Whey Protein-based Enteral Nutrition Support to Improve Protein Economy in Surgical Patients
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Purpose
A prospective, randomized and controlled study is proposed to establish whether an enteral nutrition support regimen based on pressurized whey protein and glucose improves the postoperative utilization of amino acid substrates compared to a drink based on glucose alone. The kinetics of protein metabolism (protein breakdown, protein synthesis and amino acid oxidation) will be investigated using stable isotope methodology before and after surgery in patients undergoing colon resection. Stable isotope infusions will be conducted one week before surgery and on the second postoperative day for two hours in the fasted state and for four hours while sipping the enteral nutrition support regimen. Patients will consume one of two enteral nutrition support regimens consisting of a drink containing either pressurized whey protein and glucose or glucose alone. It is hypothesized that an enteral nutrition support regimen based on pressurized whey protein and glucose promotes positive protein balance through increased protein synthesis or reduced protein breakdown compared to glucose alone.
| Condition | Intervention |
|---|---|
|
Protein Metabolism Colorectal Neoplasms |
Dietary Supplement: Oral Nutrition Support |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Intervention Model: Parallel Assignment Masking: Single Blind (Subject) Primary Purpose: Supportive Care |
| Official Title: | Whey Protein-based Enteral Nutrition Support to Improve Protein Economy in Surgical Patients |
- Protein balance [ Time Frame: Assessed for 6 hours one time before surgery and once again on the second post-op day ] [ Designated as safety issue: No ]Protein balance is assessed using the stable isotope tracer C-13 leucine. Protein breakdown, protein synthesis and amino acid oxidation are measured through blood and expired air samples.
| Enrollment: | 13 |
| Study Start Date: | January 2010 |
| Study Completion Date: | August 2010 |
| Primary Completion Date: | August 2010 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Glucose and whey protein
Patients who are randomly allocated to this group will receive a drink made of anhydrous beet dextrose and pressurized whey protein in water (200 g/L + 100g/L). Patients will sip the drink for 4 hours of the 6 hour study.
|
Dietary Supplement: Oral Nutrition Support
The patients will sip the oral nutrition support (in the form of a drink) over the course of 4 hours within each 6 hour study. Each patient will be studied once before surgery and once after surgery.
|
|
Active Comparator: Glucose only
The patients who are randomly allocated to this arm will receive a drink composed of anhydrous beet dextrose in water (200g/L). They will sip the drink for 4 hours of the 6 hour study.
|
Dietary Supplement: Oral Nutrition Support
The patients will sip the oral nutrition support (in the form of a drink) over the course of 4 hours within each 6 hour study. Each patient will be studied once before surgery and once after surgery.
|
Eligibility| Ages Eligible for Study: | 18 Years to 90 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- age older than 18 years
- ASA class I to III
- colorectal surgery for non-metastatic disease (including right, transverse, left, sigmoid, subtotal, total and hemicolectomy and low anterior resection)
- body mass index >17 and <30 kg.m-2
- stable weight over the preceding three months (<10 % body weight loss)
- serum albumin >35 g/L
Exclusion Criteria:
- severe cardiac, renal or hepatic failure
- diabetes
- hyper and hypothyroidism
- active inflammatory bowel or diverticular disease
- musculoskeletal or neuromuscular disease
- anemia (hematocrit <30)
- albumin < 25 g/l
- pregnancy
- use of steroids.
Contacts and Locations| Canada, Quebec | |
| Montreal General Hospital | |
| Montreal, Quebec, Canada, H3G 1A4 | |
| Principal Investigator: | Franco Carli, MD PhD | McGill University |
More Information
No publications provided
| Responsible Party: | Dr. Francesco Carli, McGill University |
| ClinicalTrials.gov Identifier: | NCT01276795 History of Changes |
| Other Study ID Numbers: | 09-053-SDR |
| Study First Received: | January 12, 2011 |
| Last Updated: | January 12, 2011 |
| Health Authority: | Canada: Ethics Review Committee |
Additional relevant MeSH terms:
|
Neoplasms Colorectal Neoplasms Intestinal Neoplasms Gastrointestinal Neoplasms Digestive System Neoplasms Neoplasms by Site |
Digestive System Diseases Gastrointestinal Diseases Colonic Diseases Intestinal Diseases Rectal Diseases |
ClinicalTrials.gov processed this record on June 18, 2013