Whey Protein Supplementation Improves Rehabilitation Outcomes in Hospitalized Geriatric Patients: A Double Blinded, Randomized Controlled Trial

Niccoli, Sarah; Kolobov, Anton; Bon, Trevor; Rafilovich, Seda; Munro, Heather M.; Kim, Tanner; Pearson, Trina; Lees, Simon J.

doi:10.1080/21551197.2017.1391732

Cited by 30 publications

(67 citation statements)

References 39 publications

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“…As well as exercises, nutritional interventions are proved to be important aspects. There are several studies that showed the additive effects of supplementation with protein [ 56 , 57 ], amino acids [ 58 ] to exercise intervention.…”

Section: Prevention Of the Onset And Progression Of Lsmentioning

confidence: 99%

Locomotive syndrome in Japan

Ishibashi

2018

Osteoporosis and Sarcopenia

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The present aging rate in Japan of some 28% will continue to increase along with the advancing age of elderly persons. Therefore, the demand for care will also increase. Approximately 25% of the need for nursing-care defined by the Japanese long-term care insurance system is associated with disorders or deterioration of locomotive organs. Therefore, the prevention and treatment of diseases in the locomotor system and maintenance of motor function are important for extended healthy life span and to decrease the demand for long-term care. Based on this background, the Japanese Orthopaedic Association (JOA) proposed the concept of locomotive syndrome (LS) in 2007, which is defined as reduced mobility due to impaired locomotive organs. Changes in locomotion must be noticed early to ensure the timely implementation of appropriate checks and measures of locomotion can uncover risk of acquiring LS. The acquisition of an exercise habit, appropriate nutrition, being active and evaluating and treating locomotion-related diseases are important to delay or avoid LS. The JOA recommends locomotion training consisting of four exercises to prevent and improve LS. Countermeasures against LS should become a meaningful precedent not only for Japan, but for other countries with rapidly aging populations.

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Section: Prevention Of the Onset And Progression Of Lsmentioning

confidence: 99%

Locomotive syndrome in Japan

Ishibashi

2018

Osteoporosis and Sarcopenia

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“…However, the PP analysis did not change the conclusions considerably, but the statistical power was also lower. A study with older hospitalised adults given PrS (24 g/d) and RT or RT only showed positive effects of PrS during the length of hospital admission which was > 20 d for both groups (58) . Thus, the short length of hospital stay for all participants in the present study (median of 5 d) may have blunted the chance of finding positive effects of the greater difference in protein intake between groups looking only at the hospitalisation period.…”

Section: Discussionmentioning

confidence: 94%

Protein supplementation combined with low-intensity resistance training in geriatric medical patients during and after hospitalisation: a randomised, double-blind, multicentre trial

et al. 2019

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Sarcopenia (loss of muscle mass/strength) burdens many older adults – hospitalised older adults being particularly vulnerable. Treating the condition, protein supplementation (PrS) and resistance training (RT) may act synergistically. Therefore, this block-randomised, double-blind, multicentre intervention study, recruiting geriatric patients > 70 years from three medical departments, investigated the effect of PrS combined with RT during hospitalisation and 12 weeks after discharge. Participants were randomly allocated (1:1) to receive PrS (totally 27·5 g whey protein/d, about 2000 kJ/d) or isoenergetic placebo-products (< 1·5 g protein/d) divided into two servings per d to supplement the habitual diet. Both groups were engaged in a standardised, progressive low-intensity RT programme for the lower extremities (hospital: supervised daily/after discharge: self-training 4×/week). From April 2016 to September 2017, 2351 patients were screened, 462 were eligible, and 165 included. Fourteen were excluded and ten dropped out, leaving 141 participants in the intention-to-treat analysis. The average total protein intake during hospitalisation/after discharge was 1·0 (interquartile range (IQR) 0·8, 1·3)/1·1 (IQR 0·9, 1·3) g/kg per d (protein-group) and 0·6 (IQR 0·5, 0·8)/0·9 (IQR 0·6, 1·0) g/kg per d (placebo group). Both groups improved significantly for the primary and secondary endpoints of muscle mass/strength, functional measurements and quality of life, but no additional effect of PrS was seen for the primary endpoint (30-s chair stand test, repetitions, median changes from baseline: (standard test: 0 (IQR 0, 5) (protein group) v. 2 (IQR 0, 6) (placebo group) and modified test: 2 (IQR 0, 5) (protein group) v. 2 (IQR −1, 5) (placebo group)) or any secondary endpoints (Mann–Whitney U tests, P > 0·05). In conclusion, PrS increasing the total protein intake by 0·4 and 0·2 g/kg per d during hospitalisation and after discharge, respectively, does not seem to increase the adaptive response to low-intensity RT in geriatric medical patients.

