High-protein Supplement Research Articles

The Role of Oral Nutritional Supplements in Head and Neck Cancer Patients Undergoing Chemoradiotherapy.

This study aimed to assess the impact of oral nutritional supplements (ONS) on nutritional intake, body weight, and body composition in head and neck cancer (HNC) patients undergoing chemoradiotherapy. The study evaluated whether ONS could prevent treatment-related nutritional deterioration. This prospective observational pilot study included 30 HNC patients randomized into two groups: ONS (n = 15) and No ONS (n = 15). All participants underwent chemoradiotherapy, with the ONS group receiving 200 mL of a high-calorie, high-protein supplement twice daily. Nutritional status, including body weight, BMI, fat mass, fat-free mass, and bone mass, was assessed at three time points: baseline, mid-treatment, and end of treatment. Data were analyzed using the Mann-Whitney U test, with a p-value of ≤0.05 considered statistically significant. At baseline, there were no significant differences between the two groups in body weight, BMI, or body composition. By the end of radiotherapy, the No ONS group showed significant reductions in body weight (p < 0.001), BMI (p < 0.001), fat mass (p < 0.001), and fat-free mass (p < 0.001), while the ONS group maintained more stable nutritional parameters. Acute radiotherapy toxicities, including nausea, dysphagia, and oral mucositis, were not significantly different between the two groups. ONS effectively mitigates weight loss and preserves body composition in HNC patients undergoing chemoradiotherapy. While no significant reduction in radiation-induced toxicities was observed, the nutritional benefits of ONS support its use in preventing malnutrition in this patient population. Larger studies are needed to further validate these findings.

Is high-protein supplementation beneficial for patients on cancer treatment? A Systematic review and meta-analysis

Is high-protein supplementation beneficial for patients on cancer treatment? A Systematic review and meta-analysis

Investigation of the Effectiveness of Nutrition at the Molecular Level in Patients with Sepsis

Objective: The aim of this study was to compare inflammatory and anti-inflammatory molecule levels in sepsis patients receiving normal (1.3 mg/kg/day) and high (2 mg/kg/day) protein supplementation. Methods: Two groups of patients were compared based on protein supplementation: normal (1.3 mg/kg/day) and high (2 mg/kg/day). Levels of kallistatin, nesfatin-1, plasminogen activator inhibitor-1 (PAI-1), and high mobility group box-1 (HMGB-1) were measured. Disease severity was assessed using APACHE II, SAPS, and SOFA scores. Results: Demographic characteristics and intensive care scores were similar between groups (p&gt;0.05). Group 1 had significantly higher 0-hour levels of HMGB-1, kallistatin, PAI-1, and nesfatin-1 compared to 24 and 48 hours (p&lt;0.001). Group 2 had higher 0-hour levels, but changes were not significant (p&gt;0.05) Conclusions: High-dose protein feeding in sepsis patients may not suppress inflammation-related protein synthesis despite the presence of oxidative damage and muscle catabolism.

Identification of metabolites associated with preserved muscle volume after aneurysmal subarachnoid hemorrhage due to high protein supplementation and neuromuscular electrical stimulation

The INSPIRE randomized clinical trial demonstrated that a high protein diet (HPRO) combined with neuromuscular electrical stimulation (NMES) attenuates muscle atrophy and may improve outcomes after aneurysmal subarachnoid hemorrhage We sought to identify specific metabolites mediating these effects. Blood samples were collected from subjects on admission prior to randomization to either standard of care (SOC; N = 12) or HPRO + NMES (N = 12) and at 7 days. Untargeted metabolomics were performed for each plasma sample. Sparse partial least squared discriminant analysis identified metabolites differentiating each group. Correlation coefficients were calculated between each metabolite and total protein per day and muscle volume. Multivariable models determined associations between metabolites and muscle volume. Unique metabolites (18) were identified differentiating SOC from HPRO + NMES. Of these, 9 had significant positive correlations with protein intake. In multivariable models, N-acetylleucine was significantly associated with preserved temporalis [OR 1.08 (95% CI 1.01, 1.16)] and quadricep [OR 1.08 (95% CI 1.02, 1.15)] muscle volume. Quinolinate was also significantly associated with preserved temporalis [OR 1.05 (95% CI 1.01, 1.09)] and quadricep [OR 1.04 (95% CI 1.00, 1.07)] muscle volume. N-acetylserine and β-hydroxyisovaleroylcarnitine were associated with preserved temporalis or quadricep volume. Metabolites defining HPRO + NMES had strong correlations with protein intake and were associated with preserved muscle volume.

