Nutritional Interventional trials in muscle and cachexia PhD research directions for 2023
                     NUTRITIONAL INTERVENTIONAL 
 TRIALS IN MUSCLE AND 
CACHEXIA  PHD RESEARCH 
DIRECTIONS FOR  2023
An Academic presentation by
Dr. Nancy Agnes, Head, Technical Operations, 
Phdassistance  Group www.phdassistance.com
Email: [email protected]
Today's 
OInturodtucltiionne
Interventions  
Musculoskeletal 
conditions  Multiple 
clinical conditions
Older adults with low muscle mass or function or 
sarcopenia  Older adults with malnutrition
In 
brief
Muscle loss, especially alone or in the setting of sarcopenia or cachexia, is a common condition 
that predicts  poor outcomes in ageing and illness. Research has been done to investigate the 
impact of specific nutrients  on muscle mass or function, as appropriate nutrition is crucial for 
muscle maintenance. More research,  however, is required to inform evidence-based decisions.
This comprehensive review aimed to gather and record ongoing clinical studies evaluating 
dietary treatments  as a strategy to prevent or treat poor muscle mass or function (strength and 
physical performance),  sarcopenia, or cachexia. ClinicalTrials.gov and the WHO International 
Clinical Studies Registry Platform were  searched for planned and ongoing trials through April 21, 
2021.
Based on the objective to investigate the effects of dietary treatments on muscle-related 
outcomes (i.e. muscle  mass or strength, physical performance, or muscle synthesis rate) in both 
clinical and non-clinical Trials ,  randomized controlled studies with 20 participants per arm were 
included (i.e. ageing).
Introductio
n
Muscular mass loss with or without a corresponding reduction in function (i.e., physical performance 
or muscle  strength) can happen due to ageing naturally or as a result of acute and chronic 
illnesses.
Recent pooled analyses have shown that low muscle mass and sarcopenia (i.e., low muscle mass 
and function)  are prevalent in community-dwelling and hospitalized older adults and patients with 
lung diseases, liver cirrhosis,  cancer, and other diseases. However, the prevalence of these 
conditions may vary depending on the diagnostic  criteria used.
Patients may also have muscle loss without changes in body weight or even in the context of 
obesity (sarcopenic  obesity). Cachexia is a catabolic disorder that is further defined by extreme 
weight loss with or without loss of fat  mass and inflammation brought on by underlying conditions, 
with catastrophic effects on patients. Low muscle  mass is one of the distinguishing criteria of 
cachexia (1).
Interventio
ns
Trials were organized according to the kind of nutrition  
intervention, dietary guidance, food supplement, and 
multimodal  therapies are given to participants in the 
experimental arm.
According to the classifications provided by the European 
Society  for Clinical Nutrition and Metabolism, nutritional 
treatments were  classified as food supplements, food 
modifications, food products,  fortified food products, and 
oral nutritional supplements (ONS)  (ESPEN).
The term "nutritional advise" was developed to 
encompass  studies that offered participants dietary 
guidance from licensed  dietitians/nutritionists or 
assistance from healthcare professionals,  Medical 
research workers , or self-help resources.

Types of assessed  
nutrition 
interventions
Dietary advice  
Food product  
Food 
modification  
Fortified food  
Food 
supplement
Oral nutritional  supplements  
Specialized oral nutritional 
supplements
Musculoskeletal 
conditions
In patients with a variety of musculoskeletal conditions, twelve nutrition trials (10.7%) were found 
(Figure 1). These  patients included those who have undergone or are about to undergo orthopaedic 
surgery, older adults who are  temporarily immobilized while healing from an acute fracture, and adults 
with osteoarthritis, rheumatoid arthritis, low  bone mass, or osteoporosis.
In addition, there are 40 to 400 people in the target sample size. In addition, an overview of 
nutritional research ,  treatments and food supplements stratified by musculoskeletal diseases is 
provided by studies that provide  participants with food supplements, high-protein ONS or ONS 
supplemented with HMB, or food modification alone or  in conjunction with dietary guidance.
The criticaloutcomesof most trials researchmethods of muscle mass, muscularstrength,
are  performance, or a combination of physical
these.
Figure 1: Characteristics of interventions and distribution of trials across patients with obesity and metabolic diseases (2)
Multiple clinical 
conditions
In one experiment (0.9%), 320 individuals with cancer of any kind, osteoporosis, stroke, or chronic 
renal disease are  examined to see how dietary recommendations and resistance training affect their 
conditions.
Muscle mass, physicalperformance and muscle strength are the
three-month intervention's concurrent primary  objectives.
However, it is unknown if the authors intend to carry out distinct analyses by illness category.
Older adults with low muscle 
mass or  function or sarcopenia
Ten trials (8.9%) include 52–200 older people with sarcopenia or reduced muscle mass or function. 
Although several  studies merged definitions, sarcopenia is characterized by many diagnostic criteria, 
such as those of the Asian  Working Group for Sarcopenia, the European Working Group on 
Sarcopenia in Older People (EWGSOP2), or  reduced muscle mass associated with poor muscular 
strength (HGS). Most clinical studies employ a variety of dietary  supplements.
Older adults with 
malnutrition
One trial (0.9%) recruited 93 institutionalized older persons at risk of malnutrition or moderate 
malnutrition.  Participants get a whey protein at lunch and a high-carbohydrate meal product at supper 
for 90 days. Muscular mass  measurements using DXA are the primary outcome of interest, while 
muscle strength measurements using HGS and  lower body strength tests are the secondary outcomes 
(using the 6MWT and TUG tests)(3).
Conclusio
n
This scoping review identified several current RCTs investigating the impact of dietary treatments on 
muscle mass,  muscular function, sarcopenia, or cachexia in ageing and illness.
More research is to be expected on the impact of dietary supplements and ONS including protein, 
amino acids,  omega-3 fatty acids, or HMB on these disorders.
Although many studies use the same therapies, there was methodological variation in the research 
design,  supplement dose, duration of the intervention, and outcome evaluation, and several trials 
lacked crucial data. These  problems or restrictions might make it difficult to compare research, pool 
data, or conduct upcoming meta-analyses,  limiting the ability of these ongoing investigations to 
generate recommendations supported by the available evidence.
To improve the area, PhD research offers suggestions for upcoming research studies on nutrition and 
multimodal  treatments for cachexia, sarcopenia, and muscular health.
About PhD 
Assistance
Many trials have similar interventions; methodological heterogeneity may challenge study comparisons 
and future  meta-analyses to provide evidence-based recommendations and assess the therapeutic 
effects of nutrition  interventions PhD. Assistance serves as an external mentor to brainstorm your idea 
and translate that into a  research model. Finally, we deliver, What We Promise.
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