P = 0.038), serum vitamin D3 (mean difference: 11.01 ng/mL, 95%CI: 6.44-15,58, P < 0.001), and serum vitamin E (mean difference: 4.17 ng/L, 95%CI: 1.89-6.45, P = 0.001). CONCLUSION The current study demonstrated that the combined supplementation of whey protein, vitamin D and E can significantly improve RSMI, muscle strength, and anabolic markers such as IGF-I and IL-2 in older adults with sarcopenia. Further larger well-designed studies are warranted to evaluate whether long-term whey protein supplementation can blunt the declines of muscle function and mass in older adults with sarcopenia.
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7.
The effect of whey protein on the components of metabolic syndrome in overweight and obese individuals; a systematic review and meta-analysis.
Badely, M, Sepandi, M, Samadi, M, Parastouei, K, Taghdir, M
Diabetes & metabolic syndrome. 2019;(6):3121-3131
Abstract
BACKGROUND The risk of developing chronic diseases such as diabetes, cardiovascular disease, dyslipidemia, and stroke is increased following an outbreak of metabolic syndrome. Whey protein can play a major role in preventing metabolic syndrome. OBJECTIVE This study was conducted to systematically evaluate the effect of whey protein on the components of metabolic syndrome in overweight and obesity patients. METHODS This systematic review and meta-analysis was conducted on RCTs (PROSPERO registration number: CDR42019114794). Published articles of controlled trials between 1 January 2000 to 30 May 2019 indexed in PubMed, Scopus, Web of Science and Cochrane Library were reviewed. Keywords were Whey Protein, Metabolic Syndrome, HDL Lipoprotein, Blood Pressure, Triglyceride, Fasting Blood Glucose, Waist Circumference, Overweight and Obesity or a combination of them in the title/abstracts. The mean difference was extracted for each study. All analyses performed using STATA version 11. RESULTS There were 2344 individuals reviewed in this systematic review of 37 published articles. CONCLUSION According to the results, whey supplementation significantly reduced the SBP, DBP, HDL, waist circumference, TG and FBS in intervention groups in comparing to control groups.
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8.
Effect of whey protein supplementation combined with resistance training on cellular health in pre-conditioned older women: A randomized, double-blind, placebo-controlled trial.
Nabuco, HCG, Tomeleri, CM, Sugihara, P, Fernandes, RR, Cavalcante, EF, Dos Santos, L, Silva, AM, Sardinha, LB, Cyrino, ES
Archives of gerontology and geriatrics. 2019;:232-237
Abstract
AIM: The purpose of study was to analyze the effects of a combined whey protein (WP) and RT intervention on cellular health in pre-conditioned older women. METHODS The protocol is a randomized controlled clinical trial with a sample of seventy older women, divided into 3 groups: WP-placebo (WP-PLA, n = 24), placebo-WP (PLA-WP, n = 23), and placebo-placebo (PLA-PLA, n = 23). Each group drank 35 g of product (placebo or WP) pre- and post- training. The RT program was carried out over 12 weeks (3x/week; 3 × 8-12 repetitions maximum). Total body water (TBW), intra (ICW) and extracellular (ECW) water, resistance (R), reactance (Xc), and phase angle (PhA) assessed by bioimpedance spectroscopy. Lean soft tissue (LST) was measured using dual energy X-ray absorptiometry; and food consumption was assessed by means of the average of two 24-hour recalls. ANCOVA for repeated measures was applied for comparisons, with baseline scores used as covariates. RESULTS A group by time interaction (P < 0.05) was observed for LST, ICW and the ECW/ICW ratio. There was a time effect (P < 0.05) for TBW, Xc, and PhA. A reduction (P <0.05) in R was found only in the WP-PLA and PLA-WP groups. CONCLUSION Whey protein supplementation (pre- or post-) combined with RT promoted an increase in ICW and LST, and also a reduction in ECW/ICW ratio in pre-conditioned older women. Regardless of the supplementation intake, the RT regimen improved PhA in older adult women. This trial was registered at ClinicalTrials.gov: NCT03247192.
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9.
Clinical Impact of Highly Purified, Whey Proteins in Patients Affected With Colorectal Cancer Undergoing Chemotherapy: Preliminary Results of a Placebo-Controlled Study.
