Systemic energy metabolism changes in patients with heart failure receiving specific oral nutritional supplements in combination with Mediterranean diet
Abstract
BACKGROUND: Heart failure (HF) is associated with disease-related malnutrition, all of which contribute to impaired functional capacity and adverse outcomes. Nutritional strategies combining Mediterranean diet (MD) patterns with oral nutritional supplements (ONS) have shown clinical and anti-inflammatory benefits in HF.
OBJECTIVES: To evaluate the impact of MD combined with hypercaloric, hyperproteic, omega-3-enriched ONS vs. MD alone on targeted metabolomic profiles related to energy metabolism, skeletal muscle metabolism, and amino acid handling in patients with HF.
METHODS: This study is a secondary analysis of a prospective, randomized, open-label clinical trial including patients with chronic HF. Participants were randomized to receive either MD alone or MD plus two hypercaloric, hyperproteic, omega-3-enriched ONS for 24 weeks. Targeted metabolomic profiling was performed using proton nuclear magnetic resonance, assessing glycoproteins, energy metabolism-related metabolites, muscle-related metabolites, and amino acid metabolism-related metabolites.
RESULTS: Thirty-eight patients were included, of whom 65.8% presented sarcopenia. Glycoprotein fraction levels significantly decreased over time in the whole cohort, without differences between intervention groups. In energy metabolism-related parameters, glucose and pyruvate significantly decreased in the DM-only group, whereas glycerol levels showed a trend toward increase in the intervention group, reaching statistical…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design.
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