A whey protein-based nutritional supplement improved motor functions in patients with Parkinson’s or parkinsonism who were engaged in an intensive physical rehabilitation program, according to clinical trial results.
The study, “PROtein, LEucine And vitamin D Enhancing Rehabilitation (PRO-LEADER) in patients with Parkinson’s disease or parkinsonism: An RCT,” was presented at the 2018 World Congress on Parkinson’s Disease and Related Disorders (IAPRD), held in Lyon, France.
Physical rehabilitation is a relevant approach for the treatment of motor impairment in patients with Parkinson’s or parkinsonism, a general term for neurological disorders that cause movement problems similar to those of Parkinson’s disease patients.
In the elderly, scientists have shown that muscle-targeted nutritional support can increase muscle mass and improve physical performance. However, no such evidence is available in patients with parkinsonian syndromes, which include Parkinson’s, progressive supranuclear palsy and multiple system atrophy, among other conditions, and are characterized by muscle dysfunction, especially weakness.
Researchers conducted a randomized clinical trial (NCT03124277) in Milan, Italy, testing the effectiveness of a specific regimen of muscle-targeted nutritional support on the functional status of patients with Parkinson’s or parkinsonism undergoing a multidisciplinary intensive rehabilitation treatment (MIRT).
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The trial included 150 patients (children, adults and elderly) who received a standard hospital diet with or without a nutritional supplement called FortiFit (developed by Nutricia). Per serving (40 grams), the supplement includes 20 grams whey protein (found in dairy products), 800 IU vitamin D, 3 g total leucine (an essential amino acid, meaning it cannot be naturally produced by the body), 9 g carbohydrates, 3 g fat, and a mixture of vitamins, minerals and fibers.
Patients took the supplement twice daily for 30 days.
The team primarily focused on changes in the 6-minute walking test (6MWT), an assessment of exercise capacity. They also analyzed gait speed (with the 4-minute walking test), handgrip strength, Berg balance scale, the Self-assessment Parkinson’s Disease Disability Scale — exploring self-perceived functional status — and the timed up-and-go test (TUG), which is a measure of mobility and balance. The TUG test evaluates the time taken to stand up from an arm chair, walk a distance of three meters, turn, walk back, and sit down.
Body weight and skeletal muscle mass (SMM) also were determined.
Patients who received the supplement experienced a greater increase in the distance walked in the 6MWT (mean 69.6 vs. 51.8 meters without the supplement). When accounting for changes in dopaminergic therapy as well as in SMM, the team found a similar 18.0 meters difference.
Taking the supplement also improved gait speed (0.07 m/s), TUG test score (-1.1 s), and SMM (0.5 kg).
“In patients with [Parkinson’s] or parkinsonism, the consumption of a whey protein-based nutritional formula enriched with essential amino acids and vitamin D improved the efficacy of a MIRT, particularly lower body physical function,” researchers concluded.
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