Resistance exercise augments the acute anabolic effects of intradialytic oral nutritional supplementation.
BACKGROUND
An intriguing strategy to further enhance the anabolic effects of nutritional supplementation is to combine the administration of nutrients with resistance exercise. We hypothesized that the addition of resistance exercise to oral nutrition supplementation would lead to further increases in skeletal muscle protein accretion when compared to nutritional supplementation alone in chronic haemodialysis (CHD) patients.


METHODS
We performed stable isotope protein kinetic studies in eight CHD patients during two separate settings: with oral nutritional supplementation alone (PO) and oral nutritional supplementation combined with a single bout of resistance exercise (PO + EX). Metabolic assessment was performed before, during and after haemodialysis. Both interventions resulted in robust protein anabolic response.


RESULTS
There were no differences in metabolic hormones, plasma amino acid and whole-body protein balance between the interventions. During the post-HD phase, PO + EX retained a positive total amino acid (TAA) balance (primarily due to essential amino acid) while PO returned to a negative TAA balance although this difference did not reach statistical significance (78 +/- 109 versus -128 +/- 72 nmol/100 ml/min, respectively; P = 0.69). In the post-HD phase, PO + EX had significantly higher net muscle protein balance when compared to PO (19 +/- 16 versus -24 +/- 10 microg/100 ml/min, respectively; P = 0.036) We conclude that a single bout of resistance exercise augments the protein anabolic effects of oral intradialytic nutritional supplementation when examining skeletal muscle protein turnover.
Division of Nephrology, Vanderbilt University Medical Center, 1161 21st Ave. South & Garland, S-3223 MCN, Nashville, TN 37232-2372, USA.
Karen M
KM
Majchrzak
Lara B
LB
Pupim
Paul J
PJ
Flakoll
T Alp
TA
Ikizler
D000328:Adult; D000596:Amino Acids / Q000097:blood; D018592:Cross-Over Studies; D004044:Dietary Proteins / Q000008:administration & dosage*; D004734:Energy Metabolism / Q000502:physiology*; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D008401:Gas Chromatography-Mass Spectrometry; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000503:physiopathology* / Q000628:therapy; D008297:Male; D009124:Muscle Proteins / Q000378:metabolism; D018482:Muscle, Skeletal / Q000378:metabolism; D018529:Nutritional Support / Q000379:methods*; D011379:Prognosis; D011446:Prospective Studies; D006435:Renal Dialysis / Q000379:methods*
D000596:Amino Acids; D004044:Dietary Proteins; D009124:Muscle Proteins