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Trials were organized according to the kind of nutrition intervention, dietary guidance, food supplement, and multimodal therapies are given to participants in the experimental arm.
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NUTRITIONALINTERVENTIONAL TRIALSINMUSCLEANDCACHEXIA PHDRESEARCHDIRECTIONSFOR 2023 AnAcademicpresentationby Dr.NancyAgnes,Head,TechnicalOperations,Phdassistance Groupwww.phdassistance.com Email:info@phdassistance.com
Today'sOutline Introduction Interventions Musculoskeletalconditions Multipleclinicalconditions Olderadultswithlowmusclemassorfunctionorsarcopenia Olderadultswithmalnutrition
Inbrief Muscle loss, especially alone or in the setting of sarcopenia or cachexia, is a common condition that predicts pooroutcomesinageingandillness.Researchhasbeendonetoinvestigatetheimpactofspecificnutrients on muscle mass or function, as appropriate nutrition is crucial for muscle maintenance. More research, however,is required to inform evidence-based decisions. This comprehensive review aimed to gather and record ongoing clinical studies evaluating dietary treatments as astrategy topreventortreatpoormusclemassorfunction(strengthandphysicalperformance), sarcopenia, or cachexia. ClinicalTrials.gov and the WHO International Clinical Studies Registry Platform were searched for planned and ongoing trials through April 21, 2021. Based on the objective to investigate the effects of dietary treatments on muscle-related outcomes (i.e. muscle mass or strength, physical performance, or muscle synthesis rate) in bothclinical and non-clinical Trials, randomized controlled studies with20 participants perarm were included(i.e. ageing).
Introduction Muscular mass loss with or without a corresponding reduction in function (i.e., physical performance or muscle strength) can happen due to ageingnaturally or as a resultof acute and chronic illnesses. Recent pooled analyses have shown that low muscle mass and sarcopenia (i.e., low muscle mass and function) are prevalent in community-dwelling and hospitalized older adults and patients with lung diseases, liver cirrhosis, cancer, and other diseases. However, the prevalence of these conditions may vary depending on the diagnostic criteriaused. Patients may also have muscle loss without changes in body weight or even in the context of obesity (sarcopenic obesity). Cachexia is a catabolic disorder that is further defined by extreme weight loss with or without loss of fat mass and inflammation brought on by underlying conditions, with catastrophic effects on patients. Low muscle mass is one of the distinguishing criteria of cachexia (1).
Trialswereorganizedaccording tothekindofnutrition intervention, dietary guidance, food supplement, and multimodal therapies are given to participants in the experimental arm. According to the classifications provided by the European Society for Clinical Nutrition and Metabolism, nutritional treatments were classified as food supplements, food modifications, food products, fortifiedfoodproducts,andoralnutritionalsupplements(ONS) (ESPEN). Theterm"nutritionaladvise"wasdevelopedtoencompass studies that offered participants dietary guidance from licensed dietitians/nutritionists or assistance from healthcare professionals, Medicalresearch workers , or self-help resources. Interventions
Types of assessed nutritioninterventions Dietaryadvice Foodproduct Food modification Fortifiedfood Food supplement Oral nutritional supplements Specializedoralnutritionalsupplements
Musculoskeletalconditions In patients with a variety of musculoskeletal conditions, twelve nutrition trials (10.7%) were found (Figure 1). These patients included those who have undergone or are about to undergo orthopaedic surgery, older adults who are temporarily immobilized while healing from an acute fracture, and adults with osteoarthritis, rheumatoid arthritis, low bonemass, or osteoporosis. In addition, there are 40 to 400 people in the target sample size. In addition, an overview ofnutritional research, treatmentsandfoodsupplementsstratifiedbymusculoskeletaldiseasesisprovidedbystudiesthatprovide participants with food supplements, high-protein ONS or ONS supplemented with HMB, or food modification alone or inconjunction with dietary guidance. Thecriticaloutcomesofmosttrialsare performance,or acombination ofthese. research methods of muscle mass, muscular strength, physical
Figure1:Characteristicsofinterventionsanddistributionoftrials across patientswithobesityandmetabolicdiseases(2)
Multipleclinicalconditions Inoneexperiment(0.9%),320individualswithcancerofanykind,osteoporosis,stroke,orchronicrenaldiseaseare examined to see howdietary recommendations andresistance training affect theirconditions. Musclemass,physicalperformanceandmusclestrengtharethethree-monthintervention'sconcurrentprimary objectives. However, itisunknowniftheauthorsintendtocarryout distinctanalysesbyillnesscategory.
Olderadultswithlowmusclemassor functionorsarcopenia Ten trials (8.9%) include 52–200 older people with sarcopenia or reduced muscle mass or function. Although several studies merged definitions, sarcopenia is characterized by many diagnostic criteria, such as those of the Asian WorkingGroupforSarcopenia,theEuropeanWorkingGrouponSarcopeniainOlderPeople(EWGSOP2),or reduced muscle mass associated with poor muscular strength (HGS). Most clinical studies employ a variety of dietary supplements. Olderadultswithmalnutrition Onetrial(0.9%)recruited 93institutionalizedolderpersonsatriskofmalnutritionormoderatemalnutrition. Participants get a whey protein at lunch and a high-carbohydrate meal product at supper for 90 days. Muscular mass measurements using DXA are the primary outcome of interest, while muscle strength measurements using HGS and lower body strength tests arethe secondary outcomes (usingthe 6MWT and TUG tests)(3).
Conclusion This scoping review identified several current RCTs investigating the impact of dietary treatments on muscle mass, muscular function, sarcopenia, or cachexia in ageing and illness. More research is to be expected on the impact of dietary supplements and ONS including protein, amino acids, omega-3fatty acids, or HMBon these disorders. Althoughmanystudiesusethesametherapies,therewasmethodologicalvariationintheresearchdesign, supplement dose, duration of the intervention, and outcome evaluation, and several trials lacked crucial data. These problems or restrictions might make it difficult to compare research, pool data, or conduct upcoming meta-analyses, limitingtheabilityoftheseongoinginvestigationstogeneraterecommendationssupportedbytheavailableevidence. To improve the area, PhD research offers suggestions for upcoming research studies on nutrition and multimodal treatments for cachexia, sarcopenia, and muscular health.
AboutPhDAssistance Many trials have similar interventions; methodological heterogeneity may challenge study comparisons and future meta-analysestoprovideevidence-basedrecommendationsandassessthetherapeuticeffectsofnutrition interventions PhD. Assistanceservesas anexternalmentortobrainstormyourideaandtranslatethatintoa research model. Finally, we deliver, What We Promise.
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