Oral nutritional supplements in older outpatients with heart failure: rationale and design of the ALIMENT-HF trial.

The ALIMENT-HF trial aims to determine whether high-calorie and high-protein oral nutritional supplements (ONS) are safe and beneficial for older adult outpatients with heart failure (HF). This multicentre, single-arm, interventional pilot trial is designed to evaluate the tolerance, efficacy, and safety of ONS in older adult outpatients with chronic HF, malnutrition, and anorexia. In total, 80 outpatients with HF regardless of their left ventricular ejection fraction will be treated with ONS, including high-energy (900kcal/day) and high protein (36g/day) supplementation, at eight sites in Japan. Inclusion criteria are as follows: age, ≥65years; outpatients receiving maximally tolerated guideline-directed medical therapy for HF and without change in their diuretic dosage during the last 3months; outpatients at risk of malnutrition, defined as a Malnutrition Universal Screening Tool score ≥1 point, and anorexia, defined using a Simplified Nutritional Appetite Questionnaire for the Japanese Elderly (SNAQ-JE) score of ≤14 points. Nutritional intervention will continue for up to 120days, with an observational period lasting for a further 60days. The primary outcome is a change in body weight between baseline and day 120. The ALIMENT-HF trial will evaluate the tolerance, efficacy, and safety of high-calorie and high-protein-rich ONS in older outpatients with HF co-morbid with malnutrition and anorexia and will provide insightful information for future randomized controlled trials.

Effects of high protein, arginine, and glutamine supplementation to enteral nutrition on pressure ulcers in critically ill patients: A preliminary report

Effects of high protein, arginine, and glutamine supplementation to enteral nutrition on pressure ulcers in critically ill patients: A preliminary report

Detailing the chemical composition of roasted soybeans and the effect for its use in the diet of dairy cows

Roasted soybeans are a complete source of indigestible protein in the rumen, have high sanitary and hygienic indicators, are devoid of non-nutritional substances of ordinary raw soybeans. The SoyPass and RaPass technology provides all the advantages of roasting soybeans and creates prerequisites for prolonged storage of beans for up to two years without prior drying. The introduction of full-fat flattened soybeans roasted by the Roast-A-Matic roaster into the diet of dairy cows leads to an increase in their milk productivity. Certified results of chemical research show that after frying, the percentage of crude protein significantly increased (by 2.92 points, P &lt; 0.05) and the content of total digestible nutrients (by 8.1 %, P &lt; 0.05), urease activity decreased to 0.06 ± 0.007 units of pH. The biological value of soy protein after frying corresponds to the indicators of the reference protein. Two groups of cows were involved in the study: № 1 – high-yielding cows with a daily milk yield of 30.69–35.96 L (n = 307) and № 2 – medium- and low-yielding cows with a yield of 19.05–28.88 L (n = 377). Group № 1 was given 300 g of roasted soybeans (111 g of protein) daily in their diet instead of 250 g of a high-protein supplement (200 g of protein); group No. 2 – gradually replaced 230 g of the supplement (184 g of protein) and 1500 g of 51 % meal (765 g of protein) with 1700 g of roasted soybeans (629 g of protein). In both groups, the 65-day observation period should be divided into 2 periods: 1) a 30-day period of intensive growth with a rapid increase in milk yield (up to +24.2–25.0 %); 2) the period of stabilization (from the 31st to the 65th day), characterized by some fluctuations in the % increase in milk, but in general by reliable maximum values (up to +25.0–36.7 %). The maximum daily volume in group № 1 reached 41.83 ± 1.04 and 41.83 ± 0.3 L (Р &lt; 0.01) on the 32nd and 38th days, respectively. At the same time, the range of the indicators of the individual yield in the group ranged from 10.7 to 11.7 L. Similar indicators for group № 2 were: 32.56 ± 2.74 L (Р &lt; 0.025) on the 58th day and 10.4–23.8 L. So, in the first 30 days of feeding full-fat fried soybeans, there is a rapid but unstable (with fluctuating peaks) increase in milk productivity of cows. During the 2nd month of soy consumption, the maximum milk yield is reached, when the increase in added milk is not rapid, but stable. Thus, it is advisable to introduce 1.5–2.0 kg/day of roasted soybeans (equivalent to 0.3–0.4 kg of fat/day) into the diet of dairy cows.

