Disturbances in BCAA Metabolism and the Effects of Feeding and Exercise in COPD

Chronic Obstructive Pulmonary Disease Clinical Trial

Official title:

The Effects of Exercise on the Metabolic Fate of Branched Chain Amino Acids in Relation to Aging and Chronic Disease.

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT01418469
• Other study ID #: MEC 02-059.3
• Status: Completed
• Phase: N/A
• First received: August 9, 2011
• Last updated: August 16, 2011
• Start date: December 2002
• Est. completion date: December 2004

Study information

• Verified date: August 2011
• Source: Maastricht University Medical Center
• Contact: n/a
• Is FDA regulated: No
• Health authority: Netherlands: The Central Committee on Research Involving Human Subjects (CCMO)
• Study type: Interventional

Clinical Trial Summary

Studies on resting human muscle show that ingestion of the branched-chain amino acids (BCAA): leucine, valine and isoleucine have an anabolic effect on muscle protein metabolism. However, the effects of BCAA intake on protein metabolism during exercise are less clear. When BCAA were supplied as single amino acids, without other amino acids and/or carbohydrates, no effects were observed on protein kinetics. On the other hand, ingestion of BCAA during running appeared to reduce the catabolic effect of running on muscle protein metabolism. These experiments were all performed with mixtures of the BCAA with or without carbohydrates but not in the form of complete meals with food protein as a basis. Therefore, it is still unknown whether a protein meal, containing a substantial amount of BCAA is beneficial during exercise by inducing an anabolic effect.

Whey and Casein protein contain a substantial amount of BCAA in contrast to Soy protein. Therefore, it is hypothesized that milk-based proteins are a better and more physiological source of BCAA during exercise and will lead to more protein anabolism. Most of the available studies have been carried out in young and fit humans but there are hardly any data are available in the increasing population of the elderly. Therefore it is still unknown whether a BCAA rich protein meal can enhance the anabolic effect of exercise in older individuals.

Besides sarcopenia, a substantial part of the elderly is suffering from a chronic systemic disease such as chronic obstructive pulmonary disease (COPD). COPD represents an important health care problem. COPD is the fourth leading cause of death and will be the third leading cause worldwide in 2020. Besides the local impairment, COPD is a chronic wasting disease, associated with alterations in intermediary metabolism. Substantial disturbances have been found in BCAA (and related) metabolism in these patients at rest and during exercise. It might therefore be of clinical relevance to study the metabolic effects of BCAA rich protein meals in patients with COPD at rest and during exercise.

Description:

In this study we investigate whether milk based protein sources of BCAA (casein and whey proteins) are superior to soy protein in the stimulation of protein anabolism before, during and after cycle exercise in COPD and healthy elderly and young subjects, and whether adding BCAA to soy protein will increase protein anabolism in these subjects.

To investigate Leucine, Isoleucine and Valine metabolism during and after exercise in COPD and healthy subjects

Recruitment information / eligibility

• Status: Completed
• Enrollment: 24
• Est. completion date: December 2004
• Est. primary completion date: December 2003
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: Male
• Age group: 45 Years and older

Eligibility

Inclusion Criteria:

• Irreversible chronic airflow limitation (FEV1 <70% of predicted)

• Clinically stable condition

Exclusion Criteria:

• Oxygen supplementation

• Respiratory tract infection or exacerbation of his disease at least 4 weeks prior to the study

• Oral corticosteroids as maintenance medication

• Other concomitant metabolic disease (ie malignancy, cardiac failure, recent surgery, severe endocrine, hepatic or renal disorder)

Study Design

Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Crossover Assignment, Masking: Double Blind (Subject, Investigator)

Related Conditions & MeSH terms

• Chronic Obstructive Pulmonary Disease
• Lung Diseases, Obstructive
• Pulmonary Disease, Chronic Obstructive

Intervention

Dietary Supplement:
• Caseinate
18 mg protein/kg body weight caseinate and 46 mg maltodextrin / kg body weight per 20 min sip feeding
• Whey protein isolate
18 mg protein/kg body weight whey protein isolate and 46 mg maltodextrin / kg body weight per 20 min sip feeding
• Soy
18 mg protein/kg body weight soy and 46 mg maltodextrin / kg body weight per 20 min sip feeding
• soy+BCAA
18 mg protein/kg body weight soy+BCAA and 46 mg maltodextrin / kg body weight per 20 min sip feeding

Locations

Country	Name	City	State
Netherlands	Maastricht UMC	Maastricht

Sponsors (2)

Lead Sponsor	Collaborator
Maastricht University Medical Center	European Dairy Association (EDA), Brussels

Country where clinical trial is conducted

Netherlands, 

References & Publications (2)

Engelen MP, Rutten EP, De Castro CL, Wouters EF, Schols AM, Deutz NE. Altered interorgan response to feeding in patients with chronic obstructive pulmonary disease. Am J Clin Nutr. 2005 Aug;82(2):366-72. — View Citation

Engelen MP, Rutten EP, De Castro CL, Wouters EF, Schols AM, Deutz NE. Supplementation of soy protein with branched-chain amino acids alters protein metabolism in healthy elderly and even more in patients with chronic obstructive pulmonary disease. Am J Cl — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Change in Net whole body protein synthesis	Net whole body protein synthesis during protein feeding and the response to a 20 min cycle exercise bout	6 hours	No
Secondary	Change in whole body protein synthesis rate	Whole body protein synthesis rate during protein feeding and the response to 20 min cycle exercise bout	6 hours	No
Secondary	Change in Leucine turnover	Leucine turnover during protein feeding and the response to a 20 min cycle exercise bout	6 hours	No
Secondary	Change in Isoleucine turnover	Isoleucine turnover during protein feeding and the response to a 20 min cycle exercise bout	6 hours	No
Secondary	Change in Valine turnover	Valine turnover during protein feeding and the response to a 20 min cycle exercise bout	6 hours	No
Secondary	Change in plasma lactate concentration	Plasma lactate during protein feeding and the response to a 20 min cycle exercise bout	6 hours	No
Secondary	Change in NH3 concentration	Plasma NH3 during protein feeding and the response to a 20 min cycle exercise bout	6 hours	No
Secondary	Change in plasma amino acids concentrations	Plasma amino acid concentrations during protein feeding and the response to a 20 min cycle exercise bout	6 hours	No
Secondary	Splanchnic extraction of amino acids during protein feeding	Splanchnic extraction of amino acids during protein feeding and the response to a 20 min cycle exercise bout	6 hours	No
Secondary	Change in whole body protein breakdown rate	Whole body protein breakdown rate during protein feeding and the response to cycle exercise	6 hours	No