From mitochondria to healthy aging: The role of branched-chain amino acids treatment: MATeR a randomized study

Clin Nutr. 2020 Jul;39(7):2080-2091. doi: 10.1016/j.clnu.2019.10.013. Epub 2019 Oct 18.

Abstract

Rationale: Malnutrition often affects elderly patients and significantly contributes to the reduction in healthy life expectancy, causing high morbidity and mortality. In particular, protein malnutrition is one of the determinants of frailty and sarcopenia in elderly people.

Methods: To investigate the role of amino acid supplementation in senior patients we performed an open-label randomized trial and administered a particular branched-chain amino acid enriched mixture (BCAAem) or provided diet advice in 155 elderly malnourished patients. They were followed for 2 months, assessing cognitive performance by Mini Mental State Examination (MMSE), muscle mass measured by anthropometry, strength measure by hand grip and performance measured by the Timed Up and Go (TUG) test, the 30 s Chair Sit to Stand (30-s CST) test and the 4 m gait speed test. Moreover we measured oxidative stress in plasma and mitochondrial production of ATP and electron flux in peripheral blood mononuclear cells.

Results: Both groups improved in nutritional status, general health and muscle mass, strength and performance; treatment with BCAAem supplementation was more effective than simple diet advice in increasing MMSE (1.2 increase versus 0.2, p = 0.0171), ATP production (0.43 increase versus -0.1, p = 0.0001), electron flux (0.50 increase versus 0.01, p < 0.0001) and in maintaining low oxidative stress. The amelioration of clinical parameters as MMSE, balance, four meter walking test were associated to increased mitochondrial function.

Conclusions: Overall, our findings show that sustaining nutritional support might be clinically relevant in increasing physical performance in elderly malnourished patients and that the use of specific BCAAem might ameliorate also cognitive performance thanks to an amelioration of mitochondria bioenergetics.

Keywords: Branched-chain amino acids; Elderly patients; Malnutrition; Mitochondrial activity and biogenesis; Muscle mass and strength; Oxidative stress.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged, 80 and over
  • Amino Acids, Branched-Chain / adverse effects
  • Amino Acids, Branched-Chain / therapeutic use*
  • Body Composition / drug effects
  • Cognition / drug effects
  • Dietary Supplements* / adverse effects
  • Energy Metabolism / drug effects*
  • Female
  • Geriatric Assessment
  • Hand Strength
  • Healthy Aging / drug effects*
  • Healthy Aging / metabolism
  • Humans
  • Italy
  • Male
  • Malnutrition / diagnosis
  • Malnutrition / drug therapy*
  • Malnutrition / metabolism
  • Malnutrition / physiopathology
  • Mitochondria / drug effects*
  • Mitochondria / metabolism
  • Muscle, Skeletal / drug effects
  • Muscle, Skeletal / physiopathology
  • Nutritional Status / drug effects*
  • Oxidative Stress / drug effects
  • Time Factors
  • Treatment Outcome

Substances

  • Amino Acids, Branched-Chain