Pre-sleep protein supplementation does not improve performance, body composition, and recovery in British Army recruits (part 1).

Dietary protein is crucial for optimising physical training adaptations such as muscular strength and mass, which are key aims for athletic populations, including British Army recruits. New recruits fail to meet the recommended protein intake during basic training (BT), with negligible amounts consumed in the evening. This study assessed the influence of a daily bolus of protein prior to sleep on performance adaptations, body composition and recovery in British Army recruits. 99 men and 23 women [mean ± standard deviation (SD): age: 21.3 ± 3.5 years, height: 174.8 ± 8.4 cm, body mass 75.4 ± 12.2 kg] were randomised into a dietary control (CON), carbohydrate placebo (PLA), moderate (20 g) protein (MOD) or high (60 g) protein (HIGH) supplementation group. Supplements were isocaloric and were consumed on weekday evenings between 2000 and 2100 for 12 weeks during BT. Performance tests (mid-thigh pull, medicine ball throw, 2 km run time, maximal push-up, and maximal vertical jump) and body composition were assessed at the start and end of BT. Dietary intake, energy expenditure, salivary hormones, urinary nitrogen balance, perceived muscle soreness, rating of perceived exertion, mood, and fatigue were assessed at the start, middle and end of BT. Protein supplementation increased protein intake in HIGH (2.16 ± 0.50 g⸱kg-1⸱day-1) and MOD (1.71 ± 0.48 g⸱kg-1⸱day-1) compared to CON (1.17 ± 0.24 g⸱kg-1⸱day-1) and PLA (1.31 ± 0.29 g⸱kg-1⸱day-1; p < 0.001). Despite this, there was no impact of supplementation on mid-thigh pull performance (CON = 7 ± 19%, PLA = 7 ± 19%, MOD = 0 ± 16%, and HIGH = 4 ± 14%; p = 0.554) or any other performance measures (p > 0.05). Fat-free mass changes were also similar between groups (CON = 4 ± 3%, PLA = 4 ± 4%, MOD = 3 ± 3%, HIGH = 5 ± 4%, p = 0.959). There was no impact of protein supplementation on any other body composition or recovery measure. We conclude no benefits of pre-bed protein supplementation to improve performance, body composition and recovery during BT. It is possible the training stimulus was great enough, limiting the impact of protein supplementation. However, the high degree of inter-participant variability suggests an individualised use of protein supplementation should be explored, particularly in those who consume sub-optimal (<1.6 g⸱kg-1⸱day-1) habitual amounts of protein. Clinical trial registration: The study was registered with ClinicalTrials.gov, U.S. national institutes (identifier: NCT05998590).

Resistance exercise protects mice from protein-induced fat accretion.

Low-protein (LP) diets extend the lifespan of diverse species and are associated with improved metabolic health in both rodents and humans. Paradoxically, many athletes and bodybuilders consume high-protein (HP) diets and protein supplements, yet are both fit and metabolically healthy. Here, we examine this paradox using weight pulling, a validated progressive resistance exercise training regimen, in mice fed either an LP diet or an isocaloric HP diet. We find that despite having lower food consumption than the LP group, HP-fed mice gain significantly more fat mass than LP-fed mice when not exercising, while weight pulling protected HP-fed mice from this excess fat accretion. The HP diet augmented exercise-induced hypertrophy of the forearm flexor complex, and weight pulling ability increased more rapidly in the exercised HP-fed mice. Surprisingly, exercise did not protect from HP-induced changes in glycemic control. Our results confirm that HP diets can augment muscle hypertrophy and accelerate strength gain induced by resistance exercise without negative effects on fat mass, and also demonstrate that LP diets may be advantageous in the sedentary. Our results highlight the need to consider both dietary composition and activity, not simply calories, when taking a precision nutrition approach to health.

