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Multimodal nutrition/anabolic therapy for wasting conditions

Balstad, Trude Rakela; Kaasa, Steina,b; Solheim, Tora Skeidsvolla,b

Current Opinion in Clinical Nutrition & Metabolic Care: May 2014 - Volume 17 - Issue 3 - p 226–235
doi: 10.1097/MCO.0000000000000045
TRANSLATIONAL RESEARCH IN WASTING DISEASES: Edited by Vickie E. Baracos, Claude Pichard and Didier Attaix

Purpose of review: Significant progress has been made in the field of defining and describing the pathophysiology of wasting conditions such as cachexia. The number of new promising drugs, nutritional therapy alternatives, and exercise/rehabilitation programs is increasing. The purpose of this review is to give an overview of recent clinical findings from intervention studies investigating multimodal anabolic therapies utilizing drug, nutritional, and/or exercise interventions in order to counteract wasting.

Recent findings: Anabolic agents such as ghrelin and selective androgen receptor modulators are under late-phase clinical testing and hold promise as new therapies, and their ability to mitigate weight loss and improve muscle mass and physical function is evaluated. In the past 2 years, eight new studies investigating interventions with anabolic potential in wasting have been published, among which three of these studies were multimodal.

Summary: Targeted anabolic therapies aiming to prevent or reverse wasting might involve a combination of anabolic pharmacologic drugs, nutrition, and physical exercise working concurrently to enhance muscle protein synthesis and reduce breakdown. Some anabolic pharmacological interventions demonstrate the potential to improve muscle mass, but the multimodal interventions seem in greater extent to also demonstrate improvement in physical function.

aEuropean Palliative Care Research Centre (PRC), Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology (NTNU)

bCancer Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway

Correspondence to Trude Rakel Balstad, European Palliative Care Research Centre (PRC), Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway. Tel: +47 72826060; e-mail: trude.r.balstad@ntnu.no

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins