What Supplements Can Be Useful for Maintaining Muscle Mass During Cancer Treatment?

Cancer is nowadays one of the most prevalent chronic diseases in Western society. In this sense, the diagnosis of the disease itself and the treatment lead to a decrease in physical activity levels that can increase the risk of loss of muscle mass. In addition, metabolic alterations specific to the disease occur, which aggravate tumor cachexia or exacerbated weight loss, compromising muscle mass. Finally, the disease itself can obstruct the gastrointestinal tract and can trigger secondary symptoms preventing usual nutritional intake [1].

What effects does sarcopenia or loss of muscle mass have on the cancer patient?

Muscle is not just aesthetics or strength, but also health. Cancer patients who present sarcopenia or low muscle mass have been shown to have a 3-fold lower survival rate than those cancer patients without sarcopenia [2]. This relationship between sarcopenia and mortality in cancer patients is observed not only in normal-weight patients but also in obese subjects with low muscle mass [3].

In addition, an adequate muscle mass during the oncological process can increase the physical function of patients, increase the quality of life, reduce the risk of complications derived from medical treatments and reduce the toxicity and interruption of medical treatments [4].

In this sense, between 38 and 70% of oncology patients present sarcopenia [5], and between 45-63% of patients perceive that they have lost muscle mass subjectively [6]. Additionally, between 36-86% report that they have nutritional problems maintaining their usual nutritional intake [6].

Therefore, although exercise should be the basic intervention for this situation, the nutritional interventions such as supplementation are key to managing this loss of muscle mass.

Protein supplements

During the oncological process, the nutritional needs for proteins are increased to try to maintain that potential loss of muscle mass [7]. In this regard, it is common for patients to have gastrointestinal problems that prevent them from adequately digesting larger amounts of proteins from different sources, such as meat. They may also experience a lack of appetite or early satiety. In this sense, the use of protein supplements (both whey and other protein sources, such as plant sources) can be of great use in meeting these increased requirements.

In this regard, whey protein could improve muscle mass and decrease tumor proliferation in cancer patients and especially in patients with cachexia or tumor sarcopenia [8].

Omega-3

In the oncological process, the omega-3 It is going to be an essential nutrient. In this regard, it has been observed that the joint supplementation of protein and omega-3 attenuated to a greater extent the loss of weight bodily during the treatment and even promoted a older profit of dough muscular in comparison with a control intervention with only protein [9]. In this way, its supplementation could have positive effects on cachexia and tumor sarcopenia increasing muscle protein synthesis and decreasing its degradation [10]. On the other hand, oncology patients sometimes undergo surgical procedures with the corresponding period of physical inactivity. In this context, the supplementation with omega-3 before and after of the surgery It could be of great use for that muscle maintenance [10].

Creatine

There are still few clinical trials in humans. However, a previous study observed that patients with cachexia tumoral presented minors levels circulating of creatine in comparison with those patients without cachexia [11]. Additionally, in a mechanistic way in the same study, mice with cachexia and supplemented with creatine lost their muscle mass to a lesser extent. On the other hand, the combined supplementation of creatine and protein during a physical training program increased the dough muscular and the strength more muscular to a greater extent than the group that did not take the supplement [12].

HMB

Finally, another supplement of possible interest would be the HMB, a metabolite of leucine with anticatabolic and anabolic actions. Supplementation with HMB has shown a effect beneficial in the dough muscular and function muscular in oncology patients [13]. In addition, although more studies are needed, promising results have been observed regarding hospitalization, treatment-related toxicity, and response to treatment [13].

Conclusion

In conclusion, many of the supplements used for the gain and/or maintenance of muscle mass in the athletic population can be used in the clinic to manage the risk of muscle mass loss in the oncological population. In this regard, the use of protein supplements, omega-3, creatine, and HMB can be useful tools against sarcopenia and tumor cachexia.

Lucas Jurado Fasoli – Doctor in Biomedicine (UGR). Dietitian-Nutritionist. Postdoctoral researcher at the Mixed University Institute of Sport and Health and Department of Physiology, University of Granada.

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References

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