Protein-Based Soy Flour Supplementation to Support the Effects of Weight Training on Muscle Hyper-trophy Suplemento de harina de soja a base de proteínas para respaldar

Replacement supplements are required for optimal muscular hypertrophy in athletes. However, not all athletes can afford high-protein supplements due to their high expenses. The aim of this paper is to investigate and demonstrate the efficacy of protein-based supplements in enhancing the effects of resistance training on muscle growth. This method of study is a pseudo-experimental pre-test-posttest design. Using the entire sampling technique, 14 PPLP West Sumatra Indonesian Pencak silat athletes were used as study samples. The research procedure includes the measurement of thigh muscle circumference and thigh fat thickness of athletes (pretest), treatment of lunges 1-8 times, measurement of thigh muscle circumference and thigh fat thickness of athletes after eight treatments (midtest), and the size of thigh muscle circumference and thigh fat thickness after 9-16 lunges training sessions (posttest). Soy flour was administered depending on the athlete's average food intake, administered 30 minutes after the lunges exercise. The lunge training consisted of 16 sessions, moderate intensity (30% - 50% of maximum capacity), six repetitions, five sets, and 3 - 6 minute intervals. A tape meter was used to measure thigh muscle circumference and skinfold thickness to calculate thigh fat thickness using the formula MTMC = MTC - skinfold thickness (3.14 x TSF). The test utilized was the Kruskal-Wallis test. The examination of the data yielded a p-value of 0.03 &lt; 0.05 and a percentage increase of 10.68%. In lunges training, high-protein soy flour can be administered as an alternative or replacement for supplements for muscular hypertrophy. Keywords: Muscular Hypertrophy, Soy Flour, Lunges

THU112 Effect Of Protein Supplementation On Plasma Sodium Levels And Urinary Urea Excretion In Patients With Chronic Siad—A Monocentric Open-Label Proof-Of-Concept Study—The Treasure Study

Abstract Disclosure: S. Monnerat: None. C. Atila: None. F.E. Baur: None. M. Dickenmann: None. M. Christ-Crain: None. INTRODUCTION The syndrome of inappropriate antidiuresis (SIAD) is the most common cause of euvolemic hyponatremia. Besides fluid restriction, increasing free-water clearance is an effective treatment approach that can be achieved through osmotic diuresis by administering oral urea. However, oral urea has a very peculiar taste that impedes long-term compliance. Dietary proteins are metabolized into soluble excretable urea by the liver. We hypothesized that dietary protein could increase free water clearance through urea-induced osmotic diuresis and therefore aimed to investigate the effect of high-protein supplementation on plasma sodium levels in outpatients with chronic SIAD. METHODS This is an interim analysis of a monocentric open-label proof-of-concept trial conducted at the University Hospital of Basel since October 2021. Adult outpatients with chronic SIAD of any etiology were eligible. Patients received 90g protein daily for 7 days in the form of protein powder dissolved in a maximum of 1L of liquid of choice. After a wash-out period of at least a week, patients received 30g of oral urea daily for 7 days. Patients were asked to keep their baseline fluid intake unchanged throughout the study. The primary endpoint was the increase in sodium levels from baseline to the end of the 7-day protein supplementation. RESULTS Thirteen patients, 10 females and 3 males, with chronic SIAD were included. Median [IQR] age was 63 [61, 80] and the median [IQR] duration of hyponatremia was 33 months [12, 42]. At baseline, median [IQR] plasma sodium concentration was 130 mmol/L [129, 133]. Eight patients had mild hyponatremia (130-134 mmol/L), 4 had moderate hyponatremia (125-129 mmol/L), and 1 patient had profound hyponatremia (&amp;lt;125 mmol/L). After 7 days of 90g daily protein supplementation (n = 13), sodium levels increased by a median [IQR] of 3 mmol/L [0, 5], blood urea nitrogen increased by a median [IQR] of 4.3 mmol/L [1.7, 5.1] and urinary urea corrected for urine creatinine increased by a median [IQR] of 26.0 mmol/mmol [17.1, 32.3]. After 7 days of oral urea (n = 8), sodium levels increased by a median [IQR] of 2 mmol/L [1, 3], blood urea nitrogen increased by a median [IQR] of 8.5 mmol/L [3.8, 10.2] and urinary urea corrected for urine creatinine increased by a median [IQR] of 31 mmol/mmol [21.1, 39.8]. CONCLUSION This interim analysis suggests that high-protein supplementation with protein powder increases plasma sodium levels in patients with chronic SIAD. The increase in urea concentration in both plasma and urine upon protein supplementation is comparable to the increase upon oral urea administration, which supports protein-induced ureagenesis to be the underlying mechanism of action. Presentation: Thursday, June 15, 2023

