title: Effects of branched amino acids supplementation in malnourished elderly with catabolic status.
abstract: BACKGROUND
  Among various nutrients branched amino acids (BCAAS) have been shown to be the most responsible for the stimulation of protein synthesis in various situations including catabolic states.
  
  
  OBJECTIVE
  We evaluated the effect of a small amount of proteins enriched with BCAAs (0.4 g/kg/day and 0.2 g/kg/day BCAAs) on body weight and composition; nitrogen balance, energy intake and inflammation after 2 weeks of supplementation in acute elderly with catabolic status.
  
  
  METHODS
  Two weeks randomized controlled trial.
  
  
  METHODS
  Geriatric department of teaching hospital.
  
  
  METHODS
  Thirty patients with malnutrition and inflammatory process (MNA < 24, albumin < 30 g/l and CRP > or = 20 mg/l) who agreed to participate in the study were consecutively included.
  
  
  METHODS
  Body composition was determined by labelled water dilution method; resting energy expenditure (REE) was determined by indirect calorimetry; energy intake was calculated for a 3 days period at D1 and D12. Nutritional and inflammatory proteins and cytokines (IL-6 and TNF) were measured at day 1 and 14.
  
  
  RESULTS
  No difference was observed at day 14 between supplemented (S) and control (C) group for weight (S: 58.0 +/- 11.8 kg and C: 60.0 +/- 15.9 kg); fat free mass (S: 40.7 +/- 8.3 kg and C: 40 +/- 8.2 kg); nitrogen balance (S: 1.34 +/- 2.21 g/day and C: 0.59 +/- 4.47 g/day); and energy intake (S: 20 +/- 3.6 kcal/day and C: 20.5 +/- 8.6 kcal/day). Energy intake was at similar level than REE and clearly less than energy requirement in C and S. A significant decrease was observed for orosomucoid and Prognostic Inflammatory and Nutritional Index (PINI) in S.
  
