A high-protein diet during hospitalization is associated with an accelerated decrease in soluble urokinase plasminogen activator receptor levels in acutely ill elderly medical patients with SIRS.
Study Goal
The researchers aimed to determine whether a high-protein diet combined with resistance training could accelerate the resolution of inflammation in hospitalized elderly patients with systemic inflammatory response syndrome (SIRS).
Results Summary
The intervention group showed an earlier decrease in suPAR levels during hospitalization compared to the control group, but no significant effects were observed for other inflammatory biomarkers. Nutritional support during hospitalization was associated with accelerated recovery, while post-discharge nutrition and resistance training did not significantly affect inflammation.
Population
Acutely admitted elderly patients aged >65 years with SIRS.
Effective Dosage
1.7 g/kg per day during hospitalization, and daily protein supplement (18.8 g) post-discharge.
Duration
During hospitalization and 12 weeks post-discharge.
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
nutritional support and resistance training | increase | muscle anabolism | healthy elderly | - | were shown to increase | #1 |
nutritional support and resistance training | decrease | inflammation | healthy elderly | - | were shown to reduce | #2 |
high-protein diet (1.7 g/kg per day) during hospitalization, and daily protein supplement (18.8 g) and 3 weekly resistance training sessions for 12 weeks after discharge | decrease | suPAR levels | hospitalized elderly patients with SIRS | -15.4% vs. +14.5% | had an earlier decrease | #3 |
high-protein diet (1.7 g/kg per day) during hospitalization, and daily protein supplement (18.8 g) and 3 weekly resistance training sessions for 12 weeks after discharge | decrease | suPAR levels | hospitalized elderly patients with SIRS | -2.4% vs. -28.6% | had an earlier decrease | #4 |
high-protein diet (1.7 g/kg per day) during hospitalization, and daily protein supplement (18.8 g) and 3 weekly resistance training sessions for 12 weeks after discharge | no change | interleukin-6 | hospitalized elderly patients with SIRS | no significant change | no significant effects | #5 |
high-protein diet (1.7 g/kg per day) during hospitalization, and daily protein supplement (18.8 g) and 3 weekly resistance training sessions for 12 weeks after discharge | no change | C-reactive protein (CRP) | hospitalized elderly patients with SIRS | no significant change | no significant effects | #6 |
high-protein diet (1.7 g/kg per day) during hospitalization, and daily protein supplement (18.8 g) and 3 weekly resistance training sessions for 12 weeks after discharge | no change | albumin | hospitalized elderly patients with SIRS | no significant change | no significant effects | #7 |
- | decrease | suPAR | hospitalized elderly patients with SIRS | -22% | improved significantly | #8 |
- | decrease | interleukin-6 | hospitalized elderly patients with SIRS | -86% | improved significantly | #9 |
- | decrease | CRP | hospitalized elderly patients with SIRS | -89% | improved significantly | #10 |
- | increase | albumin | hospitalized elderly patients with SIRS | +11% | improved significantly | #11 |
nutritional support during hospitalization | decrease | suPAR levels | acutely ill elderly medical patients | - | was associated with an accelerated decrease | #12 |
combined nutrition and resistance training intervention after discharge | no change | inflammatory state | acutely ill elderly medical patients | - | did not appear to affect | #13 |
Acute illness and hospitalization in elderly individuals are often accompanied by the systemic inflammatory response syndrome (SIRS) and malnutrition, both associated with wasting and mortality. Nutritional support and resistance training were shown to increase muscle anabolism and reduce inflammation in healthy elderly. We hypothesized that nutritional support and resistance training would accelerate the resolution of inflammation in hospitalized elderly patients with SIRS. Acutely admitted patients aged >65 years with SIRS were randomized to an intervention consisting of a high-protein diet (1.7 g/kg per day) during hospitalization, and daily protein supplement (18.8 g) and 3 weekly resistance training sessions for 12 weeks after discharge (Intervention, n=14), or to standard-care (Control, n=15). Plasma levels of the inflammatory biomarkers soluble urokinase plasminogen activator receptor (suPAR), interleukin-6, C-reactive protein (CRP), and albumin were measured at admission, discharge, and 4 and 13 weeks after discharge. The Intervention group had an earlier decrease in suPAR levels than the Control group: -15.4% vs. +14.5%, P=.007 during hospitalization, and -2.4% vs. -28.6%, P=.007 between discharge and 4 weeks. There were no significant effects of the intervention on the other biomarkers. All biomarkers improved significantly between admission and 13 weeks, although with different kinetics (suPAR: -22%, interleukin-6: -86%, CRP: -89%, albumin: +11%). Nutritional support during hospitalization was associated with an accelerated decrease in suPAR levels, whereas the combined nutrition and resistance training intervention after discharge did not appear to affect the inflammatory state. Our results indicate that improved nutritional care during hospitalization may accelerate recovery in acutely ill elderly medical patients.