Amino acid kinetics and the response to nutrition in patients with cancer

Abstract

Purpose: Amino acids are involved in many physiological processes in the body and serve as building blocks of proteins which are the main component of muscle mass. Often patients with cancer experience muscle wasting, which is associated with poor outcomes. The purpose of this paper is to discuss amino acid kinetics in cancer, review the evidence on the response to nutrition in patients with cancer, and to give recommendations on the appropriate level of amino acid or protein intake in cancer.

Current evidence shows that amino acid kinetics in patients with cancer are disturbed, as reflected by increased and decreased levels of plasma amino acids, an increased whole body turnover of protein and muscle protein breakdown. A few studies show beneficial effects of acute and short-term supplementation of high protein meals or essential amino acid mixtures on muscle protein synthesis.

Conclusions: Cancer is associated with disturbances in amino acid kinetics. A high protein intake or supplementation of amino acids may improve muscle protein synthesis. Future research needs to identify the optimal level and amino acid mixtures for patients with cancer, in particular for those who are malnourished.

Keywords:

• Amino acids
• anabolic response
• protein metabolism

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by an Australian Government Research Training Program Scholarship.

Notes on contributors

Barbara S. van der Meij

Barbara S. van der Meij, Conjoint Senior Research Dietitian and expert on translational research on nutrition and muscle wasting in cancer and older adults, focusing on effects of nutritional support strategies such as omega-3 polyunsaturated fatty acids, essential amino acids and meal adaptations, on body composition and quality of life.

Laisa Teleni

Laisa Teleni, Accredited Practising Dietitian and PhD student in nutrition in cancer. Focusing on nutrition assessment methods, the nutrition-related consequences of anti-cancer treatments and medical nutrition therapy.

Marielle P. K. J. Engelen

Marielle P. K. J. Engelen, Associate Professor in the Center for Translational Research in Aging & Longevity on disturbances in protein and amino acid metabolism underlying muscle wasting, and the anabolic effects of clinical nutrition and exercise in the elderly and in chronic wasting diseases (i.e. chronic obstructive pulmonary disease, cystic fibrosis, and cancer).

Nicolaas E. P. Deutz

Nicolaas E. P. Deutz, Professor in the Center for Translational Research in Aging & Longevity with research and interests in clinical nutrition and metabolism research in animals and humans. His clinical interest is using nutritional supplements to treat malnutrition in older adults, and during acute and chronic disease states.