Whey protein isolate supplementation improves body composition, muscle strength, and treatment tolerance in malnourished advanced cancer patients undergoing chemotherapy

Research output: Contribution to journalArticle

Abstract

In recent years, whey proteins (WP) have attracted increasing attention in health and disease for their bioactive functions. The aim of this study was to evaluate the benefit of WP isolate (WPI) supplementation in addition to nutritional counseling in malnourished advanced cancer patients undergoing chemotherapy (CT). In a single-center, randomized, pragmatic, and parallel-group controlled trial (ClinicalTrials.gov: NCT02065726), 166 malnourished advanced cancer patients with mixed tumor entities candidate to or undergoing CT were randomly assigned to receive nutritional counseling with (N = 82) or without (N = 84) WPI supplementation (20 g/d) for 3 months. The primary endpoint was the change in phase angle (PhA). Secondary endpoints included changes in standardized PhA (SPA), fat-free mass index (FFMI), body weight, muscle strength, and CT toxicity (CTCAE 4.0 events). In patients with the primary endpoint assessed (modified intention-to-treat population), counseling plus WPI (N = 66) resulted in improved PhA compared to nutritional counseling alone (N = 69): mean difference, 0.48° (95% CI, 0.05 to 0.90) (P =.027). WPI supplementation also resulted in improved SPA (P =.021), FFMI (P =.041), body weight (P =.023), muscle strength (P <.001), and in a reduced risk of CT toxicity (risk difference, −9.8% [95% CI, −16.9 to −2.6]; P =.009), particularly of severe (grade ≥ 3) events (risk difference, −30.4% [95% CI, −44.4 to −16.5]; P =.001). In malnourished advanced cancer patients undergoing CT, receiving nutritional counseling, a 3-month supplementation with WPI resulted in improved body composition, muscle strength, body weight, and reduced CT toxicity. Further trials, aimed at verifying the efficacy of this nutritional intervention on mid- and long-term primary clinical endpoints in newly diagnosed specific cancer types, are warranted.

Original languageEnglish
JournalCancer Medicine
DOIs
Publication statusAccepted/In press - Jan 1 2019

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Muscle Strength
Body Composition
Counseling
Drug Therapy
Neoplasms
Body Weight
Therapeutics
Fats
Whey Proteins
Health
Population

Keywords

  • cancer
  • malnutrition
  • nutritional counseling
  • whey proteins

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

@article{86f87458f608420486968a1768c17065,
title = "Whey protein isolate supplementation improves body composition, muscle strength, and treatment tolerance in malnourished advanced cancer patients undergoing chemotherapy",
abstract = "In recent years, whey proteins (WP) have attracted increasing attention in health and disease for their bioactive functions. The aim of this study was to evaluate the benefit of WP isolate (WPI) supplementation in addition to nutritional counseling in malnourished advanced cancer patients undergoing chemotherapy (CT). In a single-center, randomized, pragmatic, and parallel-group controlled trial (ClinicalTrials.gov: NCT02065726), 166 malnourished advanced cancer patients with mixed tumor entities candidate to or undergoing CT were randomly assigned to receive nutritional counseling with (N = 82) or without (N = 84) WPI supplementation (20 g/d) for 3 months. The primary endpoint was the change in phase angle (PhA). Secondary endpoints included changes in standardized PhA (SPA), fat-free mass index (FFMI), body weight, muscle strength, and CT toxicity (CTCAE 4.0 events). In patients with the primary endpoint assessed (modified intention-to-treat population), counseling plus WPI (N = 66) resulted in improved PhA compared to nutritional counseling alone (N = 69): mean difference, 0.48° (95{\%} CI, 0.05 to 0.90) (P =.027). WPI supplementation also resulted in improved SPA (P =.021), FFMI (P =.041), body weight (P =.023), muscle strength (P <.001), and in a reduced risk of CT toxicity (risk difference, −9.8{\%} [95{\%} CI, −16.9 to −2.6]; P =.009), particularly of severe (grade ≥ 3) events (risk difference, −30.4{\%} [95{\%} CI, −44.4 to −16.5]; P =.001). In malnourished advanced cancer patients undergoing CT, receiving nutritional counseling, a 3-month supplementation with WPI resulted in improved body composition, muscle strength, body weight, and reduced CT toxicity. Further trials, aimed at verifying the efficacy of this nutritional intervention on mid- and long-term primary clinical endpoints in newly diagnosed specific cancer types, are warranted.",
keywords = "cancer, malnutrition, nutritional counseling, whey proteins",
author = "Emanuele Cereda and Annalisa Turri and Catherine Klersy and Silvia Cappello and Alessandra Ferrari and Filippi, {Andrea Riccardo} and Silvia Brugnatelli and Marilisa Caraccia and Silvia Chiellino and Valeria Borioli and Teresa Monaco and Stella, {Giulia Maria} and Luca Arcaini and Marco Benazzo and Giuseppina Grugnetti and Paolo Pedrazzoli and Riccardo Caccialanza",
year = "2019",
month = "1",
day = "1",
doi = "10.1002/cam4.2517",
language = "English",
journal = "Cancer Medicine",
issn = "2045-7634",
publisher = "John Wiley and Sons Ltd",

