Hydrolyzed Casein and Whey Protein Supplementation and the Addition of Leucine to Induce Protein Anabolism in Malnourished COPD Patients

NCT ID: NCT01154400

Last Updated: 2012-10-15

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

12 participants

Study Classification

INTERVENTIONAL

Study Start Date

2009-05-31

Study Completion Date

2011-07-31

Brief Summary

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The aim of this study is the first aim of a NIH project that consists of 3 aims. The first aim examines the acute effects of two high-quality milk proteins (casein vs. whey) on whole-body and muscle protein metabolism in COPD patients with severe loss of muscle mass and the effects of adding leucine. The principal endpoints will be the extent of stimulation of net whole body protein synthesis as this is the principal mechanism by which either amino acid or protein intake causes muscle anabolism. After determining the optimal nutritional formulation based on the first aim we will continue to work on the second and third aim where fish oil supplementation will be part of the nutritional intervention as well.

Detailed Description

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Cachectic COPD patients are characterized by a decreased muscle protein synthesis and an elevated myofibrillar protein breakdown. A substantial number of these patients, characterized by an enhanced systemic inflammatory response, fails to respond to nutritional therapy, which is of clinical relevance as weight gain to nutritional therapy is a significant, independent predictor of mortality in COPD.

In the present study, the acute protein anabolic effect of two high-quality milk protein supplements in COPD will be examined by comparing a hydrolyzed casein and whey protein meal. We make use of hydrolyzed proteins to correct for absorption differences. Furthermore the effects of these milk proteins with or without enrichment of leucine will be investigated.

Variables of interest are: net whole body protein synthesis; whole body protein synthesis and breakdown rate; whole body myofibrillar protein breakdown rate; whole body collagen breakdown; kinetics of insulin; glucose; amino acid levels.

It is the investigators hypothesis that a nutritional supplement containing casein protein and high levels of leucine will target the metabolic alterations of these cachectic COPD patients and will specifically stimulate protein anabolism. The knowledge gained from this study will benefit our insight in terms of promotion of protein anabolism in COPD patients. The long-term goal is to reformulate nutritional composition in accord with the effects of COPD on protein metabolism in order to ameliorate or even prevent progressive muscle wasting in these subjects, and improve their quality of life and survival rates.

Conditions

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Chronic Obstructive Pulmonary Disease

Keywords

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casein protein whey protein hydrolysates leucine protein metabolism COPD

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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Casein protein hydrolysates

15 g casein protein hydrolysates and 15 g maltodextrin

Group Type EXPERIMENTAL

Casein protein hydrolysates

Intervention Type DIETARY_SUPPLEMENT

15 g casein protein hydrolysates + 15 g maltodextrin

Whey protein hydrolysates

15 g whey protein hydrolysates and 15 g maltodextrin

Group Type EXPERIMENTAL

Whey protein hydrolysates

Intervention Type DIETARY_SUPPLEMENT

15 g whey protein isolate + 15 g maltodextrin

Casein protein hydrolysates + LEU

15 g casein protein hydrolysates + 2.1 g LEU (40% of EAA content) + 15 g maltodextrin

Group Type EXPERIMENTAL

Casein protein hydrolysates + LEU

Intervention Type DIETARY_SUPPLEMENT

15 g casein protein hydrolysate + 2.1 g LEU (40% of EAA content) + 15 g maltodextrin

Whey protein hydrolysates + LEU

15 g whey protein hydrolysates + 1.5 g LEU (40% of EAA content) + 15 g maltodextrin

Group Type EXPERIMENTAL

Whey protein hydrolysates + LEU

Intervention Type DIETARY_SUPPLEMENT

15 g whey protein isolate + 1.5 g LEU (40% of EAA content) + 15 g maltodextrion

Interventions

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Casein protein hydrolysates

15 g casein protein hydrolysates + 15 g maltodextrin

Intervention Type DIETARY_SUPPLEMENT

Whey protein hydrolysates

15 g whey protein isolate + 15 g maltodextrin

Intervention Type DIETARY_SUPPLEMENT

Casein protein hydrolysates + LEU

15 g casein protein hydrolysate + 2.1 g LEU (40% of EAA content) + 15 g maltodextrin

Intervention Type DIETARY_SUPPLEMENT

Whey protein hydrolysates + LEU

15 g whey protein isolate + 1.5 g LEU (40% of EAA content) + 15 g maltodextrion

Intervention Type DIETARY_SUPPLEMENT

Other Intervention Names

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Casein Whey Casein + LEU Whey + LEU

Eligibility Criteria

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Inclusion Criteria

* Diagnosis of moderate to severe chronic airflow limitation, defined as measured forced expiratory volume in one second (FEV1) ≤ 70% of reference FEV1
* Shortness of breath on exertion
* Age 45 years and older
* Clinically stable condition and not suffering from respiratory tract infection or exacerbation of their disease (defined as a combination of increased cough, sputum purulence, shortness of breath, systemic symptoms such as fever) at least 4 weeks prior to the study
* Cachexia based on the criteria: Body mass index ≤ 25 kg/m2 and/or FFM-Index: FFM/height2 ≤ 17 (males), 15 (females) kg/m2 and/or recent involuntary weight loss

Exclusion Criteria

* Established diagnosis of malignancy
* Presence of fever within the last 3 days
* Established diagnosis of Diabetes Mellitus
* Untreated metabolic diseases including hepatic or renal disorder
* Presence of acute illness or metabolically unstable chronic illness
* Recent myocardial infarction (less than 1 year)
* Use of long-term oral corticosteroids or short course of oral corticosteroids in the preceding month before enrollment
* Allergy to cow's milk protein
* Any other condition according to the PI or study physicians would interfere with proper conduct of the study / safety of the patient
* Failure to give informed consent
Minimum Eligible Age

45 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Texas A&M University

OTHER

Sponsor Role lead

Responsible Party

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Marielle PKJ Engelen, PhD

PhD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Marielle Engelen, PhD

Role: PRINCIPAL_INVESTIGATOR

Texas A&M University

Locations

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University of Arkansas for Medical Sciences

Little Rock, Arkansas, United States

Site Status

Countries

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United States

References

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Engelen MPKJ, Kirschner SK, Coyle KS, Argyelan D, Neal G, Dasarathy S, Deutz NEP. Sex related differences in muscle health and metabolism in chronic obstructive pulmonary disease. Clin Nutr. 2023 Sep;42(9):1737-1746. doi: 10.1016/j.clnu.2023.06.031. Epub 2023 Jul 26.

Reference Type DERIVED
PMID: 37542951 (View on PubMed)

Jonker R, Deutz NE, Erbland ML, Anderson PJ, Engelen MP. Hydrolyzed casein and whey protein meals comparably stimulate net whole-body protein synthesis in COPD patients with nutritional depletion without an additional effect of leucine co-ingestion. Clin Nutr. 2014 Apr;33(2):211-20. doi: 10.1016/j.clnu.2013.06.014. Epub 2013 Jul 1.

Reference Type DERIVED
PMID: 23886411 (View on PubMed)

Other Identifiers

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109237

Identifier Type: -

Identifier Source: org_study_id