The effect of protein and essential amino acid supplementation on muscle strength and performance in patients with chronic heart failure: a systematic review.

Nichols, Simon; McGregor, Gordon; Al-Mohammad, Abdallah; Ali, Ali N.; Tew, Garry; O'Doherty, Alasdair F.

Abstract

Critically low skeletal muscle mass and strength, observed in 20% of people with chronic heart failure (CHF), reduces functional capacity, quality of life (QoL) and survival. Protein and essential amino acid (EAA) supplementation could be a viable treatment strategy to prevent declines in muscle strength and performance, and subsequently improve QoL and survival. This systematic review (PROSPERO: CRD42018103649) aimed to assess the effect of dietary protein and/or EAA supplementation on muscle strength and performance in people with CHF. Searches of PubMed, MEDLINE and Embase identified studies that reported changes in strength or muscle performance following protein and/or EAA supplementation in patients with CHF. Following PRISMA guidelines and using predefined inclusion/exclusion criteria relating to participants, intervention, control, outcome and study design, two reviewers independently screened titles, abstracts and full manuscripts for eligibility. Risk of bias was assessed using Cochrane Risk of Bias Tool (RCTs) or Mixed Methods Appraisal Tool (cohort studies). Data were extracted for analysis using predefined criteria. Five randomised controlled trials (RCT) and one cohort study met our inclusion criteria. All RCTs had a high risk of bias. The methodological quality of the cohort study was moderate. Heterogeneity of extracted data prevented meta-analyses, qualitative synthesis was therefore performed. Data from 167 patients with CHF suggest that protein and/or EAA supplementation does not improve strength, but may increase six-minute walk test distance, muscle mass and QoL. The limited quality of the studies makes firm conclusions difficult, however protein and/or EAA supplementation may improve important outcome measures related to sarcopenia. High-quality randomised controlled studies are needed.

Citation

NICHOLS, S., MCGREGOR, G., AL-MOHAMMAD, A., ALI, A.N., TEW, G. and O'DOHERTY, A.F. 2020. The effect of protein and essential amino acid supplementation on muscle strength and performance in patients with chronic heart failure: a systematic review. European journal of nutrition [online], 59(5), pages 1785-1801. Available from: https://doi.org/10.1007/s00394-019-02108-z

• Journal Article Type: Review
• Acceptance Date: Oct 4, 2019
• Online Publication Date: Oct 28, 2019
• Publication Date: Aug 31, 2020
• Deposit Date: Nov 29, 2023
• Publicly Available Date: Nov 29, 2023
• Journal: European journal of nutrition
• Print ISSN: 1436-6207
• Electronic ISSN: 1436-6215
• Publisher: Springer
• Peer Reviewed: Peer Reviewed
• Volume: 59
• Issue: 5
• Pages: 1785-1801
• DOI: https://doi.org/10.1007/s00394-019-02108-z
• Keywords: Chronic heart failure; Muscle mass; Protein supplements; Essential amino acid supplements
• Public URL: https://rgu-repository.worktribe.com/output/2079583