Feasibility of two levels of protein intake in patients with colorectal cancer: findings from the Protein Recommendation to Increase Muscle (PRIMe) randomized controlled pilot trial.

BACKGROUND

Low muscle mass (MM) predicts unfavorable outcomes in cancer. Protein intake supports muscle health, but oncologic recommendations are not well characterized. The objectives of this study were to evaluate the feasibility of dietary change to attain 1.0 or 2.0 g/kg/day protein diets, and the preliminary potential to halt MM loss and functional decline in patients starting chemotherapy for stage II-IV colorectal cancer.

PATIENTS AND METHODS

Patients were randomized to the diets and provided individualized counseling. Assessments at baseline, 6 weeks, and 12 weeks included weighed 3-day food records, appendicular lean soft tissue index (ALSTI) by dual-energy X-ray absorptiometry to estimate MM, and physical function by the Short Physical Performance Battery (SPPB) test.

RESULTS

Fifty patients (mean ± standard deviation: age, 57 ± 11 years; body mass index, 27.3 ± 5.6 kg/m

CONCLUSION

Individualized nutrition counselling positively impacted protein intake. However, 2.0 g/kg/day was not attainable using our approach in this population, and group contamination occurred. Increased protein intake suggested positive effects on MM and physical function, highlighting the potential for nutrition to attenuate MM loss in patients with cancer. Nonetheless, muscle anabolism to any degree is clinically significant and beneficial to patients. Larger trials should explore the statistical significance and clinical relevance of protein interventions.

Informations de copyright

Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Déclaration de conflit d'intérêts

Disclosure KF reports honoraria from Abbott Nutrition. MS reports grant/research support from AstraZeneca and Bristol Myers Squibb; consultancy for ISPEN; and honoraria from AstraZeneca, BMS, Merck, IPSEN, Viatris, and Novartis. KM reports grant/research support from Deciphera, Blueprint Medicines, AstraZeneca, and Actuate; advisory role with Pfizer Canada. KP reports grant/research support from U.S. Department of Veterans Affairs Rehabilitation Research and Development Service pRogram); speakers bureau of Abbott Nutrition Health Institute. JA reports honoraria from Danone. MS reports honoraria and/or paid consultancy from Life2Good. ND reports honoraria from Abbott Nutrition. CP reports honoraria and/or paid consultancy from Abbott Nutrition, Nutricia, Nestlé Health Science, Pfizer, and AMRA medical; and investigator-initiated funding from Almased. All other authors have declared no conflicts of interest.