Optimization of the Preservation of Muscle Mass and / or Its Recovery by a Protein-energy Chrononutrition Approach Dissociated From Meals (CARBOPTIMUS)
Muscle wasting has a multifactorial origin, including decreased physical activity, malnutrition, loss of post-incident muscle recovery abilities, and decreased ability to regenerate muscle. Among the strategies tested to improve the production of proteins and thus muscle is the supplementation of whey proteins. However this strategy does not seem sufficient and optimal to avoid muscle wasting and it must be complemented by a complementary action.
Muscle protein degradation also occurs during the nocturnal fasting periods to provide amino acids for energy purposes and to produce glucose, essential for vital organs. The preservation of the benefit of whey intake during meals could therefore be optimized by reducing the use of muscle proteins for energy purposes during the night.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Frédéric ROCHE, PhD
- Phone Number: +33 (0)477829109
- Email: frederic.roche@chu-st-etienne.fr
Study Locations
-
-
-
Saint-Étienne, France
- EHPAD Cité des Aînés
-
Saint-Étienne, France
- EHPAD La Cerisaie
-
Saint-Étienne, France
- EHPAD Le Soleil
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Resident on the Accommodation Establishments for Dependent Elderly Persons on the Mutuality of Loire, France
Risk of undernutrition or moderate undernutrition with one of the following criteria :
- Either 5-10% of weight loss in 1 month or 10-15% in 6 months.
- Or Body Mass Index (BMI) between 16 and 21
- Or Albumin levels between 30 and 35 g/L
- Or global Mini Nutritional Assessment (MNA) test between 17 and 23.5
- Or Short Emergency Geriatric Assessment (SEGA) Score >8
Exclusion Criteria:
- Sub-acute pathology (flu, gastroenteritis, bacterial infections ...) or trauma (fracture, surgery ...) in the 30 days prior to inclusion.
- Hepatocellular insufficiency
- Heart failure with decompensation
- Severe dementia,
- Insulin-treated diabetes
- Renal insufficiency (clearance <30 ml / min)
- Long-term cortico-therapy
- Cancer undergoing chemotherapy treatment or/and radiotherapy
- Gastrointestinal pathology,
- Diet incompatible with the nutritional protocol (intolerance to milk or lactose, vegetarians, vegans, ...)
- Motor disability leading to the impossibility of doing muscle function tests.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
No Intervention: control group
Patients will be randomized in the control group.
They will have test MNA (Mini Nutritional Assessment), frailty screening tool (questionnaire FiND), clinical examination, blood sample, blood sample with heparin, white blood cells, urine sample, stool sample, maximal voluntary contraction of quadriceps, walking test, get up-and-go test, Hand Grip test, physical activity questionnaire, bioelectrical impedance analysis and Dual Energy X-ray Absorptiometry (DEXA).
|
|
|
Experimental: protein group
Patients will be randomized in the protein group.
They will have test MNA (Mini Nutritional Assessment), frailty screening tool (questionnaire FiND), clinical examination, blood sample, blood sample with heparin, white blood cells, urine sample, stool sample, maximal voluntary contraction of quadriceps, walking test, get up-and-go test, Hand Grip test, physical activity questionnaire, bioelectrical impedance analysis, Dual Energy X-ray Absorptiometry (DEXA) and protein.
|
In addition to their normal meal, patients will eat 30g of whey protein every lunch during 90 days.
|
|
Experimental: protein and carbohydrates group
Patients will be randomized in the protein and carbohydrates group.
They will have test MNA (Mini Nutritional Assessment), frailty screening tool (questionnaire FiND), clinical examination, blood sample, blood sample with heparin, white blood cells, urine sample, stool sample, maximal voluntary contraction of quadriceps, walking test, get up-and-go test, Hand Grip test, physical activity questionnaire, bioelectrical impedance analysis, Dual Energy X-ray Absorptiometry (DEXA) and protein and carbohydrates.
|
In addition to their normal meal, patients will eat 30g of whey protein every lunch during 90 days and eat 60g of carbohydrates 2h after every diner during 90 days.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Appendicular lean body mass (gramme)
Time Frame: Days 0 and 90
|
Comparison appendicular lean body mass between the day of inclusion and 90 days after.
It is measuring by Dual Energy X-ray Absorptiometry (DEXA).
|
Days 0 and 90
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
total body composition
Time Frame: Days 0, 45 and 90
|
Correlation between Dual Energy X-ray Absorptiometry (DEXA) results and bioelectrical impedance analysis results to determine total body composition.
|
Days 0, 45 and 90
|
|
Plasma albumin level (g/l)
Time Frame: Days 0, 45 and 90
|
blood sample.
|
Days 0, 45 and 90
|
|
Frailty screening tool
Time Frame: Days 0 and 90
|
Determination of fragility status. 3 status : Dependent, Fragile, Robust
|
Days 0 and 90
|
|
Mini Nutritional Assessment score
Time Frame: Days 0 and 90
|
Determine nutritional status.
Score : 0-30
|
Days 0 and 90
|
|
Inflammatory status
Time Frame: Days 0, 45 and 90
|
Analysis of inflammatory status by blood sample results.
C-reactive protein (CRP), Interleukin 6 (IL-6), Tumor necrosis factor (TNFα), monocyte chemoattractant protein 1 (MCP1)
|
Days 0, 45 and 90
|
|
Hand Grip test (N)
Time Frame: Days 0 and 90
|
Analysis of muscle function tests.
|
Days 0 and 90
|
|
6 minutes walk test (m)
Time Frame: Days 0 and 90
|
Analysis of muscle function tests.
|
Days 0 and 90
|
|
Maximal voluntary contraction of quadriceps (N)
Time Frame: Days 0 and 90
|
Analysis of muscle function tests.
|
Days 0 and 90
|
|
Get up-and-go test (s)
Time Frame: Days 0 and 90
|
Analysis of muscle function tests.
|
Days 0 and 90
|
|
Profiles of the differential expression of potentials biomarkers
Time Frame: Days 0, 45 and 90
|
Analysis of profiles of the differential expression of potentials biomarkers by results of blood sample with heparin, urine sample and white blood cells.
|
Days 0, 45 and 90
|
|
microbiota
Time Frame: Days 0 and 90
|
Analysis of microbiota by stool sample results.
|
Days 0 and 90
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Study Director: Sergio POLAKOF, PhD, UMR 1019, INRA, France
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 18CH036
- 2018-A00712-53 (Other Identifier: ANSM)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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