Glycemic Index of a High Protein and High Fiber Oral Nutritional Supplement Vidaslim®

Background: Food products with a low Glycemic index (GI) help control blood glucose levels and may also help reduce body weight. The risk of obesity-related chronic diseases increases with the consumption of refined carbohydrate-rich or a diet with high GI food choices. Vidaslim®, an Oral Nutrition Supplement was formulated by Signutra Inc, with a high protein blend (whey, soy, and casein), dietary Fiber (polydextrose), and several phytonutrients with an attempt to reduce body weight. Aim: To determine the GI of the Vidaslim® in fifteen overweight / obese people aged between 20 and 45 years. Methodology: The study participants consumed the test food, Vidaslim® containing 25 g of available carbohydrate. Participants underwent 3 days of reference food (glucose) testing and 1 day of test food with 2 days of wash-out period. In between capillary blood glucose was measured after overnight fasting at 0, 15, 30, 45, 60, 90, and 120 min after consuming the reference and test food in a random order. The GI was assessed using a validated protocol by FAO and ISO (2010). Following this, the glycemic load (GL) of Vidaslim® was also calculated. Results: Out of 15 participants who completed the study, 3 were removed as statistical outliers (GI &gt; mean ± 2SD), and hence the data was presented for the remaining 12 participants. The mean age of the participants was 28.1±5.4 years, and body mass index (BMI) was 27.2±2.7 kg/m2. Vidaslim® had a low GI value of 21±3.6 (Mean+SD). The GI value was not influenced by age, sex, dietary total calories, protein, fat, carbohydrates, dietary Fiber, and physical activity levels. The Glycemic Load (GL) of Vidaslim® was 4.86 (low GL). Conclusion: The oral nutritional supplement, Vidaslim®, has a low GI and GL value, and hence, could be a suitable healthy supplement for those with obesity and diabetes.

Combining exercise, protein supplementation and electric stimulation to mitigate muscle wasting and improve outcomes for survivors of critical illness—The ExPrES study

BackgroundNeuromuscular electrical stimulation (NMES) with high protein supplementation (HPRO) to preserve muscle mass and function has not been assessed in ICU patients. We compared the effects of combining NMES and HPRO with mobility and strength rehabilitation (NMES+HPRO+PT) to standardized ICU care. ObjectivesTo assess the effectiveness of combined NMES+HPRO+PT in mitigating sarcopenia as evidenced by CT volume and cross-sectional area when compared to usual ICU care. Additionally, we assessed the effects of the combined therapy on select clinical outcomes, including nutritional status, nitrogen balance, delirium and days on mechanical ventilation. MethodsParticipants were randomized by computer generated assignments to receive either NMES+HPRO+PT or standard care. Over 14 days the standardized ICU care group (N = 23) received usual critical care and rehabilitation while the NMES+HPRO+PT group (N = 16) received 30 min neuromuscular electrical stimulation of quadriceps and dorsiflexors twice-daily for 10 days and mean 1.3 ± 0.4 g/kg body weight of high protein supplementation in addition to standard care. Nonresponsive participants received passive exercises and, once responsive, were encouraged to exercise actively. Primary outcome measures were muscle volume and cross-sectional area measured using CT-imaging. Secondary outcomes included nutritional status, nitrogen balance, delirium and days on mechanical ventilation. ResultsThe NMES+HPRO+PT group (N = 16) lost less lower extremity muscle volume compared to the standard care group (N = 23) and had larger mean combined thigh cross-sectional area. The nitrogen balance remained negative in the standard care group, while positive on days 5, 9, and 14 in the NMES+HPRO+PT group. Standard care group participants experienced more delirium than the NMES+HPRO+PT group. No differences between groups when comparing length of stay or mechanical ventilation days. ConclusionsThe combination of neuromuscular electrical stimulation, high protein supplementation and mobility and strength rehabilitation resulted in mitigation of lower extremity muscle loss and less delirium in mechanically ventilated ICU patients.Trial Registration: Clinicaltrials.gov identifier: NCT02509520. Registered July 28, 2015

Effects of Oral Nutritional Supplementation on Patients with Venous Ulcers: A Clinical Trial.