  
  CONCLUSIONS
  Our results do not confirm improvement of nutritional status with enriched BCAAs supplementation as suggested in the literature. Persistence of inflammatory condition may be an explanation despite an improvement of inflammatory status was observed in the supplemented group. Those results show clearly that energy requirements are not covered in acute hospitalized elderly people. The fact that not only energy intake but also REE are decreased brings a new insight on catabolic situations.
authors.affiliation: Service universitaire de médecine gériatrique, Centre Hospitalier Lyon-Sud, 69495 Pierre Bénite Cedex.
authors.forename: M
authors.initials: M
authors.lastname: Bonnefoy
authors.forename: M
authors.initials: M
authors.lastname: Laville
authors.forename: R
authors.initials: R
authors.lastname: Ecochard
authors.forename: J F
authors.initials: JF
authors.lastname: Jusot
authors.forename: S
authors.initials: S
authors.lastname: Normand
authors.forename: S
authors.initials: S
authors.lastname: Maillot
authors.forename: B
authors.initials: B
authors.lastname: Lebreton
authors.forename: M
authors.initials: M
authors.lastname: Jauffret
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000596:Amino Acids / Q000494:pharmacology / Q000627:therapeutic use*; D001825:Body Fluid Compartments / Q000187:drug effects; D001835:Body Weight / Q000187:drug effects; D019587:Dietary Supplements; D002149:Energy Intake / Q000187:drug effects; D005260:Female; D006801:Humans; D007249:Inflammation / Q000150:complications / Q000188:drug therapy*; D008297:Male; D044342:Malnutrition / Q000150:complications / Q000188:drug therapy*; D009584:Nitrogen / Q000097:blood; D009752:Nutritional Status / Q000187:drug effects; D009961:Orosomucoid / Q000378:metabolism
chemical_list: D000596:Amino Acids; D009961:Orosomucoid; D009584:Nitrogen
references.citation: Exp Gerontol. 2006 Feb;41(2):215-9
references.pmid: 16310330
references.citation: J Nutr. 2006 Jan;136(1 Suppl):277S-80S
references.pmid: 16365098
references.citation: J Nutr. 2006 Jan;136(1 Suppl):264S-8S
references.pmid: 16365095
references.citation: Clin Nutr. 2007 Feb;26(1):16-24
references.pmid: 17034905
references.citation: Ann Biol Clin (Paris). 1985;43(6):872-4
references.pmid: 3938626
references.citation: Am J Clin Nutr. 2005 Nov;82(5):1065-73
references.pmid: 16280440
references.citation: J Clin Endocrinol Metab. 2006 Dec;91(12):4836-41
references.pmid: 16984982
references.citation: J Appl Physiol (1985). 2004 Feb;96(2):674-8
references.pmid: 14594866
references.citation: Nephrol Dial Transplant. 2001 Sep;16(9):1856-62
references.pmid: 11522870
references.citation: Ann Surg. 1996 Apr;223(4):395-405
references.pmid: 8633918
references.citation: Hepatol Res. 2008 Jul;38(7):683-8
references.pmid: 18328070
references.citation: Am J Physiol Endocrinol Metab. 2006 Aug;291(2):E381-7
references.pmid: 16507602
references.citation: Am J Clin Nutr. 1980 Dec;33(12):2686-93
references.pmid: 6776801
references.citation: J Clin Endocrinol Metab. 1998 Dec;83(12):4289-97
references.pmid: 9851766
references.citation: J Psychiatr Res. 1975 Nov;12(3):189-98
references.pmid: 1202204
references.citation: Clin Nutr. 2004 Feb;23(1):13-21
references.pmid: 14757388
references.citation: J Clin Endocrinol Metab. 2005 Mar;90(3):1453-9
references.pmid: 15598679
references.citation: J Am Geriatr Soc. 2007 Jul;55(7):1085-9
references.pmid: 17608883
references.citation: J Nutr. 2001 Jun;131(6):1833-8
references.pmid: 11385075
references.citation: World Health Organ Tech Rep Ser. 1985;724:1-206
references.pmid: 3937340
references.citation: Curr Opin Clin Nutr Metab Care. 2005 Jan;8(1):61-5
references.pmid: 15586001
references.citation: Am J Cardiol. 2004 Apr 22;93(8A):3A-5A
references.pmid: 15094097
references.citation: J Physiol. 2003 Oct 1;552(Pt 1):315-24
references.pmid: 12909668
references.citation: J Appl Physiol (1985). 2003 Apr;94(4):1345-52
references.pmid: 12471043
references.citation: Int J Vitam Nutr Res. 1998;68(3):189-95
references.pmid: 9637950
references.citation: J Appl Physiol Respir Environ Exerc Physiol. 1983 Aug;55(2):628-34
references.pmid: 6618956
references.citation: J Nutr. 2006 Jan;136(1 Suppl):314S-8S
references.pmid: 16365105
references.citation: J Clin Endocrinol Metab. 2000 Dec;85(12):4481-90
references.pmid: 11134097
references.citation: J Nutr. 2001 Sep;131(9 Suppl):2569S-77S; discussion 2590S
references.pmid: 11533315
references.citation: J Am Soc Nephrol. 1997 Dec;8(12):1906-14
references.pmid: 9402093
references.citation: Proc Natl Acad Sci U S A. 1997 Dec 23;94(26):14930-5
references.pmid: 9405716
references.citation: FASEB J. 2004 Oct;18(13):1586-7
references.pmid: 15319361
references.citation: J Am Geriatr Soc. 2008 Jun;56(6):1045-9
references.pmid: 18554362
references.citation: Aliment Pharmacol Ther. 2004 Apr 1;19(7):779-88
references.pmid: 15043519
references.citation: FASEB J. 2005 Mar;19(3):422-4
references.pmid: 15596483
references.citation: J Gerontol A Biol Sci Med Sci. 2003 Feb;58(2):131-7
references.pmid: 12586850
references.citation: J Am Geriatr Soc. 2000 Oct;48(10):1300-9
references.pmid: 11037019
references.citation: Int J Biochem Cell Biol. 2005 Oct;37(10):1962-73
references.pmid: 15905114
references.citation: N Engl J Med. 1994 Jun 23;330(25):1769-75
references.pmid: 8190152
references.citation: Am J Clin Nutr. 1996 Apr;63(4):546-52
references.pmid: 8599318