}

TY - JOUR

T1 - Whey protein isolate supplementation improves body composition, muscle strength, and treatment tolerance in malnourished advanced cancer patients undergoing chemotherapy

AU - Cereda, Emanuele

AU - Turri, Annalisa

AU - Klersy, Catherine

AU - Cappello, Silvia

AU - Ferrari, Alessandra

AU - Filippi, Andrea Riccardo

AU - Brugnatelli, Silvia

AU - Caraccia, Marilisa

AU - Chiellino, Silvia

AU - Borioli, Valeria

AU - Monaco, Teresa

AU - Stella, Giulia Maria

AU - Arcaini, Luca

AU - Benazzo, Marco

AU - Grugnetti, Giuseppina

AU - Pedrazzoli, Paolo

AU - Caccialanza, Riccardo

PY - 2019/1/1

Y1 - 2019/1/1

N2 - In recent years, whey proteins (WP) have attracted increasing attention in health and disease for their bioactive functions. The aim of this study was to evaluate the benefit of WP isolate (WPI) supplementation in addition to nutritional counseling in malnourished advanced cancer patients undergoing chemotherapy (CT). In a single-center, randomized, pragmatic, and parallel-group controlled trial (ClinicalTrials.gov: NCT02065726), 166 malnourished advanced cancer patients with mixed tumor entities candidate to or undergoing CT were randomly assigned to receive nutritional counseling with (N = 82) or without (N = 84) WPI supplementation (20 g/d) for 3 months. The primary endpoint was the change in phase angle (PhA). Secondary endpoints included changes in standardized PhA (SPA), fat-free mass index (FFMI), body weight, muscle strength, and CT toxicity (CTCAE 4.0 events). In patients with the primary endpoint assessed (modified intention-to-treat population), counseling plus WPI (N = 66) resulted in improved PhA compared to nutritional counseling alone (N = 69): mean difference, 0.48° (95% CI, 0.05 to 0.90) (P =.027). WPI supplementation also resulted in improved SPA (P =.021), FFMI (P =.041), body weight (P =.023), muscle strength (P <.001), and in a reduced risk of CT toxicity (risk difference, −9.8% [95% CI, −16.9 to −2.6]; P =.009), particularly of severe (grade ≥ 3) events (risk difference, −30.4% [95% CI, −44.4 to −16.5]; P =.001). In malnourished advanced cancer patients undergoing CT, receiving nutritional counseling, a 3-month supplementation with WPI resulted in improved body composition, muscle strength, body weight, and reduced CT toxicity. Further trials, aimed at verifying the efficacy of this nutritional intervention on mid- and long-term primary clinical endpoints in newly diagnosed specific cancer types, are warranted.

AB - In recent years, whey proteins (WP) have attracted increasing attention in health and disease for their bioactive functions. The aim of this study was to evaluate the benefit of WP isolate (WPI) supplementation in addition to nutritional counseling in malnourished advanced cancer patients undergoing chemotherapy (CT). In a single-center, randomized, pragmatic, and parallel-group controlled trial (ClinicalTrials.gov: NCT02065726), 166 malnourished advanced cancer patients with mixed tumor entities candidate to or undergoing CT were randomly assigned to receive nutritional counseling with (N = 82) or without (N = 84) WPI supplementation (20 g/d) for 3 months. The primary endpoint was the change in phase angle (PhA). Secondary endpoints included changes in standardized PhA (SPA), fat-free mass index (FFMI), body weight, muscle strength, and CT toxicity (CTCAE 4.0 events). In patients with the primary endpoint assessed (modified intention-to-treat population), counseling plus WPI (N = 66) resulted in improved PhA compared to nutritional counseling alone (N = 69): mean difference, 0.48° (95% CI, 0.05 to 0.90) (P =.027). WPI supplementation also resulted in improved SPA (P =.021), FFMI (P =.041), body weight (P =.023), muscle strength (P <.001), and in a reduced risk of CT toxicity (risk difference, −9.8% [95% CI, −16.9 to −2.6]; P =.009), particularly of severe (grade ≥ 3) events (risk difference, −30.4% [95% CI, −44.4 to −16.5]; P =.001). In malnourished advanced cancer patients undergoing CT, receiving nutritional counseling, a 3-month supplementation with WPI resulted in improved body composition, muscle strength, body weight, and reduced CT toxicity. Further trials, aimed at verifying the efficacy of this nutritional intervention on mid- and long-term primary clinical endpoints in newly diagnosed specific cancer types, are warranted.

KW - cancer

KW - malnutrition

KW - nutritional counseling

KW - whey proteins

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U2 - 10.1002/cam4.2517

DO - 10.1002/cam4.2517

M3 - Article

C2 - 31568698

AN - SCOPUS:85073992407

JO - Cancer Medicine

JF - Cancer Medicine

SN - 2045-7634

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