Background: The dosage and safety of nutritional supplements for patients with venous ulcers are still not well established. Aim: To evaluate the effects of a high calorie, high protein, arginine-, zinc-, and vitamins A, C, and E-enriched nutritional supplement on the biochemical profile, dietary intake, anthropometry, muscle strength, and characteristics of lesions of patients with venous ulcers. Methods: A controlled before–after clinical trial with a four-week follow-up involved 27 patients with venous ulcers under outpatient treatment in Brazil. It was administered in two to three doses per day (200 mL each) of a high-calorie and high-protein supplement enriched with arginine, zinc, and vitamins A, C, and E. Patients were assessed for anthropometric parameters, dietary intake, biochemical tests, and healing conditions according to the Pressure Ulcer Scale for Healing (PUSH). Results: It was observed that an increase in energy and protein supply led to an adequate intake of immunonutrients (zinc and vitamins A, C, and E), increased body weight, increased body mass index, and stronger handgrip strength. The injury area and the score on the PUSH notably decreased after the intervention (p < 0.001). Conclusions: The administered supplement, at the tested dosage, improved the nutritional status and characteristics of lesions in patients with venous ulcers.

Supplements and high-protein foods in weight training: How do they affect maximum muscle strength?

Consumption of protein in weight training when adjusted to the needs will result in perfect muscle growth and development, especially in increasing maximum strength. In fact, many Fitness Members consume protein without paying attention to the dose, so that increasing maximum strength is not realized properly. This study aims to provide high-protein supplements and high-protein foods in weight training to increase maximum muscle strength. The design used in this study is a three group pre test and post test, consisting of a group consuming high protein supplements, a group consuming a high protein diet and a control group. The population in this study are FIK UNP students, with a total sample of 39 people. The instrument used in this study is a maximum strength test (leg &amp; Hand Dynamo Meter test). The data obtained in this study are analyzed by analysis of variance (ANOVA) with = 0.05. The results showed: (1) There was a difference in effect between the group given high protein supplements, high protein die,t and the control group, (2) The group given high protein supplements had a difference from the average of the other two groups, (3) The group given high protein supplements high-protein supplements had a difference from the average of the other two groups, (4) The high-protein diet group did not have a mean difference with the control group. The limitation in this study is that the researcher was not able to control aspects that were outside the research activities such as other high protein contamination consumed by the research food samples. The next stage, this research will look at the effects of consuming high-protein supplements on a sustainable basis on human health.

Sleep Quality After Intradialytic Oral Nutrition: A New Benefit of This Anabolic Strategy? A Pilot Study.

BackgroundSince disturbances of appetite and sleep are closely related and both affect metabolic disorders, it would be expected that a renal specific oral nutritional supplement (RS-ONS) that covers the energy the patient does not consume on the HD day, could contribute to improve the nutritional status and body composition, as well as sleep quality. There is still scarce information related to this topic.AimTo evaluate the effect of the use of intra-dialytic RS-ONS vs. RS-ONS at home on sleep quality, nutritional status, and body composition in patients on HD.MethodsAdult patients < 65 years, with ≥3 months on HD were invited to participate in an open randomized pilot study (ISRCTN 33897). Patients were randomized to a dialysis-specific high-protein supplement provided during the HD session (Intradialytic oral nutrition [ION]) or at home (control), during non-HD days (thrice weekly, for both) 12 weeks. The primary outcome was sleep quality defined by the Pittsburgh Sleep Quality Index (PSQI) score. Nutritional assessment included Malnutrition Inflammation Score (MIS), bioelectrical impedance analysis, anthropometry, 3-day food records, and routine blood chemistries.ResultsA total of 23 patients completed the study. Age was median 35 (range 24–48 years), 42% were women. At baseline, the PSQI score was median 4 (range 2–7), and MIS showed a median of 6 (range 5–8); there were no baseline differences between groups. After intervention, both groups improved their MIS scores and similarly when we analyzed the whole cohort (pre- vs. post-intervention P < 0.01). Patients in the ION group improved the overall PSQI score to median 3 (2–5), and assessment of sleep duration and sleep disturbances (pre- vs. post-intervention P < 0.05), with a trend toward an effect difference compared to patients consuming the supplement at home (P for treatment-effect across arms 0.07 for PSQI score and 0.05 for sleep latency).ConclusionOral supplementation improved nutritional status in the whole cohort, but only ION improved the PSQI score. More studies are needed to explore the nutritional strategies that influence the relationship between sleep and nutritional status in HD patients.

