Amino acid supplementation decreases plasma and liver triacylglycerols in elderly.

OBJECTIVE: Hypertriglyceridemia is a risk factor for coronary heart disease. The aim of this study was to determine the effect of amino acid (AA) supplementation on plasma, liver, and muscle lipid concentrations and insulin sensitivity in the elderly. METHODS: Twelve impaired glucose tolerant elderly (mean +/- SD 67.0 +/- 5.6 y of age, seven women and five men) ingested 11 g of essential AAs plus arginine twice a day for 16 wk, after a 7-wk control run-in. Diet and activity were not otherwise modified. Plasma lipid concentrations and oral glucose tolerance were measured every fourth week and tissue lipid concentrations (magnetic resonance spectroscopy) every eighth week. RESULTS: No changes in plasma lipids were observed during the control run-in. AA supplementation lowered plasma triacylglycerol (TG; P < 0.001), total cholesterol (P = 0.048), and very low-density lipoprotein cholesterol (P < 0.001) concentrations. Plasma TG decreased approximately 20% from the initial value of 1.45 +/- 0.18 mmol/L (mean +/- SE, 128 +/- 16 mg/dL), with the greatest decrease in the subjects starting out with the highest concentrations (r = -0.83). Similarly, liver fat content (liver TG/Intralipid standard) decreased approximately 50% from the initial value of 0.34 +/- 0.06 (P = 0.021, n = 8), with the greatest decrease in the subjects who initially had the highest values (r = -0.86). Intramuscular fat content and insulin sensitivity did not change. CONCLUSION: Diet supplementation with AAs lowers plasma TG, total cholesterol, and very low-density lipoprotein cholesterol concentrations and liver lipid content in impaired glucose tolerant elderly. AA supplementation may have a potential role in the treatment of hypertriglyceridemia or hepatic steatosis.

Effect of amino acid supplementation on muscle mass, strength and physical function in elderly.

BACKGROUND & AIMS: With advancing age there is a gradual decline in muscle mass, strength and function. The aim of this study was to determine if regular intake of a nutritional supplement containing essential amino acids (EAA)+arginine could reverse these responses in elderly subjects. METHODS: Twelve glucose intolerant subjects (67.0+/-5.6 (SD) years, 7 females, 5 males) ingested 11 g of EAA+arginine two times a day, between meals for 16 weeks. Diet and activity were not otherwise modified. Lean body mass (DEXA) was measured every fourth week. Maximal leg strength was tested and functional tests were performed at week 0, 8, 12, and 16. RESULTS: Lean body mass (LBM) increased during the study (p=0.038). At week 12, the average increase in LBM was 1.14+/-0.36 (SE) kg (p<0.05 vs baseline), whereas at week 16, the increase was 0.60+/-0.38 kg (NS vs baseline). The lower extremity strength measure score (sum of individual knee flexors and extensors' one repetition maximum, n=10) was 127.5+/-21.8 kg at baseline, and average increase during the study was 22.2+/-6.1% (p<0.001). Improvements were also observed in usual gait speed (p=0.002), timed 5-step test (p=0.007), and timed floor-transfer test (p=0.022). CONCLUSION: Supplementation of the diet with EAA+arginine improves lean body mass, strength and physical function compared to baseline values in glucose intolerant elderly individuals.

Plasma amino acid concentrations during late rehabilitation in patients with traumatic brain injury.

OBJECTIVES: To investigate whether the basal plasma amino acid concentrations in patients with traumatic brain injury (TBI) have returned to levels found in healthy controls at about 17 months postinjury and to determine the effect of intake of a mixture of essential amino acids (EAA) on plasma amino acid concentrations in TBI versus healthy controls. DESIGN: Peripheral venous amino acid concentrations in subjects with TBI were compared with concentrations in healthy controls both at rest and for 1 hour after intake of 7g of EAA. SETTING: Postacute brain injury rehabilitation center. PARTICIPANTS: Six men with TBI (age +/- standard deviation, 27+/-6y; months postinjury, 17+/-4) and 6 healthy men (age, 43+/-7y). INTERVENTION: Intake of a drink consisting of 7g of EAA. MAIN OUTCOME MEASURES: Individual and total plasma amino acid concentrations. RESULTS: Total amino acid concentration was about 12% lower in TBI versus controls (P=.022). Valine was reduced by 33% in the TBI group versus controls (P=.003), whereas the other EAA did not differ between groups. After intake of the EAA drink, plasma non-EAA increased to a significantly higher level in controls versus TBI subjects (P=.017). CONCLUSIONS: Plasma total amino acid concentration is still reduced 17 months postinjury in patients with TBI versus healthy controls, mainly because of a lower valine level. This may be of importance for both brain and muscle metabolic functions, and warrant further study. Further, ingested EAA are apparently not as readily converted to non-EAA in TBI patients as in healthy controls, suggesting that in recovery from TBI, certain non-EAA may become provisionally essential.

Relationship of depression to patient satisfaction: findings from the barriers to breast cancer study.

OBJECTIVE: Examine the association between depressive symptoms and patient satisfaction for older women with a diagnosis of breast cancer. METHODS: Prospective study of 210 women aged 65 or older from southeast Texas newly diagnosed with breast cancer. Baseline (<2 months after diagnosis) and 12 month follow-up interviews were conducted face-to-face to collect information on sociodemographic characteristics, physical and emotional health, use of health services and satisfaction with medical care. Data analyses included descriptive statistics, chi2 analysis, and multivariate logistic regression analysis. RESULTS: Average age at baseline interview was 71.8 years (SD 6.6). The sample was 70.5% non-Hispanic white, 61.0% were unmarried, and 85.2% reported no ADL limitations. Logistic regression analysis showed a significant association between increasing depressive symptoms at baseline and lower patient satisfaction at follow-up. Each unit increase in depressive symptoms at baseline was associated with a 6% decrease in the predicted odds of being "very satisfied" with medical care at follow up (OR = 0.94, 95% CI = 0.89, 0.99), after adjusting for age, marital status, race/ethnicity, stage of diagnosis and other relevant factors. Similarly, patients who had an increase in CES-D score between baseline and follow-up interview were less likely to be satisfied with their medical care at follow up. CONCLUSION: Increasing depressive symptoms are associated with lower patient satisfaction. Early recognition and treatment of depressive symptoms may improve patients' well being and perception about quality of medical care.