Mazzuca, F, Roberto, M, Arrivi, G, Sarfati, E, Schipilliti, FM, Crimini, E, Botticelli, A, Di Girolamo, M, Muscaritoli, M, Marchetti, P
Integrative cancer therapies. 2019;:1534735419866920
Abstract
Background and Aims: Sarcopenia, the loss of both lean body and skeletal muscle mass, may interfere in cancer patients outcome. As investigated, whey proteins could prevent the onset of sarcopenia. We have conducted a study to evaluate the effects of whey protein in colorectal cancer patients, undergoing 5-fluorouracil-based chemotherapy. Methods: After written informed consent, patients were blind randomized 1:1 to whey protein (ProLYOtin; arm A) versus placebo (arm B). The patients were assessed both physically and nutritionally before chemotherapy and after 3 (T2) and 6 months (T3) by body impedance assessment, L3-computed tomography scan, Mini Nutritional Assessment (MNA), and Malnutrition Universal Screening Tool (MUST) tests. Results: Forty-seven patients were included in this preliminary analysis. Baseline characteristics were well balanced between the 2 arms. During chemotherapy, 33 patients were reevaluated: anthropometric parameters (lean body mass from 68.5% to 71.2% vs 68.7% to 66.3%, and sarcopenia from 84% to 54% and 83% to 77% from baseline to T2 evaluation in arms A and B, respectively), nutritional status (MNA >24 = 100% [A] vs 73.7% [B]), and toxicity (no adverse effects in 86% [A] vs 29% [B] and 94% [A] vs 29% [B] for hematological and gastrointestinal toxicities, respectively) resulted to be significantly different. At univariate analysis, a condition of malnutrition risk according to MUST (relative risk [RR] = 7.5, P = .02) or MNA (RR = 1.45, P = .02) and ProLYOtin intake (RR = 0.12, P = .01) were found to be significantly predictive of chemotherapy toxicity. Conclusions: At present, our study shows how whey protein could be an important therapeutic option to improve nutritional status, and particularly to prevent severe toxicity during chemotherapy.
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10.
Whey Protein Supplementation Compared to Collagen Increases Blood Nesfatin Concentrations and Decreases Android Fat in Overweight Women: A Randomized Double-Blind Study.
Giglio, BM, Schincaglia, RM, da Silva, AS, Fazani, ICS, Monteiro, PA, Mota, JF, Cunha, JP, Pichard, C, Pimentel, GD
Nutrients. 2019;(9)
Abstract
UNLABELLED Protein supplements are usually used to control body weight, however, the impact of protein quality on body fat attenuation is unknown. We investigated the effects of isocaloric isoproteic supplementation of either whey protein (WG) or hydrolysed collagen supplementation (CG) on dietary intake, adiposity and biochemical markers in overweight women. METHODS In this randomized double-blind study, 37 women, [mean ± SE, age 40.6 ± 1.7 year; BMI (kg/m2) 30.9 ± 0.6], consumed sachets containing 40 g/day of concentrated whey protein (25 g total protein, 2.4 leucine, 1.0 valine, 1.5 isoleucine, n = 17) or 38 g/day of hydrolysed collagen (26 g total protein, 1.02 leucine, 0.91 valine, 0.53 isoleucine, n = 20) in the afternoon snack. The compliance was set at >70% of the total theoretical doses. The dietary intake was evaluated by a 6-day food record questionnaire. At the beginning and after eight weeks of follow-up, body composition was evaluated by using dual-energy X-ray absorptiometry and lipid profile, insulin resistance, C-reactive protein, adiponectin, leptin and nesfastin plasma concentrations were analyzed. RESULTS Supplements were isocaloric and isoproteic. There were no differences in caloric intake (p = 0.103), protein (p = 0.085), carbohydrate (p = 0.797) and lipids (p = 0.109) intakes. The branched chain amino acids (BCAA) (GC: 1.8 ± 0.1 g vs. WG: 5.5 ± 0.3 g, p < 0.001) and leucine intake (CG: 0.1 ± 0.1 g vs. WG: 2.6 ± 0.1 g, p < 0.001) were higher in WG compared to CG. BMI increased in the CG (0.2 ± 1.1 kg/m2, p = 0.044) but did not change in WG. WG decreased the android fat (-0.1 ± 0.3 kg, p = 0.031) and increased nesfatin concentrations (4.9 ± 3.2 ng/mL, p = 0.014) compared to CG. CONCLUSIONS Whey protein supplementation in overweight women increased nesfatin concentrations and could promote increase of resting metabolic rate as part of body composition improvement programs compared to collagen supplementation for 8 weeks. Additionally, our findings suggest that collagen may not be an effective supplement for overweight women who are attempting to alter body composition.