Interventions for Body Composition and Upper and Lower Extremity Muscle Strength in Older Adults in Rural Taiwan: A Horizontal Case Study.

The purpose of this study was to understand the effects of a physical activity program and high-protein supplementation on body composition and upper and lower extremity muscle strength in male older adults in rural areas. In this study, 60 healthy male older adults (mean age 77.5 ± 4.6 years) from rural areas were recruited and randomly assigned to experimental group A (intervention of the physical activity program and high-protein supplementation), experimental group B (daily routine, with only intervention of high-protein supplementation), or control group C (daily routine). Experimental group A (EGa) carried out a physical activity plan three times a week, with an exercise intensity and calorie consumption of 250 kcal (5METs × ⅔hr × 75) for 3 months and drank a high-protein supplement (1.3 g/kg BW/day) after each exercise; experimental group B (EGb) followed only the intervention of high-protein supplementation. All the participants underwent pre- and post-tests for body composition, waist–hip circumference (WC, HC), handgrip strength (HS), 30 s dominant arm curl, 30 s sit to stand, and 2 min step tests. The results of the study showed that EGa significantly decreased body mass index (BMI), body fat mass (BFM), body fat percentage (BFP), WC, HC, and waist-to-hip ratio (WHR) and increased basal metabolic rate and muscle mass. Although both EGa and EGb used high-protein supplementation, EGa’s added three-month intervention of a physical activity program made it easier for that group to increase muscle mass and muscle strength. The WHR decreased from 1.015 to 0.931, representing a decrease of 8.28%, and an obvious weight loss effect was achieved. Thus, we concluded that the best way to maintain muscle strength in older adults is through physical activity with resistance and protein supplementation, which can reduce muscle loss in older adults.

The Effectiveness of a High-Protein Liquid Dietary Supplementation in Improving Nutritional Status of Malnourished Patients in Hospital Care: a Preliminary Study

Background: Malnutrition is a very common problem in hospitalized patients. Based on studies conducted in various countries, the prevalence of hospital malnutrition ranges from 20-45%. Hospital malnutrition can occur as a result of insufficient nutrient intake, impaired absorption of nutrients in the gastrointestinal (GI) tract, loss of nutrients due to disease, or increased metabolic requirement during illness. Nutrition is the basis for the healing process as it requires good nutrients through various enzymatic reactions. Some studies have shown that hospital malnutrition increases morbidity, mortality, prolongs the duration of hospitalization, and delays recovery. To improve nutritional status, a high-protein diet can be given. Liquid diet is one of the alternative forms of nutrition because it is easier to swallow.Method: This study was a double-blind randomized controlled trial conducted to assess the effectiveness of high protein liquid dietary supplementation in malnourished hospitalized patients. The patients were assessed for their nutritional status based on ESPEN 2015 criteria. Patients who experienced malnutrition will be divided into 2 groups, namely the control group which was given normal protein liquid diet, while the intervention group was given high protein liquid diet supplementation as much as 2 bottles (200 mL) per day for 7-10 days. Furthermore, the nutritional status of the patient was assessed.Results: By administering high-protein liquid diet supplementation, there was a tendency to increase the strength of the right handgrip in 3 subjects (50%), the tendency to increase body mass index (BMI) in 3 subjects (50%), Subjective Global Assessment (SGA) score improved in 2 subjects with mild/moderate malnutrition (33.3%) and 1 subject with normal nutrition (16.7%), and the tendency to increase the fat-free mass in 3 subjects (50%).Conclusion: The administration of high protein liquid dietary supplementation tended to increase the strength of the right handgrip, BMI, SGA score, and body fat-free mass index.