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“…Because nutrition supplementation decreased readmission rate, an indirect measure of subacute/chronic improvement of the heart, it might be that such patients benefited significantly more from the long‐term nourishment of their heart and body so that after discharge, they stayed healthier and were not readmitted. Furthermore, protein supplementation has been shown to improve muscle mass and outcomes among patients in rehabilitation centers . Therefore, an effective modality of preventing adverse outcomes might be ongoing surveillance and identification of PEM among the U.S. populace in the community and provision of optimal nourishment, thereby keeping them away from rehospitalization.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, protein supplementation has been shown to improve muscle mass and outcomes among patients in rehabilitation centers. 46,47 Therefore, an effective modality of preventing adverse outcomes might be ongoing surveillance and identification of PEM among the U.S. populace in the community and provision of optimal nourishment, thereby keeping them away from rehospitalization. Studies are urgently needed to investigate the effect of such community intervention studies.…”

Section: Discussionmentioning

confidence: 99%

Inferior Outcomes of Patients With Acute Myocardial Infarction and Comorbid Protein‐Energy Malnutrition

Adejumo

Adegbala

et al. 2019

J Parenter Enteral Nutr

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Background Protein‐energy malnutrition (PEM) diminishes amino acid and energy availability, impairing the body's healing capability after injury, such as in myocardial damage following acute myocardial infarction (AMI). Aims We sought to investigate the influence of PEM on clinical outcomes of AMI. Methods We identified records with a primary discharge diagnosis of AMI from the Nationwide Inpatient Sample (2012–2014), stratified by concomitant PEM. We matched PEM to no‐PEM (1:1) using a greedy algorithm–based propensity methodology and estimated the impact of PEM on health outcomes (SAS 9.4). Results Of the 332,644 hospitalizations for AMI, 11,675 had concomitant PEM accounting for roughly $US 1.5 billion and over 119,792 hospital days. PEM was associated with older age (74.43‐ vs. 66.90‐years; P < 0.0001), female sex (49.19% vs. 38.44%; P < 0.0001), black race (12.78% vs. 10.46%; P < 0.0001), and higher comorbidity burden (Deyo > 3: 32.77% vs. 16.69%; P < 0.0001). After propensity matching, PEM was associated with higher mortality (Adjusted odds ratio [AOR]: 1.59 [1.46–1.73]), cardiogenic shock (AOR: 2.26 [2.08–2.44]), discharge to secondary facilities (AOR: 2.21 [2.10–2.33]), charges ($135,500 [$131,956–139,139] vs. $81,084 [$79,241–82,970]), cardiac artery bypass surgery (AOR:1.81 [1.66–1.97]), intra‐aortic balloon pump placement (AOR: 1.83 [1.65–2.04]) and longer length of stay (10.15‐ vs. 5.52‐days). Conclusions PEM is a predisposing factor for devastating clinical outcomes among AMI hospitalizations. Higher prevention, identification and management of PEM among high‐risk individuals (older age, female sex, and black race) residing in the community are needed.

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Whey Protein Supplementation Improves Rehabilitation Outcomes in Hospitalized Geriatric Patients: A Double Blinded, Randomized Controlled Trial

Cited by 30 publications

References 39 publications

Locomotive syndrome in Japan

Locomotive syndrome in Japan

Protein supplementation combined with low-intensity resistance training in geriatric medical patients during and after hospitalisation: a randomised, double-blind, multicentre trial

Inferior Outcomes of Patients With Acute Myocardial Infarction and Comorbid Protein‐Energy Malnutrition

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