title: A specific protein-enriched enteral formula decreases cortisolemia and improves plasma albumin and amino acid concentrations in elderly patients.
abstract: BACKGROUND
  Old age is associated with an involuntary and progressive but physiological loss of muscle mass. The aim of this study was to evaluate the effects of exclusive consumption for 6 months of a protein-enriched enteral diet with a relatively high content of branched-chain amino acids on albuminemia, cortisolemia, plasma amino acids, insulin resistance, and inflammation biomarkers in elderly patients.
  
  
  METHODS
  Thirty-two patients from the Clinical Nutrition Outpatient Unit at our hospital exclusively consumed a protein-enriched enteral diet for 6 months. Data were collected at baseline and at 3 and 6 months on anthropometric and biochemical parameters and on plasma concentrations of amino acids, cortisol, adrenocorticotropic hormone, urea, creatinine, insulin resistance, and inflammation biomarkers.
  
  
  RESULTS
  The percentage of patients with albumin concentration below normal cut-off values decreased from 18% to 0% by the end of the study. At 6 months, concentrations of total plasma (p = 0.008) and essential amino acids (p = 0.011), especially branched-chain amino acids (p = 0.031), were higher versus baseline values, whereas 3-methylhistidine (p = 0.001), cortisol (p = 0.001) and adrenocorticotropic hormone (p = 0.004) levels were lower.
  
  
  CONCLUSIONS
  Regular intake of specific protein-enriched enteral formula increases plasma essential amino acids, especially branched-chain amino acids, and decreases cortisol and 3-methylhistidine, while plasma urea and creatinine remain unchanged.
authors.affiliation: Department of Biochemistry and Molecular Biology II, Institute of Nutrition and Food Technology, Biomedical Research Center, University of Granada, Granada, Spain. jolza@ugr.es.
authors.forename: Josune
authors.initials: J
authors.lastname: Olza
authors.forename: María D
authors.initials: MD
authors.lastname: Mesa
authors.forename: Rafael M
authors.initials: RM
authors.lastname: Poyatos
authors.forename: Concepción M
authors.initials: CM
authors.lastname: Aguilera
authors.forename: Rosario
authors.initials: R
authors.lastname: Moreno-Torres
authors.forename: Milagros
authors.initials: M
authors.lastname: Pérez
authors.forename: Antonio
authors.initials: A
authors.lastname: Pérez de la Cruz
authors.forename: Angel
authors.initials: A
authors.lastname: Gil