Immunomodulating versus high-protein oral preoperative supplement in surgical patients – A two-center, prospective, randomized clinical trial

ObjectivesFor many years, immunonutrition was believed to reduce postoperative complications in patients undergoing major abdominal surgery. However, recent studies questioned that belief. Moreover, the perioperative intake of proteins has gained more and more attention and has shown clinical value. Therefore, the aim of this study was to compare the clinical effect of immunomodulating (IM) plus high-protein (HP) and pure HP supplements during the preoperative period. MethodsBetween January 2011 and December 2020, 299 well-nourished patients (130 female and 169 male; mean age: 60.8 y) undergoing major abdominal surgery at two surgical centers were randomized to receive either preoperative IM or HP oral supplements for 7 d after surgery. In all patients, an enhanced recovery after surgery protocol was applied. Outcome measures of the intend-to-treat analysis were number and type of complications, length of hospitalization, and mortality. ResultsBoth groups were comparable in terms of age, sex, and type of surgery. The median length of postoperative hospital stay was 8 d (range, 6–12 d) in the IM group and 7 d (range, 6–10 d) in the HP group (P = 0.153). Postoperative complications were observed in 29 patients (21.3%) in the IM group and 28 (17.8%) in the HP group (P = 0.442) The risk of readmission was comparable (5.1% vs 4.9%; P = 0.924) for IM and HP supplements, respectively. Postoperative nausea and vomiting occurred in 21 patients in the IM group (15.4%) and 17 patients in the HP group (10.4%; P = 0.195). No difference in gastrointestinal function evaluated with time to first flatus was observed (P = 0.272) ConclusionsThe study demonstrated no difference between preoperative IM + HP and HP supplements in surgical patients. Therefore, the routine preoperative use of IM supplements in all surgical patients cannot be recommended.

Hydroxychloride trace minerals improve apparent total tract nutrient digestibility in Bonsmara beef cattle

The effect of hydroxychloride trace minerals (HTM) on nutrient digestibility in comparison with sulfate trace minerals (STM) was tested in Bonsmara beef cattle fed Eragrostis tef hay as roughage, with high or low protein supplementation. Eight 12 month old Bonsmara beef heifers were housed individually and fed according to a duplicated 4 × 4 Latin square design. Two levels of protein supplementation, being 12.79% crude protein (CP) in the low protein concentrate and 30.16% CP in the high protein concentrate, were combined with two sources of trace minerals, being HTM and STM. All four diets contained 15 ppm added Cu, 50 ppm added Zn and 33 ppm added Mn. The Eragrostis tef hay roughage was fed ad libitum. The supplements including the minerals were fed separately daily at a fixed rate of 1.4 kg/heifer/day. Each period was 24 days starting with 18 days adaptation period followed by 6 days sampling period. The body weight and feed intake were measured during each period, to calculate growth performance. Feed and fecal samples were collected during sampling period and analyzed for nutrient digestibility, while acid insoluble ash was used as indigestible marker. On the last day of each period, rumen fluid was collected via a stomach tube for rumen pH and volatile fatty acid measurements.Results showed that HTM had a significant positive effect (P < 0.05) on dry matter (+ 1.78%, P = 0.042), organic matter (+ 1.81%, P = 0.039), neutral detergent fiber (1.80%, P = 0.020) and acid detergent fiber (+ 2.41%, P = 0.019) digestibility in Bonsmara beef cattle compared to STM, regardless of protein supplementation. Feeding higher protein level increased CP digestibility compared to low protein supplementation (+7.92%, P < 0.001), while overall the mineral sources only tended to improve CP digestibility when HTM were fed (+3.18%, P = 0.052). High CP supplementation resulted in a higher acetate (+ 0.638 g/l, P < 0.001), and butyrate (+ 0.196 g/l, P = 0.010) production in the rumen compared to low CP supplementation, regardless of mineral source. Propionate production tended to be higher in the rumen of protein supplemented heifers (+ 0.114 g/l, P = 0.060), which tended to be more evident in heifers fed HTM. However, the effects observed on nutrient digestibility and rumen parameters did not translate into differences in growth performance.