Key Findings:
This study demonstrated an inverse relationship between dietary n-3 PUFAs, highly related to ALA intake, and muscle mass in patients receiving hemodialysis (HD) treatment, suggesting that omega 3 intake may be a regulator of muscle mass and protein metabolism. In addition, a history of CVD and the ratio of n-6/n-3 PUFAs were independent risk factors for both skeletal muscle mass (SMM) and appendicular skeletal muscle mass (ASM). Muscle mass may decline 1–2% per year after age 50 years. ALA appears to be related with a greater increase in the thickness of the muscle mass in older adult males. A reduction in inflammatory cytokines as a result of ALA intake may mitigate anabolic resistance of muscle protein synthesis. This cross-sectional study was based on self-reporting of dietary intakes in patients receiving HD. The result support that ALA is a determinant of the muscle mass in HD patients. ALA consumption id encouraged to reduce age and disease related muscle loss (sarcopenia).
ABSTRACT:
Background: n-3 polyunsaturated fatty acids (PUFAs) might be useful nutritional strategy for treating patients with sarcopenia. We evaluated the effect of the intake of dietary n-3 PUFAs on the skeletal muscle mass (SMM), appendicular skeletal muscle mass (ASM), and its determinants in patients receiving standard hemodialysis (HD) treatment for the management of end stage renal disease. Methods: In this cross-sectional study, data of 111 HD patients were analyzed. Anthropometric and bioelectrical impedance measurements used to estimate the muscle mass were performed the day of dialysis immediately after the dialysis session. Routine laboratory and 3-day dietary data were also collected. The cutoff value of adequate intake (AI) for both n-3 PUFAs and alpha-linolenic acid (ALA) was 1.6 g/day and 1.1 g/day for men and women, respectively. Results: The mean age, mean dietary n-3 PUFAs intake, ALA intake, ratio of n-6/n-3 PUFAs intake, SMM, and ASM of patients were 61.4 ± 10.4 years, 2.0 ± 1.3 g/day, 1.5 ± 1.0 g/day, 9.5 ± 6.7 g/day, 23.9 ± 5.5 kg, and 17.5 ± 4.5 kg, respectively. A higher SMM and ASM significantly observed in patients who achieved an AI of n-3 PUFAs. Similar trends appeared to be observed among those patients who achieved the AI of ALA, but the difference was not significantly, except for ASM (P = 0.047). No relevant differences in demographics, laboratory and nutritional parameters were observed, regardless of whether the patients achieved an AI of n-3 PUFAs. Multivariate analysis showed that the BMI and equilibrated Kt/V were independent determinants of the muscle mass. Moreover, the ratio of n-6/n-3 PUFAs was an independent risk determinant of reduced ASM in HD patients. Conclusion: Patients with an AI of n-3 PUFAs had better total-body SMM and ASM. A higher dietary ratio of n-6/n-3 PUFAs seemed to be associated with a reduced muscle mass in HD patients. (Authors abstract)
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